Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: fluoxetine
BRAND NAME: Prozac
DRUG CLASS AND MECHANISM: Fluoxetine is an oral drug that is used for
treating depression. It is in a class of drugs called selective serotonin
reuptake inhibitors (SSRIs), a class that also contains citalopram (Celexa),
paroxetine (Paxil) and sertraline (Zoloft). Fluoxetine affects
neurotransmitters, the chemicals that nerves within the brain use to communicate
with each other. Neurotransmitters are manufactured and released by nerves and
then travel and attach to nearby nerves. Thus, neurotransmitters can be thought
of as the communication system of the brain. Serotonin is one neurotransmitter
that is released by nerves in the brain. The serotonin either travels across the
space between nerves and attaches to receptors on the surface of nearby nerves
or it attaches to receptors on the surface of the nerve that produced it, to be
taken up by the nerve and released again (a process referred to as re-uptake).
Many experts believe that an imbalance among neurotransmitters is the cause of
depression. Fluoxetine works by preventing the reuptake of one neurotransmitter,
serotonin, by nerve cells after it has been released. Since uptake is an
important mechanism for removing released neurotransmitters and terminating
their actions on adjacent nerves, the reduced uptake caused by fluoxetine
increases free serotonin that stimulates nerve cells in the brain. The FDA
approved Fluoxetine in December 1987.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules: 10, 20, and 40 mg. Capsules (delayed release): 90 mg.
Tablets: 10, 15, and 20 mg. Oral suspension: 20mg/5ml
STORAGE: Fluoxetine should be stored at room temperature 15-30°C (59-86°F).
PRESCRIBED FOR: Fluoxetine is used for treating depression, bulimia,
obsessive-compulsive disorder (OCD),
panic disorder, and
premenstrual dysphoric
disorder (PMDD).
DOSING: Depression in adults is treated with 20-80 mg of fluoxetine daily.
The recommended dose for treating depression in children is 10-20 mg daily.
After 13 weeks of daily administration, once weekly dosing may be effective in
some patients.
Bulimia is treated with 60 mg of fluoxetine daily. Long-term treatment for up
to 52 weeks has been shown to be beneficial in maintaining remission.
Obsessive-compulsive disorder in adults and children is treated with 20-60 mg
daily and panic disorder is managed with 10-60 mg daily. The recommended regimen
for PMDD is 20 mg administered every day of the menstrual cycle or daily for 14
days prior to the onset of menstruation through the first day of menses.
DRUG INTERACTIONS: Fluoxetine should not be taken with any of the monoamine
oxidase inhibitor (MAOI) class of antidepressants [for example, isocarboxazid
(Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline
(Eldepryl), and procarbazine (Matulane)] or other drugs that inhibit monoamine
oxidase [for example, linezolid (Zyvox)]. Such combinations may lead to confusion,
high
blood pressure, tremor, hyperactivity, coma, and death. Administration of
fluoxetine and MAOIs should be separated by 14 days. Similar reactions occur
when fluoxetine is combined with other drugs [for example,
tryptophan, St.
John's wort, meperidine (Demerol), tramadol (Ultram)] that increase serotonin in the brain.
Fluoxetine may increase the effect of warfarin
(Coumadin), leading to excessive
bleeding. Warfarin therapy should be monitored more frequently in patients who
are also taking fluoxetine. Combining SSRIs with
aspirin,
nonsteroidal
anti-inflammatory drugs or other drugs that affect bleeding may increase the
likelihood of upper gastrointestinal bleeding.
PREGNANCY: Use of fluoxetine during the third trimester of
pregnancy may lead
to adverse effects in the newborn.
NURSING MOTHERS: Fluoxetine is excreted in
breast milk. Therefore, taking
fluoxetine while nursing is not recommended.
SIDE EFFECTS: Fluoxetine, as with most antidepressants, can cause
nausea,
headaches, anxiety, insomnia, drowsiness, and
loss of appetite. Fluoxetine has
been implicated in serious skin rashes and vasculitis (inflammation of small
blood vessels). Increased blood pressure can occur, and blood pressure should be
monitored. Seizures have been reported as has sexual dysfunction. Some patients
may experience withdrawal reactions upon stopping fluoxetine. Symptoms of
withdrawal include anxiety, nausea, nervousness, and insomnia. The dose of
fluoxetine should be gradually reduced when therapy is discontinued.
Antidepressants increased the risk of suicidal thinking and behavior in
short-term studies in children and adolescents with depression and other
psychiatric disorders. Anyone considering the use of fluoxetine or any other
antidepressant in a child or adolescent must balance this risk of suicide with
the clinical need. Patients who are started on therapy should be closely
observed for clinical worsening, suicidal thoughts, or unusual changes in
behavior.
Last Editorial Review: 3/4/2008
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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From the Doctors at MedicineNet.com  |
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- citalopram, Celexa - Defines the medication citalopram (Celexa) an antidepressant drug that affects neurotransmitters. Article includes descriptions, uses, drug interactions, and side effects. Source:MedicineNet
- Depression - Read about depression causes, symptoms, diagnosis, treatment and types, including manic depression (bipolar disorder), postpartum depression and clinical depression. Source:MedicineNet
- sertraline, Zoloft - Information on the medication sertraline (Zoloft) a drug used to treat depression, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder, and postmenstrual dysphoric disorder. Article includes descriptions, uses, drug interactions, and side effects. Source:MedicineNet
- Read 91 more fluoxetine related articles ...
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