Calixta

Calixta - Antidepressant medicine

Category Antidepressants

Calixta is a medicine that contains an active substance called mirtazapine. It belongs to the group of antidepressant drugs. It is used in the treatment of major depression. The mechanism of action is based on a blockade of alpha-2 receptors, 5-HT1, 5-HT2 and 5-HT3 receptors.

Precautions

Calixta should be avoided in patients allergic to active substance mirtazapine or other similar drugs. If you are experiencing symptoms of an allergy, contact your doctor immediately.

Calixta should be avoided in combination with other drugs used in the treatment of depression, a so-called MAO inhibitors, such as:

  • phenelzine,
  • selegiline (can be also used in the treatment of Parkinson's disease),
  • isocarboxazid,
  • moclobemide,
  • or selective serotonin reuptake inhibitors (SSRI), which are also used in the treatment of depression, such as:
    • citalopram,
    • escitalopram,
    • sertraline,
    • fluoxetine,
    • fluvoxamine,
    • paroxetine,
    • duloxetine, and others. Concomitant use of these medicines may cause dangerous side effects. At least two weeks should pass between the last use of MAO inhibitor and starting a therapy with Calixta.

It should be avoided in patients under the age of 18, due to an increased risk of suicidal ideation.

If you are experiencing change in behavior or change in mood, or suicidal ideation, immediately stop using this medicine and contact your doctor.

The patient's family and friends need to learn about the adverse effects of this drug and immediately inform patient's doctor if they notice change in behavior of the patient.

Calixta can, although very rarely, cause agranulocytosis (decrease in the number of white blood cells) that can weaken your immune system and can be fatal! If you are experiencing flu-like symptoms, such as:

  1. fever,
  2. cough,
  3. sore throat, it can be a sign that your immune system is weakened, so it is necessary to immediately contact your doctor!

It should be avoided in patients with liver failure. If you are experiencing any symptoms of liver damage, such as:

  1. jaundice (yellowing of the skin and eyes),
  2. loss of appetite, contact your doctor.

Calixta should be avoided in patients with kidney disorders.

Calixta should be used only with extra precautions in the following conditions:

  • In patients with heart disease and diabetes
  • Epilepsy
  • Patients with schizophrenia or other mental disorders
  • In patients with enlarged prostate
  • In patients with glaucoma

This medicine can cause a reduction in sodium levels in the blood (hyponatremia) and extra precautions are needed when using this drug in combination with other drugs that also may cause hyponatremia, such as, for example, diuretics (water pills).

Use during pregnancy and breastfeeding

Calixta should be avoided during pregnancy unless the benefit to the mother outweighs risk to the child.

Calxita passes into breast milk so you should avoid breastfeeding while using this medicine. Instead of breastfeeding your baby, you can give your baby formula milk.

How to use

The usual dose is 15-30 mg once a day, at bedtime. The dose may be increased up to 45 mg daily, until a corresponding effect is achieved.

This medicine usually achieves its effect after 1-2 weeks, but if there are no results after a month of using this medicine, then treatment should be discontinued.

Treatment should last at least 6 months.

Do not stop using this medicine abruptly. The dose of this medicine should be gradually reduced, with an aim to avoid worsening of symptoms.

Example: If you were taking 30 mg of Calixta per day, first you will need to reduce the dose to 15 mg per day and take it for a one week, and week after that you need to reduce your dose again to 7.5 mg and take it for another week, and only after that you can completely stop using this medicine. Consult with your doctor about gradually reducing the dose of Calixta.

Do not use alcoholic beverages along with this drug, due to the increased risk of adverse effects.

Use with other medicines (Interactions)

Calixta should be avoided in combination with the following drugs:

  • MAO inhibitors, drugs used to treat depression, such as:
    • moclobemide,
    • selegiline,
    • phenelzine,
    • isocarboxazid, and others. At least two weeks should pass between the last use of MAO inhibitor and starting a therapy with this drug. Otherwise, you may develop serotonin syndrome (a condition that can be life-threatening)!
  • Selective serotonin reuptake inhibitors, used in the treatment of depression, such as:
    • sertraline,
    • fluoxetine,
    • paroxetine,
    • fluvoxamine,
    • citalopram,
    • escitalopram, and others. Concomitant use of these medicines with Calixta, increases the risk of serotonin syndrome.
  • Drugs used to treat insomnia and anxiety, called benzodiazepines, such as:
    • diazepam,
    • lorazepam,
    • bromazepam,
    • prazepam,
    • alprazolam,
    • midazolam and others. It may increase the effect of these medicines and cause side effects.
  • Drugs used in the treatment of allergy, the so-called H1 antihistamines, such as:
    • loratadine,
    • cetirizine,
    • levocetirizine,
    • desloratadine, and others. Calixta may increase the sedative effect of these drugs.
  • Warfarin (Farin), a drug used to treat blood clotting disorders. Concomitant use of Calixta with this drug increases the risk of bleeding.
  • Antibiotics, drugs used in the treatment of bacterial infections, such as:
    • clarithromycin,
    • erythromycin,
    • azithromycin, and others. These drugs may increase the effects of this medicine and cause side effects.
  • The drugs used in the treatment of fungal infections, such as:
    • ketoconazole,
    • fluconazole,
    • clotrimazole and others. These drugs may increase level of Calixta to increase in the blood and lead to side effects.
  • Drugs used to treat epilepsy, such as:
    • phenobarbital,
    • carbamazepine,
    • phenytoin, and others. These drugs may decrease the level of Calixta in the blood and can lead to the lack of the this drug effect.
  • St. John's Wort.

Tell your doctor about all medications and herbal products you are taking.

Side effects

Calixta may cause the following side effects:

  1. nausea,
  2. vomiting,
  3. diarrhea,
  4. increased appetite,
  5. weight gain,
  6. headache,
  7. dizziness,
  8. drowsiness,
  9. dry mouth,
  10. insomnia,
  11. hallucinations,
  12. decrease in the number of white blood cells (agranulocytosis),
  13. low blood pressure,
  14. muscle aches,
  15. joint pain,
  16. Stevens-Johnson syndrome (a serious life-threatening skin condition which manifests with blisters on the skin),
  17. decrease in sodium levels in the blood (hyponatremia),
  18. allergy and others.

Tell your doctor immediately if you are experiencing flu-like symptoms:

  1. cough,
  2. fever,
  3. sore throat,

because it can be a sign of agranulocytosis (very dangerous decrease in the number of white blood cells, which can be fatal)! When you do not have enough white blood cells, your body is more vulnerable to infection that can be fatal! However, this side effect occurs very rarely.

If you are experiencing any changes in skin, contact your doctor immediately, as this can be a sign of Stevens-Johnson syndrome.