济民药业,关爱无限 www.pidrug.com
香港济民药业微信二维码
198 9654 1773
当前位置:首页 > 药品资讯 > 精神科 > 米氮平片mirtazapine

米氮平片mirtazapine

[ 人气:100 | 日期: 2020-08-04 | 返回 | 打印 ]
米氮平片mirtazapine
药品名称:米氮平片mirtazapine
药品别名:米氮平片/米氮平口腔崩解片/瑞美隆(REMERON)
英 文 名:mirtazapine
药品价格:$ 美国市场售价 8.9 美元
研发公司:
适 用 症:用于抑郁症治疗
型号规格:每片含有效成份15mg/30mg/45mg三种规格,每瓶30片装
药品详情:

【米氮平片mirtazapine 简述】
 
    米氮平片mirtazapine又名米氮平片/米氮平口腔崩解片/瑞美隆(REMERON),可改善抑郁症状以及患者睡眠结构,提高睡眠质量;较少引起性功能障碍,提高患者依从性;使用方便、较少药物相互作用、耐受性好。


米氮平片mirtazapine_香港济民药业

 
 
【米氮平片mirtazapine 适应症】
 
    本品适用于抑郁症治疗。
 
【米氮平片mirtazapine 规格】
 
    本品为片剂,每片含有效成份15mg/30mg/45mg三种规格,每瓶30片装。
 
【米氮平片mirtazapine 服用方法】
 
    每日一次,有效剂量通常为每日15~45mg。治疗起始剂量应为15mg或30mg。
 
【米氮平片mirtazapine 注意事项】
 
    警告:
 
    临床症状的恶化和自杀风险:
 
    患有抑郁症的成年和儿童患者,无论是否服用抗抑郁药物,他们的抑郁症都有可能恶化,并有可能出现自杀意念和自杀行为以及行为异常变化,这种风险一直会持续到病情发生明显缓解时为止。已知抑郁和某些精神障碍与自杀风险有关,并且这些精神障碍本身为自杀的最强的预兆。然而,长期以来一直有这些的担忧:在某些患者治疗早期,抗抑郁药物可能对诱导抑郁症状恶化、以及产生自杀意念、行为中起着作用。抗抑郁药物(选择性5-羟色胺再摄取抑制剂和其他药物)短期安慰剂对照研究汇总分析显示,在患有抑郁症(MMD)和其他精神障碍的儿童、青少年和青年(18~24岁)中,与安慰剂相比,抗抑郁药物增加了产生自杀想法和实施自杀行为(自杀意念、行为)的风险。在短期的临床试验没有显示,在年龄大于24岁的成年人中,与安慰剂相比,使用抗抑郁药物会增加自杀意念、行为的风险;在年龄65岁及以上的成年人中,使用抗抑郁药物后,自杀意念、行为的风险有所降低。
 
    在患有抑郁症、强迫症(OCD)或其他精神障碍的儿童和青少年中进行的安慰剂对照试验(共计24项短期临床试验,9种抗抑郁药物,包括4400例患者)和在患有抑郁症或其他精神障碍的成年患者中进行的安慰剂对照试验(共计295项短期临床试验,中位持续时间为2个月,11种抗抑郁药物,约77000例患者)中,各种药物引起的自杀意念、行为的风险有很大的差异,但大部分的药物研究显示在较年轻患者有自杀风险增加的趋势。在各个不同的适应症中,自杀意念、行为的绝对风险不同,在抑郁症中的绝对风险最高。虽然在各个适应症中的绝对风险有所不同(药物与安慰剂相比),但是,在不同适应症的年龄层中风险相对稳定。表3提供了风险差异(每1000名患者中药物和安慰剂治疗产生的自杀意念、行为风险差异的例数)。
 
