Fluoxetine is a similar drug without a prescription. Fluoxetine for weight loss: dosage, how to take it correctly, how much to drink. Reviews of fluoxetine for weight loss

Antidepressant, propylamine derivative. The mechanism of action is associated with selective blockade of neuronal reuptake of serotonin into the central nervous system. Fluoxetine is a weak antagonist of cholinergic, adrenergic and histamine receptors. Unlike most antidepressants, fluoxetine does not appear to cause a decrease in the functional activity of postsynaptic β-adrenergic receptors. Helps improve mood, reduces feelings of fear and tension, eliminates dysphoria. Does not cause sedation. When taken in average therapeutic doses, it has virtually no effect on the functions of the cardiovascular and other systems.

Pharmacokinetics

Absorbed from the gastrointestinal tract. Poorly metabolized during the “first pass” through the liver. Food intake does not affect the degree of absorption, although it may slow down its rate. Cmax in plasma is achieved after 6-8 hours. Cmax in plasma is achieved only after continuous administration for several weeks. Protein binding 94.5%. Easily penetrates the BBB. Metabolized in the liver by demethylation to form the main active metabolite, norfluoxetine.

T1/2 of fluoxetine is 2-3 days, norfluoxetine is 7-9 days. 80% is excreted by the kidneys and about 15% through the intestines.

Release form

10 pieces. - contour cell packaging (2) - cardboard packs.
10 pieces. - contour cell packaging (3) - cardboard packs.
10 pieces. - contour cell packaging (5) - cardboard packs.

Dosage

Initial dose - 20 mg 1 time / day in the morning; if necessary, the dose can be increased after 3-4 weeks. Frequency of administration: 2-3 times/day.

Maximum daily dose when taken orally for adults is 80 mg.

Interaction

When used simultaneously with medicines that have a depressant effect on the central nervous system, with ethanol a significant increase in the inhibitory effect on the central nervous system is possible, as well as an increase in the likelihood of developing seizures.

When used simultaneously with MAO inhibitors, furazolidone, procarbazine, tryptophan, the development of serotonin syndrome (confusion, hypomanic state, motor restlessness, agitation, convulsions, dysarthria, hypertensive crisis, chills, tremor, nausea, vomiting, diarrhea).

With simultaneous use, fluoxetine inhibits the metabolism of tricyclic and tetracyclic antidepressants, trazodone, carbamazepine, diazepam, metoprolol, terfenadine, phenytoin, which leads to an increase in their concentration in the blood serum, increasing their therapeutic and side effects.

With simultaneous use, it is possible to inhibit the biotransformation of drugs metabolized with the participation of the CYP2D6 isoenzyme.

When used simultaneously with hypoglycemic agents, their effect may be enhanced.

There are reports of increased effects of warfarin when used simultaneously with fluoxetine.

When used simultaneously with haloperidol, fluphenazine, maprotiline, metoclopramide, perphenazine, pericyazine, pimozide, risperidone, sulpiride, trifluoperazine, cases of the development of extrapyramidal symptoms and dystonia have been described; with dextromethorphan - a case of the development of hallucinations has been described; with digoxin - a case of increased concentration of digoxin in the blood plasma.

When used simultaneously with lithium salts, an increase or decrease in the concentration of lithium in the blood plasma is possible.

With simultaneous use, it is possible to increase the concentration of imipramine or desipramine in the blood plasma by 2-10 times (may persist for 3 weeks after discontinuation of fluoxetine).

When used simultaneously with propofol, a case was described in which spontaneous movements were observed; with phenylpropanolamine - a case is described in which dizziness, weight loss, and hyperactivity were observed.

With simultaneous use, it is possible to enhance the effects of flecainide, mexiletine, propafenone, thioridazine, zuclopenthixol.

Side effects

From the side of the central nervous system: possible anxiety, tremor, nervousness, drowsiness, headache, sleep disorders.

From the outside digestive system: possible diarrhea, nausea.

From the metabolic side: increased sweating, hypoglycemia, hyponatremia are possible (especially in elderly patients and with hypovolemia).

