CALIXTA TAB. P/O PLEEN. 30MG No. 30 (BLISTERS)

Contraindications for use

This drug has only one indication for use - depression.
In all other cases, it should not be taken on its own to avoid unwanted health effects. The drug in question has virtually no contraindications for use. The only categories of patients who should not use this drug are:

• people with individual intolerance to the constituent components of the drug;
• patients who are already taking MAO inhibitors.

Pharmacodynamics

From the instructions for the drug, which due to its high price may not be affordable for everyone, it follows that Calixta should be prescribed for the treatment of depressive conditions that develop with such characteristic clinical symptoms as loss of the ability to experience pleasure and joy, loss of interest in life, psychomotor retardation, insomnia, rapid weight loss, thoughts of suicide and mood lability.

With pronounced symptoms of depression, the drug most clearly demonstrates its anxiolytic and hypnotic properties. This is what makes it effective in treating anxiety conditions. In order for the drug to have its antidepressant effect on the body, it must be taken for 1-2 weeks.

Contraindications:

- hypersensitivity to mirtazapine or to any of the excipients;

- patients with rare hereditary problems such as lactose intolerance, lactase deficiency or glucose-galactose malabsorption should not be prescribed Calixta;

— since the safety and effectiveness of the drug Calixta for children have not been established, the use of the drug Calixta for the treatment of children under 18 years of age is not recommended.

Carefully

Correction of the dosage regimen and regular medical monitoring are necessary for the following categories of patients:

- patients with epilepsy and organic brain lesions (during treatment with Calixta, in rare cases, seizures may develop);

- patients with liver or kidney failure;

- patients with heart disease (conduction disorders, angina pectoris or recent myocardial infarction);

— patients with cerebrovascular diseases (including a history of ischemic stroke);

- patients with arterial hypotension and with conditions predisposing to arterial hypotension (including dehydration and hypovolemia);

- patients who abuse drugs, are dependent on drugs that affect the central nervous system, with mania, hypomania.

Like other antidepressants, Calixta should be used with caution in the following cases:

- urinary disturbances, incl. with prostatic hyperplasia;

- acute angle-closure glaucoma and increased intraocular pressure;

- diabetes;

- with simultaneous use of benzodiazepines with the drug Calixta.

Use during pregnancy

Only a doctor can prescribe the drug during pregnancy and only if there are no other alternative solutions. Before prescribing and throughout the course of taking the drug, pregnant women should be regularly monitored by a doctor.

There is rather scant information about the drug. To obtain information about its effects, clinical studies were conducted on animals - pregnant rats and rabbits, which were administered mirtazapine at dosages of up to 100 mg/kg and 40 mg/kg. Based on the results of the studies, it was not possible to identify a teratogenic effect on the animal body.

At the same time, it was possible to establish that in female rats that were administered mirtazapine, there was an increase in post-implantation losses, a decrease in the body weight of the pups and an increase in their mortality in the first three days of lactation. Experts have not been able to establish the exact cause of such phenomena. These results were observed when doses 20 times higher than the MRDC were administered to animals. At the same time, nothing similar was observed at doses equivalent to 3 MRDC.

Given the lack of verified information about the effects of the drug during lactation, experts strongly recommend not prescribing Calixta to women during breastfeeding.

Directions for use and dosage:

The tablets should be taken orally, with liquid if necessary, and swallowed without chewing.

Adults:

The effective daily dose is usually between 15 mg and 45 mg; the initial dose is 15 mg or 30 mg.

Elderly patients:

The recommended dose is the same as for adults. In elderly patients, in order to achieve a satisfactory and safe response to treatment, increasing the dose should be done under the direct supervision of a physician.

Liver and kidney dysfunctions:

In patients with renal or hepatic impairment, the clearance of mirtazapine may be reduced. This should be taken into account when prescribing Calixta in this category of patients.

Calixta can be taken 1 time per day, preferably at the same time, before bedtime. The drug Calixta can also be prescribed to be taken 2 times a day, dividing the daily dose in half (once in the morning and once at night, the higher dose should be taken at night).

