It is important that your doctor check your progress at regular visits, to allow for changes in your dose and to help reduce any side effects.

Do not take mirtazapine with monoamine oxidase (MAO) inhibitors (e.g., furazolidone, phenelzine, procarbazine, selegiline, or tranylcypromine) or sooner than 14 days after stopping an MAO inhibitor. Do not take an MAO inhibitor sooner than 14 days after stopping mirtazapine. To do so may increase the chance of serious side effects.

Mirtazapine may cause some people to be agitated, irritable or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these adverse effects, tell your doctor right away.

REMERON may add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are taking REMERON.

Check with your doctor immediately if you develop fever, chills, sore throat, or sores in the mouth. These may be signs of a very serious blood problem that has occurred rarely in patients taking mirtazapine.

Mirtazapine may cause drowsiness or trouble in thinking. Make sure you know how you react to REMERON before you drive, use machines, or do other jobs that require you to be alert and clearheaded.

Dizziness, light-headedness, or fainting may occur , especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

REMERON may cause dryness of the mouth. For temporary relief, use sugarless gum or candy, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth feels dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• Rare
  • Convulsions (seizures);  mouth sores ;  sore throat, chills, or fever 
  
  

Also, check with your doctor as soon as possible if any of the following side effects occur:

• Less common
  • Decreased or increased movement;  mood or mental changes, including abnormal thinking, agitation, anxiety, confusion, and feelings of not caring;  shortness of breath;  skin rash;  swelling 
  
  

• Rare
  • Decreased sexual ability;  menstrual pain;  missing periods;  mood or mental changes, including anger, feelings of being outside the body, hallucinations (seeing, hearing, or feeling things that are not there), mood swings, and unusual excitement 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• More common
  • Constipation;  dizziness;  drowsiness;  dryness of mouth;  increased appetite;  weight gain 
  
  

• Less common
  • Abdominal pain;  abnormal dreams;  back pain;  dizziness or fainting when getting up suddenly from a lying or sitting position;  increased need to urinate;  increased sensitivity to touch;  increased thirst;  low blood pressure;  muscle pain;  nausea;  sense of constant movement of self or surroundings ;  trembling or shaking;  vomiting;  weakness 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.