From the outside reproductive system: decreased libido.

Allergic reactions: possible skin rash, itching.

Other: joint and muscle pain, difficulty breathing, increased body temperature.

Indications

Depression of various origins, obsessive-compulsive disorders, bulimic neurosis.

Contraindications

Glaucoma, atony Bladder, severe renal dysfunction, benign prostatic hyperplasia, simultaneous administration of MAO inhibitors, convulsive syndrome of various origins, epilepsy, pregnancy, lactation, increased sensitivity to fluoxetine.

Features of application

Use during pregnancy and breastfeeding

Use for liver dysfunction

Use for renal impairment

Use in children

Use in elderly patients

special instructions

Use with extreme caution in patients with impaired liver and kidney function, a history of epileptic seizures, and cardiovascular diseases.

In patients with diabetes mellitus changes in blood glucose levels are possible, which requires adjustment of the dosage regimen of hypoglycemic drugs. When used in weakened patients while taking fluoxetine, the likelihood of developing epileptic seizures increases.

With the simultaneous use of fluoxetine and electroconvulsive therapy, the development of prolonged epileptic seizures is possible.

Fluoxetine can be used no earlier than 14 days after discontinuation of MAO inhibitors. The period after discontinuation of fluoxetine before starting therapy with MAO inhibitors should be at least 5 weeks.

Elderly patients require dosage adjustment.

The safety of fluoxetine in children has not been established.

During the treatment period, avoid drinking alcohol.

Impact on the ability to drive vehicles and operate machinery

During treatment, you should refrain from potentially hazardous activities that require increased attention and rapid psychomotor reactions.

International name

Group affiliation

Dosage form

pharmachologic effect

Antidepressant, selective serotonin reuptake inhibitor.

Improves mood, reduces tension, anxiety and fear, eliminates dysphoria. Does not cause orthostatic hypotension, sedation, and is noncardiotoxic.

Persistent clinical effect occurs after 1-2 weeks of treatment.

Indications

Contraindications

Side effects

From the nervous system: dizziness, headache, drowsiness or insomnia, lethargy, increased fatigue, asthenia, tremor, agitation, anxiety, suicidal tendencies (typical of patients with depressive disorders), mania or hypomania.

From the digestive system: loss of appetite, dry mouth or hypersalivation, nausea, diarrhea.

Allergic reactions: skin rash, urticaria.

Others: increased sweating, weight loss, decreased libido, systemic disorders of the lungs, kidneys or liver, vasculitis.

Application and dosage

Orally, for depression, the initial dose is 20 mg/day 1 time, in the morning; if necessary, the dose is increased weekly by 20 mg/day. The maximum daily dose is 80 mg in 2-3 doses.

For bulimia and elderly patients - 60 mg in 3 doses, with obsessive states– 20-60 mg/day. Maintenance therapy – 20 mg/day. The course of treatment is 3-4 weeks.

special instructions

When treating patients with underweight, anorexigenic effects should be taken into account (progressive weight loss is possible).

In patients with diabetes mellitus, the use of fluoxetine increases the risk of developing hypoglycemia and hyperglycemia when it is discontinued. In this regard, the dose of insulin and/or any other hypoglycemic drugs used orally should be adjusted. Until significant improvement in treatment occurs, patients should be under medical supervision.

During treatment, you should refrain from taking ethanol and engaging in potentially hazardous activities that require increased attention and speed of mental and motor reactions.

The interval between the end of therapy with MAO inhibitors and the start of treatment with fluoxetine should be at least 14 days; between the end of treatment with fluoxetine and the start of therapy with MAO inhibitors - at least 5 weeks.

For liver diseases and in old age, treatment should begin with 1/2 dose.

Interaction

Enhances the effects of alprazolam, diazepam, ethanol and hypoglycemic drugs.

Increases the plasma concentration of phenytoin, tricyclic antidepressants, maprotiline, trazodone by 2 times (it is necessary to reduce the dose of tricyclic antidepressants by 50% when used simultaneously).

During electroconvulsive therapy, prolonged epileptic seizures may develop.

