Drugs Blog

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Dosage is individualized. Take exactly as prescribed.
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Do not stop taking or change the dose unless directed by your doctor.
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Maprotiline - May be given as a single daily dose or in divided doses.
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Mirtazapine - Take in a single dose, preferably at bedtime. May be taken without regard to food.
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Remeron SolTabs- Open tablet blister pack with dry hands and place the tablet on the tongue. The tablet will disintegrate rapidly and can be swallowed with saliva. No water is needed. Do not chew the tablet, split the tablet, or store the tablet for later use.
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If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
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Avoid the use of alcohol, barbiturates, or other CNS depressants (eg, tranquilizers) while taking this medicine.
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Contact your doctor if you experience sore throat, fever, chills, mouth sores, or other signs of infection. Pay particular attention to any f1u­like symptoms or other symptoms that might suggest infection.
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May cause drowsiness or dizziness. Alcohol use may increase this effect. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
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Allow at least 14 days between discontinuation of an MAO inhibitor anti­depressant (eg, phenelzine) and the start of therapy with this medicine. Also, allow at least 14 days after stopping this medicine before starting an MAO inhibitor.
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Maprotiline has been associated with seizures. This risk is higher in patients with a history of seizures, in patients taking phenothiazines (eg, promethazine) or withdrawing from benzodiazepines (eg, alprazolam).
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Inform your doctor if you are pregnant, become pregnant, are plan to become pregnant, or are breastfeeding.
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Maprotiline - Beneficial effects are sometimes seen within 3 to 7 days, although 2 to 3 weeks are usually necessary.
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Mirtazapine - Beneficial effects may take 1 to 4 weeks to occur.
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Lab tests may be required to monitor therapy. Be sure to keep appointments.
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Store room temperature (59 to 86°F) in a tightly closed container, away from light and moisture.

Type of Drug:

Antidepressant; mood-elevating agent.

How the Drug Works:

The exact mechanism of action is not known. It is believed that tetracyclic antidepressants adjust or balance how the brain and nervous system produce and respond to natural chemicals (neurotransmitters) that elevate mood.

Uses:

Maprotiline: To treat depressive illness in patients with depressive neurosis (dysthymic disorder) and manic-depressive illness (major depressive episode).

Mirtazapine: To treat depression.

Unlabeled Uses: Maprotiline is also effective for the relief of anxiety associated with depression.

Precautions:

Do not use in the following situations:

Aallergy to the tetracyclic compound or any of its ingredients electroshock therapy, concurrent (maprotiline only)

Seizures: Maprotiline use has been associated with seizures. The risk is higher in patients with a history of seizures, in patients taking phenothiazines (eg, promethazine), or when benzodiazepines (eg, alprazolam) are being withdrawn.

Pregnancy: There are no adequate or well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: Maprotiline appears in breast milk. It is not known if mirtazapine appears in breast milk. Consult your doctor before you begin breast­feeding.

Children: Safety and effectiveness in children (younger than 18 years of age for maprotiline) have not been established.

Elderly: The elimination of mirtazapine is reduced in elderly patients. In general, lower doses of maprotiline are recommended for patients older than 60 years of age. Use with caution in elderly patients.

Lab Tests: Lab test may be required periodically during treatment. Lab tests may include blood counts and enzyme levels.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or are planning to take any over-the-counter or prescription medications or dietary supplements while taking a tetracyclic compound. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with tetracyclic compounds:

• Alcohol
• Barbiturates (eg, phenobarbital)
• Benzodiazepines (eg, alprazolam)
• MAOI antidepressants (eg, phenelzine)
• phenothiazines (eg, promethazine)

Side Effects:

Every drug is capable of producing side effects. Many tetracyclic com­pound users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; vomiting; constipation; dry mouth; thirst; increased appetite; stomach pain; indigestion.

Nervous System: Confusion; anxiety; agitation; abnormal thinking; nervous­ness; tremor; twitching; drowsiness; clumsiness; dizziness; vertigo (feeling of whirling motion); weakness; fatigue; tiredness; sleeplessness; headache; abnormal dreams; increased sensitivity; apathy; depression; memory loss; numbness or tingling in the hands or feet.

Respiratory System: Difficulty breathing; cough; sinus problems: wheezing.

Circulatory System: Rapid heart rate; irregular heartbeat; increased cholesterol and triglyceride levels; increased blood pressure; low blood pressure on arising.

Skin: Rash; itching; hives; acne; dry skin; flushing; redness; hair loss. Other: Flu syndrome; general body discomfort; swelling in the hands or feet; blurred vision; muscle, joint, or back pain; frequent urination; urinary tract infection.

