Feline
Update (June 15, 2026): Mirtazapine Transdermal (Mirataz) as Appetite Stimulant and Antiemetic in Cats
TL;DR. Mirtazapine transdermal (Mirataz) acts as both an appetite stimulant and an antiemetic in cats, addressing inappetence and nausea simultaneously -- clinically useful in CKD and oncology patients where both signs co-exist.
What just dropped
- Poole et al. 2019 (https://pubmed.ncbi.nlm.nih.gov/30506924/): pivotal RCT showed mean body weight change of +3.9% with Mirataz versus +0.4% with placebo over 14 days in cats with weight loss
- Research on mirtazapine transdermal pharmacology (https://pmc.ncbi.nlm.nih.gov/articles/PMC8772540/) characterized the formulation as having both appetite stimulant and antiemetic effects in cats
Context
Mirtazapine exerts its effects through multiple receptor mechanisms: 5-HT2 and 5-HT3 antagonism (contributing to appetite stimulation and antiemetic activity) and H1 histamine antagonism. In the pivotal Mirataz field study (Poole et al. 2019), cats gaining weight averaged +3.9% body weight change versus +0.4% in placebo-treated controls across the 14-day trial period.
Research evaluating the pharmacological profile of the transdermal ointment formulation also documented an antiemetic component to mirtazapine's action in cats. This dual profile -- appetite stimulant plus antiemetic -- makes the formulation particularly relevant in clinical scenarios where both inappetence and nausea coexist, such as chronic kidney disease, hepatic lipidosis, or gastrointestinal neoplasia. The transdermal delivery route (applied to the inner pinna) bypasses the compliance challenge of oral administration in debilitated or fractious cats.
What this changes in mirtazapine transdermal (Mirataz) for feline weight loss (https://www.thevoyage.ai/forvets/knowledge/mirtazapine-transdermal-cats-appetite)
The antiemetic dimension of Mirataz's mechanism -- documented in pharmacological characterization studies -- strengthens the rationale for its use in patients where nausea co-drives inappetence, a context not fully captured by the weight-loss indication alone.
Voyage Clinical Desk
From clinical question to SOAP draft -- cited differentials, live dose calculators, owner handouts. Trained on the veterinary canon (Plumb's, Ettinger, JVIM, ACVIM consensus, 50,000+ indexed references). First answer free, no signup.
Open Voyage Clinical Desk: https://www.thevoyage.ai/forvets/ask?context=update-2026-06-15-mirtazapine-transdermal-dual-mechanism
References
- Poole M et al. 2019. A placebo-controlled clinical trial of mirtazapine transdermal ointment (Mirataz) in cats. J Vet Intern Med. https://pubmed.ncbi.nlm.nih.gov/30506924/
- Appetite stimulant and anti-emetic effect of mirtazapine transdermal ointment in cats (2021). PMC8772540. https://pmc.ncbi.nlm.nih.gov/articles/PMC8772540/
Related reads
References
More clinical updates
Update (June 15, 2026): Maropitant Reduces Vomiting in CKD Cats Without Impairing Kidney Function Markers
A prospective study found maropitant significantly reduced vomiting in CKD cats while kidney function parameters stayed stable.
Read →Update (June 15, 2026): Gabapentin Sedation in Cats — ~40% Ataxia Rate Resolves Within 8 Hours
Van Haaften 2017: ~40% of cats given pre-visit gabapentin were wobbly at exam, all resolving within 8 hours — key data for administration timing and client counseling.
Read →Update (June 15, 2026): Long-Term Telmisartan for Hypertension in Cats — Noninferior to Benazepril, Sustained BP Control
Telmisartan is noninferior to benazepril for proteinuria (Sent 2015) and demonstrates sustained blood pressure control in long-term hypertension studies in cats.
Read →Update (June 15, 2026): Capromorelin (Entyce) Field Effectiveness — 244 Dogs, 36-58% Food Intake Increase
Pivotal studies: capromorelin produced 36-58% food intake increases; field effectiveness confirmed in 244 client-owned dogs (177 in effectiveness analysis).
Read →