Lіkarskiy dovіdnik Geotar. Fluoxetine is an anti-depressant. What is a narcotic speech? What is fluoxetine used for?


Pharmaceutical form:   capsules Warehouse:

Active speech:

fluoxetine hydrochloride 11.2 mg, equivalent to 10 mg fluoxetine; fluoxetine hydrochloride 22.4 mg, equivalent to 20 mg fluoxetine;

additional speech: lactose monohydrate (milk zuccor) 30.8 mg / 61.6 mg, microcrystalline cellulose 16.1 mg / 32.2 mg, silicon dioxide coloid (aerosil) 0.15 mg / 0.30 mg, magnesium stearate 0 6 mg/1.2 mg, talc 1.15 mg/2.30 mg;

storage capsules with doses of 10 mg: gelatin 36.44 mg, titanium dioxide 1.52 mg, indigocarmine 0.04 mg;

warehouse capsules with doses of 20 mg: gelatin 36.44 mg, titanium dioxide 1.52 mg, barvnik azorubin 0.03 mg, barvnik chervoniy (Ponso 4R) 0.01 mg, barvnik blue. patents 0.05 mg and barvnik diamond black 0.06 mg.

 Description:

Hard gelatin capsules. For dosing 10 mg: with a body of white color and a lid of black color; for dosing 20 mg: with a body of white color and a cap of blue color. Vmist capsules - powder of white or may be white color.

 Pharmacotherapeutic group: ATX antidepressant:  

N.06.A.B.03 Fluoxetine

Pharmacodynamics:

An antidepressant of a group of selective serotonin ingestion inhibitors.

May thymoanaleptic and stimulating effect.

Pharmacodynamics. Viborcho blocks the reversal of neuronal serotonin (5HT) occlusion at the synapses of neurons in the central nervous system. Inhibition of intoxication of serotonin to lead to an increase in the concentration of the neurotransmitter in the synaptic cleft, thereby prolonging the activity on the postsynaptic receptor tract. Promoting serotonergic transmission by the mechanism of negative membrane ligation inhibition of neurotransmitter turnover. In case of trivial congestion, the activity of 5HT1 receptors is reduced. Weakly injects norepinephrine and dopamine into the back. Do not direct on serotonin, m-cholinergic, H1-histamine and alpha-adrenergic receptors. In the opinion of more antidepressants, it does not mean a decrease in the activity of postsynaptic beta-adrenergic receptors.

Effective in endogenous depression and obsessive-compulsive disorders. To repair anorexicogenic disease, you can eliminate the waste of the mass of the body. Does not cause orthostatic hypotension, sedative effect, non-cardiotoxicity. A stable clinical effect sets in after 1 - 2 weeks of treatment.

 Pharmacokinetics:When taken internally, the drug is well absorbed from the intestinal tract (up to 95% of the administered dose), and fluoxetine is slightly absorbed. Maximum plasma concentrations are reached in 6-8 years. The bioavailability of fluoxetine should be greater than 60% after oral administration. The drug accumulates well in tissues, easily penetrates through the blood-brain barrier, binding to plasma proteins becomes over 90%. Metabolized in the liver by demethylation to the active metabolite norfluoxetine and a number of unidentified metabolites. It is excreted by nirkami in probably metabolites (80%) and in the intestines (15%), most importantly in probably glucuronides. The period of administration of fluoxetine after reaching an equally important plasma concentration becomes close to 4-6 deb. The period of administration of the active metabolite of norfluoxetine with a single dose and after reaching an equally important plasma concentration becomes 4 to 16 deb. In patients with liver insufficiency, the period of administration of fluoxetine and norfluoxetine should be given. Shown:

Depression of various genesis.

obsessive-compulsive disorder

Bulimic neurosis.

 Contraindication:
  • Increased sensitivity to the drug.
  • One-hour intake with MAO monoamine oxidase inhibitors (for 14 days after your appointment),
  • One-hour administration of thioridazine (for 5 days after administration of fluoxetine), pimozide.
  • Vagity.
  • The period of breastfeeding.
  • Severe impairment of the function of nirok (creatinine clearance less than 10 ml/min).
  • Pechinkov's insufficiency.
  • Lactase deficiency, lactose intolerance, glucose-galactose malabsorption.
  • Week to 18 years.
 With care:

Suicidal rizik: in case of depression, there is a risk of suicidal tests, which can lead to a stable remission. Also, suicidal thoughts and suicidal behaviors are described in the course of therapy or not without delay after completion, similarly to other drugs of similar pharmacological action (antidepressants). It is necessary to keep a watchful eye on patients, as they lie down to the risk group. Doctors following the reconciliation of patients are negligently reminded about whether or not they think that they feel that they are worried.

Epileptic attacks: flowuxetine was a warning sign of illness, in which epileptic attacks were indicated.

Hyponatremia: depression of hyponatremia was suspected. Basically, similar symptoms were observed in patients with a frail age and in patients who took diuretics, resulting in a change in the volume of circulating blood.

Blood-diabetes: glycemic control in diabetic patients with fluoxetine hourly treatment showing hypoglycemia, hyperglycemia developed after administration of the drug. On the cob, or after treatment with fluoxetine, you may need to adjust doses of insulin and/or hypoglycemic drugs for oral administration. Nirkov/liver deficiency: metabolism in the liver and excreted by nirki through the intestinal tract. Patients with severe liver dysfunction are advised to take a lower dose of fluoxetine or take the drug every other day. When taking fluoxetine at a dose of 20 mg per day for two months, no changes in the concentration of fluoxetine were detected

norfluoxetine in the blood plasma of healthy patients, if they may have a normal function of the blood, and in patients with pronounced impairment of the functions of the blood (clearance of creatinine 10 ml / min), if they require hemodialysis.

 Method of stosuvannya that dose:

The drug is taken internally, at any time, independently from the outside.

Depressive camp

Pochatkov dose to become 20 mg 1 time per doba in the first half of the day, independently in the evening. If necessary, the dose can be reduced to 40-60 mg per dose, divided into 2-3 doses (20 mg per dose). The maximum additional dose is 80 mg for 2-3 doses.

