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- This is lesson n# 19 in "A DRUG IN BRIEF" Series. In this video I'm gonna discuss almost all you need to know about Fluoxetine 10 mg and 40 mg( Prozac - Sarafem): What is Prozac Used For? Fluoxetine Dosage, Side Effects & Precautions

- In 4 minutes you'll learn about:

- What is Fluoxetine?
- Fluoxetine mechanism of action, uses, dosage, side effects, and precautions...
- MORE DRUG INFO HERE:
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- In this video we'll briefly discuss what is Fluoxetine (Prozac), how it works, what it's used for, the dose and side effects, contraindications and precautions.

- Fluoxetine is an antidepressant, belongs to a category of drugs called selective serotonin re-uptake inhibitor (SSRI). It blocks reuptake of serotonin, enhancing serotonergic function.

- It is available as:
Tablets: 10 mg
Pulvules: 10 mg, 20 mg
Weekly Capsules, delayed-release: 90 mg
Solution, oral: 20 mg/5 mL

- Fluoxetine is used for Depression, obsessive-compulsive disorder (OCD) and bulimia nervosa.

Dosage

- For depression:
- Adult: 20 to 80 mg once daily in the morning.
- Administer 20 mg on alternate days to patients with hepatic impairment or severe renal impairment.
- Weekly dosing (90 mg delayed-release capsule) may be started 7 days after last 20 mg/day dose. If response is not satsifactory, consider re-establishing daily dosage regimen.

- For OCD:
- Adults: 20 to 80 mg/day.

- For Bulimia Nervosa:
- 60 mg/day administered in morning.

Duration

- The antidepressant effect is not immediate. It is necessary to wait 3 weeks before assessing therapeutic efficacy.
- In case of insufficient response after 4 weeks, dosage may be increased to 40 mg/day, except in patients with hepatic impairment or severe renal impairment.
- 6 months minimum. The treatment should be discontinued gradually (20 mg on alternate days for 2 weeks). If signs of relapse occur, increase the dose.

Contra-indications

- Administer with caution and monitor use in patients with epilepsy, diabetes, history of gastrointestinal bleeding or bipolar disorders.

Adverse effects

- It may cause:
• allergic reactions (rare): stop treatment.
• insomnia or drowsiness (caution when driving/operating machinery), gastrointestinal disturbances (take during a meal), headache, dizziness, blurred vision.
• psychic disorders: exacerbation of anxiety, possibility of a suicide attempt at the beginning of therapy, manic episode during the course treatment.
• withdrawal symptoms (dizziness, paresthesia, nightmares, etc.) possible if the treatment is discontinued abruptly.

Precautions

- Do not combine with another antidepressant.
- Monitor combination (up to 5 weeks after the discontinuation of fluoxetine) with: carbamazepine, haloperidol, risperidone, phenytoin (increases they toxicity), drugs which lower the seizure threshold (antipsychotics, mefloquine, tramadol, etc.), lithium and other serotonergics.
- Avoid aspirin and NSAIDs (risk of bleeding) and alcohol during treatment.

- Pregnancy: re-evaluate whether the treatment is still necessary; if it is continued, observe the newborn infant if the mother was under treatment in the 3rd trimester (risk of irritability, tremors, hypotony, sleeping disorders, etc.).
- Breast-feeding: avoid. Prefer paroxetine or amitriptyline.

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