Tryptophan enhances the serotonergic properties of fluoxetine (increased agitation, motor restlessness, gastrointestinal disorders).

MAO inhibitors increase the risk of developing serotonin syndrome (hyperthermia, chills, increased sweating, myoclonus, hyperreflexia, tremor, diarrhea, incoordination, autonomic lability, agitation, delirium and coma).

Drugs that have a depressant effect on the central nervous system increase the risk of side effects and increased depressive effects on the central nervous system.

When used simultaneously with drugs that have high degree binding to proteins, especially with anticoagulants and digitoxin, may increase the plasma concentration of free (unbound) drugs and increase the risk of adverse effects.

Reviews of the drug Fluoxetine: 7

I've been taking this medication for over a month now and it seems to be helping with my depression. But I would not advise anyone who has signs of depression to take it. In general, writing reviews regarding any medicine is not entirely correct and possibly dangerous. After all, everyone’s body is individual, which means the selection of the drug should also be individual. Reviews are appropriate for ordinary products, but not for tablets, this is too much.

I’ve been drinking Flu for 2 months.... I started sleeping soundly... I don’t know if this is good or bad, but I sleep during the day and at night when I’m pregnant... but I sleep great... and everything else is fine... I’ve lost weight since I was 57 up to 49 in a month... by the evening you are so energetic)) but it’s better not to wake you up in the morning, it’s useless...

I've read about the side effects and I'm scared to drink. 1 capsule in the morning I can sleep better and feel calmer. My head feels a little dull, as if I’m slowing down. I take it along with carbamazepine as prescribed by the doctor. Diagnosis of VSD

Anyone who has depression due to being overweight is totally cool!! Let's kill two birds with one stone.

Everything would be fine, but I just don’t want to have sex with him ((

They prescribed 10 mg 1/day (I have problems with muscle regulation: they either relaxed or contracted, and the disturbances occurred after taking 1 tablet of a muscle relaxant and a tablet of AD-Velafax). We waited for almost a year for it to go away, but... I took it for 4 days, half a day, because... I have a weight of 44 kg and intolerance to all neurological “delights”. Scheme 1 dose of 2.5 mg - the larynx was compressed, a so-called “lump in the throat” appeared, then the limbs relaxed so much that there was a feeling that the arms were amputated to the shoulder area and , most importantly, tightness, burning and abs in the head. The 2nd appointment went better. On the 3rd appointment I decided to increase it to 5 mg - it was simply terrible: again a sharp relaxation of the muscles of the body, limbs, and my head was so squeezed that I suffered for 2 days from terrible pain, and my face also tightened (pressure in the zygomatic region, pressure on the nose , eyes) and the jaws began to contract spontaneously. 3rd dose 2.5 mg is almost the same, but there is a sleep disorder and the jaw is compressed as if from bruxism. Those. I felt worse. I’ll try to take it for 2 weeks (according to the number of doses) with seduxen, but if seduxen doesn’t remove the side effects in the form of clenched jaws and spasms of my healthy internal organs, the smell of fried food began to make me sick, then I’m afraid I’ll have to change it. It’s a shame, because they selected my blood pressure using the Foll method, because They realized that my tolerance was pretty bad.

Anastasia, January 26, 2017, age: 16

I took fluoxetine for about 2 months with the goal of losing weight. So I lost 10 kg. The volumes dropped very sharply. I’m very glad, but these 2 months were very difficult, as I slept all day long and it was impossible to get me up.

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Content

According to pharmacological classification, Fluoxetine is an antidepressant drug. His active substance fluoxetine acts on most receptors in the brain. The product is produced by Ukrainian and Russian pharmaceutical companies.

Composition of Fluoxetine

Pharmacological properties

The antidepressant contains a propylamine derivative, the action of which is associated with a selective blockade of the reverse neuronal uptake of serotonin in the central nervous system. The active component weakly antagonizes cholinergic, histamine and adrenergic receptors, does not reduce the functional activity of postsynaptic beta-adrenergic receptors. Taking the capsules improves mood, reduces feelings of fear and tension, and eliminates dysphoria. The drug does not cause a sedative effect and does not affect the functions of the heart and blood vessels.

