Side effects of fluoxetine hcl 10mg
Fluoxetine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing
Warnings:
Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.
Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.
Warnings:
Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.
Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech).
Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.
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Uses
Fluoxetine is used to treat depression, panic attacks, obsessive compulsive disorder, a certain eating disorder (bulimia), and a severe form of premenstrual syndrome (premenstrual dysphoric disorder).This medication may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. It may decrease fear, anxiety, unwanted thoughts, and the number of panic attacks. It may also reduce the urge to perform repeated tasks (compulsions such as hand-washing, counting, and checking) that interfere with daily living. Fluoxetine may lessen premenstrual symptoms such as irritability, increased appetite, and depression. It may decrease binging and purging behaviors in bulimia.
How to use fluoxetine oral
Read the Medication Guide provided by your pharmacist before you start using fluoxetine and each time you get a refill.
If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth as directed by your doctor, usually once daily in the morning. If you are taking this medication twice a day, your doctor may direct you to take it in the morning and at noon.
If you are taking fluoxetine for premenstrual problems, your doctor may direct you to take it every day of the month or just for the 2 weeks before your period through the first full day of your period. To help you remember, mark your calendar.
If you are using the liquid form of this medication, measure the dose carefully using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Take this medication regularly to get the most benefit from it.
To help you remember, take it at the same time each day.
Keep taking this medication even if you feel well. Do not stop taking this medication without first consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased.
You should see some improvement in 1 to 2 weeks. It may take 4 to 5 weeks before you feel the full benefit.
Tell your doctor if your condition does not improve or if it worsens.
Side Effects
See also Warning section.
Nausea, drowsiness, dizziness, anxiety, trouble sleeping, loss of appetite, tiredness, sweating, or yawning may occur. If any of these effects last or get worse, tell your doctor promptly.
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: unusual or severe mental/mood changes (such as agitation, unusual high energy/excitement, thoughts of suicide), easy bruising/bleeding, muscle weakness/spasm, shakiness (tremor), decreased interest in sex, changes in sexual ability, unusual weight loss.
Get medical help right away if you have any very serious side effects, including: bloody/black/tarry stools, vomit that looks like coffee grounds, seizures, signs of kidney problems (such as change in the amount of urine), eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night, blurred vision).
If you have diabetes, fluoxetine may affect your blood sugar levels. Monitor your blood sugar regularly and share the results with your doctor. Your doctor may need to adjust your medication, diet, and exercise when you start or stop fluoxetine.
This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.
Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Precautions
Before taking fluoxetine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, personal or family history of suicide attempts, liver problems, diabetes, low sodium in the blood (such as may occur while taking "water pills" - diuretics), severe dehydration, seizures, stomach/intestinal ulcers, personal or family history of glaucoma (angle-closure type).
This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
The liquid form of this medication contains alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease.
Some medications (such as metronidazole, disulfiram) can cause a serious reaction when combined with alcohol. Ask your doctor or pharmacist about using this product safely.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Children may be more sensitive to the side effects of this drug, especially weight loss. Monitor weight and height in children who are taking this drug.
Older adults may be more sensitive to the side effects of this drug, especially bleeding and loss of coordination. Loss of coordination can increase the risk of falling. Older adults may also be more likely to develop low sodium in the blood, especially if they are taking "water pills" (diuretics).
During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying.
If you notice any of these symptoms in your newborn, tell the doctor promptly.
Since untreated mental/mood problems (such as depression, panic attacks, obsessive compulsive disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor.
This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
Interactions
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Fluoxetine can stay in your body for many weeks after your last dose and may interact with many other medications. Before using any medication, tell your doctor or pharmacist if you have taken fluoxetine in the previous 5 weeks.
Some products that may interact with this drug include: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as warfarin).
Taking MAO inhibitors with his medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for 2 weeks before and at least 5 weeks after treatment with this medication. Ask your doctor when to start or stop taking this medication.
This medication can slow down the removal of other medications from your body, which may affect how they work.
Examples of affected drugs include pimozide, thioridazine, vinblastine, antiarrhythmics (such as propafenone, flecainide), tricyclic antidepressants (such as desipramine, imipramine), among others.
Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise.
The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including other SSRIs such as citalopram/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).
Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
This medication may interfere with certain medical/laboratory tests (including brain scan for Parkinson's disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
Does fluoxetine oral interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker
Overdose
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast/irregular heartbeat, severe dizziness, fainting.
Do not share this medication with others.
Keep all regular medical and psychiatric appointments.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
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This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
Effectiveness, Ease of Use, and Satisfaction
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3.8 Overall Rating
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Most voted positive review
45 People found this comment helpful
This drug has literally saved my life.
(and the lives of my family). I was down on myself and treated others badly. I had anger issues and was very unhappy and I didn't know why. This drug has made my mood swings go away and I feel more in control. I am now a very happy person and can deal with everyday life and the challenges it brings. I have a son with ADHD and I am now more patient with hi...
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Most voted negative review
12 People found this comment helpful
I just started this drug an hour ago (20mg) and I noticed my jaws starting to hurt and a slight headache. I'm falling asleep reading the reviews. I was feeling fine just before taking the medication. I hope I sleep tonight. Is this just happening to me?
Shared reviews and ratings
SORT BYCondition: Bipolar Depression
Overall rating 2.0
EffectivenessEase of UseSatisfactionWow, just wow ?? I took one dose and turned into a monster.
Completely psychotic. So anxious, couldn’t stop crying, paranoid and filled with terror. It’s been 3 days since that dose and I still don’t feel like myself. Had decided on a change from 120 cymbalta as it didn’t seem to be working anymore after years on it. Now I am going to concentrate on exercise and CBT instead. Sure didn’t work for me, a horrible experience ?? Glad it works for some though, I guess this just proves we are all different!Read More Read Less
1
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Fill 3Created with Sketch.Condition: Anxiousness associated with Depression
Overall rating 4.7
EffectivenessEase of UseSatisfactionI was on 20mg for a long time and it worked amazing for my anxiety and depression.
I had little to no symptoms. However, it KILLED my sex drive to the point my marriage was not in a good place. I made the decision to move down to 10mg to see what would happen (as I don't want to go off them), and for me, it is a good balance. While some of my anxiety symptoms have come back, they are still better and I have my sex drive back! Worth it.
