When administered drug is well absorbed from the gastrointestinal tract (up to 95% of the dose), the use of food slows the absorption of fluoxetine significantly. Peak plasma concentrations are reached in 6-8 hours. The side effects of winstrol bioavailability after oral administration of fluoxetine is more than 60%. The drug was well accumulates in tissues readily penetrates the blood-brain barrier, binding to plasma proteins is above 90%. It is metabolized in the liver by demethylation to the active metabolite norfluoxetine and a number of unidentified metabolites. Report the news, the magnitude of the clearance of fluoxetine is 94-704 ml / min, norfluoxetine 60-336 ml / min. About 12% of the drug is released through the gastrointestinal tract. The half-life of fluoxetine is about 2-3 days, norfluoxetine – 7-9 days. In patients with hepatic failure half-lives of fluoxetine and norfluoxetine is prolonged. The drug is excreted in breast milk (25% of the serum concentration).
- Depression different genesis.
- Obsessive-Compulsive Disorder
- Bulimic neurosis.
The drug is used strictly on prescription.
Hypersensitivity to the drug, simultaneous reception with inhibitors of monoamine oxidase (MAO), thioridazine and pimozide, severe renal dysfunction (creatinine clearance less than 10 ml / min) and liver, breastfeeding, pregnancy.
Precautions : diabetes, convulsions and epilepsy of various origins (including history), Parkinson’s disease, compensated renal and / or hepatic insufficiency, excessive weight loss, suicidal thoughts.
Dosing and Administration
The drug is taken orally.
In depression, obsessive disorders kompulsivnyh starting dose is 20 mg of fluoxetine per day (in the morning), regardless of the meal. If necessary, the dose may be increased to 40 – 60 mg / day, divided into 2-3 doses. The maximum daily dose is 80 mg. The clinical effect develops within 1-4 weeks after the start of treatment in some patients it can be achieved later.
In bulimia nervosa, the drug is used in a daily dose of 60 mg, divided into 2-3 receptions.
In elderly patients the recommended daily dose is 20 mg.
Patients renal and hepatic insufficiency, side effects of winstrol as well as with low body weight is recommended to use a lower dose -. 10 mg fluoxetine per day and lengthening the interval between receptions of
duration determined by the attending physician acceptance and can last for several years.
CNS: hypomania or mania, increased suicidal tendencies, anxiety, irritability, agitation, dizziness, headache, tremor, insomnia or drowsiness, asthenic disorders, seizures. On the part of the gastrointestinal tract: loss of appetite, taste disturbance, nausea , vomiting, dry mouth or hypersalivation and diarrhea. With the genitourinary system: . incontinence or urinary retention, dysmenorrhea, vaginitis, decreased libido, sexual dysfunction in men (delayed ejaculation) are rare: allergic reactions such as skin rash, hives, itching , chills, fever, pain in muscles and joints (use of antihistamines and steroids); increased sweating, hyponatremia, tachycardia, disturbance of the visual acuity, erythema multiforme, vasculitis. May develop anorexia and weight loss. Such side effects frequently occur at the beginning or fluoxetine with increasing dose.
Symptoms: agitation, seizures, cardiac arrhythmia, tachycardia, nausea, vomiting. Treatment: specific antagonists to fluoxetine were found. Symptomatic therapy, gastric lavage with the appointment of activated charcoal, in convulsions – diazepam, maintenance of respiration, cardiac activity, body temperature.
Interaction with other drugs
The drug can not be applied simultaneously with inhibitors (e.g., selegiline, furazolidone, procarbazine and the like), including antidepressants side effects of winstrol inhibitors; and tryptophan (a precursor of serotonin), pimozide, as may develop serotonin syndrome, which manifests itself in confusion, hypomania, agitation, convulsions, dysarthria, hypertensive crises, chills, tremor, nausea, vomiting, diarrhea (see. “Cautions “).
Co-administration of fluoxetine with alcohol or with centrally acting drugs that cause depression of the central nervous system, enhances their effect.
fluoxetine blocks the metabolism of tricyclic and tetracyclic antidepressants, trazodone, carbamazepine, diazepam, metoprolol, terfenadine, phenytoin (phenytoin), which leads to an increase in their concentration in the blood serum, reinforcing their action and increasing the incidence of complications.
The combined use of fluoxetine and lithium salts requires close monitoring of the concentration of lithium in the blood as possible its increase.
fluoxetine enhances the effect of hypoglycemic drugs.
in an application with drugs, possessing high protein binding, especially with anticoagulants and digitoxin, may increase the plasma concentration of free (unbound) drugs and increase the risk of adverse effects.
Patients with diabetes may develop hypoglycemia during therapy with fluoxetine and hyperglycaemia after its cancellation.
On the background of electroconvulsive therapy may develop prolonged epileptic seizures.
After applying the appointment of inhibitors fluoxetine may be no earlier than 14 days. Do not use inhibitors and / or thioridazine earlier than 5 weeks after discontinuation of fluoxetine.
With the development, on a background of reception of fluoxetine, convulsions drug should be discontinued.
In the treatment of patients with deficiency of body weight should be considered anorectic effects (possible progressive loss of body weight ).
After discontinuation side effects of winstrol stanozolol of its therapeutic serum concentrations may persist for several weeks.
during treatment with fluoxetine intake of alcoholic beverages is not allowed.
fluoxetine may adversely affect the performance of work requiring a high rate of mental and physical reactions (drive motor vehicles, mechanisms, working at height, etc.).