Can Mirtazapine (Remeron) Tablets Be Crushed?
No, you should not crush standard Remeron tablets, but the orally disintegrating tablet formulation (REMERONSolTab) is specifically designed to disintegrate on the tongue without crushing and can be used for patients who have difficulty swallowing.
Standard Tablets vs. Orally Disintegrating Tablets
The FDA labeling for Remeron provides clear guidance on administration 1:
- Standard Remeron tablets: No specific instructions permit crushing these tablets in the official labeling
- REMERONSolTab (orally disintegrating tablets): Explicitly designed for patients with swallowing difficulties and should not be crushed, chewed, or split 1
How to Use REMERONSolTab Properly
If your patient cannot swallow tablets, REMERONSolTab is the appropriate formulation 1:
- Keep in blister pack until ready to use
- Use dry hands to open the blister
- Place tablet directly on the tongue
- Allow it to disintegrate (melts rapidly)
- Can be swallowed with saliva alone—no water needed
- Do not crush, chew, or split the orally disintegrating tablet
Important Clinical Considerations
Crushing medications poses significant risks, particularly with modified-release formulations 2. While the standard Remeron tablet is not an extended-release formulation, crushing any medication without explicit guidance can:
- Alter absorption kinetics
- Potentially increase adverse effects
- Create dosing inaccuracies
- Pose unrecognized hazards, especially in older adults 2
Practical Recommendation
If your patient has difficulty swallowing:
- Switch to REMERONSolTab formulation (available in 15 mg, 30 mg, and 45 mg strengths)
- If REMERONSolTab is unavailable or cost-prohibitive, consult with a pharmacist before crushing standard tablets
- Never assume a tablet can be safely crushed without verification
The orally disintegrating formulation provides the same bioavailability as standard tablets with minimal food effect 1, making it the safest and most appropriate option for patients with swallowing difficulties.