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MIRTAZAPINE 30MG ORODISPERSIBLE TABLETS

Active substance(s): MIRTAZAPINE

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ZISPIN® SolTab®
30mg
orodispersible tablets

(mirtazapine)
Read all of this leaflet carefully before you start
taking this medicine because it contains important
information for you.
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or
pharmacist.
This medicine has been prescribed for you only. Do
not pass it on to others. It may harm them, even if
their signs of illness are the same as yours.
If you get any side effects talk to your doctor or
pharmacist. This includes any possible side effects
not listed in this leaflet. See section 4.
The name of your medicine is ZISPIN® SolTab® 30mg
orodispersible tablets but will be referred to as Zispin
SolTab throughout this leaflet.
What is in this leaflet
1. What Zispin SolTab is and what it is used for
2. What you need to know before you take Zispin
SolTab
3. How to take Zispin SolTab
4. Possible side effects
5. How to store Zispin SolTab
6. Contents of the pack and other information
1. What Zispin SolTab Is and What It Is Used For
Zispin SolTab is one of a group of medicines called
antidepressants.
Zispin SolTab is used to treat depressive illness in adults.
Zispin SolTab will take 1 to 2 weeks before it starts
working. After 2 to 4 weeks you may start feeling better.
You must talk to your doctor if you do not feel better or if
you feel worse after 2 to 4 weeks. More information is in
section 3 heading ‘When can you expect to start feeling
better’.
2. What you need to know before you take Zispin
SolTab
Do not take Zispin SolTab
if you are allergic to mirtazapine or any of the other
ingredients of this medicine (listed in section 6). If so,
you must talk to your doctor as soon as you can
before taking Zispin SolTab.
if you are taking or have recently taken (within the
last two weeks) medicines called monoamine
oxidase inhibitors (MAO-Is).
Warnings and precautions
Talk to your doctor or pharmacist before taking Zispin
SolTab.

Children and adolescents
Zispin SolTab should normally not be used for children
and adolescents under 18 years because efficacy was
not demonstrated. Also, you should know that patients
under 18 have an increased risk of side effects such as
suicide attempt, suicidal thoughts and hostility
(predominantly aggression, oppositional behaviour and
anger) when they take this class of medicines. Despite
this, your doctor may prescribe Zispin SolTab for patients
under 18 because he/she decides that this is in their best
interests. If your doctor has prescribed Zispin SolTab for
a patient under 18 and you want to discuss this, please
go back to your doctor. You should inform your doctor if
any of the symptoms listed above develop or worsen
when patients under 18 are taking Zispin SolTab. Also,
the long-term safety effects concerning growth,
maturation and cognitive and behavioural development of
Zispin SolTab in this age group have not yet been
demonstrated. In addition, significant weight gain has
been observed in this age category more often when
treated with Zispin SolTab compared with adults.
Thoughts of suicide and worsening of your
depression
If you are depressed you can sometimes have thoughts
of harming or killing yourself. These may be increased
when first starting antidepressants, since these
medicines all take time to work, usually about two weeks
but sometimes longer.
You may be more likely to think like this:
if you have previously had thoughts about killing or
harming yourself.
if you are a young adult. Information from clinical
trials has shown an increased risk of suicidal
behaviour in adults aged less than 25 years with
psychiatric conditions who were treated with an
antidepressant.
If you have thoughts of harming or killing yourself at
any time, contact your doctor or go to a hospital
straight away.
You may find it helpful to tell a relative or close friend
that you are depressed, and ask them to read this leaflet.
You might ask them to tell you if they think your
depression is getting worse, or if they are worried about
changes in your behaviour.
Also take special care with Zispin SolTab
if you have, or have ever had one of the following
conditions.
Tell your doctor about these conditions before
taking Zispin SolTab, if not done previously.
seizures (epilepsy). If you develop seizures or
your seizures become more frequent, stop taking
Zispin SolTab and contact your doctor
immediately;
liver disease, including jaundice. If jaundice
occurs, stop taking Zispin SolTab and contact
your doctor immediately;
kidney disease;
heart disease, or low blood pressure;

