Fluoxetine: functions, dosage, side effects, how to use

What Drug Fluoxetine?

What is Fluoxetine used for?

Fluoxetine is an oral medication that is available in tablet, capsule, and liquid form. This drug is one type of antidepressant drug, namely selective serotonin reuptake inhibitors (SSRI). This drug works by increasing the amount of serotonin levels in the brain so that it can help maintain mental balance.

This drug can be used to treat depression, panic attacks, obsessive compulsive disorder (obsessive-compulsive disorder), certain eating disorders (bulimia), and severe conditions in premenstrual syndrome (premenstrual dysphoric disorder).

Not only that, this drug can improve your mood or mood, sleep, appetite, and energy levels. In addition, fluoxetine can also help increase your enthusiasm and passion for life. This medication can reduce fear, anxiety, unwanted thoughts, and panic attacks.

Fluoxetine can also reduce PMS symptoms such as irritability, increased appetite, and depression. This drug can reduce picky eating behavior in conditions of bulimia.

If you are going to buy this drug, you must include a doctor's prescription. So, you cannot get them freely at the pharmacy.

How to use fluoxetine?

Here are some things you should know when using fluoxetine, including how to use it.

• Take this medication as directed by your doctor, usually once daily in the morning. If you are using this medicine twice a day, your doctor may recommend that you use it in the morning and during the day.
• If you are taking fluoxetine for premenstrual problems, your doctor may direct you to use it every day of your period every month or just for two weeks before your period starts. To help you remember, mark up your calendar.
• If you are using this medication in liquid form, measure the dose carefully using a measuring device / special spoon. Don't use a household spoon as you may not get the correct dose.
• Dosage is based on your medical condition and response to treatment. To reduce the risk of side effects, your doctor may direct you to start using this medication at a low dose and gradually increase the dose. Follow the doctor's instructions carefully.
• Use this medicine regularly to get the maximum benefits. To help you remember, use it at the same times each day.
• It is important to continue taking this medication as prescribed even if you feel better. Do not stop taking this medication without consulting your doctor.
• You will see some changes over a period of one to two weeks. However, it will take 4-5 weeks before you experience the full benefits.
• Tell your doctor if your condition does not improve or if it gets worse.
• Follow the rules given by your doctor or pharmacist before starting treatment. If you have any questions, consult your doctor or pharmacist.

How is fluoxetine stored?

The procedure for storing fluoexetine is as follows:

• This medication is best stored at room temperature, away from direct light and damp places.
• Do not store in the bathroom and also do not freeze in the freezer.
• Other brands of this drug may have different storage rules.
• Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Meanwhile, below is the proper procedure for getting rid of fluoxetine:

• Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed.
• Do not mix this medicine with other household waste.

Consult your pharmacist or staff from your local waste disposal agency about how to safely dispose of your product.

Fluoxetine dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the fluoxetine dosage for adults?

Adult dosage for bulimia

Immediate-release oral formulations

• Recommended dosage: 60 mg orally once a day.

Adult dosage for depression

Immediate-release oral formulations

• Initial dose: 20 mg orally once a day, but may be increased after a few weeks if there are no significant changes.
• Maintenance dose: 20-60 mg orally per day.
• Maximum dose: 80 mg orally per day.

Delayed release oral capsules

• Initial dose: 90 mg orally once a week, started seven days after the previous dose of fluoxetine 20 mg.

Adult dosage for obsessive compulsive disorder

Immediate-release oral formulations

• Initial dose: 20 mg orally once a day, increasing after a few weeks if no clinical improvement is seen.
• Maintenance dose: 20-60 mg orally per day
• Maximum dose: 80 mg orally per day

Adult dosage for panic disorder

Immediate-release oral formulations

• Initial dose: 10 mg orally once a day, increasing after one week to 20 mg orally once a day
• Maintenance dose: 20-60 mg orally per day
• Maximum dose: 60 mg orally per day

Adult dosage for premenstrual dysphoric disorder

Immediate-release oral formulations

• Initial dose: 20 mg orally once a day on every day of the menstrual cycle or once daily starting 14 days before the start of menstruation until the first day of menstruation, and repeated every new cycle.
• Maintenance dose: 20-60 mg per day for either continuous or intermittent use.
• Maximum dose: 80 mg orally per day
• Duration: 20 mg daily dose has been shown to be effective for up to 6 months of treatment

What is the fluoxetine dosage for children?

