Fluoxetine

Antidepressant Drug

Drug class: Selective Serotonin Reuptake Inhibitor

Fluoxetine (PROZAC)（中文：氟西汀）

Pronunciation

Fluoxetine 10mg

Fluoxetine 20mg

Common Strengths of Fluoxetine

Fluoxetine are available in the following strengths:

• 10 mg, 20 capsules

Drug Trade Names of Fluoxetine

Prozac

Drug Usage

• Depression
• Panic disorder
• Obsessive-compulsive disorder (OCD)
• Bulimia nervosa

Mechanism of Action

It works by inhibiting the reuptake of serotonin in the brain, increasing its availability and enhancing neurotransmission.

Route of Administration

Oral

Dosages

• Depression: 20 mg/day, can be increased to 80 mg/day
• Panic disorder: 10 mg/day, can be increased to 60 mg/day
• OCD: 20 mg/day, can be increased to 80 mg/day
• Bulimia nervosa: 60 mg/day

Side Effects

Frequency	Adverse reactions
Common	Nausea: Often mitigated by taking the medication with food
	Headaches: Drinking plenty of fluids and resting can help; avoid excessive alcohol consumption
	Insomnia: Taking fluoxetine in the morning may reduce sleep disturbances
	Diarrhea: Staying hydrated is crucial to avoiding dehydration
	Fatigue or Weakness: Resting and avoiding activities that require alertness, such as driving
	Sexual Dysfunction: This includes decreased libido and difficulty achieving orgasm
	Dry Mouth: Staying hydrated and using sugat-free gum or candy can help alleviate dry mouth
	Dizziness: Moving slowly when changing positions can help reduce dizziness
Serious	Suicidal Thoughts or Actions: This is particularly a concern in children, teenagers, and young adults, especially in the first few months of treatment or when the dose is changed. Symptoms include new or worsening depression, anxiety, or unusual changes in mood or behavior.
	Serotonin Syndrome: This potentially life-threatening condition can occur when there is too much serotonin in the body. Symptoms include agitation, hallucinations, rapid heart rate, fever, nausea, vomiting, diarrhea, and muscle twitching.
	Severe Allergic Reactions: These include symptoms like diffculty breathing, swelling of the face, lips, tongue, or throat, and severe rash or hives.
	Abnormal Bleeding: This can manifest as unusual bruising or bleeding
	Low Sodium Levels: Particularly in older adults, symptoms include headache confusion weakness, and difficulty concentrating.
	Seizures
	Mania: Symptoms include excessively high energy, severe trouble sleeping, racing thoughts, reckless behavior, and unusually grand ideas.
	Less common but require immediate medical attention.

Pharmacokinetics

• Metabolism: Hepatic via CYP2D6, and CYP3A4
• Elimination: Primarily renal
• Half-life: Fluoxetine 1 to 4 days

Onset and Duration of drug action:

• Onset: May begin to show drug effects within 1 to 2 weeks
• Duration: Full therapeutic benefits are generally observed after 6 to 8 weeks of treatment.

Drug Precautions

Pregnancy

Use only if potential benefit justifies the risk to the fetus

Breastfeeding

Present in breast milk, use with acution

Children and Elderly

Lower doses are recommended for children and elderly due to increased sensitivity to side effects.

Renal Impairment

Use with caution, no specific dosage adjustments provided.

Monitoring Requirements

• Monitor for suicidal thoughts, especially in young adults
• Monitor for serotonin syndrome, especially when combined with other serotonergic drugs
• Regularly assess liver function and electrolyte levels

Drug Interactions

• Contraindicated with thioridazine due to risk of serotonin syndrome and QT prolongation
• Caution with other serotonergic drugs, NSAIDs, anticoagulants, and drugs affecting CYP2D6 metabolism

FAQ

How Should I Take the Tablet?

Take orally with or without food, usually once daily in the morning

What Should I Avoid While Taking?

Avoid alcohol and activities requiring mental alettness until you know how the tablet affects you.

What Happens if I Miss a Dose?

Take the missed dose as soon as you remember unless it is almost time for your next dose. Do not double doses.