schizophrenia. If psychotic symptoms, such as
paranoid thoughts become more frequent or
severe, contact your doctor straight away;
manic depression (alternating periods of feeling
elated/overactivity and depressed mood). If you
start feeling elated or over-excited, stop taking
Zispin SolTab and contact your doctor
immediately;
diabetes (you may need to adjust your dose of
insulin or other antidiabetic medicines);
eye disease, such as increased pressure in the
eye (glaucoma);
difficulty in passing water (urinating), which
might be caused by an enlarged prostate;
certain kinds of heart conditions that may
change your heart rhythm, a recent heart attack,
heart failure, or take certain medicines that may
affect the heart’s rhythm.
if you develop signs of infection such as inexplicable
high fever, sore throat and mouth ulcers.
Stop taking Zispin SolTab and consult your
doctor immediately for a blood test. In rare cases
these symptoms can be signs of disturbances in
blood cell production in the bone marrow. While
rare, these symptoms most commonly appear
after 4-6 weeks of treatment.
if you are an elderly person. You could be more
sensitive to the side effects of antidepressants.
Other medicines and Zispin SolTab
Tell your doctor or pharmacist if you are taking, have
recently taken or might take any other medicines.
Do not take Zispin SolTab in combination with:
monoamine oxidase inhibitors (MAO inhibitors).
Also, do not take Zispin SolTab during the two weeks
after you have stopped taking MAO inhibitors. If you
stop taking Zispin SolTab, do not take MAO inhibitors
during the next two weeks either. Examples of MAO
inhibitors are moclobemide, tranylcypromine (both
are antidepressants) and selegiline (used for
Parkinson’s disease).
Take care when taking Zispin SolTab in combination
with:
antidepressants such as SSRIs, venlafaxine and
L-tryptophan, or triptans (used to treat migraine),
tramadol (a pain-killer), linezolid (an antibiotic),
lithium (used to treat some psychiatric conditions),
methylene blue (used to treat high levels of
methemoglobin in the blood) and St. John’s Wort –
Hypericum perforatum preparations (a herbal
remedy for depression). In very rare cases Zispin
SolTab alone or the combination of Zispin SolTab
with these medicines, can lead to a so-called
serotonin syndrome. Some of the symptoms of this
syndrome are: inexplicable fever, sweating,
increased heart rate, diarrhoea, (uncontrollable)
muscle contractions, shivering, overactive reflexes,
restlessness, mood changes, and unconsciousness.
If you get a combination of these symptoms, talk to
your doctor immediately.

the antidepressant nefazodone. It can increase the
amount of Zispin SolTab in your blood. Inform your
doctor if you are using this medicine. It might be
needed to lower the dose of Zispin SolTab, or when
use of nefazodone is stopped, to increase the dose
of Zispin SolTab again.
medicines for anxiety or insomnia such as
benzodiazepines;
medicines for schizophrenia such as olanzapine;
medicines for allergies such as cetirizine;
medicines for severe pain such as morphine. In
combination with these medicines Zispin SolTab can
increase the drowsiness caused by these medicines.
medicines for infections, medicines for bacterial
infections (such as erythromycin); medicines for
fungal infections (such as ketoconazole) and
medicines for HIV/AIDS (such as HIV-protease
inhibitors) and drugs for stomach ulcers (such as
cimetidine).
In combination with Zispin SolTab these medicines
can increase the amount of Zispin SolTab in your
blood. Inform your doctor if you are using these
medicines. It might be needed to lower the dose of
Zispin SolTab, or when these medicines are stopped,
to increase the dose of Zispin SolTab again.
medicines for epilepsy such as carbamazepine and
phenytoin;
medicines for tuberculosis such as rifampicin.
In combination with Zispin SolTab these medicines
can reduce the amount of Zispin SolTab in your
blood. Inform your doctor if you are using these
medicines. It might be needed to increase the dose
of Zispin SolTab, or when these medicines are
stopped to lower the dose of Zispin SolTab again.
medicines to prevent blood clotting such as
warfarin.
Zispin SolTab can increase the effects of warfarin on
the blood. Inform your doctor if you are using this
medicine. In case of combination it is advised that a
doctor monitors your blood carefully.
medicines that may affect the heart’s rhythm such
as certain antibiotics and some anti-psychotics.
Zispin SolTab with food and alcohol
You may get drowsy if you drink alcohol while you are
taking Zispin SolTab. You are advised not to drink any
alcohol. You can take Zispin SolTab with or without food.
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be
pregnant or are planning to have a baby, ask your doctor
or pharmacist for advice before taking this medicine.
Limited experience with Zispin SolTab administration to
pregnant women does not indicate an increased risk.
However, caution should be exercised when used during
pregnancy.
If you use Zispin SolTab until, or shortly before birth, your
baby should be supervised for possible adverse effects.
When taken during pregnancy, similar drugs (SSRIs)
may increase the risk of a serious condition in babies,
called persistent pulmonary hypertension of the newborn
(PPHN), making the baby breathe faster and appear