Once inside, the active component is absorbed in the stomach and is poorly metabolized during the first passage through the liver. When there is food in the stomach, the rate of absorption slows down. Fluoxetine reaches its maximum in blood plasma after 7 hours, binds to albumin by 94.5%, and penetrates the meninges. Metabolism occurs by demethylation, producing the inactive metabolite norfluoxetine. The half-life of the drug is 2-3 days, the half-life of metabolites is 7-9 days. Excretion is carried out by the kidneys and intestines.

Indications for use of Fluoxetine

The instructions for use highlight the following indications for use of the medicine:

• depression of various origins, accompanied by phobias;
• bulimic neurosis;
• obsessive-compulsive disorders.

How to take Fluoxetine

The drug Fluoxetine is prescribed only to adults. Taken in an initial daily dose of 20 mg in the morning, if necessary, it is increased after 3-4 weeks to 60-80 mg. Capsules are taken 2-3 times a day. Maximum daily adult dose is 80 mg, in old age – 60 mg. For bulimic neurosis, 1 tablet is recommended three times a day, for obsessive-compulsive disorder - 20-60 mg per day. The maintenance daily dose is 20 mg.

How long does it take for the drug to start working?

After 2 weeks of constant use of the medicine, a significant improvement in the patient’s condition is noted. If the liver or kidneys fail, in old age or when taking other medications, the dose is halved. Sometimes patients are transferred to intermittent admission. Abrupt withdrawal of treatment is not recommended; the dose is reduced gradually over 1–2 weeks to avoid withdrawal syndrome. If, after stopping therapy or reducing the dosage, the patient's condition worsens, return to the previous dose. After positive dynamics appear, you can try to reduce the dose.

Duration of treatment

To eliminate depressive symptoms, you need to take pills for six months. For obsessive manic disorders the patient is treated for 10 weeks, then continued if necessary. If there is no effect, the treatment regimen is changed. If the dynamics are positive, treatment continues with the minimum maintenance dose. Periodically, the doctor changes the dosage taking into account the patient's condition.

For bulimia nervosa and obsessive-compulsive disorder, treatment can last up to 12–24 weeks. After completion of treatment, the active component remains in the blood for another 2 weeks, which is important to consider when prescribing other medications.

Fluoxetine for weight loss

Fluoxetine tablets are often used to treat bulimic disorder - mental disorder, in which there is no feeling of satiety, uncontrolled overeating manifests itself. Taking the drug reduces appetite, relieves the constant feeling of hunger, helps to lose weight if the cause of weight gain is excess weight is bulimia. Decreased appetite and weight loss are related to side effects, but the medication is not intended for losing extra pounds.

If you take the drug uncontrolled, anaphylactic reactions, damage to the lungs, kidneys, skin, and liver may develop. To get rid of bulimia and lose weight, take 1 tablet. per day, if well tolerated - 2 pcs. (morning and evening), but no more than 4 pcs. per day. The drug acts within 4–8 hours and is completely eliminated from the body within a week. In 1–3 months of use you can lose 5–13 kg.

special instructions

Instructions for use of Fluoxetine suggest considering the special instructions:

1. The drug should be taken with caution in cases of impaired renal function, liver function, a history of epileptic seizures, or heart and vascular diseases.
2. In diabetes mellitus, taking pills can change the level of glucose in the blood, which leads to the need to adjust the dosage of hypoglycemic drugs.
3. With weakness, patients are more likely to develop epileptic seizures. Their duration increases with simultaneous electroconvulsive therapy.
4. In old age, the dose is reduced. The medicine is not used in children, in combination with alcohol.
5. While taking capsules, you must refrain from driving a car or operating machinery.

During pregnancy

The product is prohibited for use during pregnancy and lactation. According to research, if women in the first trimester of pregnancy received treatment with the drug, their children developed congenital anomalies in the structure of blood vessels or the heart. Taking Fluoxetine in the last trimester can lead to an increase in the duration of artificial ventilation in newborns, tube feeding, and hospitalization.