Children's dosage for depression

For ages 8-18 years:

• Initial dose: 10 to 20 mg orally once a day; The 10 mg daily dose can be increased after one week to 20 mg orally once a day.

• Initial dose: 10 mg orally once a day, increasing to 20 mg orally once a day after several weeks if no clinical improvement is seen.
• Maintenance dose: 10-20 mg orally once a day.

Children's dosage for obsessive compulsive disorder

For ages 7 to 18:

• Teenagers and children with a higher body weight:
  • Initial dose: 10 mg orally once a day, increasing to 20 mg orally once a day after 2 weeks
  • Maintenance dose: 20-60 mg orally per day
  • Maximum dose: 60 mg daily

• Children with a lower body weight:
  • Initial dose: 10 mg orally once a day, increasing after a few weeks if no clinical improvement is seen
  • Maintenance dose: 20-30 mg orally once a day
  • Maximum dose: 60 mg orally per day.

In what dosage is fluoxetine available?

• Capsules, Oral: 10 mg, 20 mg, 40 mg
• Postponed capsule, Oral: 90 mg
• Solution, Oral: 20 mg / 5 mL (5 mL, 120 mL)
• Tablet, Oral: 10 mg, 20 mg, 60 mg

Fluoxetine side effects

What side effects can be experienced due to fluoxetine?

The use of fluoxetine is the same as the use of other drugs, because it can also cause symptoms of side effects. These symptoms include health conditions, ranging from mild to moderately serious.

Get emergency medical help if you have any of these signs of an allergic reaction: nausea, vomiting, sweating, hives, difficulty breathing, swelling of your face, lips, tongue, or throat, or feel like you might pass out.

Report any new or worsening symptoms to your doctor, such as changes in mood or behavior, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, restless, hostile, aggressive, hyperactive (mental or physical), more depressed, or have thoughts about suicide or hurting yourself.

The serious side effects that may occur when using fluoxetine are:

• very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeat, tremors, overactive reflexes
• nausea, vomiting, diarrhea, loss of appetite, feeling unstable, loss of coordination
• headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizures, shortness of breath or inability to breathe
• severe skin reactions - fever, sore throat, swelling of the face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially on the face or upper body) and causes blistering and peeling.

If you experience any of the above side effects, tell your doctor immediately and seek medical care. Meanwhile, less serious side effects from using fluoxetine are:

• flu symptoms such as stuffy nose, sneezing, sore throat
• drowsiness, dizziness, feeling nervous
• mild nausea, stomach pain, constipation
• increased appetite, changes in body weight
• sleep problems (insomnia)
• decreased sex drive, impotence, or difficulty having an orgasm or
• dry mouth.

The side effects above are quite mild and will go away on their own, over time. However, if these side effects do not go away, contact your doctor immediately.

Not everyone experiences the following side effects. There may be some side effects not listed above. If you have concerns about certain side effects that may occur when you use fluoxetine, it is mandatory for you to consult your doctor or pharmacist.

Fluoxetine Drug Warnings and Cautions

What should be known before using fluoxetine?

Before using fluoxetine, there are several things you should know, including:

• It is mandatory to tell your doctor that you are allergic to fluoxetine.
• tell your doctor if you are taking pimozide (Orap), thioridazine or monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped using monoamine oxidase inhibitors in the last two weeks. If you stop using fluoxetine, you should wait at least 5 weeks before you start taking thioridazine or a monoamine oxidase inhibitor.
• tell your doctor and pharmacist about the prescription and nonprescription drugs, vitamins, nutritional supplements, and herbal products you are using or will be using.
• tell your doctor about any nutritional supplements and herbal products you use, especially products that contain St John's wort or tryptophan.
• tell your doctor if you are being treated with electroshock therapy (a procedure in which small electric shocks are given to the brain to treat certain mental illnesses), if you have recently had a heart attack and if you have or have ever had diabetes, seizures, or liver disease or heart disease.
• tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or breastfeeding. If you become pregnant while using fluoxetine, call your doctor. Fluoxetine can cause problems in the newborn after delivery if it is used during the last months of pregnancy.
• Talk to your doctor about the risks and benefits of using fluoxetine every day if you are 65 years or older.
• This medicine may cause drowsiness. Do not engage in activities that require high concentration while under the influence of fluoxetine.