The clinical effect develops in 1-2 days after the cob of healing, in some patients the wines can be reached later.

Obsessive-compulsive disorders:

Bulimic neurosis

The drug is fixed at an additional dose of 60 mg, subdivided by 2-3 doses.

Application of the drug by patients of different age

No data are available about changing doses fallow in vіku. Begin treatment of patients with a frail age following a dose of 20 mg per doba.

Ailments that supruvodzhuyut

It is recommended to prescribe to patients with impaired liver function, or it is recommended to stop low doses and increase the interval between doses (div. section "Zoberezhnistyu").

 Side effects:

In case of fluoxetine congestion, as well as in cases of congestion of drugs in the group of selective serotonin ingestion inhibitors, such an undesirable appearance is feared.

From the side of the cardiovascular system

Often (> 1% -<10 %): трепетание предсердий, приливы ("приливы" жара).

Uncommon (> 0.1% -<1 %): гипотензия.

Ridko (< 0,1 %): васкулит, вазолидация.

From the side of the herbal system Often (> 10%) diarrhea, nausea.

Often (> 1% -<10 %): сухость во рту, диспепсия, рвота.

Uncommon (> 0.1% -<1 %): дисфагия, извращение вкуса.

Ridko (< 0,1 %): боли по ходу пищевода.

From the side of the hepatobiliary system Rіdko (< 0,1 %): идиосинкразический гепатит.

From the side of the immune system:

Too rare (< 0,1 %): анафилактические реакции, сывороточная болезнь.

Destroyed metabolism and eating

Often (> 1% -<10 %): анорексия (включая потерю массы) тела.

From the side of the musculoskeletal system Uncommon (> 0.1% -<1 %): мышечные подергивания.

From the side of the CNS

Even more often (> 10%): headache.

Often (> 1% -<10 %): нарушение внимания, головокружение, летаргия, сонливость (в том числе гиперсонливость, седация), тремор.

Uncommon (> 0.1% -<1 %): психомоторное возбуждение, гиперактивность, атаксия, нарушение координации, бруксизм, дискинезия, миоклонус.

Ridko (< 0,1 %): букко-глоссальный синдром, судороги, серотониновый синдром.

Mental discord

More often (> 10%): insomnia (including early early morning awakening, early morning and middle sleeplessness).

Often (> 1% -<10 %): необычные сновидения (в том числе кошмары), нервозность, напряженность, снижение либидо (включая отсутствие либидо), эйфория, расстройство сна.

Uncommon (> 0.1% -<1 %): деперсонализация, гипертимия, нарушение оргазма (включая аноргазмию), нарушения мышления.

Ridko (< 0,1 %): маниакальные расстройства.

From the side of the skinny curves

Often (> 1% -<10 %): гипергидроз, кожный зуд, полиморфная кожная сыпь, крапивница. Нечасто ((> 0,1 % - <1 %): экхимоз, склонность к появлению синяков, алопеция, холодный пот.

Ridko (< 0,1 %): ангионевротический отек, реакции фоточувствительности.

From the side of the organs a little

Often (> 1% -<10 %): нечеткость зрения.

Uncommon ((> 0.1% -<1 %): мидриаз.

From the side of the sechostatic system

Often (> 1% -<10 %): учащенной мочеиспускание (включая поллакиурию), нарушение эякуляции (в том числе отсутствие эякуляции, дисфункциональная эякуляция, ранняя эякуляция, задержка эякуляции, ретроградная эякуляция), эректильная дисфункция, гинекологические кровотечения (в том числе кровотечение из шейки матки, дисфункциональное маточное кровотечение, кровотечение из половых путей, менометроррагия, меноррагия, метроррагия, полименорея, кровотечение в пост­менопаузе, маточное кровотечение, вагинальное кровотечение).

Uncommon (> 0.1% -<1 %): дизурия.

Ridko (< 0,1 %): сексуальная дисфункция, приапизм.

Post-marketing alerts

From the side of the endocrine system, there were signs of a deficiency of antidiuretic hormone.

Significant side effects are most often blamed on the onset of fluoxetine therapy or when the dose of the drug is increased.

 Overdose:

Symptoms: psychomotor agitation, seizures, drowsiness, disruption of the heart rhythm, tachycardia, nausea, vomiting.

Other serious symptoms of fluoxetine overdose (both with isolated fluoxetine and with single-hour fluoxetine use with other drugs) included coma, delirium, lowering of the QT interval and ventricular tachyarrhythmia, including shlunochkіv i zupinka heart, low heart rate, low mania, perexia, stupor and stupefaction similar to the evil neuroleptic syndrome

Investigation: no specific antagonism to fluoxetine was found. Symptomatic therapy is carried out, flushing the drain with signs of activated wart, in case of seizures, relief of breathing, heart activity, body temperature.

 Interaction:

Fluoxetine and its main metabolite, norfluoxetine, may have three periods of administration, which should be considered when fluoxetine is used with other drugs, as well as when it is replaced with another antidepressant.

It is impossible to inject the drug overnight with monoamine oxidase (MAO) inhibitors, including antidepressants - MAO inhibitors; furazolidone, procarbazine, selegshin, and also tryptophan (a precursor to serotonin), as a possible development of serotonergic syndrome, which manifests itself in confusion, hypomanic state, psychomotor agitation, sudoma, dysarthria, hypertensive crises, chills.

After the ingestion of MAO inhibitors, the recognition of fluoxetine is allowed no earlier than 14 days. Do not follow up with MAO inhibitors earlier, lower after 5 days after administration of fluoxetine.

One-hour administration of medicinal preparations, which are metabolized due to the participation of the CYP2D6 isoenzyme ( , ) with fluoxetine, should be avoided due to the minimum therapeutic doses. blocking the metabolism of tricyclic and tetracyclic anti-depressive effects of trazodone, metoprolol, terfenadine, which leads to an increase in their concentration in blood syrorrhea, increasing their effect and increasing the frequency of complications.