1
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Fill 3Created with Sketch.Condition: Panic Disorder
Overall rating 5.0
EffectivenessEase of UseSatisfactionI have been on fluxoetine for 3 years it's honestly saved my life I was in a very dark place and constantly anxious .. having multiple panic attacks a day it was a living hell.. I started of on a low dose of 10mg as I was terrified of the side effects .
.. I had previously tried a couple different AD but didn't get passed one day on them as the side effects where brutal.. fluxoetine side effects wernt as severe for me so I stuck with it and each day that passed I started getting back to my old self.. finally escaping the obsessive thoughts in my mind.. I went up to 20mg it was great but felt like there was more room for improvement so went upto 30mg .. have felt amazing but recently I had a relapse in my mental health due to a few different health problems and an absorbing problem due to other medications.. my doctor then upped my dose to 40mg .. side effects were bare able but I felt like nothing was happening I was back to the obsessive thoughts and panic attacks.. I'm now on day 12 of my increased dose and I'm starting to feel and notice a difference in myself thank god.. I woke up this morning and actually forgot all about panic and anxiety.. as the day goes on the thoughts slip into my mind but iam able to pass over them and not panic.
.. so far this increased dose has been great.. I will check in with my doctor again in a few weeks to see if they would like to keep me on this dose or bump me up a bit more... but anyone out there that is struggling.. everyday will get better just stick with it!! There really is light at the end of the tunnel!! It definitely takes at least 2 weeks to get Into your system.. keep a dairy of how u feel each day.. uve got this!Read More Read Less
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Fill 3Created with Sketch.Condition: Panic Disorder
Overall rating 5.0
EffectivenessEase of UseSatisfactionI was really nervous to start this medicine only because I had previously tooken Lexapro and it made my anxiety worse.
I have been diagnosed with generalized anxiety and panic disorder, FLOXUTINE GAVE ME MY LIFE BACK and I am forever greatful. I started on 10mg, The first week I had a mild headache and still experienced dizziness from my anxiety until I was able to be put on 20 mg. Now that I'm on 20 mg and have been for awhile I can definitely see a difference and I no longer experience dizziness. My tip for you is FIND A PHYACTRIST THAT LISTENS.. mine started me out on a low dose due to me being skeptical cause of Lexapro and I'm happy I waited it out and gave it a shot because I feel so much better. No more late night hospital trips Read More Read Less
1
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Fill 3Created with Sketch.Condition: Panic Disorder
Overall rating 4.7
EffectivenessEase of UseSatisfactioni started taking prozac 23 days ago.
.... and to be honest the first week was super hard, i suffered from nausea, dizziness, flu like symptoms and i wasn't able to get out of bed..... now after 23 days i can tell that i feel much better ..... this medication literally helped me get through my panic and anxiety disorder
1
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Fill 3Created with Sketch.Condition: Major Depressive Disorder
Overall rating 4.3
EffectivenessEase of UseSatisfactionSo far so good! I have been on it for 23 days. I am taking 40mg.
1
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Condition: Depression
Overall rating 1.0
EffectivenessEase of UseSatisfactionNOT FOR PEOPLE WHO HAVE PANIC ATTACKS. I put my reason for taking this medication as depression but it was actually anxiety. I have medication anxiety in addition to a mild panic disorder (1-2 panic attacks a month) at the time, and i say at the time because taking this medication caused my mild panic disorder to become a full-blown panic disorder (3-4 panic attacks per week that were way more intense than before) after taking the first and only dose i ever took. in addition to my GAD & panic disorder, i have medication anxiety. i had tried lexapro before this medication & got just about every side effect possible after the first dose which made my medication anxiety worse. to deal with the anxiety of trying this medication for the first time, i got the smallest dose possible, and CUT IT IN HALF.
about 45 minutes after taking it i was hit with a sickening wave of anxiety that caused the longest lasting anxiety attack i’ve ever had, about 3 hours. i threw up multiple times and was completely unable to get food down. the anxiety exhausted me until i could nap and that would help to reset me for awhile, but eventually i would have another anxiety attack once i woke up. this went on for 3 days & i had extremely heightened anxiety for weeks afterward where i struggled to even go on car rides without having a panic attack (i found out later that fluoxetine can last up to a month in your system after you take it). i started to feel somewhat normal after that, but the damage on my psyche was done & i now understood i was not safe from these horrible anxiety attacks in my own room, hence now having a full-blown panic disorder. i definitely think that my existing anxiety enhanced the side effects of this medication, but the medication definitely played a significant part in it because im on a different medication now & didn’t have nearly the same effects despite having more anxiety about taking it.
i purposely avoided looking at side effects before i tried it to avoid my anxiety creating the side effects i read, but i did find out heightened anxiety is a side effect of this medication after recovering from trying it. so unbelievably not worth it if you are wanting something to help with panic attacks: talk to your doctor about buspirone or Buspar if you have medication anxiety & panic attacks, steer VERY clear of this horrible medication.Read More Read Less
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Fill 3Created with Sketch.Condition: Depression
Overall rating 2.3
EffectivenessEase of UseSatisfactionI took this for a few weeks about 20 years ago, and it was the worst experience in my life.
I was suffering with depression (still am), and was prescribed this drug to help. Within 2 weeks of taking it, it unlocked what I can best describe as a darker version of myself. Less caring, rough and menacing. I felt like I was watching myself do things that I couldn’t stop or control. One particular incident made me come off the tablets immediately because I did not like the person Fluoxetine had turned me into. It put me off trying other antidepressants for 20 years. (I have just started taking a different one) So while I am in the 45-54 bracket now, I was in the 19-24 bracket back then. Read More Read Less
1
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Fill 3Created with Sketch.Condition: Depression
Overall rating 2.0
EffectivenessEase of UseSatisfactionThanks for the suicide thoughts and voices in my head never will I ever touch fluoxitine ever
1
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Fill 3Created with Sketch.Condition: Depression
Overall rating 3.0
EffectivenessEase of UseSatisfactionI just started to take Prozac. The first 4 days I was sleepy and dizzy! On the fifth day I got indigestion and heart burn. I am sure it’s a side effect! Question is does it pass , or is it here to stay! I feel so sick on it! I’m willing to give it a try and stay longer, but I hope it will pass. I did not know it had to be taken at the same time everyday. Can anyone tell me if this has happened to them and does it pass !!