【米氮平片mirtazapine 不良反应】
 
    全身:常见: 不适、腹痛、急腹症;偶见: 寒战、发热、面部水肿、溃疡、光敏反应、颈强直、颈部疼痛、腹胀;罕见: 蜂窝组织炎、胸痛(胸骨下)。
 
    心血管系统: 常见:高血压、血管舒张;偶见:心绞痛、心肌梗死、心动过缓、室性期外收缩、晕厥、偏头痛、低血压;罕见:房性心律失常、二联律、血管性头痛、肺栓塞、脑缺血、心脏扩大、静脉炎、左心功能衰竭。
 
    消化系统: 常见:呕吐、厌食;偶见:嗳气、舌炎、胆囊炎、恶心和呕吐、牙龈出血、口腔炎、结肠炎、肝功能检查异常;罕见:舌变色、溃疡性口腔炎、唾液腺肥大、流涎增加、肠梗阻、胰腺炎、口疮性口腔炎、肝硬化、胃炎、胃肠炎、口腔念珠菌病、舌肿胀。
 
    内分泌系统:罕见: 甲状腺肿、甲状腺功能减退。
 
    血液和淋巴系统:罕见:淋巴结病、白细胞减少症、瘀点、贫血、血小板减少症、淋巴细胞增多症、全血细胞减少症。
 
    代谢和营养异常:常见:口渴;偶见: 脱水、体重减轻;罕见:痛风、天门冬氨酸氨基转移酶(AST)升高、伤口愈合异常、酸性磷酸酶升高、丙氨酸氨基转移酶(ALT)升高、糖尿病、低钠血症。
 
    肌肉骨骼系统:常见:肌无力、关节痛;偶见:关节炎、腱鞘炎;罕见:病理性骨折、骨质疏松性骨折、骨痛、肌炎、肌腱断裂、关节病、滑囊炎。
 
    神经系统: 常见:感觉减退、情感淡漠、抑郁、运动功能减退、眩晕、颤搐、激越、焦虑、健忘、运动机能亢进、感觉异常;偶见:共济失调、谵妄、错觉、人格解体、运动障碍、锥体外系综合征、性欲增强、协调能力异常、构音障碍、幻觉、躁狂反应、神经官能症、肌张力障碍、敌对行为、反射增强、情绪不稳定、欣快症、偏执狂样反应;罕见: 失语症、眼球震颤、静坐不能(精神运动性坐立不安)、木僵、痴呆、复视、药物依赖、麻痹、癫痫大发作、肌张力减退、肌阵挛、精神病性抑郁症、停药综合征、5-羟色胺综合征。
 
    呼吸系统: 常见:咳嗽增多、鼻窦炎;偶见:鼻衄、支气管炎、哮喘、肺炎;罕见: 窒息、喉炎、气胸、呃逆。
 
    皮肤:常见:瘙痒、皮疹;偶见:痤疮、剥脱性皮炎、皮肤干、单纯疱疹、脱发;罕见: 荨麻疹、带状疱疹、皮肤增生、脂溢性皮炎、皮肤溃疡。
 
    特殊感觉: 偶见:眼痛、调节异常、结膜炎、耳聋、角膜结膜炎、流泪障碍、青光眼、 听觉过敏、耳痛;罕见:睑炎、部分暂时性耳聋、中耳炎、味觉丧失、嗅觉倒错。
 
    泌尿生殖系统:常见:泌尿道感染;偶见:肾结石、膀胱炎、排尿困难、尿失禁、尿潴留、阴道炎、血尿、乳房疼痛、闭经、痛经、白带、阳痿;罕见:多尿、尿道炎、子宫不规则出血、月经过多、异常射精、乳房充血、乳房增大、尿急。

mirtazapine

 
Mirtazapine, sold under the brand name Remeron among others, is an antidepressant primarily used to treat depression.[7][8] Its full effect may take more than four weeks to occur, with some benefit possibly as early as one to two weeks.[9][8] Often it is used in depression complicated by anxiety or trouble sleeping.[7][10] It is taken by mouth.[8]
 
