Prozac – drug has antidepressant action. Prozac contains the active ingredient fluoxetine, a substance selectively inhibiting the reuptake of serotonin. Fluoxetine practically does not bind with other receptors, in particular, has no affinity for adrenergic, dopaminergic, histamine and cholinergic receptors. Prozac increases the level of serotonin in the brain, which leads to an increase in the duration of the stimulating action of serotonin. Fluoxetine has a marked antidepressant effect, reduces anxiety, tension and anxiety, improves mood, and helps to reduce dysphoria.
Fluoxetine has no toxic effect on the myocardium does not possess sedative activity and does not cause orthostatic hypotension.
After oral administration, fluoxetine is well absorbed in the digestive tract. Peak concentrations of fluoxetine in plasma are reached after 6-8 hours after a single dose, and equilibrium concentrations are established 2-3 weeks after the start of therapy. Fluoxetine is almost completely metabolized to norfluoksetina education and a number of unidentified substances. Metabolites excretiruyutza kidneys.
The half-life of the active component of the drug Prozac reaches 4-6 days, the active metabolite of fluoxetine from 4 to 16 days.
Indications for Use
Prozac is used for the treatment of patients with depression of different etiology.
Prozac is prescribed to patients with bulimia nervosa, and premenstrual dysphoric disorder and obsessive compulsive disorder.
Prozac – How to Use
Prozac is intended for oral use. Prozac capsules recommended swallowed whole without damaging the capsule, drinking plenty of drinking water. Prozac can be taken with or without food. Duration of therapy and dose Prozac determined by the physician.
Depression usually prescribe a treatment of 20 mg of fluoxetine per day.
For bulimia nervosa, it is generally recommended that fluoxetine in a daily dose of 60 mg.
When obsessive-compulsive disorders, usually prescribed fluoxetine at a daily dose of 20 to 60 mg.
When premenstrual dysphoric disorders usually recommended fluoxetine in a daily dose of 20 mg.
Depending on the severity of the disease and tolerability of fluoxetine, the daily dose may be increased to 80 mg.
The dose of fluoxetine is recommended to adjust patients receiving other drugs with a similar effect, as well as patients with concomitant diseases, and decline in liver function.
How does Prozac (Fluoxetine) work?
Side Effects of Prozac
In applying the drug Prozac in patients may develop undesirable effects characteristic of drugs of the group of inhibitors of reverse capture of serotonin. In particular the use of fluoxetine in patients noted the development of such adverse reactions:
- From the side of cardiovascular system: hot flashes, atrial flutter, vasodilation, lowering blood pressure, vasculitis.
- From the digestive system: dry mucous membranes of the mouth, diarrhea, vomiting, nausea, dyspepsia, loss of appetite, weight loss. In addition, the possible change in taste, the development of dysphagia and pain along the esophagus.
- From the nervous system: fatigue, weakness, paresthesia, headache, feeling cold or heat, attacks of anxiety and restlessness, lethargy, drowsiness and dizziness. In addition, the possible development of seizures, insomnia, nightmares, decreased libido, disorders of orgasm and euphoria.
- On the part of the organ of vision: mydriasis, decreased visual acuity.
- From the urogenital system: violation of ejaculation, frequent urination, erectile dysfunction, vaginal bleeding, dysuria, sexual dysfunction.
- Allergic reactions and reactions skin: urticaria, hyperhidrosis, rash, erythema, ecchymosis, petechiae, photosensitivity, alopecia, angioedema, anaphylactic shock.
Other: yawning, flu-like state, ataxia, dyskinesia, myoclonus, psychomotor hyperactivity. In a few cases noted the development of mania, hypomania and visual thinking.
Some side effects of the drug Prozac was noted in post-marketing studies, including in patients noted the development of idiosyncratic hepatitis, serotonin syndrome, priapism, and lack of secretion of antidiuretic hormone.
Warnings of Prozac
Prozac is not used for the treatment of patients indicating a history of hypersensitivity reactions to fluoxetine and optional components of the capsules.
Prozac is not used in pediatric practice.
Prozac is not prescribed in patients receiving pimozide, thioridazine (including after 5 weeks of stopping thioridazine), and drugs that inhibit monoamine oxidase (including within 2 weeks after the end of therapy with monoamine oxidase inhibitors).
Care should be taken when administering the drug Prozac patients who have had suicidal thoughts or there is a risk of such phenomena. Particularly at risk are patients in whom before you start taking fluoxetine it was noted severe depression and suicidal thoughts, and patients in whom the therapy was marked by an increase of depression and the development of insomnia. In addition to the risk factors is the development during therapy with fluoxetine expressed psychomotor stimulation.