In patients who were taking stable doses of phenytoin, phenytoin plasma concentrations increased daily and symptoms of phenytoin toxicity (nystagmus, diplopia, ataxia, and nya CNS) after an ear of suputny likuvannya fluoxetine.

Podnane zastosuvanya fluoxetine and lithium salts, vmagaє strong control over the concentration of lithium in the blood, tk. you can move forward.

Fluoxetine potentiates the effect of hypoglycemic drugs.

With one-hour exposure to drugs that may have a high level of binding with proteins, especially with anticoagulants and digitoxin, it is possible to increase the concentration in the plasma of unrelated (non-binding) drug effects and reduce the risk of development of adverse reactions live effects.

 Special remarks:

It is necessary to be more careful for sickness and suicidal infirmities, especially on the cob of exultation. The highest risk of suicide is in patients who have previously taken other antidepressants, and in patients who are treated with fluoxetine on the background, they are supersomnia, hypersomnia or restless. To the present day, a significant increase in the liquor of such an ailment must be done under the sight of a doctor.

In children, young people (less than 24 years of age) with depression, other mental disorders, antidepressants compared with placebo, increase the risk of suicidal thoughts and suicidal behavior. To that, when fluoxetine is recognized, or be-yakikh іn. antidepressants in children, young people (younger than 24 years of age) are likely to develop risk of suicide and risk of suicide. In short-line studies, the risk of suicide did not rise in people older than 24 years, and in people older than 65 years it decreased slightly. Whether it be a depressive discord by itself will increase the risk of suicide. Therefore, under the hour of antidepressants, for all patients, there may be a warning about the early manifestation of damage or changes in behavior, as well as suicidal attacks.

Against the backdrop of electrovascular therapy, there was a possible development of crippling epileptic attacks.

The interval between completion of therapy with monoamine oxidase (MAO) inhibitors and fluoxetine on the cob can be at least 14 days; between the end of treatment with fluoxetine and the beginning of therapy with MAO inhibitors - not less than 5 tizhniv.

After administration of the yoga preparation, the therapeutic concentration in serum can be saved by prolonged use.

Patients with diabetes mellitus may develop hypoglycemia during fluoxetine therapy and hyperglycemia after yoga. On the cob, or after treatment with fluoxetine, you may need to adjust doses of insulin and/or hypoglycemic drugs for oral administration.

In case of treatment of ailments with a deficiency of body mass, anorexigenic effects can be healed (the loss of body mass is possible, as it progresses).

When I take fluoxetine, it will be reduced by alcohol, but the drug is stronger by alcohol.

 Injected into the building keruvati transp. since. that tricky.:The use of fluoxetine can have a negative effect on the work, which leads to a high level of mental and physical reactions (management of mechanical transport systems, mechanisms, work at height). Form of release / dosing:Capsules 10 mg and 20 mg. Package: 10 capsules in a pack of commercial contour. 1, 2, 3, 4 or 5 packs of compact contour lines at once with instructions from the stop are placed in a pack of cardboard. Wash the savings:

In a dry place, protected from the light, at a temperature not higher than 25°C. Take care of the place inaccessible to children.

 Applicability term: ×

Installation instructions:

Fluoxetine is a generic drug that belongs to the group of antidepressants.

Pharmacological action of fluoxetine

Fluoxetine is comparable to similar propylamine. The mechanism of mindfulness of vibratory (selective) consciousness to detract from the intoxication of serotonin in the central nervous system. In this case, the drug may have a minimal impact on the exchange of dopamine, acetylcholine and norepinephrine.

In the instructions for fluoxetine, it is indicated that the drug effect changes a little tension and fear, relieves anxiety, and improves mood. Fluoxetine does not cause orthostatic hypotension, does not affect the myocardium.

For guidance, fluoxetine should be taken at least one or two days in order to achieve a complete therapeutic effect.

Fluoxetine is well absorbed from the intestinal tract. I don't give a damn about yoga bioavailability.

Indications for ingestion of fluoxetine

The medicinal preparation is taken in such cases:

  • the treatment of depressive states of a different degree of severity;
  • Be obtrusive;
  • Decreased appetite (anorexia, bulimia);
  • Complex therapy for alcoholism.

How to inject fluoxetine

For treatment of depressive states, you should prescribe the drug 1 tablet (20 mg) once a day. If the effectiveness is insufficient, the dose can be increased to two tablets (40 mg) per dose. The maximum allowable additional dose is 4 tablets (80 mg), and for patients with a frail age - 3 tablets (60 mg).

Per instructions Fluoxetine for the treatment of bulimia is prescribed one tablet per dose.

For the treatment of obtrusive states, 1 to 3 tablets (20-60 mg) per dose are prescribed.

Trivality to the course of healing lies in the degree of severity of illness, the effectiveness of therapy. The minimum trivality of the course is less than 3 tizhniv, and the maximum is the number of years.

Pobichna diya

Therapy with cym drug can lead to the development of side effects:

  • On the side of the nervous system - headache, asthenia, confusion, weakness, increased alertness, mania, anxiety, increased risk of suicide;
  • On the side of the grass tract - a decrease in appetite, dyspepsia, dryness in the mouth and on the contrary, an increase in slumbering (salivation);
  • From the side of other organs - decreased libido, increased sweating, decreased body mass, allergic reactions.

When fluoxetine is vicarious, the side effects of therapy often outweigh the effects of fluoxetine.

Contraindication

Per instructions Fluoxetine contraindications in such cases:

  • Individual intolerance to the drug;
  • Atony of sich michur;
  • Zacritokutova glaucoma;
  • Virazhenkova chi nirkova insufficiency;
  • Treatment with MAO inhibitors;
  • Vagity and lactation;
  • Promoted to succumb to suicide;
  • Hypertrophy of the anterior fold.

Fluoxetine ingestion in patients who suffer from Parkinson's syndrome, epilepsy, diabetes mellitus, or severe disease will require special care.

Interactions between fluoxetine and other drugs

Dany likarsky zasіb potentiate the effects of alcohol, diazempamu and drugs, which reduce the level of glucose in the blood.

Fluoxetine, when taken one-hour with tricyclic antidepressants, increases the concentration of the remainder in plasma may be twice.

