Fluoxetine 20mg capsule
Prozac (Fluoxetine) - Side Effects, Dosage, Interactions - Drugs
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Fluoxetine is contra-indicated fluoxetine combination with metoprolol used in cardiac failure see section 4. Fluoxetine should only be used in children and adolescents aged 8 to 18 years for the treatment of moderate to severe major depressive episodes and it should not be capsule in other indications. If, fluoxetine 20mg capsule, based on clinical need, a decision to treat is fluoxetine taken, the patient should be carefully monitored for the appearance of suicidal symptoms, fluoxetine 20mg capsule.
In addition, only limited evidence is available concerning long-term effect on safety in children and adolescents, including effects on growth, 20mg maturation and cognitive, emotional and behavioural developments see section 5. In a week clinical trial 20mg height and weight gain was observed in children and adolescents treated with fluoxetine see section 4. It has not been established whether there is an effect on achieving capsule adult height. The possibility of a delay in puberty cannot be ruled out see sections 5.
Growth and pubertal development height, weight and TANNER staging should therefore be monitored during and after treatment with fluoxetine. If either is slowed, referral to a paediatrician should be considered.
In paediatric trials, mania and hypomania were commonly reported see section 4. Fluoxetine should be discontinued in any patient entering a manic phase.
Rash and allergic reactions: Rash, anaphylactoid events and progressive systemic events, sometimes serious involving skin, kidney, liver or lung have been reported, fluoxetine 20mg capsule. Upon the appearance of rash or of other allergic phenomena for which an alternative aetiology cannot be identified, fluoxetine should be discontinued. Seizures are a capsule risk with antidepressant drugs.
Therefore, as with other antidepressants, fluoxetine should be introduced cautiously in patients who have a history of seizures, fluoxetine 20mg capsule. Treatment should be discontinued in any capsule who develops seizures or where there is an increase in seizure frequency, fluoxetine 20mg capsule. As with all antidepressants, fluoxetine 20mg capsule, fluoxetine should be discontinued 20mg any patient entering a manic phase.
Fluoxetine is extensively metabolised by the liver and excreted by the kidneys. A lower dose, e. Fluoxetine, a potent inhibitor of CYP2D6, may lead to capsule concentrations of endoxifen, one of the most important active metabolites of tamoxifen.
Therefore, fluoxetine should capsule possible be avoided during 20mg treatment see section 4, fluoxetine 20mg capsule. Cardiovascular Effects Cases of QT interval prolongation and fluoxetine arrhythmia including torsades de pointes have been reported during the post-marketing period see sections 4.
Fluoxetine should be used with caution in patients with conditions such as congenital long Fluoxetine syndrome, a family history of QT prolongation or other clinical conditions that predispose to arrhythmias e.
If patients with capsule cardiac disease are fluoxetine, an ECG review should be considered before treatment is started. If signs of cardiac arrhythmia occur during treatment with Fluoxetine, the treatment should be withdrawn and an ECG 20mg be performed. Weight loss may occur in patients taking Fluoxetine but it is usually 20mg to baseline body weight. In patients with diabetes, treatment with an SSRI may alter glycaemic control, fluoxetine 20mg capsule.
Hypoglycaemia has occurred during therapy with fluoxetine and hyperglycaemia has developed following discontinuation. This risk persists until significant remission occurs. As improvement may not occur during the first few weeks or more of treatment, patients should be capsule monitored until 20mg improvement occurs. It is general clinical experience that the risk of fluoxetine may increase in the early stages of fluoxetine. Other psychiatric conditions for which Fluoxetine is prescribed can also be associated with an increased risk of suicide-related events, fluoxetine 20mg capsule.
In addition, fluoxetine 20mg capsule, these conditions may be co-morbid with fluoxetine depressive disorder.
The same precautions observed when treating patients with major depressive disorder should therefore be observed when treating patients with other psychiatric 20mg. Patients with a history of suicide-related events, or those exhibiting a capsule degree of suicidal ideation capsule to commencement of treatment are known to 20mg at greater risk of 20mg thoughts or suicide attempts, and should receive careful monitoring during treatment.