Type of Drug:

Antidepressant; mood-elevating agent.

How the Trazodone Works:

It is not known how trazodone works to relieve depression. It is believed trazodone modifies the chemical balance in the brain, which changes behavior. It does not stimulate the brain.

Uses of The Trazodone:

To relieve mental depression.

Unlabeled Uses: Occasionally doctors may prescribe trazodone for cocaine withdrawal, to manage aggressive behavior when used with other medications, and to treat patients with panic disorder or agoraphobia (fear of open or public places) with panic attacks.

Precautions:

Do not use in the following situations: Allergy to trazodone or any of its ingredients.

Priapism: If you experience prolonged or painful penile erection, discontinue use immediately and consult your doctor. Permanent damage of normal penis function and impotence have occurred.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if trazodone appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children younger than 18 years of age have not been established.

Lab Tests: Lab tastes may be required to monitor therapy. Tests include blood counts.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements with trazodone. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with trazodone:

• Anesthetics CNS depressants (eg, alcohol, barbiturates, narcotics)
• Digoxin (eg, Lanoxin)
• Phenytoin (eg, dilantin)
• Warfarin (eg, Coumadin)

Side Effects of Trazodone:

Every drug is capable of producing side effects. Many trazodone users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Upset stomach; nausea; vomiting; diarrhea; constipation; decreased appetite; dry mouth.

Nervous System: Anger; hostility; sleeplessness; nightmares or vivid dreams; confusion; disorientation; decreased concentration; dizziness; drowsiness; excitement; fatigue; headache; tremor; impaired memory; nervousness; incoordination; lightheadedness.

Circulatory System: Changes in blood pressure; pounding in the chest; fast heartbeat.

Senses: Ringing in the ears; blurred vision; red, tired, itching eyes; nasal or sinus congestion.

Other: Shortness of breath; weight changes; swelling; aches and pains; fainting; bad taste in the mouth; abnormal skin sensations; general body discomfort; feeling of heaviness or fullness in the head; prolonged painful erection; decreased sex drive; clamminess; sweating; orthostatic hypotension (dizziness or lightheadedness when rising from a sitting or lying position).

Guidelines for Use:

• Dosage is individualized.
• Dosage will be initiated at a low level and increased gradually by your doctor.
• Take shortly after a meal or snack.
• If a dose is missed, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If more than one dose is missed, or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• May cause drowsiness, dizziness, or blurred vision. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
• Avoid alcohol or other drowsiness-causing medications (eg, antihistamines, barbiturates, narcotic pain relievers) while taking trazodone.
• Notify your doctor if you experience drowsiness, sore throat, fever, or any signs of infection.
• Male patients with prolonged and painful erections (priapism) should immediately discontinue the drug and consult their doctor.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store at controlled room temperature (59 0 to 86°F).

Above and beyond being the obvious cause of heart disease, stroke and lung cancer, the reasons for quitting cigarette smoking are becoming even clearer. There are many health conditions that have been directly linked over the past few years to cigarette smoking. If you smoke or have someone in your family who does, you should make sure that they’re aware of these other important reasons to quit - among the most prominent being that it will be more difficult to get a life insurance quote or policy. Reading this may just be the kick in the pants they need to stop harming themselves and those around them.

People who smoke often have a hard time getting a good night sleep. A recent study in Chest magazine reported that smokers are 4 times more likely to have a hard time getting to sleep and not having a restorative rest, than those who don’t smoke. Nicotine was found to be the main factor in this condition and researchers said that the stimulant properties of the drug also had another effect on the smoker’s body by sending the person’s system into nicotine withdrawal during the night. Not getting enough sleep affects your health, so that’s just one more reason to quit smoking.

Smokers Are At Risk

Smoking also helps to break down the body’s ability to fight off infections. The Advisory Committee on Immunization Practices recommended recently that smokers between 19 and 64 years of age be added to a short list of pneumococcal vaccine candidates. The reason for the recommendation was that smokers are far more susceptible to infection risk caused by pneumonia-causing bacteria. Because smoking may damage the respiratory system, it becomes easier for infectious diseases to enter the body and cause disease.

Cigarette smoking does harm to the digestive system as well. This can cause peptic ulcers, heartburn and even gallstones to occur. Smokers also run a much higher risk of developing Crohn’s disease, a painful inflammation of the digestive tract. Smokers are also prone to skin problems causing far more premature wrinkling of the skin including areas of the face, inner arms and even the buttocks.