Indications |
Oral Depression Adult: 20-40 mg daily. Max: 80 mg daily. Child: 8-18 yr: 10-20 mg daily; initiate at 10 mg daily for lower-wt children, may increase to 20 mg/day after 1 wk if necessary. Elderly: Initially, 10 mg daily, may increase by 10-20 mg every few wk as tolerated. Max Dosage: Hepatic impairment: Dose adjustments may be needed. Oral Bulimia nervosa Adult: 60 mg daily. Hepatic impairment: Dose adjustments may be needed. Oral Obsessive compulsive disorder Adult: Initially, 20 mg daily increased up to 60 mg daily after several wk if unresponsive. Max: 80 mg daily. Child: 7-18 yr: Initially, 10 mg daily; may increase to 20 mg daily after 2 wk in adolescents and higher-wt children. Usual range: 10-60 mg daily. Hepatic impairment: Dose adjustments may be needed. Oral Premenstrual dysphoric disorder Adult: 20 mg daily continuously. Alternatively, 20 mg daily, to be started 14 days before onset of menstruation and continue until 1st day of menses. May repeat with each cycle, if needed. Hepatic impairment: Dose adjustments may be needed. Oral Panic disorder Adult: Initial dose: 10 mg daily, may increase to 20 mg daily after a wk. May increase to 60 mg daily after a few wk, if needed. Hepatic impairment: Dose adjustments may be needed. |
Contraindications |
Severe renal or hepatic failure; hypersensitivity; lactation; concomitant MAOIs or within 2 wk of MAOI withdrawal. |
Warnings / Precautions |
Unstable epilepsy, liver and renal impairment, cardiac disease, diabetes, electroconvulsive therapy, bleeding disorders, closed-angle glaucoma; pregnancy. May impair performace of skilled tasks; withdraw gradually. Close monitoring of clinical worsening and behavioural changes during the 1st few mth of treatment or when there are dose changes. |
Adverse Reactions |
Nervousness, insomnia, anxiety, headache, tremor, drowsiness, dry mouth, nausea, vomiting, sweating, diarrhoea. Seizures, mania, hypomania or mixed manic states reported. Hyponatraemia; elevation of hepatic enzymes. Potentially Fatal: Rarely, systemic events possibly related to vasculitis have been reported in patients with rash but may be serious involving lungs, kidney and liver. |
Overdose Reactions |
Symptoms include abnormal accommodation, abnormal gait, confusion, unresponsiveness, nervousness, pulmonary dysfunction, vertigo, tremor, increased BP, impotence, movement disorder and hypomania. Treatment is supportive, activated charcoal may be used to remove unabsorbed drug. |
Drug Interactions |
May cause transient shift in plasma conc of tightly protein bound drugs e.g. warfarin and digoxin, resulting in adverse effects. T1/2 of diazepam is prolonged. Avoid concurrent use with clopidogrel. Potentially Fatal: Serious reactions when combined with MAOIs; at least 14 days should elapse after MAOIs withdrawal before starting fluoxetine treatment or at least 5 wk should elapse after fluoxetine treatment before starting MAOIs therapy. Two-fold increase in plasma levels of other antidepressants when combined with fluoxetine. Monitor lithium levels when combined. See Below for More fluoxetine Drug Interactions |
Mechanism of Actions |
Fluoxetine is a potent and highly selective inhibitor of serotonin (5-HT) re-uptake. No affinity for adrenoceptors or histamine, GABA-B, or muscarinic receptors. Absorption: Oral admin: Readily absorbed from the GI tract; peak plasma concentrations after 6-8 hr. Distribution: Widely distributed; enters breast milk. Protein-binding: 95%. Metabolism: Extensively hepatic by demethylation to norfluoxetine. Excretion: Urine. Elimination half-life: 1-3 days (fluoxetine), 4-16 days (norfluoxetine). |
Administration |
May be taken with or without food. |
Storage Conditions |
Oral: Store at 15-30°C. |
ATC Classification |
N06AB03 - fluoxetine ; Belongs to the class of selective serotonin reuptake inhibitors. Used in the management of depression. |
Storage |
Oral: Store at 15-30°C. |
Available As |
|
Fluoxetine
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Fluoxetine Containing Brands
Fluoxetine is used in following diseases
Drug - Drug Interactions of Fluoxetine
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