Mirastad 30 are administrated orally.
Adults: The starting dose is 15 or 30 mg daily. The dosage generally needs to be increased to obtain an optimal clinical response. The effective daily dose is usually between 15 and 45 mg.
Mirtazapine begins to exert its effect in general after 1-2 weeks of treatment. Usually need to increase the dose (at least after 1-2 weeks) to achieve optimal clinical response. Treatment with an adequate dose should result in a positive response within 2-4 weeks. With an insufficient response, the dose can be increased up to the maximum dose. If there is no response within a further 2-4 weeks, then treatment should be stopped.
Patients with depression should be treated for a sufficient period of at least 6 months to ensure that they are free from symptoms.
It is recommended to discontinue treatment with mirtazapine gradually to avoid withdrawal symptoms.
Elderly: The recommended dose is the same as that for adults. In elderly patients an increase in dosing should be done under close supervision to elicit a satisfactory and safe response.
Children: Mirtazapine should not be used in children and adolescents under the age of 18 years as efficacy was not demonstrated in two short-term clinical trials and because of safety concerns.
Renal and hepatic insufficiency: The clearance of mirtazapine may be decreased in patients with moderate to severe renal (creatinine clearance <40 ml/min) or hepatic insufficiency. This should be taken into account when prescribing mirtazapine to this category of patients.
Mirtazapine has an elimination half-life of 20-40 hours and therefore mirtazapine are suitable for once-a-day administration preferably as a single night-time dose before going to bed.
Mirtazapine may also be given in two divided doses (once in the morning and once at night-time, the higher dose should be taken at night).