Fluoxetine (Prozac) pills - Instructions for Use, Dosage, Side Effects, Reviews

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Active substance: Fluoxetine.

ATC - N06AB03 fluoxetine.

Pharmacological group - Antidepressants.

Fluoxetine is a selective serotonin reuptake inhibitors (SSRI) antidepressant. Fluoxetine affects chemicals in the brain that may be unbalanced in people with depression, panic, anxiety, or obsessive-compulsive symptoms.

Fluoxetine is used to treat major depressive disorder, bulimia nervosa (an eating disorder) obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder (PMDD).

Fluoxetine is sometimes used together with another medication called olanzapine (Zyprexa). to treat depression caused by bipolar disorder (manic depression). This combination is also used to treat depression after at least 2 other medications have been tried without successful treatment of symptoms.

Fluoxetine Variations

Fluoxetine pills - pills 10 mg, N20

Fluoxetine pills - pills 20 mg, N20

Nosological classification (ICD–10)

F32 Depressive episode;

F42 Obsessive-compulsive disorder;

F50.2 Bulimia Nervosa.

Fluoxetine Composition, structure and packing

Fluoxetine pills - Hard gelatin capsules, ¹4, with the body in white and blue cap; the contents of the capsules - granules white or almost white.

Excipients: lactose monohydrate (milk sugar), microcrystalline cellulose, colloidal silicon dioxide (Aerosil), magnesium stearate, talc.

The composition of the capsule shell: gelatin, titanium dioxide.

Fluoxetine Pharmacological action

Antidepressant, propylamine derivative. The mechanism of action is associated with selective blockade of reverse neuronal uptake of serotonin in the CNS. Fluoxetine is a weak antagonist of choline, adrenergic and histamine receptors. Unlike most anti-depressants, fluoxetine, apparently, does not cause reduction in the functional activity of postsynaptic β-adrenoceptors. Helps to improve mood, reduce fear and stress, eliminates dysphoria. Does not cause sedation. When you receive a medium therapeutic doses virtually no effect on the cardiovascular and other systems.

Pharmacokinetics

Absorbed from the gastrointestinal tract. Poorly metabolized in the “first pass” through the liver. Ingestion not affect the extent of absorption, although it may slow down its speed. C max plasma achieved after 6–8 h. C ss plasma achieved only after continuous administration for several weeks. Protein binding is 94.5%. Easily penetrates through the BBB. Metabolized in the liver by demethylation to form the main active metabolite norfluoxetine.

T 1/2 fluoxetine is 2–3 days, norfluoxetine - 7–9 days. Excreted by the kidneys 80% and through the intestines - 15%.

Fluoxetine Dosage

Initial dose - 20 mg 1 time/day in the morning; if necessary, the dose may be increased after 3–4 weeks. The frequency of reception - 2–3 times/day.

The maximum daily dose administered to adults is 80 mg.

Fluoxetine Drug Interactions

While the use of drugs, providing a depressing effect on the CNS, with ethanol may significantly increased inhibitory action on the CNS, as well as increase the likelihood of seizures.

With the simultaneous use with MAO inhibitors, furazolidone, procarbazine, tryptophan may develop serotonin syndrome (confusion, hypomania, restlessness, agitation, seizures, dysarthria, hypertensive crisis, chills, tremors, nausea, vomiting, diarrhea).

With simultaneous application of fluoxetine inhibits metabolism tricyclic and tetracyclic antidepressants, trazodone, carbamazepine, diazepam, metoprolol, terfenadine, phenytoin, which increases their concentration in the serum, increasing their therapeutic and adverse effects.

With simultaneous use may oppression biotransformation of drugs metabolized with the participation of isoenzyme CYP2D6.

While the use of hypoglycemic agents may increase their activities.

There are reports on the strengthening effects of warfarin in its simultaneous application with fluoxetine.

While the use of haloperidol, fluphenazine, maprotilinom, metoclopramide, perphenazine, peritsiazinom, pimozide, risperidone, sulpiride, trifluoperazine describes cases of extrapyramidal symptoms and dystonia; with dextromethorphan - described a case of hallucinations; with digoxin - the case of increasing the concentration of digoxin in the blood plasma.

