Merasal Dosage/Direction for Use

The tablets should be swallowed whole without chewing, with a sufficient amount of fluid.
The tablets can be taken with or without food.
Adults: The initial dose is 15 or 30mg, taken preferably in the evening. The maintenance dose is usually between 15mg and 45mg per day.
Elderly patients: As in adults. Changes, especially increments of dosage must be made cautiously and under close supervision.
Children and adolescents under 18 years of age: Mirtazapine should not be used in children and adolescents under the age of 18 years as efficacy was not demonstrated in two short-term clinical trials (see Pharmacology: Pharmacodynamics under Actions) and because of safety concerns (see Precautions, Adverse Reactions and Pharmacology: Pharmacodynamics under Actions).
Renal or hepatic insufficiency: The elimination of mirtazapine may be slower in patients with renal or hepatic insufficiency. This must be considered when mirtazapine is prescribed for these patients or the clinical responses are interpreted.
Mirtazapine tablets can be taken once daily, since the elimination half-life is 20 to 40 hours. The medicine should be taken preferably as a single dose immediately before bedtime. The daily dose can also be divided into two doses taken in the morning and at bedtime. The larger dose should be taken in the evening.
The antidepressive effect of mirtazapine usually becomes evident after 1 to 2 weeks use. Treatment with an adequate dose should result in a positive response within 2 to 4 weeks. With an insufficient response, the dose can be increased up to the maximum dose. After having obtained an optimal clinical effect and the patient is free of symptoms, the treatment should be continued for 4 to 6 months, until a gradual discontinuation can be considered. If no clinical response is observed within 2 to 4 weeks of treatment with the maximum dose, the treatment should be gradually discontinued. Gradually tapering down the dosage is necessary to avoid withdrawal symptoms.