Treatment should, if possible, be continued for 4-6 months until the patient's symptoms disappear completely. After this, treatment can be gradually withdrawn. Mirtazapine usually begins to have its effect after 1-2 weeks of treatment. Treatment with an adequate dose should lead to a positive result in 2-4 weeks. If necessary, the dose can be increased to the maximum dose (up to 45 mg). If there is no positive dynamics of treatment, treatment should be stopped after another 2-4 weeks.

Side effects

If we look at previously conducted trials, it follows that the drug caused adverse reactions in an extremely small number of patients. In human subjects, only 16% of the 453 people prescribed mirtazapine had atypical events, which is a small percentage compared with 7% of the 361 people given placebo.

It should be noted that the results obtained during such trials cannot be considered as a basis for making predictions regarding the occurrence of side effects in normal medical practice. This is explained by the fact that in the ongoing clinical trials, conditions were artificially created for the participants, which are often absent in a normal situation.

We suggest you familiarize yourself with: Tequila alcoholic drink

These figures may differ significantly from those that may be obtained from new clinical trials. But they will be able to give specialists more information regarding the impact of the administered substance and other factors on the development of side effects in the study group of patients.

https://www.youtube.com/watch?v=ytpolicyandsafetyru

The conducted research helped experts find out the following. The drug can cause:

• disturbances in the functioning of the nervous system and sensory organs, leading to drowsiness, dizziness, unusual dreams, tremors, and confusion.
• disturbances in the functioning of the gastrointestinal tract, which can manifest as constipation, increased appetite and dry mouth.
• disorders of a different nature - development of dyspnea, peripheral edema, increased urination, myalgia, back pain, flu-like syndrome, weight gain.

Experts do not rule out the possibility of developing other adverse reactions, which may include headaches, rapid heartbeat, nausea, flatulence, decreased libido, sweating, taste distortion, rhinitis, dyspepsia, diarrhea, tachycardia, orthostatic hypotension and other phenomena that may be observed in in rare cases.

Special instructions and precautions:

When using the drug Calixta, you should keep in mind:

- Worsening of psychotic symptoms may occur when antidepressants are used to treat patients with schizophrenia or other psychotic disorders; Paranoid ideas may increase.

— The depressive phase of manic-depressive psychosis during treatment can transform into a manic phase.

- In young people (under 24 years of age) with depression and other mental disorders, antidepressants, compared with placebo, increase the risk of suicidal thoughts and behavior. Therefore, when prescribing Calixta to young people (under 24 years of age), the risk of suicide should be weighed against the benefits of using the drug. In short-term studies, the risk of suicide did not increase in people over 24 years of age, and the risk of suicide decreased slightly in people over 65 years of age. Any depressive disorder itself increases the risk of suicide. Therefore, during treatment, the patient should be monitored to identify disturbances or changes in behavior, as well as suicidal tendencies.

— Despite the fact that the drug Calixta is not addictive, based on their post-registration experience, it turned out that abrupt cessation of treatment after prolonged use can sometimes cause withdrawal symptoms. Most withdrawal reactions are mild and self-limiting. The most commonly reported withdrawal symptoms were dizziness, agitation, anxiety, headache and nausea. Although these have been reported as withdrawal symptoms, it should be understood that these symptoms may be related to an underlying medical condition. It is recommended that treatment with mirtazapine be discontinued gradually.

- Elderly patients are usually more sensitive, especially to side effects. In clinical studies of Calixta, it was not noted that side effects were more common in elderly patients than in other age groups, but they may be more pronounced, but data are still limited.

- If signs of jaundice appear, treatment should be stopped.

— Patients are advised to avoid alcohol while being treated with Calixta.

- Bone marrow suppression, usually appearing as granulocytopenia or agranulocytosis, is rarely observed with the use of Calixta. Appears mostly after 4-6 weeks of treatment and is reversible after cessation of treatment. The doctor should pay close attention to symptoms such as fever, sore throat, stomatitis, and other signs of influenza-like syndrome and inform the patient about this; If such symptoms appear, you should stop treatment and do a blood test.