1
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Condition: Depression
Overall rating 5.0
EffectivenessEase of UseSatisfactionI have tried most antidepressants and others haven't agreed with me, only fluoxetine, the first week I felt a bit tired, but after that I had no negative symptoms what so ever , I never gained no weight, it really made me a calm person and feel like a normal person, I look forward to things now, I'm more confident since taking these. Only on 20mg aswell for now not upped it in the 2 years I've been taking them, which is good.
1
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Fill 3Created with Sketch.Condition: Depression
Overall rating 5.
0
I have anxiety, depression, and ocd and this medicine has made living so much easier I feel normal
1
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Fill 3Created with Sketch.Condition: Depression
Overall rating 5.0
EffectivenessEase of UseSatisfactionThese tablets changed my life. Before I was depressed, was in hospital, bad anxiety attacks, missing work, couldn’t laugh. tried sertraline no joy, citalopram, seroxat and nothing worked. These gave me a bad stomach for 3 days, after 1 month I noticed that my emotions were all still there, I’m exactly the same person but just…..have a buffer against panick and anxiety/low mood I used to experience, I no longer feel like I’m going to die every day, and when I get bad news it doesn’t floor me.
Im no longer irritable and I’m a lot more patient than I was before - highly recommend :) Read More Read Less
1
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Fill 3Created with Sketch.Condition: Posttraumatic Stress Syndrome
Overall rating 1.0
EffectivenessEase of UseSatisfactionI am just starting.. Although a little weary as I don't do anti deps. My main concern is weight gain.. Prescribed 29 mg one a day zydud flyoxetine? Feedback would be greatly appreciated
1
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Fill 3Created with Sketch.Condition: Repeated Episodes of Anxiety
Overall rating 5.
0
This is going to be a long post, but I really hope that anyone thinking about taking this medication who is scared to start will read it the whole way through. I am a therapist, and I have Generalized Anxiety Disorder, and some OCD tendencies, like listing, checking, and intense intrusive thoughts about harm, health, and safety. I have had anxiety since as early as I can remember but it wasn’t until my 20s that it really started to interfere with my life. Even as a therapist I had stigma about taking meds, and fears that it would dull my personality, or dull my creativity, or dull the positive emotions I feel. I was scared it would fundamentally change me and my sensitivities to life, which can be a source of pain but also a source of joy. I started on 10mg, and had a hard time for a month, I experienced insomnia, intense moments of anxiety, fogginess, fatigue, and mild dizziness.
Then I had a few great weeks on 10mg. I decided to up the dose to 20mg, and I actually experienced a hard time for about 5 weeks while I adjusted. I kept wanting to throw in the towel and go back to 10mg but something kept me waiting to see if things would feel better. During the five weeks adjusting to 20mg I experienced fogginess, fatigue, dizziness, mild disorientation, and anxiety. I really just didn’t feel like myself and it was scary and really hard. After 5 weeks everything changed. I now feel like I have been given a huge gift, kind of like I have been given a version of my life I didn’t know I could have. I can lay on the couch and feel safe in my body and safe in my mind instead of worrying what catastrophe could be lurking around the corner. I can go to sleep at night excited to sleep instead of fearing it will be an insomnia night. I can turn off the stove and check that it is off once instead of keeping going back to check over and over while my body gets all tight with anxiety.
I can hug my people and animals I love without immediately feeling a pang of anticipatory grief that one day I will lose them. I can lay on my deck and look at the sky and trees and feel the breeze on my face and feel grateful for my life, instead of immediately looking for a problem or thinking about a worst case scenario situation that could rob me of my happiness and contentment. I am someone who is deeply committed to doing my own inner work and I have worked for years and years on my head. I have journaled, I have become a therapist, I have been in therapy for years, I have learned to meditate, I have done anxiety workbooks, read self help books, learned about the mind body connection, learned how to really take care of myself from resting, to exercising, to learning yoga etc, taken courses on anxiety, and the list could go on and on. I didn’t want that to stop on Prozac, and that was one my fears about taking this medication. I did not want to completely lose the highs and lows of life, I wanted to keep doing my inner work, but I also did not want to have to work so hard just to function sometimes.
I can say now that Prozac does not diminish my inner work at all, instead it facilitates it. I still see my habitual response to a peaceful moment is to look for a problem, but now I have some distance on that pattern and I can see it without immediately getting lost in fear thoughts. The distance allows me to work with fear thoughts rather than just getting hooked. This medication allows me to notice when I am happy and safe, and trust those moments and enjoy them, without fear crashing in and ruining it. I have spent so much of my life thinking about darkness, pain, and fear. This medication has allowed me to notice peace, happiness, and contentment, and connect to the love in my life without the fear of loss ruining a moment. I still feel all the subtle changes in moods and emotions that I always did, but when it is around something irrational I can see what is happening in my mind and work with it, rather than getting swallRead More Read Less
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Fill 3Created with Sketch.Condition: Major Depressive Disorder
Overall rating 4.7
EffectivenessEase of UseSatisfactioni started this medication over a year ago (coming up two years) i recently had come off a drug that had not worked for me so i was referred to a psychiatrist after my gps recommendations were not working for me. I was being treated for PTSD, bulimia nervosa, anxiety and major depressive disorder. However as this SSRI took 3 weeks to a month to start fully working, it worked. I am much happier and it has stopped my negative thoughts. Although this drug has given me side effects such as weight loss, feeling numb, and very decreased sex drive. I am coming off SSRIs soon, but i will definitely say it saved my life.
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Fill 3Created with Sketch.Condition: Depression
Overall rating 5.0
EffectivenessEase of UseSatisfactionThis medication was a godsend for me. The only real side effects for me was that it somewhat blunted my emotions and it really lowered my sex drive, but other than that, it was great --no weight gain, no nausea, no dizziness, no anxiety, etc. Then after 3.5 years, it suddenly stopped working for me. Pretty upsetting for me.