Infants develop convulsions, constant crying, hypoglycemia, nervous irritability, excitability, distress syndrome, lability of body temperature and pressure, tremor, cyanosis, vomiting, hyperreflexia, and feeding difficulties. Taking capsules during feeding is also prohibited.

Drug interactions

The antidepressant Fluoxetine can be taken 2 weeks after stopping monoamine oxidase inhibitors. If the transition to these drugs is carried out after treatment with the drug, then 5 weeks should pass. Other drug interactions:

1. The combination of a medication with drugs that inhibit brain function enhances the effect of the latter and leads to the development of seizures.
2. The combination of the drug with furazolidone, tryptophan, procarbazine leads to the development of serotonin syndrome.
3. Fluoxetine inhibits the metabolism of trazodone, tricyclic, tetracyclic antidepressants, diazepam, metoprolol, phenytoin, terfenadine, and enhances the effect of hypoglycemic agents, warfarin.
4. The combination of the drug with fluphenazine, haloperidol, maprotiline, perphenazine, metoclopramide, pericyazine, risperidone, pimozide, trifluoperazine, sulpiride can lead to dystonia, with dextromethorphan - to hallucinations, with propofol - to spontaneous movements, with phenylpropanolamine - to dizziness, hyperactivity, weight loss bodies.
5. The medication increases the concentration of lithium in plasma while taking metal salts, the level of imipramine, desipramine, digoxin.
6. The drug enhances the effects of thioridazine, flecainide, zuclopenthixol, mexiletine, propafenone.

Side effects of Fluoxetine

During treatment with the drug, side effects may develop:

• sleep disturbance, anxiety, headache, tremor, drowsiness, nervousness;
• diarrhea, nausea;
• increased sweating (hyperhidrosis);
• hypoglycemia, hyponatremia;
• decreased libido;
• suicidal thoughts, anxiety;
• arterial hypotension;
• metabolic acidosis, hepatitis, bruxism;
• allergies, itching, skin rash, alopecia, dermatitis, psoriasis, erythema;
• hyperuricemia;
• hypercholesterolemia, hypokalemia, hypocalcemia, hypothyroidism;
• lymphadenopathy;
• joint, muscle pain, arthralgia, arthritis;
• difficulty breathing, increased body temperature (hyperthermia), anorexia, chills.

Overdose

Symptoms of an overdose of Fluoxetine include vomiting, epilepsy, nausea, convulsions, agitation, anxiety, and hypomania. According to doctors, high doses of the drug in combination with temazepam, codeine, maprotiline can result in death from renal failure. The victim's stomach is washed, enterosorbents, diazepam, norepinephrine are given. Blood transfusions, peritoneal dialysis, hemodialysis, and forced diuresis are not effective against intoxication.

Contraindications

Instructions for use indicate contraindications for taking capsules:

• hypersensitivity to the components of the drug;
• pregnancy, lactation;
• glaucoma;
• epilepsy;
• bladder atony;
• convulsions;
• kidney dysfunction;
• prostate hyperplasia or adenoma.

Terms of sale and storage

The product is a prescription product and can be stored away from children at temperatures up to 25 degrees for no longer than five years.

Analogs

You can replace the drug with antidepressants that contain the same or another active ingredient. Fluoxetine analogues:

• Adepress, Rexetine - tablets based on paroxetine;
• Asentra, Serlift - tablets containing sertraline;
• Paroxetine – tablets with the active ingredient of the same name;
• Elicea, Lenuxin - tablets based on escitalopram.

Fluoxetine price

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There are contraindications. Before starting use, consult your doctor.

Commercial names abroad (abroad) - Prozac, Sarafem, Fontex (USA), Zactin, Lovan, Fluohexal, Auscap (Auscapa), Depreks (Turkey), Floxet (Hungary), Flunil, Prodep, Fludac (India), Flutine, Affectine (Israel), Fluox (New Zealand), Fluoxetina (Colombia), Fluzac (Ireland), Fluxen (Ukraine), Fluoxin (Romania), Fontex (Denmark, Norway, Sweden), Ladose (Greece), Philozac (Egypt), Biozac, Deprexetin, Fluval, Biflox, Deprexit, Sofluxen, Floxet, Ranflutin (Bulgaria), Flunisan, Orthon, Refloksetin, Fluoksetin (Macedonia), Seronil (Finland), Lorien (South Africa).

