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Fluoxetine

FLUOXETINE

Manufacturer: Dr.Reddy's Laboratories Limited

Score: 148.0

Quick Summary

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) used to treat various conditions, including major depressive disorder, obsessive-compulsive disorder, bulimia nervosa, and panic disorder. It works by increasing the levels of serotonin in the brain. The recommended initial dose for adults is 20 mg/day, and for pediatric patients, it is 10 mg/day. Fluoxetine has several important safety considerations, including a boxed warning for suicidal thoughts and behaviors in children, adolescents, and young adults, and contraindications for use with monoamine oxidase inhibitors (MAOIs) and certain other medications. Special population considerations include use during pregnancy, nursing mothers, pediatric use, and geriatric use.

Key Clinical Findings and Indications

  • Major depressive disorder
  • Obsessive-compulsive disorder
  • Bulimia nervosa
  • Panic disorder

Important Safety Information

Warning

Suicidal thoughts and behaviors in children, adolescents, and young adults

Contraindications

  • Monoamine oxidase inhibitors (MAOIs)
  • Pimozide
  • Thioridazine

Adverse Reactions

  • Abnormal dreams
  • Abnormal ejaculation
  • Anorexia
  • Anxiety
  • Asthenia
  • Diarrhea
  • Dry mouth
  • Dyspepsia
  • Flu syndrome
  • Impotence
  • Insomnia
  • Libido decreased
  • Nausea
  • Nervousness
  • Pharyngitis
  • Rash
  • Sinusitis
  • Somnolence
  • Sweating
  • Tremor
  • Vasodilatation
  • Yawn

Dosing Recommendations

General Guidance

Dose adjustments may be necessary for patients with hepatic impairment, the elderly, and those with concurrent disease or multiple concomitant medications.

Major depressive disorder

Adult Dose

20 mg/day

Pediatric Dose

10 mg/day

Obsessive-compulsive disorder

Adult Dose

20 mg/day

Pediatric Dose

10 mg/day

Bulimia nervosa

Adult Dose

60 mg/day

Pediatric Dose

Not recommended

Panic disorder

Adult Dose

10 mg/day

Pediatric Dose

Not recommended

Special Population Considerations

Pregnancy

  • Fluoxetine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
  • Neonates exposed to fluoxetine in the third trimester have developed complications requiring prolonged hospitalization.

Nursing Mothers

  • Fluoxetine is excreted in human milk, and nursing while on fluoxetine is not recommended.
  • Infants exposed to fluoxetine via breast milk have developed adverse reactions such as crying, sleep disturbance, vomiting, and watery stools.

Pediatric Use

  • The safety and effectiveness of fluoxetine in pediatric patients < 8 years of age have not been established.
  • Fluoxetine has been associated with decreased weight gain and decreased alkaline phosphatase levels in pediatric patients.

Geriatric Use

  • U.S. fluoxetine clinical trials included 687 patients ≥ 65 years of age and 93 patients ≥ 75 years of age.
  • No overall differences in safety or effectiveness were observed between these subjects and younger subjects.