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Condition: Obsessive Compulsive Disorder
Overall rating 5.0
EffectivenessEase of UseSatisfactionSo when we were put into lockdown round 2 in England I was working on my own in the office, overtime, through breaks, hour train and back it was highly stressful especially at 20 and other factors in my personal life led to a massive mental breakdown. I had depression, ocd and anxiety in the past quite badly as a teen so I thought if I could get myself out of that I could get myself out of anything my brain challenged me to. Not the case. This time it hit me like a tonne of bricks. Overnight I went from a normal happy, all though stressed individual to an absolute wreck. I eat less then 100 calories a day on the days I could get something down. Physically shaking from the second I woke up to the second I went to sleep I was written out of work by my dr.
On the days I didn’t have nightmares I’d wake up in the early morning heart racing body shaking and no matter what I tried it did not stop. Meditation, herbal remedies, teas, video therapy…nothing. I was adamant I didn’t want to take any medication as all the times in the past I had got through it on my own and so I didn’t want to give in but after only a month of the same intrusive thoughts, racing heart, nausea that couldn’t be stopped I reluctantly gave in. Best decision I ever made I truly believe I would still be ill if I hadn’t taken anything. I remember going through this and other review websites for hours on end reading good reviews wishing this was all I needed. After 2 weeks I had seen a tiny amount of improvement however I had been told by family members who take this medication they felt much better after 2 weeks so I was at a point wondering if it would work. It does. after 2 weeks my heart wasn’t pounding out of my chest. After 4 the intrusive thoughts started to quieten and now I don’t hear them at all.
I know you’re thinking 4 weeks! I can’t live like this for that long but you can and you will nothing lasts forever and this too shall pass!Read More Read Less
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Fill 3Created with Sketch.Condition: Major Depressive Disorder
Overall rating 4.3
EffectivenessEase of UseSatisfactionI began on fluoxetine again about a year ago (20mg) and that dosage was fabulous until about 4 weeks ago. I began to have some more intense depressive symptoms and asked my psychiatrist if it would be ok at up my dosage to get me over the hump. She approved 40mg; I chose to begin at 30mg. Didn't help much for the 2 weeks I used it. I just upped my dose to 40mg and am going to ride this out for a month or so to give it time to fully get into my system.
I have a feeling that this might be my necessary dose for a while. I've gained about 15lbs from my lowest weight during COVID; still down about 40lbs total from my highest weight so that has been a good thing. Will update in a few more weeks. Praying for really good results!Read More Read Less
2
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Fill 3Created with Sketch.Condition: Repeated Episodes of Anxiety
Overall rating 5.0
EffectivenessEase of UseSatisfactionProzac (fluoxetine) is a wonder drug for me! It massively helped in treating my anxiety & panic attacks. I started taking 10 mg and was titrated up to 40 mg without any negative side effects. For the first time in my life, things feel more manageable, and I'm enjoying everyday activities.
Hopefully, this review helps someone else out there.
2
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Fill 3Created with Sketch.IMPORTANT INFORMATION ABOUT USER-GENERATED CONTENT ON WEBMD
The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions.
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| 💊 The composition of the drug Fluoxetine ✅ Use of Fluoxetine Save Search for analogues Interaction Description of the active ingredients of the preparation fluoxetine (Fluoxetine) The scientific information provided is general and cannot be used to make decisions. decisions about the use of a particular drug. Update date: 2020.06.09 Marketing authorization holder:OZON, OOO (Russia) ATX code: N06AB03 (Fluoxetine) Active substance: fluoxetine (fluoxetine) Rec. Dosage form
Release form, packaging and composition Fluoxetine
7 pcs. - blisters (1) - packs of cardboard. Clinical and pharmacological group: Antidepressant Pharmacotherapeutic group: Antidepressant Pharmacological action Antidepressant, propylamine derivative. The mechanism of action is associated with selective blockade of neuronal reuptake of serotonin in the CNS. PharmacokineticsAbsorbed from the gastrointestinal tract. Weakly metabolized during the "first pass" through the liver. Eating does not affect the degree of absorption, although it may slow down its rate. C max in plasma is achieved after 6-8 hours. C ss in plasma is achieved only after continuous administration for several weeks. Protein binding 94.5%. Easily penetrates through the BBB. It is metabolized in the liver by demethylation to form the main active metabolite of norfluoxetine. T 1/2 fluoxetine is 2-3 days, norfluoxetine is 7-9 days. Indications of the active substances of the drug fluoxetineDepression of various origins, obsessive-compulsive disorders, bulimic neurosis. Open list of ICD-10 codes
Dosage regimen The route of administration and dosing regimen of a particular drug depends on its form of release and other factors. Initial dose - 20 mg 1 time / day in the morning; if necessary, the dose can be increased after 3-4 weeks. The frequency of admission is 2-3 times / day. The maximum daily oral dose of for adults is 80 mg. Side effectsFrom the side of the central nervous system: possible anxiety, tremor, nervousness, drowsiness, headache, sleep disturbances. From the digestive system: possible diarrhea, nausea. From the side of metabolism: increased sweating, hypoglycemia, hyponatremia (especially in elderly patients and with hypovolemia) are possible. From the reproductive system: decreased libido. Allergic reactions: possible skin rash, itching. Other: pain in the joints and muscles, shortness of breath, fever. Contraindications for useGlaucoma, bladder atony, severe renal dysfunction, benign prostatic hyperplasia, concomitant administration of MAO inhibitors, convulsive syndrome of various origins, epilepsy, pregnancy, lactation, hypersensitivity to fluoxetine. Use in pregnancy and lactationContraindicated in pregnancy and lactation. Use in hepatic impairmentUse with extreme caution in patients with hepatic impairment. Use in impaired renal functionContraindicated in severe renal impairment. Use with extreme caution in patients with moderate and mild renal impairment. Use in childrenThe safety of fluoxetine in children has not been established. Use in elderly patientsElderly patients require dosage adjustment. Special instructions Use with extreme caution in patients with impaired liver and kidney function, with a