Mirtazep Tablet: Uses, Dosage & Side Effects in Pakistan

Mirtazep (Mirtazapine) Uses, Dosage, Side Effects & Price in Pakistan

1. Quick Info (Mukhtasir Maloomat)

2. What is Mirtazep? (Mirtazep kya hai)

Mirtazep is a prescription antidepressant tablet with Mirtazapine as the active ingredient, manufactured by Zafa Pharmaceuticals in Pakistan. Mirtazapine is a NaSSA (Noradrenergic and Specific Serotonergic Antidepressant) — it works differently from SSRIs: it blocks alpha-2 adrenergic receptors and H1 histamine receptors, increasing norepinephrine and serotonin in the brain. Its sedating effect makes it useful for patients with depression who also have insomnia. Never take it without a doctor's prescription.

3. Uses (Fayde / Kis kaam aata hai)

• Major Depressive Disorder (MDD)
• Anxiety with depression
• Insomnia associated with depression — due to its sedating properties
• Nausea/vomiting — off-label, low dose, specialist supervision only

4. Who Should Take (Kis ko leni chahiye)

• Adults diagnosed with major depressive disorder by a psychiatrist or physician
• Patients with depression who also suffer from insomnia or anxiety
• Patients who did not respond well to SSRIs and need an alternative antidepressant
• Individuals specifically prescribed Mirtazapine by their doctor

5. When NOT to Take (Kab nahi lena chahiye)

• If there is an allergy to any ingredient
• Within 14 days of taking a MAO inhibitor (e.g. Phenelzine) — this combination is life-threatening
• Bipolar disorder — only under doctor's guidance, with a mood stabiliser
• Severe liver or kidney disease — essential consultation with doctor required
• Under 18 years — only under specialist guidance

6. Dosage (Kitni leni hai)

• As prescribed — doctors typically start with a low dose

• As prescribed — dose is adjusted based on condition and patient response

• Do not exceed the recommended limit — never increase the dose without your doctor's advice

• If you miss a dose, take it as soon as you remember. If the next dose is close, skip the missed dose. Never take a double dose.

Never take Mirtazapine without a doctor. Stopping or suddenly discontinuing the dose yourself can be dangerous — only taper under doctor's guidance.

7. How to Take (Kaise lena hai)

• Generally once daily

• Same time

• Night preferred

• With or without food — either way is fine

8. Best Time (Kab lena chahiye)

• Before bedtime — use the sedating effect for sleep

• Same time daily to maintain a routine

9. Empty Stomach or After Food (Khali pait ya khane ke baad)

• Can be taken either way — with or without food. If the stomach is sensitive, taking after food is preferable. Always follow the doctor's guidance as the top priority.

10. Warnings (Ihtiyat)

• Antidepressants — including Mirtazapine — can increase suicidal thoughts, especially in patients under 25 and during the first weeks of treatment. Family members should also stay alert. If thoughts of suicide or self-harm arise — contact your doctor or emergency services immediately. Umang Helpline Pakistan: 0317-4288665.

• The combination of Mirtazapine and MAO inhibitors can be life-threatening. Do not start Mirtazapine until at least 14 days after stopping MAOIs.

• In rare cases, Mirtazapine can suppress bone marrow, reducing white blood cell counts. If fever, sore throat, or mouth ulcers appear — see a doctor immediately and get a CBC test.

• Suddenly stopping or abruptly reducing the dose can cause withdrawal symptoms and a return of depression. Only taper under doctor's guidance.

11. Precautions (Ahm ehtiyaat)

• Mirtazapine can cause severe drowsiness — assess your condition before driving or operating machinery

• Avoid alcohol completely — CNS depression and sedation are significantly increased

• Risk of falls and confusion is increased in elderly patients — close monitoring is essential

• Limited data exists during pregnancy — discuss risks and benefits with your doctor. Doctor's guidance is also required during breastfeeding.

• Store below 30°C in a cool, dry place
• Keep away from direct sunlight and moisture
• Keep well out of the reach of children

12. Side Effects (Nuksanat)

• Drowsiness / sedation (often therapeutically useful)
• Increased appetite and weight gain
• Dry mouth
• Dizziness
• Constipation

• Suicidal ideation — especially at the start of treatment — contact doctor or emergency immediately
• Severe allergic reaction / Stevens-Johnson Syndrome — seek emergency help immediately
• Agranulocytosis / bone marrow suppression (rare) — fever, sore throat, ulcers — see a doctor immediately
• Serotonin syndrome — muscle tightening, agitation, high fever

13. Drug Interactions (Dawaon ke sath reaction)

• MAO inhibitors (Phenelzine, Tranylcypromine) — CONTRAINDICATED — life-threatening combination; a gap of at least 14 days is required
• Alcohol — additive CNS depression — avoid completely
• SSRIs / SNRIs / Tramadol / Triptans — increased risk of serotonin syndrome
• CYP1A2 inhibitors (Fluvoxamine) — may raise Mirtazapine levels
• CYP3A4 inhibitors (Ketoconazole, some HIV medicines) — may raise Mirtazapine levels
• Clonidine (BP medicine) — Mirtazapine antagonizes its effect

14. When to See Doctor (Kab doctor ke paas jayein)

• Thoughts of suicide or self-harm — contact emergency or doctor immediately; Umang Helpline Pakistan: 0317-4288665
• Severe agitation, restlessness, or loss of consciousness
• Signs of serotonin syndrome: muscle tightening, high fever, agitation, diarrhea
• Fever, sore throat, or mouth ulcers
• Severe allergic reaction
• Seizure or epileptic episode

15. Alternatives (Sasti Dusri Dawaein)

Note: Switching to an alternative is always the doctor's decision — do not switch yourself.

16. Price in Pakistan (Price kitni hai)

17. FAQs (Aksar poochay jane walay sawalat)

Q: Mirtazapine kis kaam aata hai?

A: Doctors prescribe Mirtazapine (Mirtazep) for major depression, depression with anxiety, and insomnia associated with depression. It is a NaSSA antidepressant — never take it without a doctor's prescription.

Q: Mirtazapine ke side effects kya hain?

A: Common side effects include drowsiness, increased appetite and weight gain, dry mouth, and dizziness. Serious effects include suicidal thoughts — if this occurs, contact your doctor or Umang Helpline (0317-4288665) immediately.

Q: Mirtazapine neend kyun lati hai?

A: Mirtazapine blocks H1 histamine receptors, which causes sedation (drowsiness). This is why doctors also use it for insomnia associated with depression.

Q: Mirtazapine Pakistan mein kitne ki hai?

A: Mirtazep price in Pakistan varies by pharmacy and pack size. Check the updated price at your local pharmacy or Dawaai.pk.

Q: Mirtazapine band karna safe hai?

A: No — stopping Mirtazapine yourself is not safe. Sudden discontinuation can cause withdrawal symptoms and a return of depression. Only taper under doctor's guidance.

18. Medical Review (Medical jaiza)

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

19. Disclaimer (Zaroori tanbeeh)

The information on this page is for awareness only. It is not medical advice. Always consult your doctor or pharmacist before taking any medicine. PakVita is not responsible for any harm.