Impact on the ability to drive vehicles and machinery

Calixta may reduce concentration. During treatment with antidepressants, patients should avoid performing potentially dangerous activities that require high speed psychomotor reactions, such as driving a car or operating machinery.

For impaired renal function

Use with caution in patients with renal failure.

For liver dysfunction

Use with caution in patients with liver failure.

Use in old age

In elderly patients, in order to achieve a satisfactory and safe response to treatment, increasing the dose should be done under the direct supervision of a physician.

Use in childhood

Since the safety and effectiveness of Calixta for children have not been established, the use of Calixta for the treatment of children under 18 years of age is not recommended.

Calixta: reviews

Due to the peculiarities of the drug, it is necessary to take Calixta in accordance with the regimen selected by the attending physician. The medicine is prescribed for use before bedtime with a gradual increase in dosage.

• On the first day of treatment, tablets are taken in an amount of 15 mg per day, later the dosage is increased to 15-45 mg per day.
• If the medicine was prescribed to patients with renal and liver failure, then their daily dosage is reduced by a third.
• Take Calixta tablets for 4-6 months.

Overdose

In accordance with the instructions for the drug and reviews read on forums, the patient must strictly follow the instructions and recommendations of the attending physician throughout the entire treatment. This is especially true for the prescribed dosage, exceeding which can lead to the development of undesirable symptoms:

• lethargy;
• changes in blood pressure;
• hallucinations;
• tachycardia;
• disorientation;
• drowsiness.

Patients who experience one or more of the above symptoms should immediately stop taking the drug and begin treatment to restore their well-being. To do this, it is necessary to urgently rinse the stomach, take a portion of activated carbon, and after normalization of the condition, symptomatic and supportive treatment is carried out.

According to reviews on the forums, the drug, like its analogues, should be prescribed with great caution to people diagnosed with schizophrenia and other psychotic disorders, since this antidepressant can provoke an increase in psychotic symptoms in them. During therapy for the depressive phase of bipolar affective psychosis, there is a risk of relapse, accompanied by the onset of mania. Bearing in mind that such patients have a tendency to be suicidal, they should be prescribed this medicine in a small dosage.

We suggest you read: Alcohol and steroids consequences

Women of reproductive age are recommended to be prescribed proven and safe methods of contraception.

When taking the drug and its analogues, you must avoid drinking alcohol. Benzodiazepines should be prescribed with caution to patients taking mirtazapine.

In case of development of negative side reactions, the antidepressant is stopped gradually - first the dose is reduced together or with increasing intervals between doses. If you abruptly stop taking the drug after long-term use, there is a risk of unpleasant symptoms such as headaches, nausea and a general deterioration in well-being.

As patients write in reviews on forums, if a patient has jaundice, signs of an infectious disease, or changes in blood counts, it is necessary to immediately stop taking the drug.

During treatment, it is necessary, if possible, to minimize work related to driving vehicles and other activities that require increased concentration and speed of psychomotor reactions.

From the moment my attending physician prescribed this remedy to me, I only managed to be treated with it for a month. But this time was enough for me to personally find out what side effects it can cause. Every now and then I was bothered by crises accompanied by high blood pressure, and I was constantly tormented by tachycardia. Perhaps other drugs were the cause. However, this happened right when I started taking this medicine. Naturally, I immediately refused to use it further. In addition, it is very expensive, and it is very difficult to find.

Evgeniya

I started taking the drug Calixta to treat depression. My doctor chose the dosage for me - a quarter of a 30 mg tablet before bed. At first I had colorful and funny dreams, sometimes I even laughed out loud, but then everything returned to normal. My sleep was restored, I began to feel the same as before, and I had a strong desire to do something. Overall, I liked the drug. But to avoid side effects, you need to start using it with a very small dose.