bluish. These symptoms usually begin during the first 24
hours after the baby is born. If this happens to your baby
you should contact your midwife and/or doctor
immediately.
Driving and using machines
Zispin SolTab can affect your concentration or alertness.
Make sure these abilities are not affected before you
drive or operate machinery. If your doctor has prescribed
Zispin SolTab for a patient under 18 years make sure the
concentration and alertness is not affected before
participation in traffic (e.g. on bicycle).
Zispin SolTab orodispersible tablets contain sugar
spheres, containing sucrose.
Zispin SolTab orodispersible tablets contain sugar
spheres, containing sucrose. If you have been told by
your doctor that you have intolerance for some sugars,
contact your doctor before taking this medicinal product.
Zispin Soltab orodispersible tablets contain
aspartame, a source of phenylalanine.
Zispin SolTab orodispersible tablets contain aspartame, a
source of phenylalanine. May be harmful for people with
phenylketonuria.
3. How to take Zispin SolTab
Always take this medicine exactly as your doctor or
pharmacist has told you. Check with your doctor or
pharmacist if you are not sure.
How much to take
The recommended starting dose is 15 or 30mg every
day. Your doctor may advise you to increase your dose
after a few days to the amount that is best for you
(between 15 and 45mg per day). The dose is usually the
same for all ages. However, if you are an elderly person
or if you have renal or liver disease, your doctor may
adapt the dose.
When to take Zispin SolTab
Take Zispin SolTab at the same time each day.
It is best to take Zispin SolTab as a single dose before
you go to bed. However your doctor may suggest to split
your dose of Zispin SolTab – once in the morning and
once at night-time before you go to bed. The higher dose
should be taken before you go to bed.

Take the orodispersible tablet as follows
Take your tablets orally.

It will rapidly disintegrate and can be swallowed without
water.

4. Possible side effects

1. Do not crush the orodispersible tablet
In order to prevent crushing the orodispersible tablet,
do not push against the tablet pocket (Figure A)

When can you expect to start feeling better
Usually Zispin SolTab will start working after 1 to 2 weeks
and after 2 to 4 weeks you may start to feel better.

Like all medicines, this medicine can cause side effects,
although not everybody gets them.

Fig. A.
2. Tear off one tablet pocket
Each blister contains six tablet pockets, which are
separated by perforations. Tear off one tablet pocket
along the dotted lines (Figure 1).

Fig. 1.
3. Peel off the lid
Carefully peel off the lidding foil, starting in the corner
indicated by the arrow (Figures 2 and 3).

Fig. 2

Fig. 3.
4. Take out the orodispersible tablet
Take out the orodispersible tablet with dry hands and
place it on the tongue.
(Figure 4).

Fig. 4.

It is important that, during the first few weeks of the
treatment, you talk with your doctor about the effects of
Zispin SolTab:
2 to 4 weeks after you have started taking Zispin
SolTab, talk to your doctor about how this
medicine has affected you.
If you still don’t feel better, your doctor may prescribe a
higher dose. In that case, talk to your doctor again after
another 2 to 4 weeks. Usually you will need to take Zispin
SolTab until your symptoms of depression have
disappeared for 4 to 6 months.
If you take more Zispin SolTab than you should
If you or someone else has taken too much
Zispin SolTab, call a doctor straight away.
The most likely signs of an overdose of Zispin SolTab
(without other medicines or alcohol) are drowsiness,
disorientation and increased heart rate. The
symptoms of a possible overdose may include changes
to your heart rhythm (fast, irregular heartbeat) and/or
fainting which could be symptoms of a life-threatening
condition known as Torsade de Pointes.
If you forget to take Zispin SolTab
If you are supposed to take your dose once a day
Do not take a double dose to make up for a forgotten
dose. Take your next dose at the normal time.
If you are supposed to take your dose twice a day
if you have forgotten to take your morning dose,
simply take it together with your evening dose.
if you have forgotten to take your evening dose, do
not take it with the next morning dose; just skip it and
continue with your normal morning and evening
doses.
if you have forgotten to take both doses, do not
attempt to make up for the missed doses. Skip both
doses and continue the next day with your normal
morning and evening doses.
If you stop taking Zispin SolTab
Only stop taking Zispin SolTab in consultation with
your doctor.
If you stop too early, your depression might come back.
Once you are feeling better, talk to your doctor. Your
doctor will decide when treatment can be stopped.
Do not suddenly stop taking Zispin SolTab, even when
your depression has lifted. If you suddenly stop taking
Zispin SolTab you may feel sick, dizzy, agitated or
anxious, and have headaches. These symptoms can be
avoided by stopping gradually. Your doctor will tell you
how to decrease the dose gradually.
If you have any further questions on the use of this
medicine, ask your doctor or pharmacist.

