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Fluoxetine

Brand Names: Prozac, Sarafem, Prozac Weekly, Selfemra

Generic Name: Fluoxetine

Drug Class: Antidepressants, SSRIs

What Is Fluoxetine and How Does It Work?

Fluoxetine is a prescription drug used to treat depression, panic attacks, obsessive-compulsive disorder, bulimia, and a severe form of premenstrual syndrome.

Fluoxetine may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. It may also decrease fear, anxiety, unwanted thoughts, and the number of panic attacks. It may also reduce the urge to perform repeated tasks (compulsions such as hand-washing, counting, and checking) that interfere with daily living. Fluoxetine may lessen premenstrual symptoms such as irritability, increased appetite, and depression. It may decrease binging and purging behaviors in bulimia.

Fluoxetine is available under the following different brand names: Prozac, Sarafem, Prozac Weekly, and Selfemra.

Dosages of Fluoxetine:

Adult and pediatric dosages

Capsule

  • 10 mg
  • 20 mg
  • 40 mg

Tablets

  • 10 mg
  • 20 mg
  • 60 mg

Capsule, delayed-release: (adult dosage only)

  • 90 mg

Oral Solution

  • 20 mg/5ml

Dosage Considerations – Should be Given as Follows:

Adult dosage considerations:

Major Depressive Disorder

Prozac

  • 20 mg orally each day, may consider gradually increasing dose after several weeks by 20 mg/day; not to exceed 80 mg each day

Prozac Weekly

  • 90 mg orally each week

Children older than 8 years

  • 10-20 mg orally per day, initially start at 10 mg/day in lower weight children, may gradually increase dose after 1 week; not to exceed 20 mg per day

Obsessive-Compulsive Disorder

Adult

Prozac

  • 20 mg orally each day, may consider gradually increasing dose after several weeks by 20 mg/day (20-60 mg/day recommended range); not to exceed 80 mg each day

Prozac Weekly

  • 90 mg orally each week

Children older than 7 years

  • 10 mg orally per day, initially; may gradually increase dose after 2 weeks to 20 mg per day; further increases may be considered after several weeks

Adolescents and higher-weight children

  • Typical dosage range 20-60 mg per day

Lower-weight children

  • Typical dosage range 20-30 mg per day

Bulimia Nervosa

Initial or maintenance:

  • May adjust dose to 60 mg orally each day over several days

Panic Disorder

  • Initial: 10 mg orally each day for first week, THEN 20 mg orally each day. May consider gradually increasing dose after several weeks; not to exceed 60 mg per day; doses higher than 60 mg/day not evaluated

Premenstrual Dysphoric Disorder

  • Continuous (Sarafem): 20 mg orally each day initially; may gradually increase dose; not to exceed 80 mg/day, OR
  • Intermittent (Sarafem): 20 mg orally each day starting 14 days before menstruation and through first full day of menses (repeat each cycle)

Fibromyalgia (Off-label)

  • 20-80 mg orally each day

Dosing considerations

Migraine (Off-label)

Prophylaxis

  • 20-40 mg orally each day

Hot Flashes Caused by Hormonal Chemotherapy (Off-label)

  • 20 mg/day orally for 4 weeks

Raynaud Phenomenon (Off-label)

  • 20-60 mg/day orally

Dosing Modifications

Upon therapy discontinuation, taper gradually over 4-6 months to minimize incidence of withdrawal symptoms and allow for detection of re-emerging symptoms; if withdrawal symptoms intolerable, following a dose reduction, resume previously prescribed dose and/or decrease dose at more gradual rate.

Renal impairment: Use caution; drug accumulation may occur with severe renal impairment.

Hepatic impairment (cirrhosis): Decreased clearance of parent drug and active metabolite (norfluoxetine); lower or less frequent dose recommended.

Geriatric dosage considerations

  • Initial 10 mg orally per day, may gradually increase dose by 10-20 mg after several weeks as tolerated
  • Do not take at night unless sedation occurs
  • Preferred drug of choice in elderly over tricyclic antidepressants because of fewer side effects
Medically Reviewed by a Doctor on 4/5/2017



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