Elena

When I began to feel very bad, I tried for a long time to understand the cause of my illness. For this I had to visit many doctors. In the end, I had an MRI, which showed that I had cervical osteochondrosis, which was causing all the symptoms of VSD. For many months I could not sleep peacefully. As a treatment, I was prescribed a course of injections, and additionally a massage and Calixta before bed.

I purchased the medicine with a dosage of 30 mg. I received a recommendation from the doctor that I should take 15 mg at night. But, as I later found out, this dose turned out to be too high. The next day I slept like the dead. I woke up only the next morning. So if you decide to take this product, I recommend starting with a low dosage of 7.5 mg. After that, my insomnia went away and my depression also disappeared. Now I take 7.5 mg tablets and sleep peacefully. This is an excellent remedy for depression.

We invite you to read: How many people have survived from alcohol?

Vitaly

Calixta - official instructions for use, analogues, price, availability in pharmacies

catad_pgroup Antidepressants Analogs, articles

Dosage form:

film-coated tablets

Compound

One film-coated tablet contains: active substance: mirtazapine 15 mg, 30 mg or 45 mg.

; excipients: lactose monohydrate – 44.40 / 88.80 / 133.20 mg, corn starch – 28.00 / 56.00 / 84.00 mg, hyprolose – 15.00 / 30.00 / 45.00 mg, microcrystalline cellulose – 15.00 / 30.00 / 45.00 mg, pregelatinized starch – 15.00 / 30.00 / 45.00 mg, talc – 1.40 / 2.80 / 4.20 mg, magnesium stearate – 0.70 / 1.40 / 2.10 mg, silicon dioxide – 0.50 / 1.00 / 1.50 mg; tablet shell: hypromellose-5 CPS – 2.40 / 4.80 / 7.20 mg, macrogol 6000 – 0.20 / 0.40 / 0.60 mg, titanium dioxide – 0.25 / 0.50 / 1, 05 mg, yellow iron oxide dye (E 172) (for dosages 15 mg and 30 mg) – 0.10 / 0.15 mg, red iron oxide dye (E 172) (for 30 mg dosages) – 0.05 mg, talc – 0.05 / 0.10 / 0.15 mg.

Description

15 mg: Oblong, yellow film-coated tablets with a score line on one side. 30 mg: Oblong, brownish-pink film-coated tablets with a score line on one side. 45 mg: Oblong, white film-coated tablets.

Pharmacological properties

The drug Calixta® is a tetracyclic antidepressant with a predominantly sedative effect.

The drug is most effective for depressive conditions with the presence in the clinical picture of symptoms such as an inability to experience pleasure and joy, loss of interest (anhedonia), psychomotor retardation, sleep disturbances (especially in the form of early awakenings) and weight loss, as well as other symptoms: suicidal thoughts and daily mood fluctuations. The antidepressant effect of Calixta® usually occurs after 1-2 weeks of treatment.

Pharmacodynamics Mirtazapine is an antagonist of presynaptic α2-adrenergic receptors in the central nervous system and enhances central noradrenergic and serotonergic transmission of nerve impulses.

In this case, the enhancement of serotonergic transmission is realized only through serotonin 5-HT1 receptors, since mirtazapine blocks serotonin 5-HT2 and 5-HT3 receptors.

Both enantiomers of mirtazapine are believed to have antidepressant activity, the S(+) enantiomer by blocking α2-adrenergic and serotonin 5-HT2 receptors, and the R(-) enantiomer by blocking serotonin 5-HT3 receptors.

The sedative properties of mirtazapine are due to its antagonistic activity towards H1-histamine receptors. Mirtazapine is generally well tolerated. In therapeutic doses, it has virtually no m-choline blocking effect and has virtually no effect on the cardiovascular system.

Pharmacokinetics After oral administration of the drug, mirtazapine is rapidly absorbed (bioavailability about 50%), reaching maximum plasma concentrations after approximately 2 hours. About 85% of mirtazapine is bound to plasma proteins.

The average half-life is from 20 to 40 hours (rarely up to 65 hours). A shorter half-life is observed in young people. The equilibrium concentration of the substance is reached after 3-4 days and subsequently does not change.