If you experience any of the following serious side
effects, stop taking mirtazapine and tell your doctor
immediately.
Uncommon (may affect up to 1 in 100 people):
feeling elated or emotionally ‘high’ (mania)
Rare (may affect up to 1 in 1,000 people):
yellow colouring of eyes or skin; this may suggest
disturbance in liver function (jaundice)
Not known (frequency cannot be estimated from the
available data):
signs of infection such as sudden unexplainable high
fever, sore throat and mouth ulcers (agranulocytosis).
In rare cases mirtazapine can cause disturbances in
the production of blood cells (bone marrow
depression). Some people become less resistant to
infection because mirtazapine can cause a temporary
shortage of white blood cells (granulocytopenia). In
rare cases mirtazapine can also cause a shortage of
red and white blood cells, as well as blood platelets
(aplastic anemia), a shortage of blood platelets
(thrombocytopenia) or an increase in the number of
white blood cells (eosinophilia).
epileptic attack (convulsions)
a combination of symptoms such as inexplicable
fever, sweating, increased heart rate, diarrhoea,
(uncontrollable) muscle contractions, shivering,
overactive reflexes, restlessness, mood changes,
unconsciousness and increased salivation. In very
rare cases these can be signs of serotonin
syndrome.
thoughts of harming or killing yourself
severe skin reactions (Stevens-Johnson Syndrome,
toxic epidermal necrolysis)
Other possible side effects with mirtazapine are:
Very common (may affect more than 1 in 10 people):
increase in appetite and weight gain
drowsiness or sleepiness
headache
dry mouth
Common (may affect up to 1 in 10 people):
lethargy
dizziness
shakiness or tremor
nausea
diarrhoea
vomiting
constipation
rash or skin eruptions (exanthema)
pain in your joints (arthralgia) or muscles (myalgia)
back pain
feeling dizzy or faint when you stand up suddenly
(orthostatic hypotension)

swelling (typically in ankles or feet) caused by fluid
retention (oedema)
tiredness
vivid dreams
confusion
feeling anxious
sleeping problems
Uncommon (may affect up to 1 in 100 people):
abnormal sensation in the skin e.g. burning, stinging,
tickling or tingling (paraesthesia)
restless legs
fainting (syncope)
sensations of numbness in the mouth (oral
hypoaesthesia)
low blood pressure
nightmares
feeling agitated
hallucinations
urge to move
Rare (may affect up to 1 in 1,000 people):
muscle twitching or contractions (myoclonus)
aggression
abdominal pain and nausea; this may suggest
inflammation of the pancreas (pancreatitis)
Not known (frequency cannot be estimated
from the available data):
abnormal sensations in the mouth (oral paraesthesia)
swelling in the mouth (mouth oedema)
swelling throughout the body (generalized oedema)
localized swelling
hyponatraemia
inappropriate anti-diuretic hormone secretion
severe skin reactions (dermatitis bullous, erythema
multiforme)
sleep walking (somnambulism)
speech disorder
Additional side effects in children and adolescents
In children under 18 years the following adverse events
were observed commonly in clinical trials: significant
weight gain hives and increased blood triglycerides.
Reporting of side effects
If you get any side effects, talk to your doctor or
pharmacist. This includes any possible side effects not
listed in this leaflet. You can also report side effects
directly via the Yellow Card Scheme Website:
www.mhra.gov.uk/yellowcard
By reporting side effects you can help provide more
information on the safety of this medicine.

5. How to store Zispin SolTab
KEEP OUT OF THE SIGHT AND REACH OF
CHILDREN.
Do not use Zispin SolTab after the ‘Use by’ date on the
push through strip and pack.
Store in the original package in order to protect from light
and moisture.
If the tablets become discoloured or show signs of
deterioration, you should seek the advice of your
pharmacist.
6. Contents of the pack and other information
What Zispin SolTab contains
Each tablet contains 30mg mirtazapine, which is an
antidepressant, as the active ingredient.
The other ingredients are sugar spheres, hypromellose,
povidone K30, magnesium stearate, basic butylated
methacrylate copolymer, aspartame (E951), anhydrous
citric acid, crospovidone (type A), mannitol (E421),
microcrystalline cellulose, natural and artificial orange
flavour (No. SN027512) and sodium hydrogen carbonate.
What Zispin SolTab looks like and contents of the
pack
Zispin SolTab is round, white, standard bevelled-edge
orodispersible tablet imprinted ‘TZ2’ on one face.
Zispin SolTab is packed in child-resistant perforated unit
dose blister strip.
Zispin SolTab comes in packs of 30 orodispersible
tablets.
Manufactured by: N.V. Organon, Kloosterstraat 6,
5349 AB Oss, The Netherlands.
Procured from within the EU and repackaged by the
Product Licence holder: B&S Healthcare, Unit 4,
Bradfield Road, Ruislip, Middlesex, HA4 0NU, UK.
Zispin® SolTab® 30mg orodispersible Tablets
PL18799/1254
POM
Leaflet date: 16.06.2016
Zispin, SolTab are registered trademarks of Merck Sharp
and Dohme.

