Rasagiline & Remeron

sunflower4u · 04-06-2009, 02:37 PM

Has anyone tried rasagiline while taking remeron? Med-check says moderate risk if both are used. I have my pharmacist checking into it further but wondered if anyone had any experience with the two.

Thanks and would appreciate any input!

Sunflower

mrsD · 04-07-2009, 07:51 AM

Here is the Patientsville reports on Remeron:

http://patientsville.com/medication/...de_effects.htm

It is hard to find information about this drug.
Official party line is:

Quote:

Drugs Affecting Hepatic Metabolism

The metabolism and pharmacokinetics of REMERON® (mirtazapine) Tablets may be affected by the induction or inhibition of drug-metabolizing enzymes.
Drugs that are Metabolized by and/or Inhibit Cytochrome P450 Enzymes

Many drugs are metabolized by and/or inhibit various cytochrome P450 enzymes, e.g., 2D6, 1A2, 3A4, etc. In vitro studies have shown that mirtazapine is a substrate for several of these enzymes, including 2D6, 1A2, and 3A4. While in vitro studies have shown that mirtazapine is not a potent inhibitor of any of these enzymes, an indication that mirtazapine is not likely to have a clinically significant inhibitory effect on the metabolism of other drugs that are substrates for these cytochrome P450 enzymes, the concomitant use of REMERON® with most other drugs metabolized by these enzymes has not been formally studied. Consequently, it is not possible to make any definitive statements about the risks of coadministration of REMERON® with such drugs.

http://www.rxlist.com/remeron-drug.htm

The only effect I have seen in practice from Remeron alone that was significant are the effects on the blood.

Remeron is not used commonly, so reports will be less.
Officially it does not have a MAOI warning: BUT

Quote:

The mechanism of action of REMERON® (mirtazapine) Tablets, as with other drugs effective in the treatment of major depressive disorder, is unknown.

Evidence gathered in preclinical studies suggests that mirtazapine enhances central noradrenergic and serotonergic activity. These studies have shown that mirtazapine acts as an antagonist at central presynaptic α2 adrenergic inhibitory autoreceptors and heteroreceptors, an action that is postulated to result in an increase in central noradrenergic and serotonergic activity.

Mirtazapine is a potent antagonist of 5-HT2 and 5-HT3 receptors. Mirtazapine has no significant affinity for the 5-HT1A and 5-HT1B receptors.

Mirtazapine is a potent antagonist of histamine (H1) receptors, a property that may explain its prominent sedative effects.

Mirtazapine is a moderate peripheral α1 adrenergic antagonist, a property that may explain the occasional orthostatic hypotension reported in association with its use.

Mirtazapine is a moderate antagonist at muscarinic receptors, a property that may explain the relatively low incidence of anticholinergic side effects associated with its use.

Often drug interaction sites/engines will offer suggested warnings based on the general category selected. So sometimes they are misleading. They also may NOT have the newest information available either. (I found this true for the interaction of SSRIs + triptans--which seemed to take eons to get into the data base).

So you may not get a definite answer to your question.

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