history of epileptic seizures, cardiovascular diseases. In patients with diabetes mellitus, changes in blood glucose levels are possible, which requires correction of the dosing regimen of hypoglycemic drugs. When used in debilitated patients while taking fluoxetine, the likelihood of developing epileptic seizures increases. With the simultaneous use of fluoxetine and electroconvulsive therapy, prolonged epileptic seizures may develop. Fluoxetine can be used no earlier than 14 days after discontinuation of MAO inhibitors. The period after the abolition of fluoxetine before the start of therapy with MAO inhibitors should be at least 5 weeks. Elderly patients require dosage adjustment. The safety of fluoxetine in children has not been established. Do not drink alcohol during treatment. Influence on the ability to drive vehicles and mechanisms During the period of treatment, one should refrain from potentially hazardous activities that require increased attention and rapid psychomotor reactions. Drug interactionsWhen used simultaneously with drugs that have a depressant effect on the central nervous system, with ethanol, a significant increase in the inhibitory effect on the central nervous system, as well as an increase in the likelihood of convulsions, is possible. With simultaneous use with MAO inhibitors, furazolidone, procarbazine, tryptophan, serotonin syndrome may develop (confusion, hypomania, restlessness, agitation, convulsions, dysarthria, hypertensive crisis, chills, tremor, nausea, vomiting, diarrhea). With simultaneous use, fluoxetine inhibits the metabolism of tricyclic and tetracyclic antidepressants, trazodone, carbamazepine, diazepam, metoprolol, terfenadine, phenytoin, which leads to an increase in their concentration in blood serum, an increase in their therapeutic and side effects. With simultaneous use, inhibition of the biotransformation of drugs metabolized with the participation of the CYP2D6 isoenzyme is possible. When used simultaneously with hypoglycemic agents, their action may be enhanced. There have been reports of increased effects of warfarin when co-administered with fluoxetine. When used simultaneously with haloperidol, fluphenazine, maprotiline, metoclopramide, perphenazine, periciazine, pimozide, risperidone, sulpiride, trifluoperazine, cases of extrapyramidal symptoms and dystonia have been described; with dextromethorphan - a case of the development of hallucinations is described; with digoxin - a case of increasing the concentration of digoxin in the blood plasma. When used simultaneously with lithium salts, an increase or decrease in the concentration of lithium in the blood plasma is possible. With simultaneous use, an increase in the concentration of imipramine or desipramine in the blood plasma by 2-10 times is possible (may persist for 3 weeks after fluoxetine is discontinued). When used simultaneously with propofol, a case has been described in which spontaneous movements were observed; with phenylpropanolamine - a case is described in which dizziness, weight loss, hyperactivity were observed. Co-administration may enhance the effects of flecainide, mexiletine, propafenone, thioridazine, zuclopenthixol. Keep |
(21151) 
INN WHO registered 
- polymer containers (10) - packs of cardboard. 
Fluoxetine is a weak antagonist of cholino-, adreno- and histamine receptors. Unlike most antidepressants, fluoxetine does not appear to cause a decrease in the functional activity of postsynaptic β-adrenergic receptors. Helps improve mood, reduces feelings of fear and tension, eliminates dysphoria. Does not cause sedation. When taken in average therapeutic doses, it practically does not affect the functions of the cardiovascular and other systems. 
Excreted by the kidneys 80% and through the intestines - about 15%. 
The optimal dosage regimen is determined by the doctor. Compliance of the dosage form of a particular drug with indications for use and dosing regimen should be strictly observed. 
FLUOXETINE - instruction, composition, use, dosage, indications, contraindications, reviews
Pharmacist
Tags: #for depression #with obsessive-manic disorders #with bulimia #adults #do not use for children
Information about the use of prescription drugs
Dose:
film-coated tablets 20 mg, No.
10, 20
Manufacturer:
Experimental plant "GNTsLS", Ltd./Health, FK, Ltd., Ukraine, 61057, Kharkiv region, Kharkov, Vorobiev street, house 8/61013, Kharkov region, Kharkov, Shevchenko street, house 22.
Adapted instruction
Dosage form:
tablets
Manufacturer:
Direct production: Pilot plant "GNTsLS", LLC/Zdorovye, FK, LLC, Ukraine, 61057, Kharkiv region, Kharkiv, Vorobiev street, house 8/61013, Kharkiv region, Kharkiv, Shevchenko street, house 22.
Pharmacotherapeutic group:
Antidepressants
Holiday category:
Prescription.
Attention
The scientific information provided is general, based on officially approved instructions for use and cannot be used to make a decision on the possibility of using a particular medicinal product.
Official instruction
Compound:
Dosage form:
tablets
Basic physical and chemical properties:
Manufacturer:
Experimental plant "GNTsLS", Ltd./Health, FK, Ltd., Ukraine
Manufacturer Location:
61057, Kharkiv region, Kharkiv, Vorobiev street, 8/61013, Kharkiv region, Kharkiv, Shevchenko street, 22.
Pharmacotherapeutic group:
Antidepressants
Pharmacological properties:
Indications for use:
Contraindications:
Application Features:
Skin rashes and allergic reactions.
With the use of fluoxetine, cases of skin rashes, anaphylactic reactions and progressive systemic disorders involving the skin, lungs, and liver in the pathological process have been reported. If skin rashes or other allergic reactions occur, the etiology of which cannot be determined, fluoxetine should be discontinued.
Convulsions. There is a potential risk of seizures when using antidepressant drugs. Fluoxetine should be discontinued in patients who experience seizures and there is an increased risk of seizures. Fluoxetine should be avoided in patients with unstable seizure disorders/epilepsy.
Mania. Antidepressants should be used with caution in patients with mania or hypomania. Fluoxetine should be discontinued in patients with a manic phase.
Liver/kidney function. Fluoxetine is extensively metabolized in the liver and excreted by the kidneys. Low doses as alternative daily doses are recommended in patients with hepatic impairment. When taking 20 mg per day for 2 months in patients with renal insufficiency (creatinine clearance <10 ml / min) and patients requiring hemodialysis, plasma levels of fluoxetine or norfluoxetine are the same as in patients with normal renal function.
It is contraindicated for use in severe hepatic and renal insufficiency.
Tamoxifen. The use of fluoxetine, a potent inhibitor of CYP2D6, can lead to a decrease in the concentration of endoxifen, one of the most important active metabolites of tamoxifen. Thus, the simultaneous use of tamoxifen and fluoxetine should be avoided whenever possible.