In the recommended dose range, the pharmacokinetic parameters of mirtazapine have a linear relationship with the administered dose of the drug. Food intake does not affect the pharmacokinetics of the drug. Mirtazapine is extensively metabolized and excreted in urine and feces over several days.

The main pathways of its metabolism in the body are demethylation and oxidation followed by conjugation.

Cytochrome P450 isoenzymes (CYP2D6 and CYP1A2) are involved in the formation of the 8-hydroxy metabolite of mirtazapine, while CYP3A4 presumably determines the formation of N-demethylated and N-oxidized metabolites. Demethylmirtazapine is pharmacologically active. Mirtazapine clearance is reduced in patients with renal or hepatic impairment.

Contraindications

Hypersensitivity to mirtazapine or to any of the excipients.

Patients with rare hereditary problems such as lactose intolerance, lactase deficiency or glucose-galactose malabsorption should not be prescribed Calixta®.

Since the safety and effectiveness of Calixta® for children have not been established, the use of Calixta® for the treatment of children under 18 years of age is not recommended.

Carefully

Correction of the dosage regimen and regular medical monitoring are necessary for the following categories of patients:

• patients with epilepsy and organic brain lesions (during treatment with Calixta®, in rare cases, seizures may develop);
• patients with liver or kidney failure;
• patients with heart disease (conduction disorders, angina pectoris or recent myocardial infarction);
• patients with cerebrovascular diseases (including a history of ischemic stroke);
• patients with arterial hypotension and with conditions predisposing to arterial hypotension (including dehydration and hypovolemia);
• patients who abuse drugs, are dependent on drugs that affect the central nervous system, with mania, hypomania.

Like other antidepressants, Calixta® should be used with caution in the following cases:

• urination disorders, incl. with prostatic hyperplasia;
• acute angle-closure glaucoma and increased intraocular pressure;
• diabetes;
• with simultaneous use of benzodiazepines with Calixta®.

The safety of using Calixta® during pregnancy in humans has not been established, but no teratogenic effect has been detected in animals, so the drug can be used during pregnancy only if the benefit to the mother outweighs the potential risk to the fetus. The use of Calixta® during lactation is not recommended due to the lack of data on its excretion in human breast milk. The tablets should be taken orally, with liquid if necessary, and swallowed without chewing. Adults:

The effective daily dose is usually between 15 mg and 45 mg; the initial dose is 15 mg or 30 mg.

Elderly patients:

The recommended dose is the same as for adults. In elderly patients, in order to achieve a satisfactory and safe response to treatment, increasing the dose should be done under the direct supervision of a physician.

Liver and kidney dysfunctions:

In patients with renal or hepatic impairment, the clearance of mirtazapine may be reduced. This should be taken into account when prescribing Calixta® in this category of patients. Calixta® can be taken once a day, preferably at the same time, before bedtime.

Calixta® can also be prescribed to be taken 2 times a day, dividing the daily dose in half (once in the morning and once at night, the higher dose should be taken at night). Treatment should, if possible, be continued for 4-6 months until the patient's symptoms disappear completely.

After this, treatment can be gradually withdrawn.

Mirtazapine usually begins to have its effect after 1-2 weeks of treatment. Treatment with an adequate dose should lead to a positive result in 2-4 weeks. If necessary, the dose can be increased to the maximum dose (up to 45 mg). If there is no positive dynamics of treatment, treatment should be stopped after another 2-4 weeks.

Side effect

People with depression experience a range of symptoms related to the disease, so it can sometimes be difficult to distinguish between symptoms related to the disease and symptoms caused by the drug. The following classification is used to indicate the frequency of side effects: very often (>1/10), often (>1/100 and 1/1000 and 1/10000 and

Source: https://medi.ru/instrukciya/kaliksta_12550/

Interaction with other drugs

https://www.youtube.com/watch?v=ytcopyrightru

Calixta should be prescribed with caution due to the risk of adverse effects resulting from interactions with other drugs. Thus, the drug, when taken with medications containing ethanol, can have a depressing effect on the central nervous system. When treated with anxiolytics of the benzodiazepine structure, the drug has a pronounced sedative effect.

