Mirtazapine

(mir-taz-ah-peen)
Category: Tetracyclic Antidepressant; Antiemetic; Appetite Stimulant
Other Names for this Medication: Remeron®
Common Dosage Forms: Veterinary: None. Human: Oral Tablets: 7.5 mg, 15 mg, 30 mg, & 45 mg; Orally Disintegrating Tablets: 15 mg, 30 mg, & 45 mg. Dosages may need to be made (compounded) to accurately dose cats and small dogs.

This information sheet does not contain all available information for this medication. It is to help answer commonly asked questions and help you give the medication safely and

effectively to your animal. If you have other questions or need more information about this medication, contact your veterinarian or pharmacist.

Key Information

X May be given with or without food. If your animal vomits after receiving mirtazapine on an empty stomach,
give with food or treat to see if this helps. If vomiting continues, contact your veterinarian.

X Tolerated well in dogs. More side effects seen in cats and dosage may need to be adjusted if they occur. Common side effects include: vocalization, behavior changes, and tremors or shaking. Report excessive drowsiness or vocalization to your veterinarian.

X If your animal is receiving the orally disintegrating tablets, make sure hands are dry before handling the tablet. Place the tablet under the animal’s tongue and hold mouth closed for several seconds to allow it to dissolve (should occur quickly). After the tablet has melted, offer your animal water.

How is this medication useful?

In dogs and cats, mirtazapine may be useful as an appetite stimu- lant and to prevent vomiting and motion sickness.

The FDA (U.S. Food & Drug Administration) has approved this drug for use in humans, but it is not officially approved for use in ani- mals. The FDA allows veterinarians to prescribe products contain- ing this drug in different species or for other conditions in certain situations. You and your veterinarian can discuss why this drug is the most appropriate choice.

What should I tell my veterinarian to see if this medication can be safely given?

Many things might affect how well this drug will work in your animal. Be sure to discuss the following with your veterinarian so together you can make the best treatment decisions.

XXOther drugs can interact with this drug, including other appetite stimulant drugs (eg, cyproheptadine, oxazepam), so be sure
to tell your veterinarian and pharmacist what medications (including vitamins, supplements, or herbal therapies) you give your animal, including the amount and time you give each.

XXTell your veterinarian about any conditions or diseases your pet may have now or has had in the past.

XXIf your animal has been treated for the same disease or condition in the past, tell your veterinarian about the treatment and how well it did or didn’t work.

XXIf your animal is pregnant or nursing, talk to your veterinarian about the risks of using this drug.

XXTell your veterinarian and pharmacist about any medication side effects (including allergic reactions, lack of appetite, diarrhea, itching, hair loss) your pet has developed in the past.

When should this medication not be used or be used very carefully?

No drug is 100% safe in all patients, but your veterinarian will discuss with you any specific concerns about using this drug in your animal.

This drug SHOULD NOT be used in patients:

XXThat are allergic to it.

XXThat have received a MAOI (monoamine oxidase inhibitor, including selegiline or amitraz dips and collars) or have stopped taking one in the last 14 days.

This drug should be used WITH CAUTION in patients:
XXThat have kidney disease. Dosages may need to be reduced or

the drug not given as often.

XXThat have heart disease, diabetes, severe liver disease, glaucoma, and gastrointestinal or urinary blockage.

If your pet has any of these conditions or signs, talk to your veteri- narian about the potential risks versus benefits.

What are the side effects of this medication?

Mirtazapine is usually well tolerated in dogs and side effects are rarely seen. In cats, mirtazapine may cause more side effects that, if they occur, can often be seen within 90 minutes of a dose. Reducing the dosage or giving smaller doses more often may help limit these adverse effects.

Side effects that usually are not serious include:

XXVocalization.
XXMild tremors or shaking.XXSleepiness or sedation (fatigue).XXIncreased affection (cats).

You don’t have to be overly concerned if you see any of these unless they are severe, worsen, or continue to be a problem. Contact your veterinarian if this happens.

Side effects that may be serious or indicate a serious problem:

XXSevere tremors, shaking.
XXSevere hyperactivity, hyperexcitability (over excited) or agitation

(nervous, upset, unable to relax).
XXLow blood pressure (fainting, collapsing) if doses are too high.XXFast heartbeat if doses are too high.
If you see any of these, contact your veterinarian immediately.

©2017 PharmaVet, Inc. ALL RIGHTS RESERVED. Plumb’s® Veterinary Medication Guides have not been reviewed by FDA Center for Veterinary Medicine.

If my pet gets too much of this medication (an overdose), what should I do?

If you witness or suspect an overdose, contact your veterinarian or an animal poison control center for further advice. Animal poison control centers that are open 24 hours a day include: Pet Poison HELPLINE (855-764-7661) and ASPCA Animal Poison Control Cen- ter (888-426-4435); a consultation fee is charged for these services.

How should this medication be given?