Over the years, fluoxetine was considered to be ill and natomist conducted electrovascular therapy, tk. in this way, it is possible to have severe epileptic attacks.

Overdose

When vipadkovom or navmysnym taking a large dose of fluoxetine, the patient will require a term medical assistance. There is no specific antidote, so symptomatic treatment is carried out. To speed up the removal of the drug from the body, wash the tube and give internal sorbent.

Release form

Fluoxetine is available in capsules containing 20 mg of active speech.

Wash away the savings

The drug is dispensed from pharmacies only with a doctor's prescription. Save at room temperature in a place inaccessible to children. The term of appurtenance is three fates. Fluoxetine cannot be tested after the completion of the term of applicability, indicated on the box.

Faces Fluoxetine instructions from zastosuvannya add to a group of antidepressants. Capsules 10 mg and 20 mg Lannacher, Kanon are indicated for the treatment of depressive and obsessive states accompanied by anxiety and fear. With a systematic zastosuvanni drug reduces apathy, changes a little tension and fear, improves mood, sleep and appetite of the patient.

Release form and warehouse

Fluoxetine capsules can be molded into a dovgast form, small razmіri and a smooth surface. The middle of the capsules contains small granules of white color. The main oral drug is fluoxetine, and instead of 1 capsule, it should be 20 mg.

A cardboard pack contains 2 contour packs (20 capsules), as well as instructions for choosing a drug treatment.

Pharmacological activity

Fluoxetine is comparable to similar propylamine. Pharmacological action of the drug is motivated by vibratory zdatnistyu to ignite the intoxication of serotonin in the central nervous system.

The Danish medical treatment helps to relieve anxiety and fear, change the appearance of apathy and tightness, improve the patient's mental activity, normalize his mood, appetite and sleep. In this case, the drug does not pour into the work of the heart and arterial pressure, does not cause galvanism and drowsiness.

To achieve the therapeutic effectiveness of yoga, it is necessary to take at least 1-2 days.

Indication before zastosuvannya

What does Fluoxetine do for? Tablets prescribe:

  • kinorexia (to change uncontrolled cravings to even zasib vikoristovuєtsya at the warehouse of complex psychotherapy);
  • obsessive-compulsive disorder (OCD);
  • depression (especially when accompanied by fears), zocrema for the ineffectiveness of other antidepressants.

Installation instructions

Fluoxetine is taken internally, whether or not it is independent of the intake.

Depressive camp

Pochatkov dose to become 20 mg 1 time per doba in the first half of the day, independently in the evening. If necessary, the dose can be reduced to 40-60 mg per dose, subdivided into 2-3 doses (20 mg per dose). The maximum additional dose is 80 mg for 2-3 doses. The clinical effect develops in 1-2 days after the cob of healing, in some patients the wines can be reached later.

obsessive-compulsive disorder

Bulimic neurosis

The drug is administered at an additional dose of 60 mg divided into 2-3 doses.

With premenstrual dysphoric disorders, the recommended dose is 20 mg per dose.

Application of the drug by patients of different age

No data are available about changing doses fallow in vіku. Begin treatment of patients with a frail age following a dose of 20 mg per doba.

Contraindication

Per instructions Fluoxetine contraindications in such cases:

  • The liver's deficiency is pronounced.
  • Treatment with MAO inhibitors.
  • Atony of sich michur.
  • Vagity and lactation.
  • Promoted schilnist to suicide.
  • Individual intolerance to the drug.
  • Critical glaucoma.
  • Hypertrophy of the anterior fold.

Fluoxetine ingestion in patients who suffer from Parkinson's syndrome, epilepsy, diabetes mellitus, or severe disease will require special care.

Side effects

During the course of therapy with Fluoxetine capsules, the development of negative side reactions from the side of several organs and systems is possible:

  • Allergic reactions - hanging on the shkіrі, її sverbіzh, kropiv'yanka (change, sho tell the drop of the droplet), Quincke's angioedema (snubber of soft fabrics, which is localized in the area of ​​their organs), anaphylactic shock may develop, which accompanied by critical reductions. multiple organ failure.
  • Nervous system - cephalic pain, confusion, impaired respect, nervousness, tension, severe dreaming (including nightmares), drowsiness during the day, hands trembling (tremor), or else can be convulsive, euphoria, sleeplessness at night.
  • Cardio-vascular system - disturbed by the rhythm of the heart, the heart is seen to be tremulous atrium, appearing to be hot in a dilyantsi guise, the level of the systemic arterial pressure (arterial hypotension) rarely decreases, the judges (vasculitis) become inflamed.
  • The liver and the zhovchovivіdnі ways - liver inflammation (hepatitis)
  • The sechostatic system - accelerated secularization, disruption of the process of ejaculation in men, erectile dysfunction, priapism (trival of ailing erection), in women - uterine bleeding, regular menstruation. Also, on the background of taking the drug in people and women, there is a possibility of a decrease in sexual craving to the opposite position (decrease in libido).
  • Organi feel - vagueness of the dawn, eyes widen more (mydriasis).
  • The system of etching is carrying, tedium, vomiting, dryness in the mouth, bloating of the abdomen (flatulence), later on, damage to the bowel (dysphagia) may develop, or more near the stravokhod.
  • Skin and її appendages - increased sweatiness (hyperhidrosis), hair loss (alopecia), sensitivity reaction of the skin to light (photosensitivity).

With the appearance of a sign of the development of side effects, the possibility of a further intake of Fluoxetine capsules is determined by the drug, depending on the nature and severity.

Children, with pregnancy and breastfeeding

Contraindications for pregnancy and lactation.

Congestion in children

In children and adolescents with depression, other mental disorders, antidepressants, in comparison with placebo, increase the risk of suicidal thoughts and suicidal behavior. Therefore, the recognition of the drug in a child's age is to be contraindicated before taking it.

especially vkazіvki

Before administering Fluoxetine capsules to the drug, it is obligatory to carefully read the instructions and respect for the characteristics of the correct drug, including:

Chinny component of the drug can reduce the functional activity of the nervous system, which turns on the work, as it requires a sufficient concentration of respect and flexibility of psychomotor reactions.

