Mianserin - Oral

Mianserin is used to treat depression.

Take Mianserin exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

You may take this medicine with or without food, preferably between meals throughout the day or as a single dose at bedtime. Try to take it at the same time each day.

Swallow the tablet whole. Do not chew the tablet.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and your response to the medication.

Mianserin must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as this may worsen your condition.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following conditions:

• mania (feeling highly excited, being over-active and easily irritated or distracted)
• severe liver disease

as Mianserin may not be suitable for you.

Do not breastfeed while you are being treated with this medicine.

Do not take Mianserin if you are currently taking or have taken a medicine to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.

Inform your doctor if you have the following conditions:

• history of self-harm or having thoughts of self-harm
• current or history of epilepsy (fits or seizures)
• heart disease e.g. recent heart attack, heart block, irregular or abnormal heartbeat
• at risk of seizures e.g. head trauma or injury, brain damage, frequent drinker or consume large amount of alcohol
• diabetes
• bipolar disorder (mental condition that causes extreme mood changes between feeling very high [mania] and very low [depression])
• phaeochromocytoma (rare tumour of the adrenal gland causing high blood pressure)
• blood vessel problems
• increased pressure in the eye
• urinary retention (inability to empty the bladder and urinate)
• prostate enlargement
• kidney disease
• mild to moderate liver disease

Let your doctor know if you are pregnant.

Be sure to check with your doctor or pharmacist before giving Mianserin to the elderly. Elderly people may be more sensitive to the side effects.

If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking this medicine.

Medicines for depression such as Mianserin may increase the risk of suicidal thoughts and behaviour. As depression and some psychiatric disorders are themselves associated with an increased risk of suicide, it is important for you or your family members to monitor your condition, especially at the start of treatment and if your dosage is still being adjusted. If you experience new or sudden changes in mood, behaviour, thoughts or feelings, or a worsening of your depression with suicidal thoughts or attempts, harm to self or harm to others, contact your doctor immediately.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. complete blood count, electrolyte levels, blood sugar levels, heart, liver and kidney function) may be done while you are being treated with this medicine.
• Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure during treatment.
• Regular monitoring of signs of infection (e.g. sore throat, fever) may also be needed.

What lifestyle changes should I make to cope with depression?

Regular exercise and eating a healthy diet will help increase energy and hormones in the body such as serotonin, endorphins and other feel-good chemicals that minimise mood swings. Get enough sleep, as lack of sleep may cause irritability, moodiness, sadness, and tiredness.

Mianserin may cause drowsiness. If affected, do not drive or take part in any activity in which you need to be alert.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.

Other side effects include any of the following: headache, dry mouth, constipation, tiredness, joint pain, breast tenderness, rash, and sweating.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• unusual changes in mood or behaviour (being too depressed, agitated, or having thoughts of self-harm)
• fits or seizures
• trouble passing urine
• fast or irregular heartbeat, passing out

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Mianserin if you are currently taking or have taken a medicine to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxacid, phenelzine, tranylcypromine in the last 14 days.

Inform your doctor and pharmacist if you are taking or using any of these medicines:

• medicines for epilepsy e.g. carbamazepine, phenytoin, phenobarbital, primidone
• medicines for high blood pressure e.g. diazoxide, hydralazine, nitroprusside
• medicines for cold or allergy
• atomoxetine (medicine to treat hyperactivity disorders)
• blood-thinning medicines e.g. warfarin

This list does not include all medicines that may interact with Mianserin.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol. Alcohol intake may worsen the drowsiness caused by Mianserin.

Store in a cool, dry place away from the reach of children.

Protect from light.

Medicines must not be used past the expiry date.