For this medication to work, give it exactly as your veterinarian has prescribed. It’s a good idea to always check the prescription label to be sure you are giving the drug correctly.

XXThe drug may be given either with food or on an empty stomach. If your pet vomits or acts sick after receiving the drug on an empty stomach, try giving the next dose with food or a small treat. If vomiting continues, contact your veterinarian.

XXIf your animal is receiving the orally disintegrating tablets, make sure your hands are dry before handling the tablet. Place the tablet under the animal’s tongue and hold mouth closed for several seconds to allow it to dissolve (should occur quickly). After the tablet has melted, offer your animal water.

XXIn cats, the drug is often given every three days, but if side effects occur, your veterinarian may reduce the dose and have you give it daily or every other day.

XXCompounded liquid forms of this medication must be measured carefully. Your veterinarian or pharmacist can help by providing special measuring spoons or syringes.

XXIf you have difficulty getting your animal to take the medicine, contact your veterinarian or pharmacist for tips to help with dosing and reducing the stress of medication time.

XXThis medication can be given for various lengths of time. Be sure you understand how long your veterinarian wants you
to continue giving this medication. Prescription refills may be necessary before the therapy will be complete. Before stopping this medication, talk to your veterinarian, as there may be important reasons to continue its use.

What should I do if I miss giving a dose of this medication?

If you miss a dose, give it when you remember and then wait the amount of time between doses recommended by your veterinarian before giving another dose. Do not double-up or give extra doses.

How should I store this medication?

XXStore this medication in the original prescription bottle or an approved dosage reminder container (ie, pill minder) at room temperature and protected from light.

XXIf you are using the orally disintegrating tablets, keep them stored in their blister container. Once opened, immediate use is recommended; if not used immediately, tablets should be protected from moisture and humidity.

XXIf your veterinarian or pharmacist has made (compounded) a special formulation for your animal, follow the storage recommendations and expiration date for the product.

XXKeep away from children and other animals.
Can handling this medication be hazardous to me, my family, or

other pets?

There are no specific precautions required when handling this med- ication unless you are allergic to it. Wash your hands after handling any medication.

How should I dispose of this medication if I don’t use it all?

XXDo not flush this medication down the toilet or wash it down the sink. If a community drug “take-back” program is available, use this option. If there is no take-back program, mix the drug with coffee grounds or cat litter (to make it undesirable to children and animals and unrecognizable to people who might go through your trash), place the mixture in a sealable plastic bag to keep it from leaking out, and throw the bag out with the regular trash.

XXDo not save left over medication for future use or give it to others to use.

What other information is important for this medication?

XXDosages may need to be made (compounded) to accurately dose cats and small dogs.

XXUse of this drug may not be allowed in certain animal competitions. Check rules and regulations before entering your animal in a competition while this medication is being administered.

If you have any other questions or concerns about this medica- tion, contact your veterinarian or pharmacist.

©2017 PharmaVet, Inc. ALL RIGHTS RESERVED. Plumb’s® Veterinary Medication Guides have not been reviewed by FDA Center for Veterinary Medicine.

Mirtazapine, Transdermal

(mir-taz-ah-peen)
Category: Appetite Stimulant
Other Names for this Medication: Mirataz®
Common Dosage Forms: Veterinary: Transdermal ointment 2% (20 mg/g). Human:None.

This information sheet does not contain all available information for this medication. It is to help answer commonly asked questions and help you give the medication safely and effectively to your animal. If you have other questions or need more information about this medication, contact your veterinarian or pharmacist.

Key Information

XXUsed for management of weight loss in cats.

XXTransdermal ointment may cause application site reactions such as reddening of the skin, crusting/ scabbing, and residue.

XXCommon side effects include: vocalization, behavior changes, and tremors or shaking. Contact your veterinarian if your cat experiences excessive sleepiness or vocalization.

XXWear gloves before handling this medication. Avoid contact with treated cat for 2 hours after applying medicine.

How is this medication useful?

Mirtazapine may be prescribed as an appetite stimulant to help manage weight loss in cats.

The FDA (U.S. Food & Drug Administration) has approved this drug for management of weight loss in cats. The FDA allows veterinari- ans to prescribe products containing this drug in different species or for other conditions in certain situations. You and your veterinar- ian can discuss why this drug is the most appropriate choice.

What should I tell my veterinarian to see if this medication can be safely given?

Many things might affect how well this drug will work in your animal. Be sure to discuss the following with your veterinarian so together you can make the best treatment decisions.
XXOther drugs (including other appetite stimulant drugs such as

cyproheptadine and oxazepam) can interact with mirtazapine, so be sure to tell your veterinarian and pharmacist what medications (including vitamins, supplements, or herbal therapies) you give your animal, including the amount and time you give each.

XXTell your veterinarian about any conditions or diseases your animal may have now or has had in the past.

XXIf your animal has been treated for the same disease or condition in the past, tell your veterinarian about the treatment and how well it did or didn’t work.

