Mirtazapine Orally Disintegrating Tablets and Zithromax Tri-Pak

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using mirtazapine together with azithromycin can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Available data suggest that mirtazapine may cause mild prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. Using exposure response analysis, a positive relationship between mirtazapine concentrations and prolongation of the QTc interval was identified in a clinical randomized trial with placebo and positive (moxifloxacin) controls involving 54 healthy volunteers. However, the degree of QT prolongation observed with both the 45 mg (therapeutic) and 75 mg (supratherapeutic) doses of mirtazapine was not at a level generally considered to be clinically meaningful. In 6-week placebo-controlled trials where a total of 338 patients received mirtazapine and 261 patients received placebo, QTc prolongation >=500 msec was not observed among mirtazapine-treated patients. Mean change in QTc was +1.6 msec for mirtazapine and -3.1 msec for placebo, which are well below the generally accepted critical threshold for cardiovascular safety. Nonetheless, cases of QT prolongation, torsade de pointes, ventricular tachycardia, and sudden death, have been reported during postmarketing use of mirtazapine according to the manufacturer. The majority of reports occurred in association with overdose or in patients with other risk factors for QT prolongation, including concomitant use of QT-prolonging medications. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s).

MANAGEMENT: Caution is recommended if mirtazapine is used in combination with other drugs that can prolong the QT interval. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.

Mirtazapine Orally Disintegrating Tablets

Generic Name: mirtazapine

Brand name: Remeron, Remeron SolTab

Synonyms: Mirtazapine

What is Mirtazapine Orally Disintegrating Tablets?

Zithromax Tri-Pak

Generic Name: azithromycin

Brand name: Zithromax, Zmax, AzaSite, Azithromycin 3 Day Dose Pack, Azithromycin 5 Day Dose Pack, Zithromax Tri-Pak, Zithromax Z-Pak, Zithromax IV

Synonyms: Zithromax

What is Zithromax Tri-Pak?