Cardiovascular disorders. Cases of QT interval prolongation and ventricular arrhythmias have been reported. Use with caution in patients with conditions such as congenital long QT interval, a history of prolongation of the QT interval, or other clinical conditions that can lead to arrhythmias (eg, hypokalemia and hypomagnesemia, bradycardia, acute myocardial infarction or decompensated heart failure) or in case of an increase in the concentration of fluoxetine (for example, liver failure). Before starting the use of fluoxetine, an ECG should be performed. If symptoms of cardiac arrhythmia occur during treatment with fluoxetine, fluoxetine should be discontinued and an ECG study should be performed.
Weight loss. Patients taking fluoxetine may experience weight loss.
Diabetes mellitus. In patients with diabetes mellitus during treatment with fluoxetine, changes in blood glucose levels were noted. Hypoglycemia occurred during treatment with fluoxetine, and after drug withdrawal, hyperglycemia. At the beginning and at the end of treatment with fluoxetine, dose adjustment of insulin and / or antidiabetic drugs for oral administration may be necessary.
Suicide/suicidal ideation or clinical deterioration. Depression is associated with an increased risk of suicidal thoughts and suicide attempts. The risk exists until a certain remission occurs. Improvement may not occur for several or more weeks of treatment, patients should be closely monitored until improvement occurs. General clinical experience suggests that the risk of suicide may increase in the early stages of recovery.
Patients with major depressive disorder and other psychiatric illnesses should be monitored continuously as other psychiatric disorders may develop.
Patients should be closely monitored, especially those at high risk of suicidal ideation or attempts, especially at the start of treatment or when the dose is changed. It is contraindicated in patients with suicidal thoughts.
The use of antidepressants in adults with psychiatric disorders has been shown to increase the risk of suicidal behavior in patients under 25 years of age taking antidepressants. Appropriate measures should be taken if clinical deterioration, suicidal attempts or behavioral changes occur.
Akathisia/psychomotor dysphoria. The use of fluoxetine has been associated with the development of akathisia, which is subjectively characterized by the need to move, often with the inability to stand or sit. This is especially noted in the first weeks of treatment. Patients who develop such symptoms are not recommended to increase the dose.
Withdrawal symptoms. Withdrawal symptoms often occur if treatment is abruptly stopped. The risk of developing withdrawal symptoms depends on many factors, including the duration of treatment, the dose, and the level of dose reduction.
Dose reductions should be titrated over 1 or 2 weeks as needed by the patient.
Withdrawal symptoms: dizziness, sensory disturbances (including paresthesias), sleep disturbances (including insomnia and heavy dreams), asthenia, agitation or agitation, nausea and/or vomiting, tremor and headache. In general, withdrawal symptoms are moderate to moderate, but may be severe. Usually occur within the first days after the abolition of fluoxetine. Usually the symptoms resolve on their own within the first 2 weeks, although in some cases they can last 2-3 months or longer. Thus, it is recommended to gradually reduce the dose of fluoxetine over at least 1-2 weeks according to the needs of the patient.
Bleeding. Subcutaneous hemorrhages such as ecchymosis or purpura have been reported. Ecchymosis occurs rarely with fluoxetine treatment. Other hemorrhagic manifestations (gynecological bleeding, gastrointestinal bleeding and other skin or mucous hemorrhages) were also observed rarely.
The drug should be used with caution in patients who are simultaneously taking oral anticoagulants and drugs that affect platelet function (atypical antipsychotics such as clozapine, phenothiazine, most tricyclic antidepressants, acetylsalicylic acid, non-steroidal anti-inflammatory drugs), or other drugs that may increase the risk bleeding, patients with a history of bleeding.
Mydriasis. There are reports of the occurrence of mydriasis in patients taking fluoxetine. Therefore, caution should be exercised in patients with elevated intraocular pressure or risk of acute angle-closure glaucoma. It is contraindicated in patients with glaucoma.
Electrical anticonvulsant therapy. Rarely, there have been cases of an increase in the duration of seizures in patients taking fluoxetine during electroconvulsive therapy. Therefore, caution should be exercised in these patients.
St. John's wort. With the simultaneous use of fluoxetine and St. John's wort, the risk of serotonergic effects, such as serotonin syndrome, may occur with the use of serotonin reuptake inhibitors and herbal preparations containing St.
John's wort.
Rare cases of serotonin syndrome or neuroleptic malignant syndrome have been reported in patients taking fluoxetine, especially in combination with other serotonergic (among others L-tryptophan) and/or neuroleptic drugs. Since these symptoms can be life-threatening, treatment with fluoxetine should be discontinued and supportive and symptomatic therapy should be provided if the following symptoms are present: hyperthermia, rigidity, myoclonus, instability of the autonomic nervous system with possible impairment of vital functions, mental status, including impaired consciousness, irritability , progressive agitation to delirium and coma.
Fluoxetine may cause hyponatremia. This is mainly characteristic of elderly patients and patients receiving diuretics, due to a decrease in circulating blood volume.
The preparation contains sugar and lactose. If the patient has an intolerance to some sugars, a doctor should be consulted before taking this drug.
Use during pregnancy or lactation:
Contraindicated.
The ability to influence the reaction rate when driving:
During treatment with fluoxetine, you should refrain from driving or operating machinery.
Children:
Do not use in children.
Dosage and administration:
The drug is taken by mouth, regardless of the time of the meal.
Major depressive episodes/disorders. It is necessary to start fluoxetine therapy with 20 mg per day in one morning dose - this dose is sufficient to achieve an antidepressant effect. If clinically necessary, after 3-4 weeks from the start of therapy, the dose may be increased to 20 mg 2 times a day; although increasing the dose may exacerbate side effects, for some patients with an insufficient response to treatment with a dose of 20 mg, the dose can be gradually increased to 60 mg per day.
The dose is increased individually and with caution, therapy should be started with the minimum effective dose.
Patients with depressive disorders should be treated for sufficient time, for at least 6 months, to ensure that there are no symptoms of the disease.