MIRTAZAPINE SolTab®
30mg
orodispersible tablets
Read all of this leaflet carefully before you start
taking this medicine because it contains important
information for you.
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or
pharmacist.
This medicine has been prescribed for you only. Do
not pass it on to others. It may harm them, even if
their signs of illness are the same as yours.
If you get any side effects talk to your doctor or
pharmacist. This includes any possible side effects
not listed in this leaflet. See section 4.
The name of your medicine is Mirtazapine SolTab® 30mg
orodispersible tablets but will be referred to as
Mirtazapine SolTab throughout this leaflet.
What is in this leaflet
1. What Mirtazapine SolTab is and what it is used
for
2. What you need to know before you take
Mirtazapine SolTab
3. How to take Mirtazapine SolTab
4. Possible side effects
5. How to store Mirtazapine SolTab
6. Contents of the pack and other information
1. What Mirtazapine SolTab Is and What It Is
Used For
Mirtazapine SolTab is one of a group of medicines called
antidepressants.
Mirtazapine SolTab is used to treat depressive illness in
adults.
Mirtazapine SolTab will take 1 to 2 weeks before it starts
working. After 2 to 4 weeks you may start feeling better.
You must talk to your doctor if you do not feel better or if
you feel worse after 2 to 4 weeks. More information is in
section 3 heading ‘When can you expect to start feeling
better’.
2. What you need to know before you take
Mirtazapine SolTab
Do not take Mirtazapine SolTab
if you are allergic to mirtazapine or any of the other
ingredients of this medicine (listed in section 6). If so,
you must talk to your doctor as soon as you can
before taking Mirtazapine SolTab.
if you are taking or have recently taken (within the
last two weeks) medicines called monoamine
oxidase inhibitors (MAO-Is).
Warnings and precautions
Talk to your doctor or pharmacist before taking
Mirtazapine SolTab.
Children and adolescents

Mirtazapine SolTab should normally not be used for
children and adolescents under 18 years because
efficacy was not demonstrated. Also, you should know
that patients under 18 have an increased risk of side
effects such as suicide attempt, suicidal thoughts and
hostility (predominantly aggression, oppositional
behaviour and anger) when they take this class of
medicines. Despite this, your doctor may prescribe
Mirtazapine SolTab for patients under 18 because he/she
decides that this is in their best interests. If your doctor
has prescribed Mirtazapine SolTab for a patient under 18
and you want to discuss this, please go back to your
doctor. You should inform your doctor if any of the
symptoms listed above develop or worsen when patients
under 18 are taking Mirtazapine SolTab. Also, the longterm safety effects concerning growth, maturation and
cognitive and behavioural development of Mirtazapine
SolTab in this age group have not yet been
demonstrated. In addition, significant weight gain has
been observed in this age category more often when
treated with Mirtazapine SolTab compared with adults.
Thoughts of suicide and worsening of your
depression
If you are depressed you can sometimes have thoughts
of harming or killing yourself. These may be increased
when first starting antidepressants, since these
medicines all take time to work, usually about two weeks
but sometimes longer.
You may be more likely to think like this:
if you have previously had thoughts about killing or
harming yourself.
if you are a young adult. Information from clinical
trials has shown an increased risk of suicidal
behaviour in adults aged less than 25 years with
psychiatric conditions who were treated with an
antidepressant.
If you have thoughts of harming or killing yourself at
any time, contact your doctor or go to a hospital
straight away.
You may find it helpful to tell a relative or close friend
that you are depressed, and ask them to read this leaflet.
You might ask them to tell you if they think your
depression is getting worse, or if they are worried about
changes in your behaviour.
Also take special care with Mirtazapine SolTab
if you have, or have ever had one of the following
conditions.
Tell your doctor about these conditions before
taking Mirtazapine SolTab, if not done previously.
seizures (epilepsy). If you develop seizures or
your seizures become more frequent, stop taking
Mirtazapine SolTab and contact your doctor
immediately;
liver disease, including jaundice. If jaundice
occurs, stop taking Mirtazapine SolTab and
contact your doctor immediately;
kidney disease;
heart disease, or low blood pressure;

