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Commonly reported side effects of mirtazapine 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. See below for a comprehensive list of adverse effects.
For the ConsumerApplies to mirtazapine: oral tablet, oral tablet disintegrating
Oral route (Tablet; Tablet, Disintegrating)
Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults with major depressive disorder and other psychiatric disorders in short-term studies. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared with placebo in adults aged 65 or older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Mirtazapine is not approved for use in pediatric patients.
Along with its needed effects, mirtazapine 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 while taking mirtazapine:
Less common
Rare
Some side effects of mirtazapine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
For Healthcare Professionals
Applies to mirtazapine: oral tablet, oral tablet disintegrating
Nervous systemVery 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
GastrointestinalVery 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
MetabolicVery 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
PsychiatricCommon (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
CardiovascularCommon (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
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.
MusculoskeletalCommon (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
RespiratoryCommon (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
GenitourinaryCommon (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
OtherCommon (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
ImmunologicCommon (1% to 10%): Influenza/flu syndrome
Frequency not reported: Infection
DermatologicUncommon (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)
OcularRare (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
HepaticRare (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
RenalRare (0.01% to 0.1%): Kidney calculus, cystitis
HematologicVery 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
EndocrineVery rare (less than 0.01%): Goiter, hypothyroidism
Frequency not reported: Inappropriate antidiuretic hormone secretion
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/3/2022.
Source: Drugs.com Mirtazapine (www.drugs.com/mirtazapine.html).
May 24, 2022
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