Obsessive-manic disorders. The recommended dose is 20 mg per day. Although increasing the dose may exacerbate side effects, for some patients with insufficient response to treatment within 2 weeks, the dose of 20 mg can be gradually increased to 60 mg per day.
If there is no clinical effect within 10 weeks of treatment, fluoxetine therapy should be reconsidered. If a positive therapeutic effect was obtained from the treatment, fluoxetine therapy should be continued at an individually selected dose of the drug. The dose is increased individually and with caution, therapy should be carried out with a minimum maintenance dose. Periodically, the patient's need for drug treatment should be reviewed.
Prolonged pharmacotherapy (greater than 24 weeks) in patients with obsessive-compulsive disorder has not been studied.
Bulimia nervosa. For adults and elderly patients, the dose is 20 mg per day. Prolonged pharmacotherapy (over 3 months) in patients with bulimia has not been studied.
General recommendations. The recommended dose is 20 mg per day, which can be increased if necessary. The maximum daily dose is 80 mg. Doses greater than 80 mg per day have not been studied. If it is necessary to use a single dose of less than 20 mg, it is necessary to use another form of the drug in the appropriate dosage.
Fluoxetine can be administered 1-2 times a day, regardless of meal times.
After stopping the drug, the active substance circulates in the body for another 2 weeks, which should be taken into account when prescribing other drugs or stopping treatment.
Maintenance therapy. As with other antidepressants, it may take 3-4 weeks for fluoxetine to show full effect.
The dose of the drug for patients with renal or hepatic insufficiency, in elderly patients with concomitant diseases, as well as for patients taking other drugs, should be reduced.
Elderly patients increase the dose with caution. Usually the daily dose does not exceed 40 mg.
The maximum daily dose is 60 mg.
Reduced dose or intermittent dosing (eg every other day) may be recommended in patients with hepatic impairment or concomitant use of drugs that may interact with fluoxetine.
Abrupt discontinuation of fluoxetine therapy should be avoided. To cancel the drug, the dose should be gradually reduced over 1-2 weeks to avoid withdrawal syndrome. If there are symptoms of deterioration with a decrease in dose or discontinuation of treatment with the drug, you should return to treatment with the previous effective therapeutic dose of the drug. After some time, the doctor may continue to gradually reduce the dose.
Overdose:
Side effects:
General disorders: weakness, including asthenia, feeling of trembling, chills, fatigue, feeling unwell, feeling cold, hot, abnormal sensations, neuroleptic syndrome.
On the part of the blood and lymphatic system: thrombocytopenia, hemorrhagic manifestations, subcutaneous or mucous hemorrhages, bruising tendencies.
From the immune system: hypersensitivity reactions, including angioedema, anaphylactic shock, anaphylactoid reactions, serum sickness.
From the endocrine system: insufficient secretion of ADH.
Metabolic disorders: loss of appetite, including anorexia, hyponatremia.
From the side of the nervous system: headache, attention disorders, dizziness, dysgeusia, lethargy, drowsiness, including hypersomnia, sedation, tremor, psychomotor hyperactivity, dyskinesia, ataxia, impaired coordination of movements, myoclonus, convulsions, epileptic seizures, psychomotor agitation, impaired attention, anxiety, dysphemia, impaired concentration, akathisia, bucoglosalny syndrome, serotonin syndrome, memory impairment, including morning awakening, insomnia when falling asleep, insomnia at night, agitation, nervousness, restlessness, tension, decreased libido, including loss of libido, sleep disturbances, including abnormal dreams, nocturnal delusions, insomnia, depersonalization, elevated mood, euphoria, thought disturbances, orgasm disturbances including anorgasmia, bruxism, hypomania, mania, hallucinations, agitation, panic attacks, suicidal thoughts and behavior (may result from an underlying medical condition), confusion, upset flavors of speech, change in taste.
On the part of the organ of vision: blurred vision, mydriasis.
On the part of the hearing and vestibular apparatus: tinnitus.
From the side of the cardiovascular system: palpitations, ventricular arrhythmia, including torsades de pointes, prolongation of the QT interval, sensation of hot flushes, sensation of hot flushes, hypotension, vasculitis, vasodilation.
From the respiratory system: yawning, shortness of breath, pharyngitis, respiratory disorders (inflammatory processes or various histopathological changes and / or fibrosis, epistaxis.
From the digestive tract: diarrhea, nausea, vomiting, dyspepsia, dry mouth, dysphagia, pain in the esophagus, gastrointestinal bleeding, including most often bleeding from the gums, vomiting blood, bloody stools, rectal bleeding, hemorrhagic diarrhea, ground and gastric ulcer bleeding.
From the digestive system: idiosyncratic hepatitis.
From the skin and subcutaneous tissue: rash, including erythema, exfoliative rash, miliaria, erythematous, follicular, generalized, macular, maculopapular, papular, morbilliform rash, pruritic rash, vesicular rash, rash around the umbilicus, photosensitivity, erythema multiforme that may progress to Stevens-Johnson syndrome or toxic epidermal necrolysis (Lyell's syndrome), pruritus, urticaria, purpura, alopecia, ecchymosis.
From the musculoskeletal system: arthralgia, muscle twitching, myalgia.
From the urinary system: frequent urination, dysuria, urinary retention, urination disorders, pollakiuria.
From the reproductive system: gynecological bleeding, including bleeding from the cervix, uterine dysfunction, uterine bleeding, bleeding from the genitals, menometrorrhagia, polymetrorhagia, postmenopausal bleeding, vaginal bleeding; erectile dysfunction, ejaculatory disorders including ejaculatory failure, ejaculatory dysfunction, premature ejaculation, delayed ejaculation, retrograde ejaculation, sexual dysfunction, galactorrhea, hyperprolactinemia, priapism.
Investigation: weight loss, impaired liver function.
Cases of suicidal thoughts and behavior have been reported while taking fluoxetine or immediately after fluoxetine withdrawal.
Bone fractures: increased risk of bone fractures in patients receiving serotonin reuptake inhibitors and antidepressants.
The mechanism by which these risks develop is unknown.