schizophrenia. If psychotic symptoms, such as
paranoid thoughts become more frequent or
severe, contact your doctor straight away;
manic depression (alternating periods of feeling
elated/overactivity and depressed mood). If you
start feeling elated or over-excited, stop taking
Mirtazapine SolTab and contact your doctor
immediately;
diabetes (you may need to adjust your dose of
insulin or other antidiabetic medicines);
eye disease, such as increased pressure in the
eye (glaucoma);
difficulty in passing water (urinating), which
might be caused by an enlarged prostate;
certain kinds of heart conditions that may
change your heart rhythm, a recent heart attack,
heart failure, or take certain medicines that may
affect the heart’s rhythm.
if you develop signs of infection such as inexplicable
high fever, sore throat and mouth ulcers.
Stop taking Mirtazapine SolTab and consult your
doctor immediately for a blood test. In rare cases
these symptoms can be signs of disturbances in
blood cell production in the bone marrow. While
rare, these symptoms most commonly appear
after 4-6 weeks of treatment.
if you are an elderly person. You could be more
sensitive to the side effects of antidepressants.
Other medicines and Mirtazapine SolTab
Tell your doctor or pharmacist if you are taking, have
recently taken or might take any other medicines.
Do not take Mirtazapine SolTab in combination with:
monoamine oxidase inhibitors (MAO inhibitors).
Also, do not take Mirtazapine SolTab during the two
weeks after you have stopped taking MAO inhibitors.
If you stop taking Mirtazapine SolTab, do not take
MAO inhibitors during the next two weeks either.
Examples of MAO inhibitors are moclobemide,
tranylcypromine (both are antidepressants) and
selegiline (used for Parkinson’s disease).
Take care when taking Mirtazapine SolTab in
combination with:
antidepressants such as SSRIs, venlafaxine and
L-tryptophan, or triptans (used to treat migraine),
tramadol (a pain-killer), linezolid (an antibiotic),
lithium (used to treat some psychiatric conditions),
methylene blue (used to treat high levels of
methemoglobin in the blood) and St. John’s Wort –
Hypericum perforatum preparations (a herbal
remedy for depression). In very rare cases
Mirtazapine SolTab alone or the combination of
Mirtazapine SolTab with these medicines, can lead to
a so-called serotonin syndrome. Some of the
symptoms of this syndrome are: inexplicable fever,
sweating, increased heart rate, diarrhoea,
(uncontrollable) muscle contractions, shivering,
overactive reflexes, restlessness, mood changes,
and unconsciousness. If you get a combination of
these symptoms, talk to your doctor immediately.

the antidepressant nefazodone. It can increase the
amount of Mirtazapine SolTab in your blood. Inform
your doctor if you are using this medicine. It might be
needed to lower the dose of Mirtazapine SolTab, or
when use of nefazodone is stopped, to increase the
dose of Mirtazapine SolTab again.
medicines for anxiety or insomnia such as
benzodiazepines;
medicines for schizophrenia such as olanzapine;
medicines for allergies such as cetirizine;
medicines for severe pain such as morphine. In
combination with these medicines Mirtazapine
SolTab can increase the drowsiness caused by these
medicines.
medicines for infections, medicines for bacterial
infections (such as erythromycin); medicines for
fungal infections (such as ketoconazole) and
medicines for HIV/AIDS (such as HIV-protease
inhibitors) and drugs for stomach ulcers (such as
cimetidine).
In combination with Mirtazapine SolTab these
medicines can increase the amount of Mirtazapine
SolTab in your blood. Inform your doctor if you are
using these medicines. It might be needed to lower
the dose of Mirtazapine SolTab, or when these
medicines are stopped, to increase the dose of
Mirtazapine SolTab again.
medicines for epilepsy such as carbamazepine and
phenytoin;
medicines for tuberculosis such as rifampicin.
In combination with Mirtazapine SolTab these
medicines can reduce the amount of Mirtazapine
SolTab in your blood. Inform your doctor if you are
using these medicines. It might be needed to
increase the dose of Mirtazapine SolTab, or when
these medicines are stopped to lower the dose of
Mirtazapine SolTab again.
medicines to prevent blood clotting such as
warfarin.
Mirtazapine SolTab can increase the effects of
warfarin on the blood. Inform your doctor if you are
using this medicine. In case of combination it is
advised that a doctor monitors your blood carefully.
medicines that may affect the heart’s rhythm such
as certain antibiotics and some anti-psychotics.
Mirtazapine SolTab with food and alcohol
You may get drowsy if you drink alcohol while you are
taking Mirtazapine SolTab. You are advised not to drink
any alcohol. You can take Mirtazapine SolTab with or
without food.
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be
pregnant or are planning to have a baby, ask your doctor
or pharmacist for advice before taking this medicine.
Limited experience with Mirtazapine SolTab
administration to pregnant women does not indicate an
increased risk. However, caution should be exercised
when used during pregnancy.
If you use Mirtazapine SolTab until, or shortly before
birth, your baby should be supervised for possible

