Fluoxetine acts selectively by blocking reabsorption of the hormone known as serotonin in the presynaptic nerve endings, which causes an accumulation of serotonin and thus leading to an increased serotonergic neurotransmission. Fluoxetine is intended for the treatment of depressive disorders (all forms of depression), obsessive-compulsive disorder and bulimia nervosa (an eating disorder that manifests as uncontrolled binge eating, followed by forced vomiting).
Fluoxetine contraindications include
•Hypersensitivity to fluoxetine or other SSRis;
•Concomitant use of fluoxetine with a monoamine oxidase inhibitors (MAOIs) or thioridazine is strictly forbidden;
•Impaired kidney functions
What you should be aware before starting Fluoxetine
You need to inform your doctor if you have any of the following disorders:
•If you have spasms or seizures or have had seizures in the past;
•If you develop a rash or other hypersensitivity symptoms;
•If you have had mania;
•If you have diabetes type I or type II - doctor will probably adjust the dose of insulin and / or other anti-diabetic medicines;
•If you have any problems with your liver or kidney
•If you have heart problems (angina pectoris or myocardial infarction);
•In elderly patients taking diuretics (medicines that accelerate the excretion of fluids from the body);
•If you are being treated with electroconvulsive therapy;
•If you are prone to bleeding.
In children and adolescents under 18 years of age, safety and efficacy of this medicine is not yet established. Therefore, patients younger than 18 years should not use this drug. Please, strictly follow doctor’s instructions regarding the termination of the treatment.
Interactions
Tell your doctor if you are taking or have recently applied any other medicines including medicines obtained without a prescription.
•Concurrently use of fluoxetine and monoamine oxidase inhibitors - MAOIs is strictly contraindicated. Do not take Fluoxetine within two weeks after stopping MAO inhibitors.
•Thioridazine
•Astemizole (allergy medicine). Concomitant use is associated with increased risk of cardio toxicity
•Clarithromycin Concomitant use is associated with increased risk of adverse effects
•Tramadol Concomitant use is associated with increased risk of serotonin syndrome. Symptoms of serotonin syndrome include: diarrhea, fever, sweating, mood swings, behavior changes, hyper reflexes, rapid heart rate and tremor
•Triptans. Concomitant use is associated with increased risk of serotonin syndrome
•Diltiazem use is associated with diltiazem toxicity (nausea, facial flushing, edema and headache)
•Aspirin. Concomitant use is associated with increased risk of bleeding
•Quinidine. Concomitant use is associated with increased risk of toxicity expression of both medicines
•Ketorolac. Concomitant use is associated with increased risk of hallucinations
•Anti-epileptic medicines (phenytoin, carbamazepine). Concomitant use is associated with increased risk of side effects
•Antipsychotics (haloperidol, clozapine). Concomitant use is associated with increased risk of extrapyramidal symptoms
•Benzodiazepines (Alprazolam, lorazepam). Concomitant use is associated with increased risk of benzodiazepines side effects.
•Lithium. Concomitant use is associated with increased risk of lithium toxicity (weakness, tremor, increased thirst and confusion)
•Tricyclic antidepressants
•metoprolol Concomitant use is associated with increased risk of Metoprolol adverse effects
•Tryptophan. Concomitant use is associated with increased risk of serotonin syndrome
•Fluphenazine. Concomitant use may cause acute parkinsonism symptoms
•warfarin Concomitant use is associated with increased risk of bleeding
Digoxin Concomitant use is associated with increased risk of digoxin toxicity (nausea, vomiting, and arrhythmias);
•Ginkgo. Concomitant use is associated with increased risk of serotonin syndrome
•Herbal remedies containing St. John's wort (Hypericum perforatum). Concomitant use is associated with increased risk of serotonin syndrome
•Alcoholic beverages, Concomitant use may enhance the sedative effects of fluoxetine.
Fluoxetine use during pregnancy and breastfeeding
Consult health professionals before you start taking this medicine.
About 0.5 % of your dose gets into breast milk. Breastfeeding should be avoided while on Fluoxetine treatment.
How to use
It is recommended to take this medicine with enough liquids. You should know that it is important to take this medicine every day at the same time.
Dosage
To see recommended dosage regimens you should
Dosing: Adult
Depression, obsessive-compulsive disorder, premenstrual dysphoric disorder, bulimia: Oral: 20 mg/day in the morning; may increase after several weeks by 20 mg/day increments; maximum: 80 mg/day; doses >20 mg may be given once daily or divided twice daily. Note: Lower doses of 5-10 mg/day have been used for initial treatment.
Side effects
Immediately stop using this medicine if you are experiencing the following adverse effects:
•allergic reaction symptoms, such as:
•itching,
•hives,
•swelling of the lips,
•swelling of the tongue and difficulty breathing
• Unexplained fever, rapid breathing, increase sweeting, muscle stiffness, restlessness, confusion, (mainly in elderly patient taking water pills) , abnormal ejaculation, anexiety,hypersensivity to sunlight, weight loss, gastrointestinal side effect, sleep disorder, nightmare, decrease appetite, fatigue, mood swings, uncontrolled movements, seizures, hallucination, agitation, nervousness, panic attack, blurred vision.
If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional.