What Remeron is and who it is for

Remeron is the brand name for mirtazapine, an antidepressant used primarily for major depressive disorder. It can help improve sleep and appetite and reduce anxiety symptoms associated with depression. Some clinicians may use it off-label for conditions such as insomnia related to depression, generalized anxiety, or appetite stimulation when clinically appropriate.

The strengths commonly dispensed include 7.5 mg, 15 mg, and 30 mg tablets. Your prescriber will select a dose based on your health status, age, and symptoms. For quick navigation, jump to alternatives and prices or USA legal guidance.

What should I tell my health care provider before I take this medicine?

Before starting, share your full medical history and current medications. Tell your prescriber if any of the following apply:

  • Any unusual or allergic reactions to mirtazapine, medicines, foods, dyes, or preservatives
  • Thoughts of suicide or a prior suicide attempt
  • Kidney problems or liver disease
  • Pregnant, planning pregnancy, or trying to conceive
  • Breast-feeding
  • Bipolar disorder or a history of manic episodes

Pediatric use: Discuss carefully with a pediatrician. Safety and dosing for children or adolescents require specialist oversight.

How should I use this medicine?

Take by mouth with water, preferably in the evening since drowsiness is common. Follow the exact directions on your prescription label. Take doses at regular intervals and do not change your dose or stop abruptly unless your doctor tells you to. If you and your prescriber decide to stop, the dose is usually tapered.

Overdose: If you suspect an overdose, call a poison control center (1-800-222-1222 in the USA) or seek emergency care immediately.

It may take 1 to 4 weeks to notice meaningful improvement. Do not be discouraged if you do not feel better right away. For specific questions about drug interactions, see interactions.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is less than 4 hours before your next scheduled dose. If it is close to your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at once.

What may interact with this medicine?

Do not take mirtazapine with the following:

  • Tryptophan supplements
  • MAO inhibitors such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), selegiline (Eldepryl, Carbex)
  • St. John's wort products
  • Procarbazine

Other interactions that require caution include:

  • Medicines for depression, anxiety, or psychosis, as combining serotonergic drugs can raise serotonin syndrome risk

This is not a complete list. Provide your prescriber with a full list of prescription drugs, OTC medicines, vitamins, and herbal supplements. Also mention alcohol, tobacco, or recreational drug use, as these can affect how mirtazapine works.

What should I watch for while using this medicine?

Keep regular follow-up appointments. It can take several weeks for the full effect. Inform your clinician promptly about new or worsening depression or suicidal thinking, especially when starting or after dose changes.

Monitor for sudden changes in mood or behavior such as anxiety, agitation, panic, irritability, hostility, aggression, impulsivity, severe restlessness, hyperactivity, or insomnia. If these occur, contact your clinician right away.

Mirtazapine can cause drowsiness or dizziness. Until you know how it affects you, avoid driving or using machinery. Stand up slowly to reduce the risk of lightheadedness or fainting, particularly if you are older. Alcohol can increase drowsiness and dizziness; it is best to avoid alcoholic drinks.

Dry mouth can occur. Sugarless gum, lozenges, and adequate water intake may help. If severe or persistent, consult your doctor.

What side effects may occur?

Call your doctor right away or seek urgent care for serious effects such as:

  • Unusual bruising or bleeding
  • Swelling of the hands or feet
  • High fever, sore throat, or mouth ulcers and blisters
  • Severe stomach pain with nausea and/or vomiting
  • Allergic reactions: rash, hives, itching, swelling of face, lips, or tongue
  • Breathing problems
  • Confusion or major mood changes, including suicidal thoughts
  • Extreme tiredness or weakness out of proportion to activity
  • Vomiting that does not stop
  • Flu-like symptoms such as chills, cough, muscle or joint aches

Common effects that are usually mild and may not need medical care unless persistent or bothersome include:

  • Weight gain
  • Constipation
  • Increased appetite

If you have questions about side effects, contact your prescriber or pharmacist. For life-threatening reactions, call 911.

Where should I keep my medicine?

Store at room temperature, 15 to 30 degrees C (59 to 86 degrees F), protected from moisture and light. Keep out of reach of children and pets. Dispose of unused or expired medicine according to local guidelines; do not flush unless instructed. Many pharmacies and communities offer take-back programs.

Alternatives, similar medicines, and USA price overview

Some patients may respond better to different antidepressants. Therapeutically similar or alternative options include:

  • SSRIs: sertraline, escitalopram, fluoxetine, paroxetine, citalopram
  • SNRIs: venlafaxine, desvenlafaxine, duloxetine, levomilnacipran
  • Other options: bupropion, trazodone, vortioxetine, vilazodone
  • Augmentation strategies when appropriate: lithium, certain atypical antipsychotics, psychotherapy

Very rough USA retail price ranges without insurance (may vary widely by pharmacy, discount cards, and strength):

  • Mirtazapine generic: about $6 to $25 for 30 tablets of 15 mg; $8 to $35 for 30 tablets of 30 mg
  • Brand Remeron: commonly $200 to $450 for 30 tablets depending on strength
  • Sertraline generic: roughly $4 to $15 for 30 tablets of common strengths
  • Escitalopram generic: about $6 to $20 for 30 tablets
  • Venlafaxine ER generic: around $10 to $40 for 30 capsules
  • Duloxetine generic: typically $8 to $35 for 30 capsules
  • Bupropion SR/XL generic: about $8 to $30 for 30 tablets

Note: Insurance copays, manufacturer coupons, and pharmacy discount programs can reduce out-of-pocket costs substantially. Ask your pharmacist to price-check several options. For legal considerations around purchasing, see USA legal notes.