Withdrawal symptoms. Discontinuation of fluoxetine predominantly results in withdrawal symptoms. Common symptoms of which are dizziness, sensory disturbances (including paresthesias), sleep disturbances (including insomnia and heavy dreams), asthenia, agitation or agitation, nausea and/or vomiting, tremor and headache. In general, withdrawal symptoms are moderate to moderate, but can be severe and prolonged. Usually occur within the first days after the abolition of fluoxetine. Thus, it is recommended to gradually reduce the dose of fluoxetine over at least 1-2 weeks according to the needs of the patient.
Drug interaction:
The period between discontinuation of MAO inhibitors and the start of treatment must be at least 14 days. After the abolition of fluoxetine before the start of therapy with MAO inhibitors, at least 5 weeks should pass. Severe, sometimes fatal reactions (hyperthermia, rigidity, myoclonus, autonomic instability, rapid changes in vital signs and impaired brain function, including severe agitation, delirium, and coma) have been noted in patients taking fluoxetine in combination with MAO inhibitors, as well as in those who stopped taking it and then started therapy with MAO inhibitors.
Simultaneous use of fluoxetine with MAO inhibitors is contraindicated.
The long half-life of both fluoxetine and norfluoxetine should be taken into account when considering pharmacodynamic and pharmacokinetic drug interactions (eg, when switching from fluoxetine to other antidepressants).
Phenytoin. With the combined use of fluoxetine and phenytoin, changes in their blood levels are noted. In some cases, there were manifestations of toxicity. Doses of drugs should be titrated and the clinical condition of patients monitored.
Serotonergic drugs. When used simultaneously with other serotonergic drugs (for example, tramadol, triptans), the risk of serotonin syndrome may increase. With the use of triptans, there is an increased additional risk of coronary vasoconstriction and hypertension.
Lithium and tryptophan. Fluoxetine with lithium or tryptophan should be used with caution, as there have been cases of serotonin syndrome with the simultaneous use of serotonin reuptake inhibitors with these drugs.
When using fluoxetine with lithium, it is necessary to more often monitor the clinical condition of the patient.
CYP2D6 isoenzyme. Since the metabolism of fluoxetine (as well as tricyclic antidepressants and other selective serotonin antidepressants) is involved in the cytochrome enzyme CYP2D6 system, simultaneous use with drugs that are also metabolized by these enzymes can lead to interaction reactions. Therefore, treatment with drugs that are metabolized by this system and that have a narrow therapeutic index (eg, flecainide, encainide, carbamazepine, and tricyclic antidepressants) should be initiated at low doses if the patient is receiving fluoxetine concomitantly or has taken it within the previous 5 weeks. If fluoxetine is included in the treatment regimen of a patient who is already taking a similar drug, a dose reduction of the first drug should be considered.
Pharmacokinetic interactions between CYP2D6 inhibitors and tamoxifen have been described in the literature, with a 65-75% reduction in one of the more active forms of tamoxifen, eg endoxifen, reported.
Several studies have noted a decrease in the effectiveness of tamoxifen with the simultaneous use of certain serotonin reuptake inhibitors. A decrease in the effectiveness of tamoxifen cannot be excluded, therefore, if possible, the simultaneous use of potent inhibitors of CYP2D6, including fluoxetine, should be avoided.
Fluoxetine may enhance the effects of alprazolam, diazepam, so they should be used with caution.
When used simultaneously with fluoxetine, there is a change in blood concentrations of clozapine, diazepam, alprazolam, imipramine and desipramine, and in some cases manifestations of toxic effects are observed. When taking fluoxetine with these drugs, it is necessary to reconsider the conservative selection of the dose of the drug and monitor the patient's condition.
Fluoxetine binds tightly to plasma proteins, therefore, when fluoxetine is administered with another drug that binds tightly to plasma proteins, changes in plasma concentrations of both drugs are possible.
Oral anticoagulants. With the simultaneous use of fluoxetine with warfarin, an increase in bleeding time was noted. The change in anticoagulant action (laboratory parameters and/or clinical symptoms) was inconsistent. As in the case of treatment with warfarin with other drugs, careful monitoring of blood coagulation parameters should be carried out during warfarin therapy before the start of use or in the event of discontinuation of treatment with fluoxetine. If it is necessary to prescribe other drugs after the abolition of fluoxetine, the long half-life of fluoxetine and its active metabolite norfluoxetine should be taken into account and, in this regard, the possibility of developing drug interactions.
Electrical anticonvulsant therapy. Rarely, there have been cases of an increase in the duration of seizures in patients taking fluoxetine during electroconvulsive therapy. Therefore, caution should be exercised in these patients.
Prolongation of the QT interval.
Pharmacokinetic and pharmacodynamic studies of fluoxetine with other drugs that prolong the QT interval have not been conducted. An addictive effect of fluoxetine and these medicinal products cannot be ruled out. Therefore, caution should be exercised when fluoxetine is co-administered with drugs that prolong the QT interval, such as class IA and III antiarrhythmics, antipsychotics (eg, phenothiazine derivatives, pimozide, haloperidol), tricyclic antidepressants, certain antimicrobials (eg, , sparfloxacin, moxifloxacin, intravenous erythromycin, pentamidine), antimalarials, especially halofantrine, some antihistamines (astemizole, mizolastine).
Alcohol. In studies, fluoxetine did not increase blood alcohol levels or increase the effects of alcohol. However, the simultaneous use of serotonin reuptake inhibitors and alcohol is not recommended.
St. John's wort. As with other serotonin reuptake inhibitors, pharmacodynamic interactions of fluoxetine with St. John's wort may occur, therefore, when using the drug with St.
Fluoxetine enhances the effect of hypoglycemic drugs.
Best before date:
5 years.
Storage conditions:
Store below 25°C in original packaging. Keep out of the reach of children.
Release form / packaging:
Tablets No. 10 No. 10×2 in blister packs.
Holiday category:
Prescription.
Additional information
Dosage:
film-coated tablets 20 mg, No. 10, 20
Registration:
Experimental plant "GNTsLS", Ltd./Health, FK, Ltd., Ukraine, 61057, Kharkiv region, Kharkov, Vorobieva street, house 8/61013, Kharkov region, Kharkov, Shevchenko street, house 22.
ATX code N06AB03:
Attention
The scientific information provided is general, based on officially approved instructions for use and cannot be used to make a decision on the possibility of using a particular medicinal product.
