Note: This document contains side effect information about mirtazapine. Some dosage forms listed on this page may not apply to the brand name Remeron SolTab.
Summary
Common side effects of Remeron SolTab include: severe sedation, constipation, drowsiness, increased serum cholesterol, weight gain, fatigue, insomnia, increased appetite, xerostomia, and decreased appetite. Other side effects include: dizziness, increased serum triglycerides, tremor, dyspepsia, hot flash, palpitations, vertigo, abnormal dreams, bitter taste, decreased libido, and diaphoresis. Continue reading for a comprehensive list of adverse effects.
Applies to mirtazapine: oral tablets and orally disintegrating tablets.
Warning
-
Suicidality in Children and Adolescents
- Antidepressants may increase risk of suicidal thinking and behavior (suicidality) in children and adolescents with major depressive disorder and other psychiatric disorders (See Pediatric Use under Cautions); balance this risk with clinical need.a b Mirtazapine is not approved for use in pediatric patients.a b
- Closely monitor pediatric patients who are started on mirtazapine therapy for clinical worsening, suicidality, or unusual changes in behavior; involve family members and/or caregivers in this process. (See Worsening of Depression and Suicidality Risk under Cautions.)a b
Side effects include:
Somnolence, increased appetite, weight gain, dizziness.
For Healthcare Professionals
Applies to mirtazapine: oral tablet, oral tablet disintegrating.
Nervous system
Very common (10% or more): Somnolence (up to 54%)
Common (1% to 10%): Dizziness, tremor, headache, sedation/drowsiness
Uncommon (0.1% to 1%): Hypesthesia, hypokinesia, vertigo, amnesia, hyperkinesia, paresthesia, lethargy
Rare (0.01% to 0.1%): Syncope, migraine, ataxia, dyskinesia, extrapyramidal syndrome, coordination abnormal, dysarthria, dystonia, reflexes increased, restless legs, akathisia (psychomotor restlessness)
Very rare (less than 0.01%): Vascular headache, cerebral ischemia, aphasia, nystagmus, stupor, dementia, paralysis, grand mal convulsion, hypotonia, taste loss, myoclonus, parosmia
Frequency not reported: Hypertonia, taste perversion, convulsions (insults)
Postmarketing reports: Impaired concentration, cerebrovascular disorder, movement disorders[Ref]
Gastrointestinal
Very common (10% or more): Dry mouth (up to 25%), constipation (up to 13%)
Common (1% to 10%): Nausea
Uncommon (0.1% to 1%): Abdominal pain, abdominal syndrome acute, vomiting, diarrhea
Rare (0.01% to 0.1%): Abdomen enlarged, eructation, glossitis, nausea and vomiting, gum hemorrhage, stomatitis, colitis, oral hypoesthesia
Very rare (less than 0.01%): Tongue discoloration, ulcerative stomatitis, salivary gland enlargement, increased salivation, intestinal obstruction, pancreatitis, aphthous stomatitis, gastritis, gastroenteritis, oral moniliasis, tongue edema
Frequency not reported: Dyspepsia, flatulence, oral paresthesia, mouth edema[Ref]
Metabolic
Very common (10% or more): Increased appetite (up to 17%), weight gain (up to 12%)
Uncommon (0.1% to 1%): Anorexia
Rare (0.01% to 0.1%): Dehydration, weight loss
Very rare (less than 0.01%): Gout, acid phosphatase increased, diabetes mellitus, hyponatremia
Frequency not reported: Hypertriglyceridemia
Postmarketing reports: Hypercholesterolemia, hyperlipidemia[Ref]
Psychiatric
Common (1% to 10%): Abnormal dreams, thinking abnormal, confusion
Uncommon (0.1% to 1%): Apathy, depression, agitation, anxiety, insomnia
Rare (0.01% to 0.1%): Delirium, delusions, depersonalization, increased libido, hallucinations, manic reaction/mania, neurosis, hostility, emotional lability, euphoria, paranoid reaction, nightmares/vivid dreams
Very rare (less than 0.01%): Drug dependence, psychotic depression, withdrawal syndrome, serotonin syndrome, aggression
Frequency not reported: Nervousness, decreased libido, suicidal ideation, suicidal behavior, somnambulism
