Monograph Details
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Central Nervous System
> Anxiety/OCD
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PROZAC |
| Manufacturer |
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Dista Products Company |
| Legal Classification |
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Rx
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| Pharmacological Class |
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SSRI. |
| Generic Name |
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Fluoxetine (as HCl) 10mg, 20mg, 40mg; caps. |
| Also |
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• PROZAC ORAL SOLUTION
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| Indications |
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Panic disorder. Obsessive-compulsive disorder (OCD). |
| Children |
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<7yrs: not recommended. 7–17yrs: OCD: initially 10mg/day; may increase after 2 weeks to 20mg/day; range 20–60mg/day. Lower weight children: range 20–30mg/day. |
| Adults |
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Panic disorder: initially 10mg/day in AM; increase after 1 week to 20mg/day; max 60mg/day. OCD: initially 20mg daily in AM; may give doses >20mg/day in 2 divided doses (AM and noon); max 80mg/day. Both: titrate over several weeks. Hepatic impairment: reduce dose, see literature. |
| Contraindications |
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During or within 14 days of MAOIs. Concomitant pimozide, thioridazine (may cause QTc prolongation). |
| Precautions |
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Discontinue if unexplained allergic reaction occurs. Renal or hepatic dysfunction. History of seizures. Recent MI. Unstable heart disease. ECT (prolonged seizures). Reevaluate periodically in long-term use. Avoid abrupt cessation. Monitor weight. Diseases that affect metabolism or hemodynamic response. Volume depletion. Diabetes. Suicidal tendencies. Write Rx for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
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See Contraindications. Do not start MAOI or thioridazine within at least 5 weeks of discontinuing fluoxetine. Concomitant SSRIs, SNRIs, tryptophan: not recommended. May potentiate protein-bound drugs (eg, warfarin, digoxin) and those metabolized by CYP2D6 (eg, tricyclics, vinblastine, flecainide). May potentiate carbamazepine, phenytoin. Monitor lithium, phenytoin, warfarin, tricyclics. Caution with benzodiazepines (eg, diazepam, alprazolam), antipsychotics (eg, clozapine, haloperidol), other CNS drugs, antiplatelets. Caution with triptans, linezolid, lithium, tramadol, St. John's wort; may cause serotonin syndrome (eg, weakness, incoordination, hyperreflexia). Hyponatremia with diuretics. |
| Adverse Reactions |
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Nausea, CNS stimulation (eg, anxiety, nervousness, insomnia), somnolence, headache, mania/hypomania, anorexia, weight loss, tremor, asthenia, sexual dysfunction, sweating, GI disturbances, respiratory symptoms, motor impairment, serum sickness, hypo- or hyperglycemia, rash (may be serious), urticaria, pruritus; rarely: platelet dysfunction. Children: thirst, hyperkinesia, agitation, personality disorder, epistaxis, urinary frequency, menorrhagia. |
| How Supplied |
Caps 10mg—100
20mg—30, 100, 2000
40mg—30
Liq—4oz |
| Additional Resources |
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• Related Prescribing Note |
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