Fluoxetine Lannacher, 20 mg capsules 20 pcs

Fluoxetine has antidepressant, anorexigenic effects.

It selectively inhibits serotonin reuptake, which leads to increase of its concentration in the synaptic cleft, strengthening and prolongation of its action on postsynaptic receptors. Increasing serotonergic transmission by negative feedback mechanism inhibits the metabolism of the neurotransmitter.

In prolonged use it lowers the activity of 5-NT1 receptors. It also blocks serotonin reuptake in platelets. Weakly affects the reuptake of noradrenaline and dopamine. It has no direct effect on serotonin, m-cholinergic, H1-histamine and alpha-adrenoceptors. Unlike most antidepressants it does not cause decrease of activity of postsynaptic beta-adrenoreceptors.

Effective in endogenous depression and obsessive-compulsive disorders. It improves mood, reduces tension, anxiety and feelings of fear and eliminates dysphoria. Has anorexigenic effect, may cause weight loss. In patients with diabetes, it can cause hypoglycemia; when fluoxetine is withdrawn, it can cause hyperglycemia. A pronounced clinical effect in depression occurs after 1-4 weeks of treatment, in obsessive-compulsive disorders – after 5 weeks or more.

When fluoxetine is used during pregnancy, an increased risk of preterm delivery, developmental abnormalities and poor adaptation of newborns (including difficulty breathing, cyanosis, excitability) have been noted.

There is evidence for efficacy of fluoxetine in eating disorders (anorexia nervosa), alcoholism, anxiety disorders, including sociophobia; diabetic neuropathy, affective, including Bipolar disorders; dysthymia, autism, panic attacks, premenstrual syndrome, narcolepsy, catalepsy, obstructive sleep apnea syndrome, kleptomania, schizophrenia, schizoaffective disorders and others.

Indications

– Depression of various genesis.
– Bulimia nervosa.
– Obsessive-compulsive disorders (compulsive states).

Active ingredient

Composition

In 1 capsule contains:

fluoxetine hydrochloride 22.4 mg, which corresponds to the content of fluoxetine 20 mg.

Additional Ingredients:

Lactose,

Microcrystalline cellulose,

colloidal silicon dioxide (aerosil),

talc,

magnesium stearate.

Capsule composition:

Titanium dioxide,

Diamond black,

p> patent blue,

Ponceau 4R,

azorubin,

gelatin.

How to take, the dosage

Ingestion. Persistent clinical effect is achieved after 2-3 weeks of treatment, maintenance therapy can be continued up to 6 months.

Depression: 20 mg once daily in the morning. If necessary, after 3-4 weeks, the dose may be increased to 20 mg 2 times a day (morning and evening). The maximum daily dose is 80 mg 1-2 times a day.

Bulimic neurosis: up to 60 mg/day.

Compulsive disorders: 20-60 mg/day.

Interaction

It is incompatible with MAO inhibitors, other antidepressants, furazolidone, procarbazine because it causes serotonergic syndrome (chills, hyperthermia, muscle rigidity, myoclonus, vegetative lability, hypertensive crisis, agitation, tremor, motor anxiety, seizures, diarrhea, hypomanic state, delirium, coma. Possible fatal outcome).

In concomitant use with drugs that have a high degree of binding to plasma proteins (oral anticoagulants, oral hypoglycemic agents, cardiac glycosides, etc.), mutual displacement from binding to the protein with changes in the concentration of free fraction in the blood, the risk of side effects increases. The risk of bleeding with warfarin increases.

Inhibits biotransformation of drugs metabolized with participation of CYP2D6 cytochrome P450 isoenzyme (tricyclic antidepressants, dextromethorphan, vinblastine, carbamazepine). It prolongs the T1/2 of diazepam and potentiates the effects of alprazolam.

Concomitant use alters (increases or decreases) the plasma concentration of lithium, increases phenytoin (to clinical manifestations of its overdose), tricyclic antidepressants (imipramine, desipramine) increases by 2-10 times.

Tryptophan increases the serotonergic properties of fluoxetine (agitation, motor restlessness, GI dysfunction are possible). Incompatible with ethanol.

Special Instructions

Close monitoring of patients with suicidal tendencies is required, especially at the beginning of treatment. The risk of suicide is highest in patients who have previously taken other antidepressants and in patients who have excessive fatigue, hypersomnia or motor anxiety during treatment with fluoxetine.

The anorexigenic properties of fluoxetine should be considered when treating patients with low body weight.

Long-lasting epileptic seizures are possible during electroconvulsive therapy with fluoxetine.

The interval between withdrawal of MAO inhibitors and starting fluoxetine should be more than 2 weeks, and at least 5 weeks between withdrawal of fluoxetine and taking MAO inhibitors.

Influence on driving and operating machinery:

With caution, use for drivers of vehicles and people whose activities require increased concentration and rapid psychomotor reactions. Alcohol should be avoided during treatment.

Contraindications

– Hypersensitivity.
– Use of MAO inhibitors (in the previous 2 weeks).
– Hepatic and renal failure (creatinine clearance less than 10 ml/min).
– Epilepsy and seizures (history).
– Suicidal tendencies.
– Diabetes mellitus.
– Bladder atony.
– Closed-angle glaucoma.
– Hypertrophy of the prostate.
– Pregnancy.
– Breastfeeding.
With caution:
– Childhood (safety and efficacy not established).
– Myocardial infarction, including in the anamnesis.
– Liver cirrhosis.
– Older age.
– In cardiovascular disease.
– Insufficiency of liver function and/or kidneys.

Side effects

CNS disorders: dizziness, headache, sleep disturbances, increased fatigue, asthenia, tremor, agitation, motor agitation, increased suicidal tendencies, anxiety, mania or hypomania.

Gastrointestinal disorders: decreased appetite, impaired taste, nausea, vomiting, dry mouth or hypersalivation, diarrhea.

Allergic reactions: in the form of skin rash, itching, urticaria, myalgia, arthralgia, fever.

Urogenital system disorders: urinary incontinence or retention, dysmenorrhea, vaginitis, decreased libido, impaired sexual function in men (delayed ejaculation).

Others: increased sweating, tachycardia, visual acuity, weight loss, systemic lung, kidney or liver disorders, vasculitis.

Overdose

Symptoms: nausea, vomiting, restlessness, agitation, hypomania, seizures and other symptoms of CNS agitation.

Treatment: gastric lavage, administration of activated charcoal, diazepam for convulsions.

Pregnancy use

It is contraindicated in pregnancy. Breastfeeding should be discontinued during treatment.

Similarities