Postmarketing reports: Psychomotor restlessness, drug withdrawal symptoms, paroniria[Ref]
Cardiovascular
Common (1% to 10%): Peripheral edema, edema
Uncommon (0.1% to 1%): Hypertension, vasodilation, orthostatic hypotension
Rare (0.01% to 0.1%): Angina pectoris, myocardial infarction, bradycardia, ventricular extrasystoles, hypotension
Very rare (less than 0.01%): Chest pain substernal, atrial arrhythmia, bigeminy, cardiomegaly, phlebitis, left heart failure
Frequency not reported: Chest pain, palpitation, tachycardia, postural hypotension, ECG changes
Postmarketing reports: Ventricular arrhythmia, Torsades de pointes, generalized edema, localized edema[Ref]
There was a mean increase in heart rate observed in patients given this drug compared to placebo (3.4 bpm versus 0.8 bpm, respectively); however, the clinical significance of this difference is unknown.[Ref]
Musculoskeletal
Common (1% to 10%): Back pain, myalgia
Uncommon (0.1% to 1%): Myasthenia, arthralgia, twitching
Rare (0.01% to 0.1%): Neck rigidity, neck pain, arthritis, tenosynovitis
Very rare (less than 0.01%): Pathologic fracture, osteoporosis fracture, bone pain, myositis, tendon rupture, arthrosis, bursitis
Postmarketing reports: Increased creatine kinase blood levels, rhabdomyolysis[Ref]
Respiratory
Common (1% to 10%): Dyspnea
Uncommon (0.1% to 1%): Cough increased, sinusitis
Rare (0.01% to 0.1%): Epistaxis, bronchitis, asthma, pneumonia
Very rare (less than 0.01%): Respiratory/pulmonary embolus, asphyxia, laryngitis, pneumothorax, hiccup
Frequency not reported: Pharyngitis, rhinitis
Postmarketing reports: Pulmonary embolism[Ref]
Genitourinary
Common (1% to 10%): Urinary frequency
Uncommon (0.1% to 1%): Urinary tract infection
Rare (0.01% to 0.1%): Dysuria, urinary incontinence, urinary retention, vaginitis, hematuria, breast pain, amenorrhea, dysmenorrhea, leukorrhea, impotence
Very rare (less than 0.01%): Polyuria, urethritis, metrorrhagia, abnormal ejaculation, breast engorgement, breast enlargement, urinary urgency, menorrhagia[Ref]
Other
Common (1% to 10%): Asthenia
Uncommon (0.1% to 1%): Malaise, thirst, fatigue
Rare (0.01% to 0.1%): Chills, fever, face edema, ulcer, ear pain, deafness, hyperacusis
Very rare (less than 0.01%): Healing abnormal, partial transitory deafness, otitis media
Frequency not reported: Pain, tinnitus[Ref]
Immunologic
Common (1% to 10%): Influenza/flu syndrome
Frequency not reported: Infection[Ref]
Dermatologic
Uncommon (0.1% to 1%): Pruritus, rash, exanthema
Rare (0.01% to 0.1%): Photosensitivity reaction, acne, exfoliative dermatitis, dry skin, herpes simplex, alopecia
Very rare (less than 0.01%): Cellulitis, petechia, urticaria, herpes zoster, skin hypertrophy, skin ulcer, seborrhea
Frequency not reported: Sweating
Postmarketing reports: Stevens-Johnson Syndrome, bullous dermatitis, erythema multiforme, toxic epidermal necrolysis, rash (including erythematous and maculopapular)[Ref]
Ocular
Rare (0.01% to 0.1%): Eye pain, abnormality of accommodation, conjunctivitis, keratoconjunctivitis, lacrimation disorder, angle-closure glaucoma
Very rare (less than 0.01%): Diplopia, blepharitis
Frequency not reported: Amblyopia
Postmarketing reports: Glaucoma[Ref]
Hepatic
Rare (0.01% to 0.1%): Cholecystitis, liver function tests abnormal
Very rare (less than 0.01%): Cirrhosis of the liver, AST increased, ALT increased
Postmarketing reports: Jaundice, hepatitis[Ref]
Renal
Rare (0.01% to 0.1%): Kidney calculus, cystitis[Ref]
Hematologic
Very rare (less than 0.01%): Lymphadenopathy, leukopenia, anemia, thrombocytopenia, lymphocytosis, pancytopenia
Frequency not reported: Bone marrow depression (granulocytopenia, agranulocytosis, aplastic anemia, thrombocytopenia), eosinophilia
Postmarketing reports: Thromboembolic disorder, coagulation disorder[Ref]
Endocrine
Very rare (less than 0.01%): Goiter, hypothyroidism
Frequency not reported: Inappropriate antidiuretic hormone secretion[Ref]