Indications for REMERON:
Major depressive disorder (MDD).
Initially 15mg once daily at bedtime; increase at intervals of at least 1–2 weeks; max 45mg/day. SolTab: Dissolve on tongue and swallow with or without water.
During or within 14 days of MAOIs. Concomitant linezolid or IV methylene blue.
Suicidal thoughts and behaviors.
Increased risk of suicidal thoughts and behavior in children, adolescents and young adults; monitor closely for clinical worsening or unusual changes. Screen for bipolar disorder. History of mania/hypomania. Risk of agranulocytosis; monitor for fever, infection. Monitor for serotonin syndrome; discontinue if occurs. Angle-closure glaucoma. Known cardiovascular or cerebrovascular disease. History of QT prolongation. Moderate to severe renal or hepatic impairment. Seizure disorders. Dehydration. Hypovolemia. Phenylketonuria (SolTab). Avoid abrupt cessation. Elderly. Pregnancy. Nursing mothers.
Central alpha-2 antagonist.
See Contraindications. Increased risk of serotonin syndrome with other serotonergic drugs (eg, SSRIs, SNRIs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Increased risk of QT prolongation and/or ventricular arrhythmias with concomitant drugs known to prolong the QTc interval (eg, certain antipsychotics or antibiotics). May be potentiated by strong CYP3A inhibitors (eg, itraconazole, ritonavir, nefazodone), cimetidine. Antagonized by strong CYP3A inducers (eg, phenytoin, carbamazepine, rifampin). Avoid concomitant alcohol, benzodiazepines (eg, diazepam, alprazolam). Monitor INR with warfarin.
Somnolence, increased appetite, weight gain, dizziness, nausea, dry mouth, constipation, asthenia; akathisia, hypo- or hypertension, elevated cholesterol, triglycerides, or transaminases; rarely: hyponatremia (esp. elderly), agranulocytosis.
Renal (major), fecal. Half-life: ~20–40 hours.