Soltab

Soltab (Mirtazapine) is used to treat depression. Mirtazapine is an antypical antidepressant. Doctors prescribe Soltab to patients diagnosed with major depressive disorder. Like most antidepressant drugs, the exact mechanism of action of Mirtazapine is unknown.

Soltab is a prescription medicine and must be used only with doctor’s supervision. Again like most antidepressants, use of Soltab is associated with suicidal behavior. Patients using Soltab must constantly be monitored and frequently seen by the doctor. 

The doctor will consider the following before prescribing Soltab

Allergies

Tell the doctor if you experienced allergies or sensitivities to Soltab or Mirtazapine before. You cannot take Soltab if you are allergic to it.

Drug interactions

Many drugs interact with Soltab and cause serious adverse effects. Certain drugs should not be used together with Soltab. Tell your doctor if you took the following medicines recently for the past 14 days, which should not be taken with Soltab:

• Tryptophan or supplements with L-tryptophan
• MAO inhibitors such as Linezolid, Isocarboxazid, Methylene blue injection, Phenelzine, Rasagiline, Selegiline, Tranylcypromine, and others

Tell the doctor if you are taking the following medicines before taking Soltab. These medicines may require adjustment of your dose and closer monitoring:

• Triptans such as Almotriptan, Rizatriptan, Sumatriptan, and Zolmatriptan, and other medicines used to treat migraines
• Tricyclic antidepressants such as Amitryptiline, Amoxapine,  Desipramine, Doxepin, Imipramine, Trimipramine and Protriptyline
• St. John’s wort
• Fentanyl
• Lithium medications
• Tramadol
• Buspirone

Risk of suicide

Soltab and many medicines used to treat depression are associated with suicidal behavior. Note that individuals who are depressed may already have thoughts about suicide before taking Soltab. Tell the doctor if you experienced thoughts of self-harm or have suicide attempts before. Patients taking Soltab should be monitored closely, and they must be seen by the doctor regularly to check their progress.

Use on children

Soltab cannot be given to patients below 18 years old.

Use on elderly

Soltab can be given to elderly patients, but they may need closer monitoring due to the risk of kidney problems.

Health problems

Make sure to tell the doctor all your health conditions before taking Soltab. The doctor needs to know if you have any of the following health conditions before taking Soltab:

• Phenylketonuria, as orally-disintegrating Soltab tablets contains phenylalanine
• Liver disease
• Kidney disease
• Heart disease
• Chest pain or angina
• History of heart attack or stroke
• Having bipolar disorder or manic-depressive disorder
• Seizures or epilepsy
• Low blood pressure
• Spells of lightheadedness or fainting
• Elevated cholesterol or triglycerides
• History of drug abuse
• History of suicidal thoughts or behavior

Use of alcohol

You cannot take alcohol if you are taking Soltab. Alcohol may enhance the risk of side effects of Soltab.

Pregnancy

If you are pregnant, make sure to tell it to the doctor before taking Soltab. Soltab is an FDA pregnancy category C dru, which means it is not proven completely safe for pregnant patients.

Breastfeeding

When taking Soltab, call the doctor first before breastfeeding. It is not well known if Soltab can be expressed into breast milk. 

Soltab is available in tablets that you take by mouth. Follow doctor’s instructions in taking Soltab. Soltab is usually taken once a day at bedtime. You can take Soltab with or without food.

Soltab is available in regular tablets and orally-disintegrating tablets. Take regular Soltab tablets with water.

The doctor may prescribe you to take orally-disintegrating tablets. Here are the instructions in taking them:

• Do not open the blister pack unless you are ready to take them.
• Open and peel back the foil to expose the tablet. Avoid pushing the tablet through the foil, which will crush the tablet.
• With dry hands, place the tablet in your mouth.
• Allow the tablet to dissolve in the mouth without chewing. You can drink a liquid to swallow the dissolved tablet.

Note that you need to take Soltab for several weeks before you can feel its effects.

If you missed a dose of Soltab, take a dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and stick to regular dosing. Do not increase the dose of Soltab to make up for the missed dose.

You can overdose if you take too much Soltab tablets. Symptoms of overdose include confusion, memory problems, drowsiness, and rapid heart rate. If this happens, call emergency medical services right away.

Do not discontinue taking Soltab without doctor’s approval.

Store Soltab at room temperature away from moisture, heat, and light.

You must visit your doctor regularly when taking Soltab to check your progress and detect early signs of side effects. Make sure to keep up with clinic visits and lab tests.

Mirtazapine may impair your senses and lower reaction times. Do not drive or perform dangerous tasks after taking Mirtazapine.

Do not drink alcohol while you are having treatment with Soltab.

Call the doctor right away if you experience thoughts of harming yourself or having suicidal attempts.

When you are taking Soltab, do not take any other medication unless ordered by the doctor. 

Mirtazapine may cause side effects that require medical attention. Call your doctor right away if you experience any of the following symptoms:

• Severe allergic reaction symptoms such as skin rash, hives, itching, swelling of the mouth, throat, nose, or face
• Possible symptoms of reduced white blood cell counts such as sudden weakness or illness, fever, chills, sore throat, mouth sores, redness or swelling of gums, and trouble swallowing.
• Symptoms of possible serotonin syndrome such as agitation, hallucinations, fever, rapid heartbeats, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, and fainting.
• Symptoms of too low sodium levels such as headache, confusion, slurring of speech, severe weakness, vomiting, loss of coordination, and unsteadiness.
• Severe nervous system reaction symptom such as very stiff muscles, high fever, sweating, confusion, rapid or uneven heartbeats, tremors, and feeling of about to faint.
• Worsening depression
• New symptoms such as changes in mood or behavior, anxiety, panic attacks and insomnia
• Feelings of impulsiveness, irritation, agitation, hostility, aggression, restlessness, hyperactive thoughts and behavior
• Thoughts of suicide or hurting yourself
• Racing thoughts, reduced need for sleep, engaging in risky behaviors, feelings of extreme happiness or sadness,
• Blurring or having tunnel vision, eye pain or swelling, or seeing halos around lights
• Lightheadedness
• Changes in weight or appetite
• Appearance of rash, blisters or severe pain in the palms of the hands or soles of the feet.

Soltab may cause the following side effects that are minor and not harmful to health:

• Drowsiness
• Dizziness
• Strange or vivid dreams
• Changes in vision
• Dryness of the mouth
• Constipation
• Increased appetite
• Gaining weight