Is fluoxetine safe for pregnant and lactating women?

There are no adequate studies regarding the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category C according to the US Food and Drug Administration (FDA) in America or the equivalent of the Food and Drug Administration (BPOM) in Indonesia. The following references the pregnancy risk categories according to the FDA:

• A = No risk,
• B = not at risk in several studies,
• C = May be risky,
• D = There is positive evidence of risk,
• X = Contraindicated,
• N = Unknown

There are not enough studies in women to find out any risks to the baby when using this medicine during breastfeeding. Consider the potential benefits and risks before using this medication while breastfeeding.

Fluoxetine Drug Interactions

What other medicines may interact with fluoxetine?

Drug interactions can change the performance of your medications or increase the risk of serious side effects. Not all possible drug interactions are listed in this article. Keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. Do not start, stop, or change the dose of any medication without your doctor's approval.

Use of this drug with other medicines that make you drowsy can worsen this effect. Ask your doctor before using fluoxetine with sleeping pills, narcotic pain medication, muscle relaxer, or medication for anxiety, depression, or seizures.

Many drugs can interact with fluoxetine. Not all possible interactions are listed here. Tell your doctor about all the drugs you start using and stop using during treatment. The following are drugs that can interact with fluoxetine, including:

• alprazolam (Xanax)
• anticoagulants ('blood thinners') such as warfarin (Coumadin)
• antidepressants (mood elevators) such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin, imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Norpramin), and
• aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
• clopidogrel (Plavix), clopidogrel (Plavix), diazepam (Valium)
• digoxin (Lanoxin)
• diuretics ('water pills')
• Linezolid
• flecainide (Tambocor)
• insulin or oral medication for diabetes
• lithium (Eskalith, Lithobid)
• medicine for anxiety and Parkinson's disease
• methylene blue
• medications for mental illness such as clozapine (Clozaril) and haloperidol (Haldol)
• medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), Naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig)
• medications for seizures such as carbamazepine (Tegretol) and phenytoin (Dilantin); sedative
• sibutramine (Meridia)
• sleeping pills
• tramadol (Ultram)
• Soothing
• vinblastine (Velban)
• St. John wort
• tramadol
• tryptophan (sometimes called L-tryptophan)
• medications to treat mood disorders, thinking disorders, or mental illness - amitriptyline, desipramine, lithium, nortriptyline, and many others
• migraine medicine - rizatriptan, sumatriptan, zolmitriptan
• narcotic pain medication - fentanyl, tramadol.

Can food or alcohol interact with fluoxetine?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions may interact with Fluoxetine?

The presence of other health problems in your body may affect the use of this drug. Tell your doctor if you have other health problems. The following are health problems that can interact with fluoxetine:

• bipolar disorder (mood disorder with mania and depression)
• bleeding problems
• diabetes
• glaucoma (angle closed type)
• hyponatremia (low sodium in the blood)
• mania, including history
• heart attack or stroke, recent or historical
• heart failure
• heart rhythm problems (for example, QT prolongation), or history
• hypokalemia (low potassium in the blood)
• hypomagnesemia (low magnesium in the blood)
• liver disease

Fluoxetine overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

Symptoms of an overdose that may occur when using fluoxetine are:

• confusion
• not responsive
• nervous
• uncontrollable shaking of parts of the body
• dizzy
• fast, irregular beating heartbeat.
• seeing things or hearing voices that aren't there (hallucinating)
• fever
• passed out
• coma (loss of consciousness for a period of time)

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.