Prozac
Prozac (Fluoxetine)Pharmacological action
Antidepressant.
Pharmacokinetics
After intake it is well soaked up from GASTROINTESTINAL TRACT. Cmax it is reached through 6-8 h.
Distribution
Linkage with fibers of a blood plasma - more than 90 %. It is distributed on all organism. Css in plasma it is reached after reception of a preparation within several weeks. Css after long reception of a preparation are similar to the concentration observed on 4-5 week of reception of a preparation.
Metabolism
Indications
- Depression of a various aetiology;
- A nervous bulimia;
- Premenstrual dysphoric disorder.
Dosage regimen
At depression the initial recommended dose makes 20 mg/days
At a nervous bulimia the recommended dose makes 60 mg/days
At premenstrual dysphoric disorders the recommended dose makes 20 mg/days
The recommended doses can be enlarged or reduced, however preparation application in a dose more than 80 mg/sut was not studied.
The preparation can be accepted irrespective of food intake.
There are no data about necessity of change of a dose depending on age.
At patients with disturbances of function of the liver, accompanying diseases or accepting other preparations, it is necessary to reduce doses and to lower frequency of reception.
Side effect
From the alimentary system: a diarrhoeia, a nausea, vomiting, a dysphagia, a dyspepsia, a food faddism.
From nervous system: cramps, a myoclonus, a tremor, an anorexia (up to loss of mass of a body), the alarm accompanied by palpitation, anxiety, nervousness, agitation, giddiness, fatigability (drowsiness, an asthenia), disturbance of process of concentration and thinking, maniacal reaction, dream disturbances (unusual dreamings, a sleeplessness); sight disturbances (a mydriasis, a sight illegibility); disturbances from vegetative nervous system.
From genitourinary system: emiction disturbances (including the speeded up emiction), a priapism / a long erection, sex disturbances.
Allergic reactions: an itch, a dermal eruption, an urticaria, anaphylactic reactions, a vasculitis, the reactions similar to implications of a serum disease.
Dermatological reactions: a photosensitivity, an alopecia.
The other: a yawning, an ecchymoma.
Contraindications
- The established hypersensibility to Fluoxetine.
Pregnancy and lactemia
In experimental researches on animals it is not taped the direct or mediated negative influence of Fluoxetine on embryos or foetus development, or on pregnancy course. As reproduction researches on animals not always allow to prognosticate reaction of the person, to apply Prozac at pregnancy follows only in emergency cases.
Prozac it is allocated with thoracal milk, therefore the preparation should be prescribed with care to feeding mothers.
Influence Fluoxetine on process of sorts at the person is not known.
Special indicatings
There are reports on occurrence of a dermal eruption, anaphylactic reactions and progressing system disturbances with involving in pathological process of a skin, lungs, a liver, kidneys for the patients accepting Prozac. At occurrence of a dermal eruption or other possible allergic reactions which aetiology cannot be defined, reception of Prozac should be cancelled.
As well as in case of application of other antidepressants, Prozac is necessary to prescribe with care the patient at whom in the anamnesis epileptic attacks became perceptible.
At sick of a diabetes during treatment the hypoglycaemia, and after preparation cancellation - a hyperglycaemia became perceptible. In the beginning and after the treatment termination correction of doses of insulin and-or hypoglycemic preparations for intake can be demanded.
Results of experimental researches
In researches in vitro and on animals it is not received carcinogenicity proofs.
Use in pediatrics
Safety and efficiency of Prozac application at children is not established.
Influence on ability to driving of motor transport and to management of mechanisms
The preparations influencing mental activity, can influence ability of decision-making and on skills of driving of the car. It is necessary for patient to advise to avoid car or management driving by dangerous mechanisms until absence of influence of a preparation on ability to these kinds of activity will be established.
Overdosage
Symptoms: a nausea, vomiting, attacks, disturbance of function of cardiovascular system (from symptomless arrhythmias to a cardiac standstill), disturbance of function of respiratory system.
Treatment: the control of the general condition and warm activity along with carrying out of the general symptomatic and a maintenance therapy. The specific antidote is unknown. Efficiency of an artificial diuresis, a dialysis, a hemoperfusion, a two-dimensional transfusion is improbable.
At overdosage treatment it is necessary to consider possibility of application of several medicinal preparations.
Medicinal interaction
Prozac is not necessary to prescribe simultaneously with inhibitors MAO and within not less than 14 days after the termination of treatment by inhibitors MAO. After cancellation Prozac and the beginning of treatment by inhibitors MAO should exist an interval not less than 5 weeks.
Therefore treatment by preparations which are metabolized by this system and which have a narrow therapeutic index, it is necessary to begin with the least doses if the patient simultaneously receives Prozac or accepted it within the last 5 weeks.
Prozac strongly contacts fibers of plasma. As well as in case of treatment by warfarin in a combination to many other things medicinal preparations, in the beginning of application or in case of the treatment termination against therapy by warfarin it is necessary to carry out the careful control of indicators of coagulation of blood.
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