Fluohexal

Generic Name: Fluoxetine hydrochloride
Product Name: Fluohexal

Indication

• Major depression
• Obsessive compulsive disorder
• Pre-menstrual dysphoric disorder
• Bulimia nervosa
• Panic disorder
• Post-traumatic stress disorder

Action

SSRIs work by selective inhibition of pre-synaptic uptake of serotonin (5- hydroxytryptamine, 5-HT). Fluoxetine has an active metabolite norfluoxetine, that contributes significantly to its effects and has a long half life (up to 16 days). Fluoxetine inhibits CYP2D6 and its active metabolite, norfluoxetine, inhibits CYP3A4. This contributes to specific drug interactions.

Dose advice

Major depression:

• 20mg once daily, gradually increasing if necessary to 60mg daily.
• Use of maintenance doses > 20mg is not usually necessary.

Obsessive compulsive disorder, Bulimia nervosa:

• 20mg once daily, gradually increasing as indicated to 60-80mg daily.

Panic disorder:

• 10mg daily, do not exceed 20mg daily.

Post-traumatic stress disorder:

• Continuous treatment: 20mg once daily; Cyclic treatment: 20mg once daily starting 14 days before the anticipated start of menstruation until the first full day of menses.

Schedule

S4

Common side effects

• Nausea
• Agitation
• Insomnia
• Drowsiness
• Tremor
• Dry mouth
• Diarrhoea
• Dizzness
• Headache
• Sweating
• Asthenia
• Anxiety
• Weight gain or loss
• Sexual dysfunction
• Rhinitis
• Myalgia
• Rash

Uncommon side effects

• Extrapyramidal reactions (including Tardive Dyskinesia and dystonia)
• Sedation
• Confusion
• Palpitations
• Tachycardia
• Hypotension
• SIADH
• Abnormal platelet aggregation/ haemorrhagic complications (e.g. bruising, epistaxis, purpura)

Rare:

• Elevated liver enzymes
• Hepatitis
• Hepatic failure
• Galactorrhoea
• Blood dyscrasias
• Seizures
• Akathesia

For further information talk to your doctor.