dr falkinburg,i am 70 year old male with mild to moderate kidney gfr was 49 and no protein in urine.i am taking lunesta for sleep,but was thinking of  trying remeron.the fact that remeron stays in your body 30 hours,i dont know if its a good choice with kidney impairment.your answer would help me understand if i should stay on lunesta or switch to 15mg remeron/it seems to have a lot of side  effects compared to remeron.thanks for your help

Good evening, Mickey,

Your kidney function of 49 cc/min should not effect the dosing of remeron. That GFR should be more than adequate to excrete the drug.

However, remeron is an antidepressant and drowsiness is one of its side effects. Its main use is  for its psychotropic effects.
If you are not having difficulties with lunesta, and it is effective, I would be inclined not to rock the boat.

Another issue with remeron is that after you are on it for a while it must not be stopped precipitously because seizures (convulsions) can occur.

This may be more than you wanted from me, so, suffice it to say that your kidney function is not a concern here and should significantly impact the pharmacokenetics of remeron.

Good luck.


Dr Falkinburg  


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Newell R. Falkinburg, M.D., FACP


I am a board certified nephrologist and emeritus professor of medicine at a major medical school and past Director of Nephrology & Hypertension at a university affiliated hospital. I have expertise in all areas of clinical nephrology, dialysis, transplantation and plasmapheresis.


Professor of medicine Director of Nephrology


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