All drugs used in neurology and psychiatry.

You can ask a question or leave a review about the medicine (please, do not forget to indicate the name of the drug in the text of the message).

Preparations containing Fluoxetine (ATC code N06AB03):

Prozac (original Fluoxetine) - official instructions for use. The drug is a prescription, the information is intended only for healthcare professionals!

Clinical and pharmacological group:

Antidepressant.

pharmachologic effect

Antidepressant. It is a selective serotonin reuptake inhibitor, which determines its mechanism of action. Fluoxetine has virtually no affinity for other receptors, for example, α1-, α2- and β-adrenergic receptors, serotonin receptors, dopamine receptors, histamine H1 receptors, m-cholinergic receptors and GABA receptors.

Pharmacokinetics

Suction

After oral administration, it is well absorbed from the gastrointestinal tract. Cmax is reached after 6-8 hours.

Bioavailability when taken orally is more than 60%. Dosage forms fluoxetine for oral administration is bioequivalent.

Distribution

Binding to blood plasma proteins is more than 90%. Distributed throughout the body. Css in plasma is achieved after taking the drug for several weeks. Css after long-term use of the drug is similar to the concentrations observed at 4-5 weeks of drug use.

Metabolism

Intensively metabolized in the liver to norfluoxetine and a number of other unidentified metabolites.

Removal

Excreted in the urine in the form of metabolites. T1/2 of fluoxetine is 4-6 days, and its main active metabolite is 4-16 days.

Indications for use of PROZAC®

• depression of various etiologies;
• bulimia nervosa;
• obsessive-compulsive disorder;
• premenstrual dysphoric disorder.

Dosage regimen

For obsessive-compulsive disorders, the recommended dose is 20-60 mg per day.

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

The drug can be taken regardless of meals.

There is no data on the need to change the dose depending on age.

In patients with impaired liver function, concomitant diseases, or taking other drugs, the dose should be reduced and the frequency of administration should be reduced.

Side effect

From the digestive system: diarrhea, nausea, vomiting, dysphagia, dyspepsia, taste perversion; in isolated cases - idiosyncratic hepatitis.

From the central nervous system and peripheral nervous system: convulsions, ataxia, bucco-glossal syndrome, myoclonus, tremor, anorexia (up to weight loss), anxiety accompanied by palpitations, restlessness, nervousness, agitation, dizziness, fatigue (drowsiness, asthenia), disturbance of the process of concentration and thinking, manic reaction, sleep disturbances (unusual dreams, insomnia); visual impairment (mydriasis, blurred vision); disorders of the autonomic nervous system (dry mouth, increased sweating, vasodilation, chills), serotonin syndrome (complex clinical manifestations changes mental state and neuromuscular activity in combination with autonomic disorders of the nervous system).

From the outside genitourinary system: urinary disorders (including frequent urination), priapism/prolonged erection, sexual disorders (decreased libido, delayed or absent ejaculation, lack of orgasm, impotence).

From the outside endocrine system: disturbances in ADH secretion.

Allergic reactions: itching, skin rash, urticaria, anaphylactic reactions, vasculitis, reactions similar to serum sickness.

Dermatological reactions: photosensitivity, alopecia.

Other: yawning, ecchymosis.

Contraindications to the use of PROZAC®

• established hypersensitivity to fluoxetine.

Use of PROZAC® during pregnancy and breastfeeding

Experimental studies on animals did not reveal direct or indirect negative effects of fluoxetine on the development of the embryo or fetus or on the course of pregnancy. There is no evidence of mutagenicity or impairment of fertility from in vitro or animal studies. Because animal reproduction studies do not always predict human response, Prozac should be used during pregnancy only when absolutely necessary.

