Fluoxetine Hydrochloride(floo ox’ e teen)
Apo-Fluoxetine (CAN), Co-Fluoxetine (CAN), Gen-Fluoxetine (CAN), Novo-Fluoxetine (CAN), PMS-Fluoxetine (CAN), Prozac, Prozac Weekly, ratio-Fluoxetine (CAN), Sarafem
PREGNANCY CATEGORY C
Drug Classes
Antidepressant
SSRI
Therapeutic Actions
Acts as an antidepressant by inhibiting CNS neuronal uptake of serotonin; blocks uptake of serotonin with little effect on norepinephrine; little affinity for muscarinic, histaminergic, and alpha1-adrenergic receptors.
Indications
Treatment of depression; most effective in patients with major depressive disorder
Treatment of depressive episodes associated with bipolar I disorder in combination with olanzapine
Short-term treatment of treatment-resistant depression with olanzapine
Treatment of OCD
Treatment of bulimia
Treatment of PMDD (Sarafem)
Treatment of panic disorder with or without agoraphobia
Unlabeled uses: Raynaud phenomenon, alcoholism, borderline personality disorder, fibromyalgia, hot flashes, diabetic neuropathy, nocturnal enuresis, post-herpetic neuralgia, PTSD, migraine prevention
Contraindications and Cautions
Contraindicated with hypersensitivity to fluoxetine, pregnancy.
Use cautiously with impaired hepatic or renal function, diabetes mellitus, lactation, seizures; history of suicide attempts.
Available Forms
Tablets—10, 15, 20 mg; capsules—10, 20, 40 mg; liquid—20 mg/5 mL; DR capsules—90 mg
Dosages
Adults
Antidepressant: The full antidepressant effect may not be seen for up to 4–6 wk. Initially, 20 mg/day PO in the morning. If no clinical improvement is seen, increase dose after several weeks. Administer doses larger than 20 mg/day on a bid schedule or once a day in the morning. Do not exceed 80 mg/day. Once stabilized, may switch to 90-mg DR capsules once a week.
OCD: Initially, 20 mg/day PO. If no clinical improvement is seen, increase the dose after several weeks. Usual dosage range is 20–60 mg/day PO; may require up to 5 wk for effectiveness. Do not exceed 80 mg/day.
Bulimia: 60 mg/day PO in the morning.
PMDD (Sarafem): 20 mg/day PO or 20 mg/day PO starting 14 days before the anticipated beginning of menses and continuing through the first full day of menses, then no drug until 14 days before next menses; do not exceed 80 mg/day.
Panic disorder: 10 mg/day PO for the first week; increase to 20 mg/day if needed. Maximum dose, 60 mg/day.
Depressive episodes of bipolar I disorder: 20 mg/day PO with 5 mg olanzapine.
Treatment of treatment-resistant depression: 20–50 mg/day PO with 5–20 mg olanzapine.
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