The attending physician must persuade the patient to immediately report any thoughts or feelings that cause anxiety.
With Prozac caution should be appointed patients with diabetes, impaired renal function and liver, epilepsy, indicating a history of epileptic seizures, as well as elderly patients.
Prozac during Pregnancy
The studies observed 2072 cases of fluoxetine in the early stages of pregnancy. No identified unwanted effects of the drug
Prozac to the fetus during pregnancy. Care should be taken when administering the drug Prozac late in pregnancy, when the risk of newborn withdrawal symptoms (including the development of short-term motor restlessness, rapid breathing, irritability and difficulties with feeding).
During pregnancy, the drug Prozac is possible if the expected benefit significantly exceeds the potential risks. In the appointment of fluoxetine in the third trimester of pregnancy should monitor the condition of the newborn.
The active ingredient of the drug Prozac passes into breast milk. Use caution, prescribing fluoxetine to women who feed their babies breast.
Prozac is forbidden to take combined with pimozide, thioridazine (including after 5 weeks of stopping thioridazine), and drugs that inhibit monoamine oxidase, including preparations of Hypericum perforatum (including within 2 weeks after the end of therapy with monoamine oxidase inhibitors).
With the combined use of the drug Prozac with other drugs, as well as when replacing the drug with another drug with antidepressant action should take into account that fluoxetine has a long half-life.
Fluoxetine with combined use increases plasma concentration and toxicity of phenytoin. Should be used with caution in concomitant use of these drugs and to increase the dose of fluoxetine or phenytoin during concomitant use.
The combined drug Prozac serotonergic agents (including tramadol and triptan) leads to an increase risk of serotonin syndrome. In addition, the combined use of fluoxetine with triptone increases the risk of hypertension, and vasoconstriction of coronary vessels.
Fluoxetine potentiates sedative effect alprazolama and increases its plasma concentration when administered simultaneously.
The combined use of fluoxetine with benzodiazepines may lead to increased plasma concentrations of the latter.
Lithium and tryptophan in the combined use with fluoxetine can cause serotonin syndrome. The simultaneous use of these funds is allowed only under the supervision of a physician.
Be careful to use fluoxetine in conjunction with drugs metabolized by the isozyme CYP2 D6 and drugs that alter the activity of this enzyme. These combinations can alter the pharmacokinetic profile of fluoxetine and preparations, metaboliziruthan with the participation of CYP2 D6.
Fluoxetine may increase the severity of the effects of oral anticoagulants different groups and prolong bleeding time. If necessary, the combined use of the drug Prozac with oral anticoagulants or if you take anticoagulants within 5 weeks after the end of therapy with fluoxetine should monitor the blood clotting.
Fluoxetine may increase the duration of seizures in patients receiving electroconvulsive therapy.
You should not take products containing ethyl alcohol, and drinking alcohol during therapy with the drug Prozac.
Overdose of Prozac
When receiving excessive doses of the drug Prozac in patients may develop seizures, sleepiness, vomiting, nausea and tachycardia. In addition, in cases of overdose of fluoxetine may develop lengthening of Q-T interval, ventricular tachyarrhythmia, delirium, cardiac arrest, coma, hypotension, mania, fainting, stupor, pyrexia and conditions, such as neuroleptic malignant syndrome.
It was reported 633 cases of overdose of Prozac, 378 cases had full recovery in 15 patients survived the disorders caused by taking high doses of fluoxetine, including accommodation disturbances, confusion, nervousness, vertigo, disorders of respiratory function, arterial hypertension, erectile dysfunction, movement disorder and hypomania. Reported cases of death due to overdose of fluoxetine. The largest known dose of fluoxetine adopted at once, is 8 grams (the case ended in complete recovery). Minimal dose of fluoxetine, which caused death, was 520 mg taken at one time (in this case, a clear causal relationship has not been established).
The specific antidote is unknown. With the development of symptoms of overdose should monitor the patient’s condition and function of the cardiovascular system. On prescription symptomatic therapy.
The holding of forced diuresis, peritoneal and hemodialysis with an overdose of fluoxetine is ineffective.
Prozac capsules, packaged in 14 pieces in a blister packing of polymer film and aluminum foil, in a cardboard box invested 1 or 2 of the blister package.
Drug Prozac should be stored and transported in its original packaging at a temperature range of from 15 to 30°C.
In compliance with the best practices for storing the drug Prozac shelf life 3 years after production.
Prodep, Proflusak, Fluval, Fluoxetine.
See also the list of analogues of the drug Prozac.
1 capsule of the drug Prozac contains:
Fluoxetine hydrochloride (calculated as fluoxetine) – 20 mg;
Pharmaceutical group: Antidepressants
Active substance: Fluoxetine