Fluoxetine
- Atc Codes:N06AB03
- CAS Codes:59333-67-4
- PHARMGKB ID:59333-67-4
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Felicium, Floccin, Fluctine, Fluoxetin, Fluoxetine, Fluoxibene, Flux, FluxoMed, Mutan, NuFluo, Positivum; Belgium: Docfluoxetine, Fluox, Fluoxemed, Fluoxetine, Fluoxone, Fontex, Prosimed, Prozac; Bulgaria: Biflox, Biozac, Deprexit, Fluoxetin, Ranflutin, Sofluxen; Cyprus: Afeksin, Fluoxetin, Fluxil, Magrilan, Meropan, Plazeron, Prozit; Czech Republic: Defluox, Deprex, Floxet, Fluoxetin, Fluoxetine, Fluzak, Magrilan, Prozac; Denmark: Fluoxetin, Flutin, Fontex; Estonia: Flux, Fluxemed, Nycoflox; Finland: Fluoxetin, Fluoxone, Seromex, Seronil; France: Fluoxetine, Prozac; Germany: Fluctin, Fluctine, Fluox Basics, Fluoxe-Q, FluoxeLich, Fluoxetin, Fluoxgamma, Fluoxtab, Fluxet, Fluxone, Prozac, Reconcile; Greece: Dagrilan, Diledos, Dinalexin, Exostrept, Flonital, Fluxadir, Fokeston, Ladose, Orthon, Sartuzin, Sofelin, Stephadilat-S, Stressless, Thiramil, Zinovat; Hungary: Deprexin, Floxet, Fluoxetin, Portal, Prozac; Ireland: Affex, Bellzac, Biozac, Fluoxetine, Fluzac, Gerozac, Norzac, Prozac, Prozamel, Prozatan, Prozit; Italy: Azur, Clexiclor, Diesan, Flotina, Fluoxeren, Fluoxetina, Prozac, Xeredien; Latvia: Fluoxetine, Flux, Fluxemed; Lithuania: Fluoxetine; Luxembourg: Prozac; Malta: Afeksin, Flunital, Fluoxetine, Fluxil, Magrilan, Oxactin, Prozac, Salipax; Netherlands: Fluoxetine, Flustad, Prozac; Poland: Andepin, Bioxetin, Deprexetin, Fluoksetyna, Fluoxetin, FluoxoLek, Prozac, Salipax, Seronil, Xetiran; Portugal: Digassin, Fluoxetina, Prozac, Psipas, Selectus; Romania: Floxet, Fluoxin, Fluran, Magrilan, Portal, Prozac, Rofluxin; Slovakia: Fluxemed, Hapilux, Magrilan; Slovenia: Fluval, Fodiss, Portal, Prozac, Salipax; Spain: Adofen, Fluoxetina, Luramon, Prozac, Reneuron; Sweden: Fluoxetin, Fluoxetine, Fontex; UK: Fluoxetine, Oxactin, Prozac.
North America
Canada: Fluoxetine, FXT 40, Prozac; USA: Prozac, Sarafem.
Latin America
Argentina: Alental, Animex-On, Captaton, Eburnate, Equilibrane, Faboxetina, Felixina, Fluoxetina, Fluoxiram, Foxetin, Lapsus, Mitilase, Nervosal, Neuro Laz, Prozac, Saurat; Brazil: Daforin, Deprax-Aché, Depress, Eufor, Fluox, Fluoxetin, Fluoxetina, Fluxene, Neo Fluxetin, Nortec, Prozac, Prozen, Psiquial, Verotina; Mexico: Auroken, Axtin, Deprozin, Farmaxetina, Flocet, Florexal, Fluneurin, Fluoxac, Fluoxetina, Fluralex, Flutinax, Fusum, Indozul, Lebensart, Ovisen, Pisaurit, Prozac, Quanilene, Regultron, Siquial, Ulmely, Zatin.
Drug combinations
Fluoxetine and Olanzapine
Chemistry
Fluoxetine Hydrochloride: C~17~H~18~F~3~NO HCl. Mw: 345.79. (1) Benzenepropanamine, N-methyl-γ-[4-(trifluoromethyl)phenoxy]-, hydrochloride, (±)-; (2)(±)-N-Methyl-3-phenyl-3-[(α,α,α-trifluoro-p-tolyl)oxy]propylamine, hydrochloride. CAS-59333-67-4 (1988).
Pharmacologic Category
Antidepressants; Selective Serotonin-reuptake Inhibitors. (ATC-Code: N06AB03).
Mechanism of action
Mechanism of action as antidepressant or anti-obsessive agent unclear, but presumed to be linked to potentiation of serotonergic activity in CNS resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT). Potent, highly selective reuptake inhibitor of serotonin. Increases synaptic concentrations of serotonin in the CNS but has little or no effect on other neurotransmitters.
Therapeutic use
Treatment of major depressive disorder (MDD), binge-eating and vomiting in moderate-to-severe bulimia nervosa, obsessive-compulsive disorder (OCD), premenstrual dysphoric disorder (PDD), or panic disorder with or without agoraphobia.
Pregnancy and lactiation implications
Possible complications reported in neonates exposed to fluoxetine, late in third trimester. Use not recommended during lactation. Increased risk of depression relapse observed in women who discontinued antidepressant therapy during pregnancy compared with those who remained on antidepressant therapy.
Unlabeled use
Selective mutism. Treatment of mild dementia-associated agitation in nonpsychotic patients.
Contraindications
Hypersensitivity to fluoxetine or any component of the formulation. Patients currently receiving MAOIs, pimozide, or thioridazine.
Warnings and precautions
Antidepressants increase risk of suicidal thinking and behavior in children, adolescents, and young adults (18-24 years of age) with MDD and other psychiatric disorders. Fluoxetine is FDA approved for treatment of OCD in children ≥7 years of age and MDD in children ≥8 years of age. May worsen psychosis in some patients or precipitate shift to mania or hypomania in bipolar disorder. Fluoxetine not FDA approved for treatment of bipolar depression. Possible anaphylactoid reactions (e.g. angioedema, bronchospasm, laryngospasm, and/or urticaria). Risk of impaired mental alertness or physical coordination. Allergic events and rash (vasculitis, lupus-like syndrome, laryngospasm, anaphylactoid reactions, and pulmonary inflammatory disease) may develop. Risk of bleeding including upper GI bleeding. May cause insomnia, anxiety, nervousness, or anorexia. May cause or exacerbate sexual dysfunction. SSRIs and SNRIs associated with development of SIADH. Hyponatremia reported rarely (predominately in the elderly). May cause weight loss. Use with caution in the following situations: history of MI or unstable heart disease, diabetes mellitus (may alter glycemic control), renal or hepatic impairment (clearance decreased and plasma concentrations increased), and in elderly patients (risk of hyponatremia and other adverse events may be increased). Seizures are possible (use with caution in previous seizure disorder or conditions predisposing to seizures). Potential for severe reaction when used with MAOIs. Serotonin syndrome may occur with concomitant proserotonergic drugs (i.e. SSRIs/SNRIs or triptans) or agents which reduce metabolism of fluoxetine. Concurrent use of serotonin precursors (e.g. tryptophan) not recommended. Fluoxetine may elevate plasma levels of thioridazine (concurrent use contraindicated), thus increasing risk of QTc interval prolongation (may lead to serious ventricular arrhythmias, such as torsade de pointes-type arrhythmias, and sudden death). May increase risks associated with electroconvulsive therapy. Fluoxetine and its metabolites have a long half-life; effects and interactions noted may persist for prolonged periods following discontinuation. May cause withdrawal syndrome.