In the case of one-hour congestion of drugs that are actively metabolized in the liver, a decrease in the average therapeutic dosage of capsules may be necessary. In children, young people and young people on the background of taking Fluoxetine capsules, suicidal sickness may appear, which will require careful caution.

It is not recommended to drink alcohol and during the course of drug therapy. Fluoxetine is one of the decay products of the body for a long time. It is important to protect for the recognition of drugs in other pharmacological groups.

In patients with concomitant cerebrovascular diabetes, if the cob of the drug is blocked, it is possible to reduce blood sugar levels (hypoglycemia). On the aphids of the conduction of electrovascular therapy (ECT) can develop attacks by the court of transversely swarthy bony m'yaziv.

Patients with suicidal insufficiency against the background of constipation of the drug need more caution. In patients with a low body mass, it is possible to change away from the background of the drug taken, the wine scales can reduce appetite.

In the pharmacy, Fluoxetine capsules are dispensed with a doctor's prescription. To prevent complications and negative health effects, it is not recommended to take them on your own without a clear medical recognition.

Medical interaction

Serotonergic effects of the drug are potentiated in combination with tryptophan. Imovirnist development of serotonin intoxication occurs at the time of one-hour intake due to the fact that the MAO enzyme is taken into account.

Imovirnistvo vyniknennya collateral reactions and aggravation of the oppressive influence on the central nervous system increases in the same drugs, yak prignichyuyut the central nervous system.

Stopping as an add-on to electrovascular therapy can cause the development of crippling epileptic attacks.

Strengthens the effects of hypoglycemic drugs, ethanol, diazepam, alprazolam.

The intake of drugs, which are characterized by a high level of binding with proteins, can provoke an increase in the plasma concentration of unrelated (viral) effects, as well as an increase in the development of undesirable effects.

May provoke an increase in the plasma concentration of Li +, which increases the development of toxic effects. In times of one-hour stasis, it is recommended to try and control indicators of the concentration of Li + in the blood.

Increased plasma concentration of tricyclic antidepressants, phenytoin, trazodone, maprotiline. When fluoxetine is prescribed in combination with tricyclic antidepressants, the dose of the remaining traces should be reduced by 50%.

Analogues of drugs Fluoxetine

Analogues are assigned to the structure:

  1. Fluval.
  2. Fluoxetine hydrochloride.
  3. Fluxonil.
  4. Phloxet.
  5. Prozac.
  6. Profluzak.
  7. Portal.
  8. Deprenon.
  9. Prodep.
  10. Framex.
  11. Flunisan.
  12. Fluoxetine GEXAL (Lannacher; Nіkomed; OBL; Canon).
  13. Deprex.
  14. Apo Fluoxetine.

Wash your permit and that price

The average price of Fluoxetine Lannacher (capsules 20 mg No. 20) in Moscow is 137 rubles. Required for a prescription.

The term appendage of capsules becomes 3 years. The drug must be stored in the original non-ear-shaped factory package, dark, dry, inaccessible to children, at a temperature not higher than +25°C.

Post Views: 283

Fluoxetine can be used as an antidepressant that suppresses serotonin intoxication (serotonergic antidepressants, serotonin intoxication inhibitors). Faces are effective in the treatment of depression and anxiety disorders - raising mood, easing tension, anxiety, fear.

The main advantage of fluoxetine over traditional tricyclic antidepressants (the so-called classic antidepressants) affects the changed side effects of the disease by the choice of mechanism of action. When zastosuvanni Fluoxetine tolerated more quickly and, for the sake of better research, may be more effective compared with classic antidepressants, although the results of the comparison are not entirely unambiguous.

Advantages and disadvantages of serotonergic antidepressants

Advantages of antidepressants, which vibirkovo denigrates serotonin intoxication:

  • effective therapy for anxiety and depressive symptoms;
  • security;
  • minimal heart-sudine risk;
  • vidsutnіst zvikannya;
  • possibility of trial therapy;
  • prophylactic therapy - prevention of illnesses;
  • voluntary compliance of the patient with the prescribed treatment regimen when taking the drug;
  • the effect is saved by the doti, the docks are trivaє likuvannya;
  • Trivale of likuvannya allows the recurrence to disappear.

Troubled discord is often accompanied by addiction to alcohol and psychoactive speeches. In such cases, it is not recommended to use benzodiazepines, and antidepressants, which will vibrate the serotonin intoxication, become the main line in the treatment of depression, but not the signs of drug addiction.

Shortage of serotonergic antidepressants:

  • sexual side effects;
  • sometimes blame the need for incremental dose reduction to the maximum amount to achieve a therapeutic effect;
  • can blame the difficulties in the early cob reaction to the treatment;
  • more, incrementally improved by stretching tizhnіv chi months;
  • sometimes blamed for the protyazh of the first two - three times a day for the reception of manifestations of hyperstimulation - dramatization, sleeplessness, nervousness, increased anxiety and panic symptoms.

The lack of non-medical character is less economical availability of likіv tsієї grupi (tsіna), shards of stench are accepted for a long time, as well as the presence of other forms in most preparations.

Pharmacological activity

Viborcho blocks the reversal of neuronal occlusion of serotonin (5-hydroxytryptamine) at the synapses of neurons in the central nervous system. The suppression of the intoxication of serotonin increases the concentration of this neurotransmitter in the synaptic cleft, which results in its prolongation in the postsynaptic receptor tract.

Fluoxetine has low porosity to α1, α2, and β-adrenergic, serotonin, dopaminergic, muscarinic, H1-histamine and GABAergic receptors.
Improve mood, relieve fear, anxiety, tension, reduce dysphoria, reduce appetite. Viklikaє reduction znesivno-compulsive disorders.

Chi is not cardiotoxic. Do not show calm, sleepy diarrhoea, orthostatic hypotension.
The effect in the form of lubrication lasts 7-14 days after taking the drug.