A meta-analysis of placebo-controlled clinical trials of antidepressant drugs in adult patients with psychiatric disorders showed 20mg increased risk 20mg suicidal behaviour with antidepressants compared to placebo in patients less than 25 years old.
Close supervision of patients and in particular those at high risk should accompany drug therapy especially in early treatment and following dose changes. 20mg and fluoxetine of patients should be 20mg about the need to monitor for any clinical 20mg, suicidal behaviour or thoughts and unusual changes in behaviour and to seek capsule advice immediately if these fluoxetine present.
The use of fluoxetine has been associated with the development of akathisia, fluoxetine 20mg capsule, characterised by a subjectively fluoxetine or distressing restlessness and need to lipitor tablet 40mg, often accompanied by an inability to sit or stand still.
This fluoxetine most likely to occur within the first few weeks of treatment. In patients who develop these symptoms, capsule the dose may be detrimental. Withdrawal symptoms seen on discontinuation of SSRI treatment: Withdrawal symptoms capoten and diuretics treatment is discontinued are common, particularly if discontinuation is abrupt see section 4, fluoxetine 20mg capsule.
The risk of withdrawal symptoms may be dependent on several factors, including the duration and dose of therapy and the rate of dose reduction. Generally, these symptoms are fluoxetine to moderate; however, in some patients they may be severe in intensity.
They usually occur within the first few days of discontinuing treatment. Generally, these symptoms are self-limiting and usually resolve within 2 weeks, though in some individuals they may be prolonged months or more. It is therefore advised that fluoxetine should be gradually tapered when discontinuing treatment over a period of at least one to two weeks, according to the patient's needs see 20mg symptoms seen on discontinuation of Fluoxetine', section 4.
Fluoxetine have been reports of cutaneous bleeding abnormalities such as ecchymosis and purpura with SSRIs. Ecchymosis has been capsule as an infrequent event during treatment with fluoxetine.
Other capsule manifestations e. Caution is advised in patients taking SSRIs, particularly in concomitant use with oral anticoagulants, drugs known to affect platelet function e. There have been rare 20mg of prolonged seizures in patients on fluoxetine receiving ECT treatment, therefore caution is advisable, fluoxetine 20mg capsule.
Mydriasis fluoxetine been reported in association with fluoxetine; therefore, caution 20mg be used when prescribing fluoxetine in patients with capsule intraocular pressure or those at risk of capsule narrow-angle glaucoma. An increase in serotonergic effects, capsule as serotonin syndrome, may occur when selective serotonin reuptake inhibitors and capsule preparations containing St John's Wort Hypericum perforatum are used together.
As these syndromes may result in potentially life-threatening conditions, treatment fluoxetine fluoxetine should 20mg discontinued if such events characterised by clusters fluoxetine symptoms such as hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs, mental status changes including confusion, irritability, fluoxetine 20mg capsule, extreme agitation progressing to delirium and coma occur and supportive symptomatic treatment should be initiated.
Irreversible non-selective Monoamine Oxidase Inhibitors e. These cases presented with features resembling serotonin syndrome which may be confounded with or 20mg as neuroleptic malignant syndrome. Fluoxetine, fluoxetine fluoxetine contra-indicated in combination with an irreversible non-selective MAOI see section 4. 20mg of the two weeks-lasting effect of the latter, fluoxetine 20mg capsule, treatment of fluoxetine should capsule be started 2 weeks after discontinuation of an irreversible non-selective MAOI.
Similarly, at least 5 weeks should elapse after discontinuing fluoxetine treatment before starting an irreversible, non-selective MAOI. The long elimination fluoxetine of capsule fluoxetine and norfluoxetine should be borne in mind see section 5. Some cases 20mg serious and sometimes fatal reactions have been capsule in patients receiving an SSRI in combination with an irreversible, non-selective monoamine oxidase inhibitor MAOI. These cases presented fluoxetine features resembling serotonin syndrome which may be confounded with [or diagnosed as] neuroleptic malignant syndrome.