Common side effects include increased weight, sleepiness, and dizziness.[8] Serious side effects may include mania, low white blood count, and increased suicide among children.[8]Withdrawal symptoms may occur with stopping.[11] It is not recommended together with an MAO inhibitor.[8] It is unclear if use during pregnancy is safe.[8] How it works is not clear but may involve blocking certain adrenergic and serotonin receptors.[7][8] Chemically, it is a tetracyclic antidepressant (TeCA).[8] It also has strong antihistamine effects.[7][8]
 
Mirtazapine came into medical use in the United States in 1996.[8] The patent expired in 2004, and generic versions are available.[12][8] In the United States the wholesale cost as of 2018 is about US$3 per month.[13] In the United Kingdom a month supply costs less than 20 pounds per month.[11] In the United States about 5.5 million prescriptions were written for mirtazapine in 2016.[14]
 
Medical uses
 
Mirtazapine is primarily used for major depressive disorder and other mood disorders.[15][16]Onset of action appears faster than some SSRIs and similar to tricyclic antidepressants.[17][9]
There is also some tentative evidence following conditions and is sometimes prescribed off-label for their treatment:
§  Generalized anxiety disorder[7][18]
§  Social anxiety disorder[19]
§  Obsessive–compulsive disorder[19]
§  Panic disorder[19]
§  Post-traumatic stress disorder[19]
§  Low appetite/underweight[20][21][22]
§  Insomnia[23][24]
§  Nausea and vomiting[10][25][26]
§  Itching[27][28]
§  Headaches and migraine[25][29][30]
 
Effectiveness and tolerability
 
In 2010 NICE published a guideline for treating depression that included a review of antidepressants. It recommended generic SSRIs as first line choices, as they are "equally effective as other antidepressants and have a favourable risk–benefit ratio."[31] With respect to mirtazapine, it found: "There is no difference between mirtazapine and other antidepressants on any efficacy measure, although in terms of achieving remission mirtazapine appears to have a statistical though not clinical advantage. In addition, mirtazapine has a statistical advantage over SSRIs in terms of reducing symptoms of depression, but the difference is not clinically important. However, there is strong evidence that patients taking mirtazapine are less likely to leave treatment early because of side effects, although this is not the case for patients reporting side effects or leaving treatment early for any reason."[32]
A 2011 Cochrane review that compared mirtazapine to other antidepressants, found that while it appears to have a faster onset in people for whom it works (measured at 2 weeks), it is about the same as other antidepressants at 6 weeks.[9]
 
A 2012 review focused on antidepressants and sleep found that in many people with sleep disorders caused by depression, mirtazapine reduces the time it takes to fall asleep and increases the quality of sleep, but that in some people it can disturb sleep, especially at higher doses, causing restless leg syndrome in 8 to 28% of people and in rare cases causes REM sleep behavior disorder.[33]
 
A 2018 analysis of 21 antidepressants found them to be fairly similar overall.[34] It found tentative evidence for mirtazapine being in the more effective group and middle in tolerability.[34]
After one week of usage, mirtazapine was found to have an earlier onset of action compared to SSRIs.[17][35]
 
 
Overdose
 
Mirtazapine is considered to be relatively safe in the event of an overdose,[35] although it is considered slightly more toxic in overdose than most of the SSRIs (except citalopram).[52] Unlike the tricyclic antidepressants, mirtazapine showed no significant cardiovascular adverse effects at 7 to 22 times the maximum recommended dose.[42] Case reports of overdose with as much as 30 to 50 times the standard dose described the drug as relatively nontoxic, compared to tricyclic antidepressants.[53][54]
Twelve reported fatalities have been attributed to mirtazapine overdose.[55][56] The fatal toxicity index (deaths per million prescriptions) for mirtazapine is 3.1 (95% CI: 0.1 to 17.2). This is similar to that observed with SSRIs.[57]
 
 