It is not advisable to prescribe the antidepressant Calixta together with MAO inhibitors. You can take it no earlier than two weeks have passed since the end of treatment with MAO inhibitors.

The drug may have a negative effect when used together with inducers or inhibitors of metabolic enzymes, which have the ability to change the concentration of mirtazapine in the blood.

According to the results obtained during observations, in healthy people who took the cytochrome P450 inducer phenytoin along with mirtazapine 30 mg, a twofold increase in the clearance of mirtazapine was noted, due to which their plasma concentration of mirtazapine significantly decreased by 45%.

Carbamazepine, which is an inducer of cytochrome P450, is undesirable for joint use. If it is taken together with mirtazapine, it is possible to double the clearance of mirtazapine, which can have an even more negative effect and cause a decrease in the concentration of the active component in the blood plasma by 60%.

Another drug whose medicinal properties can be negatively affected by Calixta is Cimetidine. It is a weak inhibitor of CYP1A2, CYP2D6 and CYP3A4. It has been proven that when healthy people took this drug along with mirtazapine, an increase in the concentration of the substance by more than 50% was noted.

In people participating in a study of the CYP3A4 inhibitor ketoconazole who were prescribed mirtazapine with this drug, there was an increase in mirtazapine Cmax and AUC of approximately 40% and 50%, respectively.

The drug should be prescribed with caution to patients taking strong CYP3A4 inhibitors, which should primarily include azole antifungals, HIV protease inhibitors, Erythromycin and Nefazadone.

Myelotoxic drugs, which in combination with mirtazapine enhance the manifestation of hematotoxicity of the latter, can have a negative effect on this medication.

Calixta - instructions for use, reviews from patients and doctors

The drug Calixta is a tetracyclic antidepressant that has a sedative effect on the nervous system.

In accordance with the presented instructions for use, the drug Calixta is used in neurology and psychiatry.

In particular, the drug shows high effectiveness in mono- and polytherapy of depression of various etiologies. Due to the active effect of mirtazapine, the drug is prohibited for use in pediatrics.

General information about the drug Calixta

Calixta is a psychotropic drug that belongs to the group of antidepressant medications. INN – Mirtazapine. The main indication noted in the official instructions is depression of varying degrees of severity.

Forms of release and cost

Calixta is manufactured in the form of oblong tablets with the main component – ​​mirtazapine. The tablets are coated in different shades. The color of the shell depends on the dosage of the active component:

• yellow shell – mirzapine dosage 15 mg;
• pink-brown tablets – dosage 30 mg;
• white – 45 mg.

Tablets with 15 mg of active substance are packaged in blisters (30 pieces in one blister). There is 1 blister in a cardboard box along with the annotation.

Tablets with a dosage of 30 mg and 45 mg are packaged in 15 pieces in a blister, in a cardboard package there are 2 blisters and instructions for using the medication.

Average cost of Calixta in the Russian Federation:

Pharmacodynamics and pharmacokinetics

Mirtazapine is an antagonist of presynaptic adrenaline receptors in the central nervous system. The component enhances the transmission of impulses of noradrenergic and serotonergic types in nerve fibers.

The sedative effect of mirtazapine is due to inhibition of histamine H1 receptors. Mirtazapine is well tolerated by the patient, and in therapeutic dosages does not block choline receptors and does not affect the blood flow system and myocardial function.

The pharmacokinetics of the drug Calixta is as follows:

• absorption of the active component in the gastrointestinal tract is high;
• bioavailability – 50%;
• the maximum concentration in the blood plasma is diagnosed 120 minutes after taking the tablet;
• binding to plasma protein compounds – 85%;
• metabolism occurs in liver cells;
• dimethyl-mirtazapine is the active conjugate;
• the medication is eliminated from the body using the kidneys (with urine) and liver (with feces);
• The half-life of the main component is 20-40 hours.