Fluoxetine is excreted in breast milk, so the drug should be administered with caution to nursing mothers.

The effect of fluoxetine on labor in humans is unknown.

Use for liver dysfunction

In patients with impaired liver function, the dose should be reduced and the frequency of administration should be reduced.

Use in children

The safety and effectiveness of Prozac in children have not been established.

special instructions

There are reports of skin rash, anaphylactic reactions and progressive systemic disorders involving pathological process skin, lungs, liver, kidneys in patients taking fluoxetine. If a skin rash or other possible allergic reactions, the etiology of which cannot be determined, Prozac should be discontinued.

As with other antidepressants, Prozac should be used with caution in patients with a history of epileptic seizures.

When using fluoxetine, there have been cases of hyponatremia (in some cases, the level of sodium in the blood was less than 110 mmol/l). Mostly, such cases were observed in elderly patients and in patients receiving diuretics, due to a decrease in blood volume.

In patients with diabetes mellitus, hypoglycemia was observed during treatment with Prozac, and hyperglycemia was observed after discontinuation of the drug. At the beginning and after the end of treatment with fluoxetine, dose adjustments of insulin and/or oral hypoglycemic drugs may be required.

Experimental results

There is no evidence of carcinogenicity from in vitro or animal studies.

Impact on the ability to drive vehicles and operate machinery

Drugs that affect mental functioning may affect decision-making and driving skills. Patients should be advised to avoid driving a car or operating dangerous machinery until it has been established that the drug does not affect the ability to perform these types of activities.

Overdose

Symptoms: nausea, vomiting, seizures, dysfunction of cardio-vascular system(from asymptomatic arrhythmias to cardiac arrest), dysfunction respiratory system and signs of changes in the state of the central nervous system from excitement to coma.

Cases of overdose of fluoxetine alone are usually mild, death was observed extremely rarely.

Treatment: control general condition and cardiac activity along with general symptomatic and supportive therapy. A specific antidote is unknown. The effectiveness of forced diuresis, dialysis, hemoperfusion, and cross-transfusion is unlikely.

When treating an overdose, the possibility of using multiple drugs should be considered.

Drug interactions

Prozac should not be co-administered with MAO inhibitors and for at least 14 days after stopping treatment with MAO inhibitors. After discontinuation of fluoxetine and initiation of treatment with MAO inhibitors, there should be an interval of at least 5 weeks. If long-term treatment with fluoxetine was carried out and/or the drug was used in high doses, then this interval should be increased. Among patients who had previously taken fluoxetine and started taking MAO inhibitors at a shorter interval, serious cases of serotonin syndrome (manifestations of which may be similar to NMS), including death, have been reported.

Fluoxetine has the ability to inhibit the CYP2D6 isoenzyme. Therefore, treatment with drugs that are metabolized by this system and that have a narrow therapeutic index should be started with the lowest doses if the patient is concurrently receiving fluoxetine or has taken it within the previous 5 weeks. If fluoxetine is included in the treatment regimen of a patient already taking a similar drug, a reduction in the dose of the first drug should be considered.

When used simultaneously with Prozac, changes in blood concentrations of phenytoin, carbamazepine, haloperidol, clozapine, diazepam, alprazolam, lithium, imipramine and desipramine were observed, and in some cases manifestations were observed toxic effect. When taking fluoxetine in combination with these drugs, conservative dosage selection should be provided and the patient's condition should be monitored.

Fluoxetine is tightly bound to plasma proteins. Therefore, when prescribing fluoxetine while using another drug that binds tightly to plasma proteins, changes in the plasma concentrations of both drugs are possible.

When fluoxetine was used concomitantly with warfarin, an increase in bleeding time was observed. Changes in anticoagulant action (laboratory values ​​and/or Clinical signs and symptoms) were inconsistent. As with warfarin in combination with many other drugs, close monitoring of blood clotting parameters should be performed when fluoxetine is initiated or discontinued during warfarin therapy.

If it is necessary to prescribe other drugs after discontinuation of Prozac, the long half-life of fluoxetine and its active metabolite norfluoxetine and, therefore, the possibility of drug interactions should be taken into account.