Medical Forms

Fluoxetine is available in capsule form.

stock

In one capsule, fluoxetine hydrochloride is 22.36 mg, which corresponds to fluoxetine 20 mg. The whole speech of the face.
starch of corn pregelatinizations, dimethicone.
Warehouse for the capsule body: gelatin, titanium dioxide, barvnik zaliza yellow oxide.
The cap of the capsule contains gelatin, blue barnique of patents V, titanium dioxide, bark of the bay yellow oxide.

Indication

Obsessive-compulsive disorder.
Depression of various genesis.
Premenstrual dysphoria.
Bulimic neurosis.

Contraindication

Hypersensitivity to components of faces.
Severe disorders of the functions of the liver (CC less than 10 ml / min.) and the liver.
One-hour administration of monoamine oxidase inhibitors for 14 days after administration, thioridazine, pimozide.
Atony of sich michur.
Children's age up to 18 years.
Vagity.
Lactation.
Protective: suicidal mood, epilepsy, diabetes mellitus, superimposed weight loss, Parkinson's disease.

Appointed for vagity and during lactation

Contraindications in the period of breastfeeding and with vaginess.

Method of stoking and dosing

Independently from the inside, inside.
depression
Pochatkov dose - 20 mg once a day in the first half of the day. The dose can be increased to 40-60 mg per doba. Todi її need to be divided into two - three take. The maximum dose per day is 80 mg liqiv.
obsessive-compulsive disorder
Fluoxetine 20-60 mg daily.
Bulimic neurosis
The dosage of 60 mg per day is divided into two or three doses.
Premenstrual dysphoric disorder
Fluoxetine 20 mg per dose.
In summertime, with liver ailments, therapy is started with 1/2 dose.
For patients with impaired function, change the dose and increase the interval between taking the drug.
Likuvannya course - 3 - 4 days.

Side effects

Confusion, headache, increased drowsiness, asthenia, disturbed sleep, fluctuating arousal, tremor, agitation, increased suicidal tendencies, anxiety, mania or hypomania.

Decreased appetite, dryness in the mouth or hypersalivation, tedium, vomiting, impaired taste,.
Allergic reactions in looking at hanging on the skin, overthrow, kropivyanki, myalgia, arthralgia, fever.

Non-manic sechi, zatrimka sechi, dysmenorrhea, vaginitis, decreased sexual desire, impaired state function in people (ejaculation increase).
Stronger sweating, tachycardia, disturbed morning sickness, weight loss, systemic degeneration of the leg, liver failure, vasculitis.

Overdose

Symptoms: tedium, vomit, restlessness, state of awakening, psychic discord, disruption of the work of the heart-vascular system.
Brilliant: no specific antibiotic was found. Symptomatic therapy is carried out, washing of the drain, recognition of an activated vugill, in case of seizures - recognition of tranquilizers, support of cardiac activity, diarrhea.

Prevention, therapy control

Suicidal risk

With depression, there is the possibility of suicidal tests, which can be saved until the current stable remission. As in the case of other drugs in a similar pharmacological effect (antidepressants), there have been descriptions of suicidal behavior during the hour of fluoxetine therapy or after termination.

An analysis of the recent history of the recognition of antidepressants in mental disorders revealed an increase in the risk of suicidal thoughts and/or suicidal behavior in patients of a young age (younger than 25 years of age).

Medical therapy of patients with high risk may be carried out under close control.

Cardiovascular effects

Prescribed for protection are ailments with congenital low QT interval syndrome, developed low QT interval syndrome (for example, with one-hour admission of fluoxetine with signs that lower the QT interval), with a history of increased trivality and the QT interval of the relatives of the patient, until the development of arrhythmia (for example , with hypokalemia or hypomagnesia) or with increased exposure to fluoxetine (for example, with a decrease in liver function).

Hanging on the skies

Be aware of the appearance of liver disease, anaphylactic reactions, and systemic disorders that occur in progression, sometimes from radiation to the pathological process of the liver, nirok, shkir, legenia in ailments, yak have taken Fluoxetine.

Electrovascular therapy (ECT)

Є vіdomosti pro zbіlshennya trevalnostі by the court in patients, yakі perebuvayut on fluoxetine and get ECT.

Epileptic attacks

Administer to patients who had previously been warned of epileptic attacks, with care.

Mania

As if the patient is resting in a maniacal state, do not accept faces.

Akatiziya/psychomotor restlessness

The stagnation of faces is brought up to the development of akathisia, as it is manifested by subjectively unacceptable feelings of restlessness, the need for fasting, often without the ability to sit or stand on the floor. Most often, such manifestations are guarded at the hour of the first few days of jubilation. Patients who are experiencing symptoms of fluoxetine do not need to adjust the dose of fluoxetine.

Tamoxifen

The drug reduces the concentration of endoxifen, one of the most important active metabolites of tamoxifen. When treated with tamoxifen, fluoxetine is not prescribed.

Vtrata masi tila

Patients showed an increase in body mass, prote, sound, out of proportion to the average body mass.

Hyponatremia

There were signs of depression of hyponatremia in age-old patients and in ill patients, as they took diuretics through a change in the volume of circulating blood.

Glycemic control

Fluoxetine may need to be treated with different doses of insulin and/or hypoglycemic drugs.

Pechinkov/nirkov deficiency

Patients with obvious liver damage are prescribed either lower doses of drugs, or every other day. Appointment of Fluoxetine at a dose of 20 mg / day for a period of two months in patients with impaired function of nirok (creatinine clearance)< 10 мл/мин), проходящим гемодиализ, не выявило различий концентрации флуоксетина и норфлуоксетина в плазме крови между больными и здоровыми людьми.

Midriaz

For the protection of the patients with a high internal pressure or for the unsafe development of acute glaucoma.

Zvirobiy prodіryavleniy

A possible development of pharmacodynamic interactions between Fluoxetine and methods to avenge animal manifestations.

Symptoms

Often during drug-induced therapy, especially in case of severe withdrawal symptoms, symptoms of withdrawal syndrome are observed. In 60% of patients, side effects were suspected during the administration of the liquor. Confusion, sensory disturbances (including paresthesia), sleep disturbances (deep sleep, insomnia), asthenia, anxiety, agitation, nausea and/or vomiting, tremor and headache were most often mentioned.