Indications and contraindications for taking Calixta

The drug Calixta is effective in the treatment of depressive conditions with the following symptoms:

• lack of joy in life and loss of interest in it;
• psychomotor retardation;
• disturbance of sleep rhythms;
• emotional overexcitation;
• constant mood swings;
• a sharp decrease in body weight;
• thoughts about suicide.

It is prohibited to use Calixta for the following reasons:

• allergy to the medicinal composition;
• patients with genetic pathologies - lactase deficiency, as well as lactose intolerance;
• children under 18 years of age;
• lactation period and pregnancy.

During pregnancy, a doctor can prescribe medication therapy only if the benefits of treatment for the mother are higher than the risks of developing intrauterine pathologies in the child.

For treatment during the lactation period, it is necessary to interrupt feeding and transfer the newborn to artificial formula.

The drug is not used in pediatric practice due to insufficient information about the safety of Calixta in this period.

With great caution and dosage adjustments, it is prescribed to patients with the following pathologies:

• epilepsy;
• organic lesions of parts of the brain;
• kidney and liver failure;
• cardiological pathologies - myocardial infarction and ischemia, impaired conduction of cardiac impulses, angina pectoris;
• cerebrovascular pathologies – a history of ischemic stroke;
• hypotension and hypovolemia;
• dependence on medications;
• manias and phobias.

Also prescribed with restrictions for the following disorders in the patient’s body:

• prostate hyperplasia;
• impaired urination;
• angle-closure glaucoma;
• high intraocular pressure;
• diabetes.

Lerivon - instructions for use, reviews and analogues

Instructions for use of the drug Calixta

The tablets are taken orally whole, without breaking the protective shell. You need to drink them with enough water.

The daily dosage of Calixta ranges from 15 to 45 mg. The initial dosage is 15 mg or 30 mg, depending on the progression of the pathology.

The medicine is taken once a day, but if necessary, the doctor can distribute the daily dosage into 2 doses.

The medication must be taken at the same time, and when the dosage is divided into 2 doses, patients take most of the dose the night before going to bed.

The first therapeutic effect from the use of Calixta is noticeable 7-15 days after the start of therapy. The duration of the medication course is 4-6 months or until the severe symptoms of depression completely disappear. After the symptoms of the pathology disappear, the dosage should be reduced gradually over 4 weeks. Treatment with the maximum permissible dose can be carried out for no longer than 1 month.

The instructions indicate that for elderly patients, adjustment of the treatment regimen is not necessary. Increasing the therapeutic dose in elderly patients is carried out only under the supervision of the attending physician.

If there is no positive dynamics in therapy, then stop treatment with this medication and the doctor selects analogues of Calixta or prescribes another treatment regimen. In case of insufficiency of liver and kidney function, dose adjustment is necessary.

Possible side effects of Calixta and overdose

With depression, it is very difficult to distinguish the symptoms of a side effect of a drug from the symptoms of the disease. The use of the drug can provoke the following disorders:

• agranulocytosis and eosinophilia;
• aplastic anemia.

• drowsiness and decreased concentration and attention;
• sedation;
• headache and severe dizziness;
• lethargy;
• tremor and paresthesia;
• fainting;
• convulsions;
• stroke;
• paresthesia of the oral cavity.

• dryness of the oral mucosa and stomatitis;
• nausea, which can provoke a gag reflex;
• diarrhea;
• swelling of the oral mucosa;
• increased transaminases;
• epigastric and abdominal pain.

1. Dermatological manifestations:

• rashes on the epidermis and itching;
• hives.

1. Musculoskeletal system:

• myalgia and arthralgia;
• painful sensations in the back.

• increased appetite;
• overweight.

1. Blood flow system and myocardium:

• nightmares and insomnia;
• confusion and overexcitement;
• hallucinations and agitation;
• mania and thoughts of suicide;
• anxiety and irritability.