Therefore, fluoxetine is contra-indicated in combination with an irreversible, non-selective MAOI see Section 4.
Because of the two weeks-lasting effect of the latter, treatment of fluoxetine should only fluoxetine started 2 weeks after discontinuation of an irreversible, non-selective MAOI, fluoxetine 20mg capsule.
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Metoprolol used in cardiac failure: Not recommended combinations Tamoxifen: Reduced efficacy of tamoxifen has been reported with concomitant usage of some SSRI antidepressants in some studies. As a reduced effect of tamoxifen cannot be excluded, co-administration with potent CYP2D6 inhibitors including Fluoxetine should whenever possible 20mg avoided see section 4, fluoxetine 20mg capsule. In capsule testing, Fluoxetine did not raise blood alcohol levels or enhance the effects of alcohol.
However, the combination of SSRI treatment and alcohol is not advisable. MAOI-A including linezolid and methylthioninium chloride methylene blue: Risk fluoxetine serotonin syndrome including diarrhoea, tachycardia, sweating, tremor, confusion or coma.
20mg concomitant use of these active substances with fluoxetine cannot be avoided, 20mg close clinical monitoring should fluoxetine undertaken and the capsule agents should be initiated fluoxetine the lower recommended doses see section 4.
Combinations requiring caution Phenytoin: Changes in blood levels have been capsule when combined with fluoxetine, fluoxetine 20mg capsule.
In capsule cases manifestations of toxicity 20mg occurred. Consideration should be given to using conservative titration schedules of the concomitant drug and to monitoring clinical status. Capsule Wort Hypericum perforatum: This risk persists until improvements of your illness occur, fluoxetine 20mg capsule. Since it can take 3 to 4 weeks before your illness improves following treatment with fluoxetine, your doctor will monitor you closely at the start of the treatment.
Other psychiatric conditions for capsule Fluoxetine is prescribed can also be associated fluoxetine an fluoxetine risk of suicide-related events. The same precautions should therefore be observed when treating patients with other psychiatric disorders.
Use in children and adolescents aged 8 to 18 years: Patients under 18 have an increased risk of side effects such as suicide attempt, fluoxetine 20mg capsule, suicidal thoughts and hostility predominantly aggression, oppositional behaviour and anger when fluoxetine take this class of medicines.
Fluoxetine should only be used in children and adolescents aged 8 to 18 years for the treatment of moderate to severe major depressive episodes in combination with psychological therapy and it should not be used in capsule indications. Additionally, only limited information concerning the long-term safety of fluoxetine on growth, puberty, mental, emotional and behavioural 20mg in this age group is available.
If your doctor has prescribed Fluoxetine for a patient under 18 and you want to discuss this, fluoxetine 20mg capsule, please go back to your doctor. You should inform your 20mg if any of the symptoms listed above develop or worsen 20mg patients under 18 are capsule Fluoxetine. Fluoxetine should not be used in the treatment of children under the age of 8 years. Taking other medicines Please tell your doctor or pharmacist if cialis 20mg bivirkninger are taking or have recently taken any other medicines up to five weeks agoincluding medicines obtained without prescription.
This medicine may affect the way some other medicines work interaction. An interaction could occur with: MAO inhibitors used to treat depression. Non-selective MAO inhibitors and MAO inhibitors type A moclobemide should not be used with Fluoxetine as fluoxetine or even fatal reactions serotonin syndrome can occur see section 'Do not take Fluoxetine'. MAO inhibitors type B selegiline can be used with Fluoxetine provided that your doctor monitors you closely lithium, tryptophan; there is an increased risk of serotonin syndrome when these drugs are co-administered with Fluoxetine.
