Romeron

Remeron is a drug that has antidepressant therapeutic effects. Its active element, the substance mirtazapin, leads to a steady blocking of the activity of endings like H1, as a result of which a noticeable sedation develops.

In the case of the use of the component mirtazapin in medicament portions, the cholinolytic effect on the patient almost does not develop. In addition, the drug does not change the function of the CAS.

[1],

Indications Romerona

It is used as a treatment for deep depression.

[2], [3]

Release form

The release of the therapeutic component is carried out in tablets - 10 or 30 pieces inside the pack.

[4]

Pharmacodynamics

Mirtazapine is an antagonist of presynaptic α-2 endings; It stimulates the movement of serotonergic and noradrenaline neural impulses. The drug blocks the endings of 5-HT2, as well as 5-HT3, as a result of which the impulse is only capable of passing through 5-HT1.

[5], [6], [7], [8], [9], [10]

Pharmacokinetics

The drug is very good and at a high speed is absorbed inside the circulatory system, and its bioavailability indicators are 50%. Cmax values are recorded after 2 hours. The active component is well synthesized inside the plasma with blood protein.

Excretion is carried out for 20-40 hours (can reach up to 65). It reaches equilibrium values after 4 days, after which it no longer accumulates inside the body. Eating does not affect the pharmacokinetics of drugs.

The process of excretion is carried out with urine and feces for several days. Metabolic processes are developed with the help of CYP2D6 enzymes, as well as CYP1A2 hemoprotein P450.

In the case of renal or hepatic pathologies, clearance values of mirtazapine decrease.

[11], [12], [13]

Dosing and administration

Apply the drug to the inside, washing down the tablet with water (do not divide or chew).

It is necessary to use medicine one-time for days (it is recommended to do it before going to bed, for the night).

When required, the portion is allowed to divide into 2 uses. In this evening the dosage should be more.

At the end of treatment, it is required to gradually reduce the amount of drugs in order to avoid the appearance of withdrawal syndrome.

Usually used dosages in the range of 15-45 mg of the substance. The size of the initial portion is equal to 15 or 30 mg. The maximum effect of the drug is noted after 1-2 weeks after the start of treatment. If required, the dose is allowed to increase.

In the absence of improvements after a month of using Remeron, it is necessary to replace the drug.

Persons with kidney failure need to constantly monitor the QC values.

If a patient has severe hepatic diseases, therapy should be carried out under medical supervision.

[19], [20], [21]

Use Romerona during pregnancy

There is only limited information regarding the use of the drug during pregnancy. In animal tests, no adverse effects on children were detected. Decision on the use of Remerona during pregnancy should the attending doctor.

In the case of a woman taking antidepressants during pregnancy, after childbirth, postnatal examination of the newborn is required to eliminate the likelihood of withdrawal syndrome.

The active element of the drug in small quantities passes inside the mother's milk. It is required to consult a doctor regarding the termination of breastfeeding.

Contraindications

It is contraindicated for persons with symptoms of intolerance regarding the elements of the drug, and also to combine it with MAOI.

[14], [15]

Side effects Romerona

It is often quite difficult to determine whether the appearing violations are side effects of drugs, or manifestations of depression.

Most often, when the medication was administered, the following symptoms occurred: dry oral mucous membranes, feeling tired, increased appetite, drowsiness, weight gain, dizziness with headaches and sedation. More rarely noted: confusion, insomnia, lethargy and tremor, and in addition arthralgia, peripheral puffiness, myalgia, pain, affecting the back, decrease in blood pressure and severe fatigue; more vomiting, diarrhea and nausea, and pseudo rubella.

Occasionally or individually develop:

• hallucinations, nightmares, agranulocytosis and hyponatremia;
• severe psychomotor agitation, paresthesia, aplastic anemia and myoclonia;
• agitation, thrombocytopenia, serotonin intoxication and suicidal tendencies;
• swelling, affecting the oral mucosa, and an increase in the activity of hepatic enzymes;
• erythema, bullous form of dermatitis and SJS;
• TEN and hormone imbalance (antidiuretic hormone).

[16], [17], [18]

Overdose

Often poisoning Remeron leads to the development of light disorders: sedation, suppression of the central nervous system, disorientation, increase / decrease in blood pressure and tachycardia. When intoxicating with several drugs at the same time, the manifestations can be more severe, sometimes reaching death.

Symptomatic and supportive measures are performed, gastric lavage is performed and activated charcoal is administered.

[22], [23], [24]

Interactions with other drugs

The drug potentiates an inhibitory effect on the central nervous system, which is exerted by sedatives and antihistamine drugs, benzodiazepines, opioids and antipsychotics.

Mirtazapin is forbidden to combine with IMAO. The interval between such treatment cycles should last at least 14 days.

At the same time, Remeron cannot be combined with triptan, venlafaxine, SSRI, hunter and tramadol, as well as with L-tryptophan and lithium, because this can increase the frequency of development of negative symptoms and their intensity.

Caution is needed when combining a substance with cimetidine, nefazodone, ketoconazole, and besides with erythromycin and azole antimycotics.

During the period of therapy it is forbidden to drink alcohol.

During the use of drugs with warfarin, it is required to monitor the values of PTT, because such a combination increases the blood coagulability values.

Carbamazepine with phenytoin and agents that induce the activity of the CYP3A4 enzyme, increase clearance rates of mirtazapine. In this regard, its concentration is reduced by approximately half. Connection with any substances that induce the activity of hepatic enzymes, requires adjustment of the dose of drugs.

[25],

Storage conditions

Remeron is required to be kept closed from small children in a dry place at temperatures between 2-30 ° C.

[26], [27], [28],

Shelf life

Remeron is allowed to apply for a 36-month term since the sale of the drug.

[29]

Application for children

It is forbidden to use Remeron in pediatrics (up to the 18th anniversary).

When tests with placebo, in which adolescents participated, they showed strong hostility and suicidal behavior.

Analogs

Analogues of the medication are the drugs Alventa, Trittiko, Deprexor and Venlift with Deprivit and Velaksin, and in addition Mianserin with Venlaksor and Gellarium Hypericum with Intrivom. At the same time, Coaxil, Prefaxin, Asafen, Medofaxin with Neuroplant, Melitor and Deprim with Lerivon, as well as Pyrazidol, Velbutrin, Negrustin and Brintellix are on the list. In addition, Valdoksan, Depresil, Normazidol, Simbalta with Venlafaxine and Miaser are among them.

[30], [31], [32], [33]

Reviews

Remeron is mainly prescribed for VSD and panic attacks - this is what is said in the medical reviews. The drug is usually transferred without complications, improves the appetite with sleep and the patient's condition. At times, additional medications are used to eliminate the adverse symptoms of drugs.

[34], [35]