Overdose symptoms:

• CNS depression;
• disorientation in space and time;
• tachycardia and cardiac arrhythmia - arrhythmia;
• pressure fluctuations;
• coma and death.

Overdose therapy consists of the following measures:

• rinse the patient’s stomach and rid the body of any remaining medication;
• allow sorbents to be taken in;
• lay the patient horizontally and ensure unhindered air flow to him (open the window, unbutton the shirt collar);
• Call a doctor for resuscitation or symptomatic therapy.

Special recommendations for the use of Calixta

When using the drug Calixta in therapy, the following factors must be taken into account:

• In patients with pathologies such as schizophrenia, psychotic symptoms increase when using antidepressants. Paranoid thoughts also increase in such patients;
• the manic-depressive stage of psychosis, when used in the treatment of antidepressants, can go into the manic stage and rapidly progress;
• In patients under 24 years of age, Calixta and other antidepressants may provoke suicidal behavior and become a risk factor for thoughts of suicide. Therefore, before prescribing this medication, it is necessary to weigh all the positive and negative aspects of therapy. Treatment with Calixta must be carried out under the supervision of the attending physician;
• the medication is not addictive, but the medication must be discontinued gradually, reducing the dosage to the minimum, because if Calixta therapy is abruptly discontinued, the patient may develop negative withdrawal symptoms. Such manifestations may be associated with the underlying pathology and cause relapse of depression;
• during treatment with an antidepressant, it is prohibited to drink alcohol and alcohol-containing medications with any percentage of alcohol in them;
• The combined use of Calixta and Erythromycin, antifungal medications, and HIV protease inhibitors is not allowed;
• joint therapy with Cimetidine involves reducing the dosage of Calixta due to an increase in the concentration of the mirtazapine component in the blood;
• At the first symptoms of jaundice development in the body, therapy with this medication must be stopped.

Analogues of the drug

Substitutes for the drug Calixta can be structural drugs with mirtazapine, as well as drugs that have other active ingredients, but have the same therapeutic direction. The most popular analogues:

• Paroxetine - the active component of paroxetine, is a therapeutic substitute for Calixta. This medication is prescribed for the treatment of panic disorder, depression of various etiologies and different types - reactive, endogenous, as well as depression with a constant feeling of anxiety;
• structural analogue of Mirtazapine. This antidepressant is prescribed for the following mental pathologies - depression and anxiety, affective disorders and panic, obsessive-compulsive disorder, anorexia with constant nausea and severe vomiting, migraine-like pain and severe headaches with different locations, as well as for patients in the post-traumatic period after brain injury or severe stress;
• structural analogue of Noxibel. The antidepressant enhances adrenergic and serotonergic impulse transmission. The main component in the analogue is mirtazapine. It is prescribed for the following pathologies - anhedonia, insomnia and nightmares, psychomotor retardation, sudden weight loss, thoughts of suicide, paranoid thoughts, anxiety and the development of phobias.

Reviews about the use of Calixta

Reviews about Calixta are mixed both from psychiatrists and from patients. The toxicity of the drug is noted if therapeutic dosages are not observed and taken for a long time, but at the same time, the high effectiveness of the antidepressant and the ability of a short course of medication to restore a normal mental state are also noted.

Doctors

1. Kalinyuk Yu.N., psychiatrist: “I prescribe Calixta to patients with severe depression. The medication is part of a complex therapy that reduces the symptoms of anxiety and depression in a short course of 3-4 weeks. More severe forms of depression and depression can be treated for up to six months.”
2. Ivanova O.N., psychotherapist: “An excellent drug for the treatment of neurological disorders and sleep disorders. Particularly effective for the treatment of anxiety and depressive disorders in older patients. It is also worth noting the affordable price and high quality of the drug.”
3. Dokukin A.G.
   , psychiatrist: “I use it for depressive disorders of various kinds, there are practically no side effects, although in the first days of taking it, lethargy and lethargy are possible. The effect of the drug is determined quite quickly, it is similar to Amitriptyline.

   The price is quite high, but it is fully justified by the high quality of the drug.”