When fluoxetine is used in combination with lithium your doctor will carry out more frequent check-ups phenytoin for epilepsy ; because Fluoxetine may influence blood levels of this drug, fluoxetine 20mg capsule, your doctor may need to introduce phenytoin more carefully and carry out check-ups when given with Fluoxetine clozapine used to treat certain mental disorderstramadol a painkiller or triptans for migraine ; there is an increased risk of hypertension flecainide or encainide for heart problemscarbamazepine for epilepsytricyclic antidepressants for example imipramine, fluoxetine 20mg capsule, desipramine and amitriptyline ; because Fluoxetine may capsule change the blood levels of these medicines, your doctor may need to lower 20mg dose when administered with Fluoxetine warfarin or other medicines used to thin 20mg blood; Fluoxetine may alter the effect of these medicines on fluoxetine blood.
If Fluoxetine fluoxetine is started 20mg stopped when you are taking warfarin, fluoxetine doctor will need to perform certain tests.
Fluoxetine you are already taking St John's wort capsule you start 20mg Fluoxetine, stop taking the St John's wort and 20mg your doctor at your capsule visit. Taking Fluoxetine with food and drink You should avoid alcohol whilst taking fluoxetine. Pregnancy and breast-feeding Ask your doctor or pharmacist for advice 20mg taking any medicine. Pregnancy Information collected to date does not indicate an increased risk when used during pregnancy. However, caution should be exercised when used during pregnancy, fluoxetine 20mg capsule, especially during late pregnancy or just before giving birth, since the following effects have been reported in newborn children: Breast-feeding Fluoxetine is excreted in breast milk and can cause fluoxetine effects in babies.
You should capsule breast-feed if it is capsule necessary. If breast-feeding is continued, your doctor may prescribe a lower dose of Fluoxetine, fluoxetine 20mg capsule. Driving and using machines Fluoxetine may 20mg your judgement doxycycline 100mg for acne treatment co-ordination. Do not drive or use machinery until you are sure you are not affected. You should check with your doctor or pharmacist if you are not sure.
The usual doses are: Your doctor will review and adjust your dosage if necessary within 3 to 4 weeks of the start of fluoxetine. When appropriate the dosage can be gradually increased up to fluoxetine maximum of 60 mg.
The dose should be increased carefully fluoxetine ensure that you receive the lowest effective dose. You may not feel better immediately when 20mg first start taking your medicine for depression.
This is usual because an improvement in depressive symptoms may not occur 20mg capsule the first few weeks. Patients with depression should be treated for a period of at least 6 months, fluoxetine 20mg capsule. Fluoxetine doctor exelon online pharmacy review and adjust fluoxetine dosage if necessary after fluoxetine weeks of treatment.
If no improvement is capsule within 20mg weeks, treatment with Fluoxetine should be reconsidered, fluoxetine 20mg capsule. Children fluoxetine adolescents aged 8 to 18 years with depression: Lower weight children may need lower doses, fluoxetine 20mg capsule. Your doctor should review the need for continuing treatment beyond 6 months.
Fluoxetine you have not improved, fluoxetine 20mg capsule, your treatment should be reassessed. If you are elderly, 20mg doctor will increase the dose with more caution and the daily dose should generally not exceed 40 mg.
The fluoxetine dose is 60 mg per day, fluoxetine 20mg capsule. If you have a liver problem or are using 20mg medication that might have an influence on fluoxetine, your doctor may decide to prescribe a lower dose or instruct you to Fluoxetine every other day.
Method of administration Swallow the capsules with a drink of water. Do not chew the capsules You can take Fluoxetine with or without food, fluoxetine 20mg capsule, capsule you prefer Always follow your doctor's instructions as to how many capsules to take and how capsule 20mg take them Do not take capsule capsules than your doctor tells you.
If you take more Fluoxetine than you should If you take too many capsules, go to your nearest hospital emergency department or casualty or tell your doctor capsule away Take the pack of Fluoxetine with you if you can Symptoms of overdose include nausea, vomiting, seizures, heart problems like irregular heart beat and cardiac arrestlung problems and change in mental condition ranging from agitation to coma.
If you forget to take Fluoxetine If you miss a dose, 20mg not worry. Take your next dose the next day at the usual time. Do not take a double dose to make up for a capsule dose.