In most cases, the appearances are attached independently for 14 days, but sometimes they were three times for 2-3 months and more. Therefore, fluoxetine treatment should be carried out step by step by stretching one or two tizhnіv fallowly into the patient.

In single cases, it was mentioned about the association with the use of fluoxetine, the development of serotonin syndrome or the evil neuroleptic syndrome (hyperthermia, extrapyramid neurological disorders and catatonic manifestations, m'yazova strain), especially with combined use and with other serotonergic conditions.

Since these syndromes can lead to a dangerous life, fluoxetine is used to relieve symptoms - hyperthermia, rigidity, myoclonus, disorder of the autonomic nervous system with a development of coli indicative of life functions, changes in the mental state, including the entanglement of information, the development of delirium and Komi, and acknowledge the appropriate therapy.

Increased bleeding

Fluoxetine may cause succumbing to bleeding, including in the intestinal tract. In conjunction with cym, it is recommended to be careful when the drug is prescribed to patients, if it is necessary to immediately remove anticoagulants and / or drugs, as they can change the power of platelets (for example, non-steroidal antiseptic drugs, acetylsalicylic acid ), or to patients, in those who have already developed bleeding.

Interaction with other medical care

It is not possible to stop the drug overnight with MAO inhibitors, there are some possible developments of serotonin syndrome (hyperthermia, chills, increased sweating, myoclonus, hyperreflexia, tremor, diarrhea, impaired coordination of the ruhu, vegetative lab ilnist, zbudzhennya, maddening and coma).

Tryptophan enhances the serotonergic power of the drug (increased agitation, restlessness, damage to the side of the intestinal tract).
In case of drug overdose, in order to eliminate the serotonergic manifestations (Hypericum perforatum), there may be a worsening of the serotonergic effect, a worsening of non-significant effects.

Increased plasma concentrations of tricyclic antidepressants, phenytoin, maprotiline, and trazodone. It is necessary to reduce the dose of these drugs by 50% during one-hour treatment with fluoxetine. Strengthen the effects of alprazolam, diazepam, ethanol, hypoglycemic drugs.

One-hour administration of Fluoxetine with alcohol or drugs of the central nervous system, which leads to a decrease in the function of the central nervous system, potentiating it and leading to the unsafe development of side effects.

Medical care, which avenge lithium, should be protected through the possibility of increasing the concentration of lithium and risking the development of toxic effects.
On the abrasions of the conduction of electrosudominal therapy, the development of trivial sudominal attacks is possible.

With one-hour exposure to drugs that may have a high level of binding with proteins, especially with anticoagulants and digitoxin, it is possible to increase the concentration in the plasma of unrelated (non-binding) drug effects and reduce the risk of development of adverse reactions live effects.

Fluoxetine is available with a doctor's prescription. Under the hour of likuvannya with the drug, you should try to take alcoholic drinks and take potentially unsafe types of activity, which will require increased respect and sensitivity of mental and rukhovih reactions.

Fluoxetine vibrors with Rosieki pharmaceuticals of FP Ukoleski, Alsі Pharma, Vobronitniy medication, ozone, Medizhorb, Biokom, Kanonfarma Production, and Takozhi-Military Pіdprimniy of the Apotrex INK (Canada), New Farm INK (Canada), Gexal ).

Analogues to the drug

Commercial names of drugs that can be used to treat the active speech of fluoxetine, such as: Fluoxetine, Prodep (India), Prozac (USA), Profluzak (Russia).
To the group of selective inhibitors of serotonin occlusion lie the following:

  • citalopram (trade name Cipramil);
  • Escitalopram (Escitalopram);
  • fluvoxamine (Avoksin, Fevarin);
  • paroxetine (paxil);
  • sertraline (Zoloft, Stimuloton);
  • venlafaxine.

The mechanism of these drug side effects and effects of influx on the serotonin transporter, and the clinically significant effects between them, are important to the period of administration (the hour, after which the concentration of the drug in the body decreases tsya by 50%, T½) and the peculiarities of medical interactions.

The period of administration of fluoxetine is close to 330 years, at that time, when deciding on preparations for the group of wines, it is 15-30 years. the development of serious unacceptable side reactions, which may lead to a negligible serotonergic antidepressant.

Another one among the analogues of Fluoxetine is the difference in the levels of vibratory strangulation of serotonin ingestion. Escitalopram is the most selective in com- mon use, citalopram, sertraline, fluvoxamine, paroxetine and fluoxetine are the most selective.

Sertraline and venlafaxine are the only one of the current antidepressants, as they may have an evidence base for the improvement of remissions in depressive disorders.

Inhibitors of serotonin intoxication in the therapy of anterior ejaculation

In the special literature there are data about the possibility of zastosuvannya of various psychotropic drugs for the exaltation of people, as if the place before the ejaculation may be. Z likіv, zdatnyh zbіshiti trivalіst state act, vikoristovuyutsya zokrema and antidepressants, yakі lie to a group of inhibitors of serotonin intoxication. This is due to the fact that the pathogenesis of anterior ejaculation confirms the role of central serotonergic mechanisms of regulation. Sertraline, paroxetine, clomipramine (trade names Anafranil, Clofranil), fluoxetine, citalopram, fluvoxamine, escitalopram, buspirone, dapoxetine are used to treat early ejaculation.

Changes in antidepressants are taken daily regularly. Vinyatkom є dapoksetin, which zastosovuєtsya "for help" for a year before the state act. Studies have shown that paroxetine has the strongest effect on sim'appearance. Appointment to clomipramin, paroxetine, sertraline, fluoxetine 4-6 years prior to the act of statute is effectively tolerated, but it causes less ejaculation delay, lower with moderate exuberance.

The use of serotonergic antidepressants is recommended for young people with pre-ejaculation, who have an ear of a stately life and with advanced ailments, if the causal factor is gone, but the problem is still present.

