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Indications/Uses
Listed in Dosage.
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Dosage/Direction for Use
Adult: PO Depression Initial: 20 mg once daily. Max: 80 mg/day in 2 divided doses. Bulimia nervosa 60 mg/day as a single or in divided doses. Obsessive compulsive disorder Initial: 20 mg once daily, increased up to 60 mg/day if necessary. Max: 80 mg/day in 2 divided doses. Panic disorder Initial: 10 mg once daily, increase to 20 mg/day after a wk. May further increase to 60 mg/day. Premenstrual dysphoric disorder 20 mg/day continuously or 20 mg/day to be started 14 days before menstruation and continued until 1st day of menses; repeat w/ each cycle.
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Administration
May be taken with or without food.
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Contraindications
Concomitant admin or w/in 2 wk of MAOI withdrawal. Concomitant use w/ pimozide or thioridazine.
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Special Precautions
Patient w/ history of mania/hypomania, seizure disorder; DM, raised intraocular pressure or at risk of acute narrow-angle glaucoma. Patient w/ risk factors for QT prolongation. Hepatic and severe renal impairment. Elderly, childn. Pregnancy and lactation. Patient Counselling May impair ability to drive or operate machinery. Monitoring Parameters Monitor closely for clinical worsening, suicidal behaviour or thoughts and unusual behavioural changes; signs/symptoms of serotonin syndrome.
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Adverse Reactions
Insomnia, nervousness, anxiety, restlessness, tension, sleep disorder, abnormal dreams, headache, attention disturbances, dizziness, lethargy, tremor, somnolence, dysgeusia, blurred vision, palpitations, flushing, yawning, vomiting, dry mouth, dyspepsia, urticaria, rash, pruritus, hyperhidrosis, frequent urination, arthralgia, gynaecological bleeding, erectile dysfunction, ejaculation disorder, fatigue, chills, feeling jittery; decreased appetite, wt and libido.
Potentially Fatal: Suicidal thoughts and behaviour, serotonin syndrome. |
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Drug Interactions
May lead to serotonin syndrome w/ serotonergic drugs (e.g. triptans, TCAs, fentanyl, tramadol, lithium, buspirone, tryptophan). May increase risk of bleeding w/ aspirin, NSAIDs, warfarin and other anticoagulants. May increase plasma levels of phenytoin.
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CIMS Class
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ATC Classification
N06AB03 - fluoxetine ; Belongs to the class of selective serotonin reuptake inhibitors. Used in the management of depression.
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