Fluoxetine Dosage & Rx Info | Uses, Side Effects

Fluoxetine Generic Name & Formulations

Legal Class

General Description

Fluoxetine (as HCl) 10mg, 20mg; tabs.

Pharmacological Class

SSRI.

How Supplied

Contact supplier

Manufacturer

Various generic manufacturers

Mechanism of Action

Although, the exact mechanism of fluoxetine is unknown, it is presumed to be linked to its inhibition of CNS neuronal uptake of serotonin.

Fluoxetine Indications

Indications

Premenstrual dysphoric disorder.

Fluoxetine Dosage and Administration

Adult

Give daily throughout menstrual cycle or intermittently (start 14 days before expected menses onset through first full day of menses). Initially 20mg/day; max 80mg/day. Hepatic dysfunction: reduce dose.

Children

Not established.

Fluoxetine Contraindications

Contraindications

During or within 14 days of MAOIs; do not start an MAOI during or within 5 weeks of fluoxetine. Concomitant pimozide, thioridazine, linezolid, IV methylene blue.

Fluoxetine Boxed Warnings

Boxed Warning

Suicidality and antidepressant drugs.

Fluoxetine Warnings/Precautions

Warnings/Precautions

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. Monitor for serotonin syndrome or neuroleptic malignant syndrome-like symptoms; discontinue if occurs. Discontinue if unexplained allergic reaction (eg, rash) occurs. History of seizures. ECT. Screen for bipolar disorder; may activate mania/hypomania; monitor. Volume depletion. Conditions that affect metabolism or hemodynamic response. Cardiac disease. Hyponatremia (esp. elderly). Diabetes. Risk for bleeding events. Angle-closure glaucoma. Sexual dysfunction. Monitor for weight changes. Write ℞ for smallest practical amount. Reevaluate periodically. Avoid abrupt cessation. Labor & delivery. Pregnancy (avoid 3^rdtrimester; see full labeling for effects on neonate). Nursing mothers: not recommended.

Fluoxetine Pharmacokinetics

Distribution

Plasma protein bound: ~94.5%.

Metabolism

Hepatic.

Elimination

Renal. Half-life: 1–3 days.

Fluoxetine Interactions

Interactions

See Contraindications. Do not start with concomitant linezolid or IV methylene blue; if treatment is necessary, discontinue fluoxetine before starting; monitor for serotonin syndrome for 5 weeks or until 24hrs after last dose of linezolid or IV methylene blue, whichever comes first. Do not start thioridazine within at least 5 weeks of discontinuing fluoxetine. Concomitant SSRIs, SNRIs, tryptophan: not recommended. Increased risk of serotonin syndrome with other serotonergic drugs (eg, other SSRIs, SNRIs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue); monitor. May potentiate protein-bound drugs (eg, warfarin, digoxin) and those metabolized by CYP2D6 (eg, tricyclics, vinblastine, flecainide). May potentiate carbamazepine, phenytoin. Monitor lithium, phenytoin, warfarin, tricyclics. Caution with benzodiazepines (eg, diazepam, alprazolam), antipsychotics (eg, clozapine, haloperidol), other CNS drugs, antiplatelets. Increased risk of bleeding with NSAIDs, aspirin, warfarin, and others that affect coagulation. Hyponatremia with diuretics.

Fluoxetine Adverse Reactions

Adverse Reactions

Headache, asthenia, pain, accidental injury, infection, flu syndrome, nausea, diarrhea, insomnia, dizziness, nervousness, abnormal thinking, decreased libido, rhinitis, pharyngitis; rash (may be serious).

Fluoxetine Clinical Trials

See Literature

Fluoxetine Note

Notes

Formerly known under the brand name Sarafem.

Fluoxetine Patient Counseling