XXIf your animal is pregnant or nursing, talk to your veterinarian about the risks of using this drug.

XXTell your veterinarian and pharmacist about any medication side effects (including allergic reactions, lack of appetite, diarrhea, itching, hair loss) your animal has developed in the past.

When should this medication not be used or be used very carefully?

No drug is 100% safe in all patients, but your veterinarian will discuss with you any specific concerns about using this drug in your animal.

This drug SHOULD NOT be used in patients:

XXThat are allergic to it.

XXThat have received a MAOI (monoamine oxidase inhibitor, including selegiline or amitraz dips and collars) or have stopped taking one in the last 14 days.

This drug should be used WITH CAUTION in patients:
XXThat have kidney disease. Dosages may need to be reduced or

the drug may need to be given less often.

XXThat have heart disease, diabetes, severe liver disease, glaucoma, and gastrointestinal or urinary blockage.

If your animal has any of these conditions or signs, talk to your veterinarian about the potential risks versus benefits.

What are the side effects of this medication?

Mirtazapine is usually well tolerated in cats, but side effects can occur and are often seen within 90 minutes of a dose. Reducing the dose or giving smaller amounts more often may help limit these side effects.

Common but not serious side effects include:

XXApplication site reactions (eg, reddening of the skin, crusting/ scabbing, residue).

XXVocalization.
XXMild tremors or shaking.XXSleepiness or acting tired.XXIncreased affection.

You don’t have to be overly concerned if you see any of these signs unless they are severe, worsen, or continue to be a problem. Con- tact your veterinarian if this happens.

Side effects that may be serious or indicate a serious problem:

XXSevere tremors, shaking.
XXSevere hyperactivity, hyperexcitability (over-excitement) or

agitation (nervous, upset, unable to relax).
XXLow blood pressure (fainting, collapsing) if doses are too high.XXFast heartbeat if doses are too high.
If you see any of these signs, contact your veterinarian immediately.

©2017 PharmaVet, Inc. ALL RIGHTS RESERVED. Plumb’s® Veterinary Medication Guides have not been reviewed by FDA Center for Veterinary Medicine.

If my pet gets too much of this medication (an overdose), what should I do?

If you witness or suspect an overdose, contact your veterinarian or an animal poison control center for further advice. Animal poison control centers that are open 24 hours a day include: Pet Poison HELPLINE (855-764-7661) and ASPCA Animal Poison Control Cen- ter (888-426-4435); a consultation fee is charged for these services.

How should this medication be given?

For this medication to work, give it exactly as your veterinarian has prescribed. It is a good idea to always check the prescription label to be sure you are giving the drug correctly.

XXMirtazapine ointment is applied every 24 hours. If side effects occur, your veterinarian may reduce the dose and/or have you apply the ointment every other day.

XXIf you have difficulty applying the medicine to your cat, contact your veterinarian or pharmacist for tips to help with dosing and reducing the stress of medication time.

XXThis medication can be given for various lengths of time. Be sure you understand how long your veterinarian wants you
to continue giving this medication. Prescription refills may be necessary before the therapy will be complete. Before stopping this medication, talk to your veterinarian, as there may be important reasons to continue its use.

What should I do if I miss giving a dose of this medication?

If you miss a dose, wait to give the next dose until the following day when it is usually time to do so and then resume daily dosing. Do not double-up or give extra doses.

How should I store this medication?

XXStore this medication in the original container at room temperature and protected from light.

XXDiscard transdermal ointment within 30 days of first use.XXKeep away from children and other animals.

Can handling this medication be hazardous to me, my family, or other pets?

XXWear disposable gloves while handling this medication. Do not reuse gloves; once used, they should be thrown away.

XXWash your hands with soap and water after handling any medication.

XXPeople or other animals in the household should not come in contact with the treated animal for 2 hours to reduce risk of exposure to the medicine. If accidental exposure occurs, wash area thoroughly with soap and water. If accidental eye exposure occurs, flush eyes with water.

How should I dispose of this medication if I don’t use it all?

XXDo not flush this medication down the toilet or wash it down the sink. If a community drug “take-back” program is available, use this option. If there is no take-back program, mix the drug with coffee grounds or cat litter (to make it undesirable to children and animals and unrecognizable to people who might go through your trash), place the mixture in a sealable plastic bag to keep it from leaking out, and throw the bag out with the regular trash.

XXDo not save leftover medication for future use or give it to others to use.

What other information is important for this medication?

XXAbrupt discontinuation of mirtazapine after long-term administration may cause signs of withdrawal.

XXUse of this drug may not be allowed in certain animal competitions. Check rules and regulations before entering your animal in a competition while this medication is being administered.

If you have any other questions or concerns about this medica- tion, contact your veterinarian or pharmacist.

©2017 PharmaVet, Inc. ALL RIGHTS RESERVED. Plumb’s® Veterinary Medication Guides have not been reviewed by FDA Center for Veterinary Medicine.