In an application with lithium salts may increase or decrease the concentration of lithium in blood plasma.

With simultaneous use may increase the concentration of imipramine and desipramine in plasma is 2–10 times (and may persist for 3 weeks after discontinuation of fluoxetine).

While the use of propofol, a case in which spontaneous movements were observed; with phenylpropanolamine - described a case in which were observed dizziness, weight loss, hyperactivity.

With simultaneous use may increase the effects of flecainide, mexiletine, propafenone, thioridazine, zuclopenthixol.

Fluoxetine at Pregnancy and lactation

Contraindicated during pregnancy and lactation.

Fluoxetine Side effects

CNS: possible anxiety, tremor, nervousness, drowsiness, headache, sleep disturbances.

On the part of the digestive system: diarrhea, nausea.

From a metabolism: possible increased sweating, hypoglycemia, hyponatremia (especially in elderly patients and when hypovolemia).

Reproductive system: decreased libido.

Allergic reactions: possible skin rash, itching.

Other: pain in joints and muscles, shortness of breath, increased body temperature.

Fluoxetine Indications

Depression of various origins, obsessive-compulsive disorders, bulimic neurosis.

Fluoxetine Contraindications

Glaucoma, bladder atony, severe renal dysfunction, benign prostatic hyperplasia, co-administration of MAO inhibitors, convulsions of various origins, epilepsy, pregnancy, lactation, hypersensitivity to fluoxetine.

Fluoxetine Cautions

With extreme caution in patients with impaired liver function and kidney, with a history of epileptic seizures, cardio-vascular diseases.

Patients with diabetes can change the level of glucose in the blood, which requires the correct dosing regimen hypoglycemic agents. When used in debilitated patients with fluoxetine increases the likelihood of developing seizures.

With simultaneous use of fluoxetine and electroconvulsive therapy may develop prolonged seizures.

Fluoxetine can be applied not earlier than 14 days after discontinuation of MAO inhibitors. The period after the abolition of fluoxetine before therapy MAO inhibitors should not be less than 5 weeks.

Elderly patients need correction of dosing regimen.

Safety of fluoxetine in children has not been established.

During treatment avoid alcohol.

Effects on ability to drive vehicles and management mechanisms

During the period of treatment should refrain from potentially hazardous activities requiring increased attention and rapid psychomotor reactions.

Fluoxetine Reviews

William, 32 years, At the moment, only the drug Fluoxetine pulled out of six-month depression …

Elena 45 years, Fluoxetine is inexpensive, have sedative and hypnotic action effect without increasing the maintenance dose is well tolerated, effective.

Ban 33 years, At the age of 13-14 I became depressed. Probably, it happens many teenagers: nobody loves me, I'm ugly / a unlucky / a, would be better if I was not in this world! I also still have a big problem in the family, and then a few sessions with a psychologist would solve this problem. But because most of these family problems on my problem did not pay proper attention, and I myself thought that this is only a bad mood, and soon everything will pass. But up to 19 years, nothing has passed, the problems accumulated, sometimes have thoughts of suicide, and now I realize how scared I was close to suicide. The problem is that I do not understand why I feel so bad; without false modesty, I say: I have a very beautiful girl, have friends, of course, I am not deprived of the attention of the opposite sex, and nothing I do not know failure. But I did not want to live, I thought that I was in a deep hole, and no one will help me out. I realized that I have a really big problem, and we must do something!

Honestly, I have learned about Fluoxetine/Prozac is online psychological support. To the doctor, I never went and decided without consulting drink this drug. Make a reservation, it is better to first consult with your doctor, and do not rely on the age-old Russian "maybe". I saw this drug 6 months. began to see the effect after 2 weeks of treatment: I began to improve mood, I started looking for a way out of a depressed state, there was power, I became interested in new things, a new hobby. Over time, somewhere in 4-5 months, I realized that I Fluoxetine/Prozac is no longer needed - I was happy! But all the same cutting a full 6 month course of "just in case".

Those who face such a disease as "prolonged depression" will understand my euphoria, from what I felt alive again. And I'm eternally grateful to this drug for it!