adverse effects. When taken during pregnancy, similar
drugs (SSRIs) may increase the risk of a serious
condition in babies, called persistent pulmonary
hypertension of the newborn (PPHN), making the baby
breathe faster and appear bluish. These symptoms
usually begin during the first 24 hours after the baby is
born. If this happens to your baby you should contact
your midwife and/or doctor immediately.
Driving and using machines
Mirtazapine SolTab can affect your concentration or
alertness. Make sure these abilities are not affected
before you drive or operate machinery. If your doctor has
prescribed Mirtazapine SolTab for a patient under 18
years make sure the concentration and alertness is not
affected before participation in traffic (e.g. on bicycle).
Mirtazapine SolTab orodispersible tablets contain
sugar spheres, containing sucrose.
Mirtazapine SolTab orodispersible tablets contain sugar
spheres, containing sucrose. If you have been told by
your doctor that you have intolerance for some sugars,
contact your doctor before taking this medicinal product.
Mirtazapine Soltab orodispersible tablets contain
aspartame, a source of phenylalanine.
Mirtazapine SolTab orodispersible tablets contain
aspartame, a source of phenylalanine. May be harmful
for people with phenylketonuria.
3. How to take Mirtazapine SolTab
Always take this medicine exactly as your doctor or
pharmacist has told you. Check with your doctor or
pharmacist if you are not sure.
How much to take
The recommended starting dose is 15 or 30mg every
day. Your doctor may advise you to increase your dose
after a few days to the amount that is best for you
(between 15 and 45mg per day). The dose is usually the
same for all ages. However, if you are an elderly person
or if you have renal or liver disease, your doctor may
adapt the dose.
When to take Mirtazapine SolTab
Take Mirtazapine SolTab at the same time each day.
It is best to take Mirtazapine SolTab as a single dose
before you go to bed. However your doctor may suggest
to split your dose of Mirtazapine SolTab – once in the
morning and once at night-time before you go to bed.
The higher dose should be taken before you go to bed.

Take the orodispersible tablet as follows
Take your tablets orally.

It will rapidly disintegrate and can be swallowed without
water.

4. Possible side effects

1. Do not crush the orodispersible tablet
In order to prevent crushing the orodispersible tablet,
do not push against the tablet pocket (Figure A)

When can you expect to start feeling better
Usually Mirtazapine SolTab will start working after 1 to 2
weeks and after 2 to 4 weeks you may start to feel better.

Like all medicines, this medicine can cause side effects,
although not everybody gets them.

Fig. A.
2. Tear off one tablet pocket
Each blister contains six tablet pockets, which are
separated by perforations. Tear off one tablet pocket
along the dotted lines (Figure 1).

Fig. 1.
3. Peel off the lid
Carefully peel off the lidding foil, starting in the corner
indicated by the arrow (Figures 2 and 3).

Fig. 2

Fig. 3.
4. Take out the orodispersible tablet
Take out the orodispersible tablet with dry hands and
place it on the tongue.
(Figure 4).

Fig. 4.

It is important that, during the first few weeks of the
treatment, you talk with your doctor about the effects of
Mirtazapine SolTab:
2 to 4 weeks after you have started taking
Mirtazapine SolTab, talk to your doctor about
how this medicine has affected you.
If you still don’t feel better, your doctor may prescribe a
higher dose. In that case, talk to your doctor again after
another 2 to 4 weeks. Usually you will need to take
Mirtazapine SolTab until your symptoms of depression
have disappeared for 4 to 6 months.
If you take more Mirtazapine SolTab than you should
If you or someone else has taken too much
Mirtazapine SolTab, call a doctor straight away.
The most likely signs of an overdose of Mirtazapine
SolTab (without other medicines or alcohol) are
drowsiness, disorientation and increased heart rate.
The symptoms of a possible overdose may include
changes to your heart rhythm (fast, irregular heartbeat)
and/or fainting which could be symptoms of a lifethreatening condition known as Torsade de Pointes.
If you forget to take Mirtazapine SolTab
If you are supposed to take your dose once a day
Do not take a double dose to make up for a forgotten
dose. Take your next dose at the normal time.
If you are supposed to take your dose twice a day
if you have forgotten to take your morning dose,
simply take it together with your evening dose.
if you have forgotten to take your evening dose, do
not take it with the next morning dose; just skip it and
continue with your normal morning and evening
doses.
if you have forgotten to take both doses, do not
attempt to make up for the missed doses. Skip both
doses and continue the next day with your normal
morning and evening doses.
If you stop taking Mirtazapine SolTab
Only stop taking Mirtazapine SolTab in consultation
with your doctor.
If you stop too early, your depression might come back.
Once you are feeling better, talk to your doctor. Your
doctor will decide when treatment can be stopped.
Do not suddenly stop taking Mirtazapine SolTab, even
when your depression has lifted. If you suddenly stop
taking Mirtazapine SolTab you may feel sick, dizzy,
agitated or anxious, and have headaches. These
symptoms can be avoided by stopping gradually. Your
doctor will tell you how to decrease the dose gradually.
If you have any further questions on the use of this
medicine, ask your doctor or pharmacist.