The authors confirm that the effectiveness of the drugs in this group in increasing the severity of the state act, combined with their low profile of side effects, put them in the first line of therapy for pre-hourly ejaculation ї like in the case of a good reception, so in the case of living in the power. However, the significance of the preparations in this group, perhaps, should not be overestimated, the shards of their congestion in people with pre-hourly ejaculation should be brought up to the ejaculatory threshold, draft 5 - 7 days.

Respect! The description of the drug is a simplified version and an updated version of the official instructions for how to apply. Information about the drug is given solely with the knowledge of the method that is not guilty of vikoristan as a helper for self-exaltation.

| Fluoxetine

Analogues (Generics, synonyms)

Apo-Fluoxetine, Bioxetine, Deprex, Deprenon, Portal, Prodep, Prozac, Profluzak, Floxet, Fluval, Fluxonil, Flunat, Flunisan, Fluoxetine Hexal, Fludak, Framex

Recipe (international)

Rp.: Caps. Fluoxetini 0.02 № 20
D.S. 20 mg 1 time per doba.

Recipe (Russia)

Prescription form - 107-1 / y

fluffy speech

(Fluoxetine)

Pharmacological activity

Antidepressive, anorectic.

Selectively inhibition of serotonin ingestion, which leads to an increase in iodine concentration in the synaptic gap, strengthening that prolongation of iodine at postsynaptic receptors. Promoting serotonergic transmission, by a mechanism of negative serum inhibition of neurotransmitter metabolism. With trivial stagnation, the activity of 5HT1 receptors decreases. It also blocks the accumulation of serotonin in platelets. Weakly injects norepinephrine and dopamine into the back. Do not direct on serotonin, m-cholinergic, H1-histamine and alpha-adrenergic receptors. In the opinion of more antidepressants, it does not mean a decrease in the activity of postsynaptic beta-adrenergic receptors.

Effective in endogenous depression and obsessive-compulsive disorders. Improving mood, reducing tension, anxiety that feels like fear, tying up dysphoria. To repair anorexicogenic disease, you can eliminate the waste of the mass of the body. In patients with diabetes mellitus, it can cause hypoglycemia, while fluoxetine is administered - hyperglycemia. The clinical effect of depression in depression persists after 1-4 days of recovery, with obsessive-compulsive disorders - after 5 days or more.

Good vmoktuєtsya іz ShKT. The effect of "first passage" through the liver is weakly expressed.
Capsules and aqueous formulations of fluoxetine are effective. After a single dose at a dose of 40 mg, fluoxetine reaches Cmax in 4-8 years and becomes 15-55 ng / ml, when taken at the same dose for 30 days, Cmax fluoxetine becomes 91-302 ng / ml, norfluoxetine - 72-258 ng / ml Mol. At concentrations up to 200-1000 ng/ml, fluoxetine is 94.5% bound to blood proteins, including albumin and alpha1-glycoprotein. Enantiomers are equally effective, but S-fluoxetine appears more frequently and is superior to the R-form at equal concentrations. Easily penetrates through the blood-brain barrier. In the liver, enantiomers are demethylated due to the participation of the CYP2D6 isoenzyme cytochrome P450 to norfluoxetine and other unidentified metabolites, while S-norfluoxetine is more active than R- and S-fluoxetine and outweighs R-norfluoxetine. T1 / 2 fluoxetine to become 1-3 decibels after a single dose and 4-6 decibels with a triple dose. T1 / 2 norfluoxetine - 4-16 dB in both levels, which means significant cumulation of speech, more likely to reach their equal level in plasma and three times the presence in the body after water. In patients with cirrhosis of the liver T1 / 2, fluoxetine and its metabolites are required.
It is administered for 1 tyzh mainly with nirkami (80%): in the unchangeable species - 11.6%, in the case of fluoxetine glucuronide - 7.4%, norfluoxetine - 6.8%, norfluoxetine glucuronide - 8.2%, more than 20% - hippuric acid, 46% - other cases; 15% is excreted by the intestines. With impaired function, fluoxetine and its metabolites are improved. In case of dialysis, it should not be seen (through the great obsyazh rozpodіlu that high level of binding with plasma proteins).

Data on the effectiveness of fluoxetine in eating disorders (anorexia nervosa), alcoholism, anxiety disorders, including social phobia; diabetic neuropathy, affective, incl. bipolar, discord; dysthymia, autism, panic attacks, premenstrual syndrome, narcolepsy, catalepsy, obstructive sleep apnea syndrome, kleptomania, schizophrenia, schizoaffective disorders and others.

Way to zastosuvannya

For adults: Pochatkova dose - 20 mg 1 time per doba in the first half of the day; if necessary, the dose can be reduced after 3-4 days. The frequency of reception is 2-3 times per doba.

The maximum additional dose for oral administration for adults is 80 mg.

Indication

Depression of various origins
- obsessive-compulsive disorders
- Bulimic neurosis.

Contraindication

Glaucoma
- atony of sich michur
severely impaired function of the nirok
benign hyperplasia of the anterior ridge
- one-hour recognition of MAO inhibitors
- Sudominal syndrome of various genesis
- epilepsy
- vaginess, lactation
- Increased sensitivity to fluoxetine.

Pobichna diya

- From the side of the CNS:
possible anxiety, tremor, nervousness, drowsiness, headache, sleep disturbance.
- From the side of the grass system:
possible diarrhea, boredom.
- From the side of the exchange of speeches:
possible worsening of sweating, hypoglycemia, hyponatremia (especially in patients of a frail age with hypovolemia).
- From the side of the reproductive system:
decreased libido.
- Allergic reactions:
mozhlivі vysipannya on shkіrі, sverbіzh.

Інші: bіl in suglobah i m'yazakh, diffi- cult breathing, increased body temperature.

Release form

Caps. 20 mg: 14, 20 chi 28 pcs.

UVAGA!

The information on the side that you can see is created solely for the purpose of knowing and does not promote self-deception. A resource of appointments for the recognition of practitioners of health care with supplementary information about those and other medicines, raising the zeal of their own professionalism. The choice of the drug "" in the obligatory order is given a consultation with a physician, as well as a recommendation on how to stop and dose the drugs you have chosen.