There have been rare cases of increased duration of seizures in patients taking fluoxetine during electroconvulsive therapy.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

The drug should be stored at room temperature(from 15° to 30°C), out of the reach of children.

Fluoxetine is a strong antidepressant indicated for drug therapy for obsessive and depressive conditions, which are accompanied by the presence of fears.

Systematic use of this drug helps patients overcome apathy, improve mood, normalize appetite and sleep, and reduce feelings of fear and tension.

First acquaintance with the medicine

The active ingredient of the drug is fluoxetine hydrochloride.

The pharmacological property is based on its ability to inhibit reuptake into the central nervous system serotonin - the main neurotransmitter called the hormone of pleasure (or happiness).

It is he who is responsible for a good mood, the absence of tearfulness, pickiness, and boredom. The therapeutic effect of the drug improves the patient’s psycho-emotional activity and does not affect blood pressure, functional activity heart, does not cause drowsiness and lethargy.

The drug is prescribed for:

• obsessive states;
• various depressions;
• premenstrual dysphoria;
• alcoholism.

Pros and cons of the drug

The main advantages of the drug are:

• lack of hypnotic effect and cardiotoxic effect;
• availability in the pharmacy network;
• democratic price.

The disadvantages of the drug include the following side effects:

• allergic reaction to the main component of the drug;
• pregnancy;
• breastfeeding a baby;
• pathological processes in the liver and kidneys;
• diabetes mellitus;
• epileptic conditions.

This predominance of “minuses” over “pluses” is a consequence of the fact that this medicinal product already outdated. Today, the pharmaceutical industry provides patients with modern analogues Fluoxetine, which have the ability selective influence on the human body.

Why are people looking for fluoxetine analogs?

Price issue

Fluoxetine is not the best cheap drug(its price is about 300 rubles) and in order to save money you have to look for more affordable analogues.

Among them are Framex and Flunat - these are more affordable medications that cost from 100 to 150 rubles, and their low price is due to their less famous name.

By-effect

A high-quality and proven drug, but it has certain disadvantages, or rather a number of side effects:

• bowel dysfunction;
• infrequent headaches that appear an hour after administration;
• increased heart rate, which can lead to tachycardia;
• overdrying of the mucous membrane;
• blurred vision;
• increased sweat secretions;
• general malaise;
• found in women taking the drug painful sensations in the mammary glands and violation menstrual cycle(up to several weeks);
• nausea and vomiting;
• noise in ears;
• constant feeling of fatigue;
• sleep disorders;
• depression;
• acne and allergic irritations;
• broken bones;
• sexual apathy (loss of interest in sex).

The list of contraindications is quite long and that is why most people are looking for more harmless analogues. For example, it could be Flunat or Deprex. The drugs have a natural composition and a less aggressive effect on the patient’s body.

No choice

Of course, the last reason why people turn to analogues this drug– this is simply its absence on the shelves in pharmacies, since Fluoxetine is a sought-after medication.

If this medicine is not available in the pharmacy, then you should turn your attention to Profluzac and Fluval, which are identical in their action and composition.

Analogues in terms of active substance, composition, action

By active substance fluoxetine hydrochloride has the following analogues:

• Apo-Fluoxetine;
• Bioxetine;
• Deprex;
• Deprenon;
• Flunate;
• Fluval;
• Fluoxetine-Canon;
• Fluoxetine-Nycomed.

Similar medications in composition and effects on the body:

• Portal, composition: fluoxetine and vitamin supplements;
• Prodep, composition: fluoxetine and calcium;
• Prozac, composition: fluoxetine and sedatives.

Unlike fluoxetine, almost all similar drugs have fewer impurities in their composition, which means they are more harmless.

TOP - 15 best analogues

Popular analogues:

A question of price and free access

Cheap analogues of the antidepressant Fluoxetine:

• Floxet – 150 rubles;
• Profluzak – 75 rubles.

Over-the-counter analogues of Fluoxetine:

• Portal;
• Bioxetine.

Domestic analogues:

• Portal;