If you experience any of the following serious side
effects, stop taking mirtazapine and tell your doctor
immediately.
Uncommon (may affect up to 1 in 100 people):
feeling elated or emotionally ‘high’ (mania)
Rare (may affect up to 1 in 1,000 people):
yellow colouring of eyes or skin; this may suggest
disturbance in liver function (jaundice)
Not known (frequency cannot be estimated from the
available data):
signs of infection such as sudden unexplainable high
fever, sore throat and mouth ulcers (agranulocytosis).
In rare cases mirtazapine can cause disturbances in
the production of blood cells (bone marrow
depression). Some people become less resistant to
infection because mirtazapine can cause a temporary
shortage of white blood cells (granulocytopenia). In
rare cases mirtazapine can also cause a shortage of
red and white blood cells, as well as blood platelets
(aplastic anemia), a shortage of blood platelets
(thrombocytopenia) or an increase in the number of
white blood cells (eosinophilia).
epileptic attack (convulsions)
a combination of symptoms such as inexplicable
fever, sweating, increased heart rate, diarrhoea,
(uncontrollable) muscle contractions, shivering,
overactive reflexes, restlessness, mood changes,
unconsciousness and increased salivation. In very
rare cases these can be signs of serotonin
syndrome.
thoughts of harming or killing yourself
severe skin reactions (Stevens-Johnson Syndrome,
toxic epidermal necrolysis)
Other possible side effects with mirtazapine are:
Very common (may affect more than 1 in 10 people):
increase in appetite and weight gain
drowsiness or sleepiness
headache
dry mouth
Common (may affect up to 1 in 10 people):
lethargy
dizziness
shakiness or tremor
nausea
diarrhoea
vomiting
constipation
rash or skin eruptions (exanthema)
pain in your joints (arthralgia) or muscles (myalgia)
back pain
feeling dizzy or faint when you stand up suddenly
(orthostatic hypotension)

swelling (typically in ankles or feet) caused by fluid
retention (oedema)
tiredness
vivid dreams
confusion
feeling anxious
sleeping problems
Uncommon (may affect up to 1 in 100 people):
abnormal sensation in the skin e.g. burning, stinging,
tickling or tingling (paraesthesia)
restless legs
fainting (syncope)
sensations of numbness in the mouth (oral
hypoaesthesia)
low blood pressure
nightmares
feeling agitated
hallucinations
urge to move
Rare (may affect up to 1 in 1,000 people):
muscle twitching or contractions (myoclonus)
aggression
abdominal pain and nausea; this may suggest
inflammation of the pancreas (pancreatitis)
Not known (frequency cannot be estimated
from the available data):
abnormal sensations in the mouth (oral paraesthesia)
swelling in the mouth (mouth oedema)
swelling throughout the body (generalized oedema)
localized swelling
hyponatraemia
inappropriate anti-diuretic hormone secretion
severe skin reactions (dermatitis bullous, erythema
multiforme)
sleep walking (somnambulism)
speech disorder
Additional side effects in children and adolescents
In children under 18 years the following adverse events
were observed commonly in clinical trials: significant
weight gain hives and increased blood triglycerides.
Reporting of side effects
If you get any side effects, talk to your doctor or
pharmacist. This includes any possible side effects not
listed in this leaflet. You can also report side effects
directly via the Yellow Card Scheme Website:
www.mhra.gov.uk/yellowcard
By reporting side effects you can help provide more
information on the safety of this medicine.

5. How to store Mirtazapine SolTab
KEEP OUT OF THE SIGHT AND REACH OF
CHILDREN.
Do not use Mirtazapine SolTab after the ‘Use by’ date on
the push through strip and pack.
Store in the original package in order to protect from light
and moisture.
If the tablets become discoloured or show signs of
deterioration, you should seek the advice of your
pharmacist.
6. Contents of the pack and other information
What Mirtazapine SolTab contains
Each tablet contains 30mg mirtazapine, which is an
antidepressant, as the active ingredient.
The other ingredients are sugar spheres, hypromellose,
povidone K30, magnesium stearate, basic butylated
methacrylate copolymer, aspartame (E951), anhydrous
citric acid, crospovidone (type A), mannitol (E421),
microcrystalline cellulose, natural and artificial orange
flavour (No. SN027512) and sodium hydrogen carbonate.
What Mirtazapine SolTab looks like and contents of
the pack
Mirtazapine SolTab is round, white, standard
bevelled-edge orodispersible tablet imprinted ‘TZ2’ on
one face.
Mirtazapine SolTab is packed in child-resistant perforated
unit dose blister strip.
Mirtazapine SolTab comes in packs of 30 orodispersible
tablets.
Manufactured by: N.V. Organon, Kloosterstraat 6,
5349 AB Oss, The Netherlands.
Procured from within the EU and repackaged by the
Product Licence holder: B&S Healthcare, Unit 4,
Bradfield Road, Ruislip, Middlesex, HA4 0NU, UK.
Mirtazapine SolTab® 30mg orodispersible Tablets
PL18799/1254
POM
Leaflet date: 16.06.2016
Mirtazapine, SolTab are registered trademarks of Merck
Sharp and Dohme.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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