Mirtazapin Hexal (Mirtazapine)

Mirtazapine works by blocking presynaptic α2‑adrenergic receptors, which leads to increased release of norepinephrine and serotonin. It also antagonizes 5‑HT2 and 5‑HT3 receptors while stimulating 5‑HT1 receptors, and blocks H1 histamine receptors, producing its antidepressant and sedative effects.

The dose of Mirtazapin Hexal is individualized by the prescribing clinician based on the patient’s clinical condition, response, and tolerability. The prescriber determines the appropriate starting dose and any subsequent adjustments.

Safety of mirtazapine in pregnancy and lactation has not been definitively established. Clinicians should weigh the potential benefits against possible risks and consider alternative therapies when treating pregnant or nursing individuals.

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Mirtazapine belongs to the NaSSA class, differing from SSRIs and SNRIs that primarily inhibit serotonin or serotonin‑norepinephrine reuptake. Its strong antihistamine activity often results in sedation and weight gain, which can be advantageous for patients with insomnia or loss of appetite, whereas SSRIs are generally less sedating.

Store the tablets at ambient temperature, preferably below 25 °C. Keep them in the original container, protect from moisture and light, and keep out of reach of children. Do not store in humid or excessively hot environments.

Mirtazapin Hexal is taken orally, usually once daily in the evening due to its sedative effect. It may be swallowed with or without food, but consistent administration with respect to meals helps maintain stable absorption.

Serious risks include the emergence or worsening of suicidal thoughts, especially early in treatment, serotonin syndrome when combined with other serotonergic drugs, severe neutropenia or agranulocytosis, and rare hypersensitivity reactions such as Stevens‑Johnson syndrome.

Mirtazapin Hexal should be avoided in patients with known hypersensitivity to mirtazapine, those currently taking monoamine oxidase inhibitors, or individuals with severe hepatic impairment unless the prescriber decides the benefit outweighs the risk.