Menelat 30 Special Precautions

Mirtazapine should be used with caution in patients with epilepsy, hepatic or renal impairment and cardiac disorders such as conduction disturbances, angina pectoris and recent myocardial infarction, and also in patients with hypotension, diabetes mellitus, psychoses and those with history of bipolar disorder. Treatment should be stopped if jaundice develops. Although Mirtazapine has only weak antimuscarinic activity, caution should nevertheless be exercised in patients with micturition disturbances, angle-closure glaucoma and raised intra-ocular pressure.
Patients should be advised to report any of the following symptoms during treatment: fever, sore throat, stomatitis or other signs of infection; treatment should be stopped and blood count performed. Drowsiness is often experienced at the start of therapy and patients, if affected, should not drive or operate machinery.
Patients should be closely monitored during early therapy until improvement in depression is observed because suicide is an inherent risk in depressed patients. Mirtazapine should be withdrawn gradually to reduce the risk of withdrawal symptoms.