注:药品如有新包装,以新包装为准。以上资讯仅供医护人员内部讨论,不作任何用药依据,具体用药指引,请咨询主治医师。

更多相关资讯:返回顶部
最新药品资讯
  • Venclyxto(维奈妥拉)联合MabThera治疗慢淋白血病,患者死亡风险降低!
  • Tagrisso(Osimertinib)在英国获批用于两种肺癌适应症的治疗
  • ziritaxestat治疗弥漫性皮肤系统性硬化症(dcSSc)2期概念验证研究成功!
  • 美国FDA批准GSK三联疗法:可同时治疗哮喘和慢阻肺
  • NBIb-1817一次性治疗帕金森病(PD)显著改善运动功能、延长ON时间
  • 口服抗生素tebipenem HBr治疗cUTI和AP关键III期临床成功,疗效不劣于ertapenem
  • 下一代选择性免疫调节剂IMU-838治疗多发性硬化症(RRMS)具有显著疗效,有良好的安全性和耐受性!
  • Fintepla(芬氟拉明)口服溶液治疗Dravet综合征相关癫痫的第三项3期研究结果:抽搐发作显著减少
  • 视神经脊髓炎谱系障碍(NMOSD)创新药Enspryng(satralizumab)获美FDA批准
  • Fasenra与标准类固醇同时治疗鼻息肉三期临床结果积极
  • Darzalex Faspro申请新适应症,治疗轻链(AL)淀粉样变性!
  • 地诺单抗(Xgeva,denosumab)治疗实体瘤骨转移疗效怎样?
  • 新药IDH1抑制剂Tibsovo治疗胆管癌效果怎么样?
  • 拜耳Nubeqa(达罗他胺)治疗非转移性去势抵抗性前列腺癌显著延长患者生存!
  • FDA对罗氏Tecentriq治疗三阴性乳腺癌研究发出警告!
  • 加码多发性硬化症!罗氏启动三项临床试验研究
  • Xeglyze说明书-价格-功效与作用-副作用
  • 赛诺菲/再生元Dupixent(达必妥®)显著延缓哮喘患者肺功能下降:疗效维持3年!
  • 默沙东止咳药gefapixant2项关键III期临床试验成功:咳嗽频率显著降低
  • Ryplazim(纤溶酶原)再次申请上市:首个先天性纤溶酶原缺乏症(C-PLGD)治疗药物!
  • 拜耳Adempas用于经PDE5i治疗反应不足的肺动脉高压(PAH)患者IV期临床成功
  • Midostaurin(米哚妥林)适应症是什么?优势在哪里?
  • 艾普利Apixaban可以在哪里买到正品?
  • 维奈妥拉/维奈托克(VENETOCLAX)怎么服用?注意事项是什么?
  • 芦可替尼Ruxolitinib治疗特应性皮炎效果好不好?
  • 巯嘌呤片(6-MP)Puri-nethol治疗急性白血病效果如何?
  • 晚期HCC患者能从Ramucirumab中获益吗?
  • 赫赛汀+拉帕替尼治疗乳腺癌效果更好
  • 欧盟批准Imfinzi(英飞凡):一线治疗广泛期小细胞肺癌(ES-SCLC)!
  • 第三代强效COMT抑制剂Ongentys(opicapone)用于治疗帕金森病(PD)的新药在日本上市!


  • 如您发现本网站有文字编辑或内容错误,请点击此处发送(需要安装有foxmail或outlook支持),


    或发邮件至:info@morecare.hk,香港济民药业感谢您的到访!


    欢迎您添加香港济民药业微信,或在公众号内留言。

    香港济民微信公众号
    • 香港济民药业友情链接
    • 友情链接

    联系我们:

    地址:
    Rm. 314, Sun Ling Plaza, 30 On Kui Street, Fanling, HONG KONG
    邮箱:
    info@pidrug.com
    电话:
    198 9654 1773
    粤ICP备17150936号
    香港济民药业官方网站
    • 关注我们 :
    • 香港济民药业微博
    • 关注香港济民药业博客
    • 香港济民药业微信公众号