(Legend)

Generic Name

• Fluoxetine
  T½ = 1–3 d (norfluoxetine: 5–7 d)
  Protein binding = 94.5%
  Pregnancy category C

Trade Name

• Prozac
• Prozac Weekly
• Serafem & Selfemra [PMDD]

Dose Range/Adult Daily Dose

• Range: 20–80 mg po
  Depression/OCD: Start 20 mg/d po, may ↑ weekly up to 80 mg; Panic disorder: Start 10 mg/d po up to 60 mg/d; Prozac Weekly: 90 mg/wk
  Serafem: start 20 mg/d up to 60 mg/d or start 14 days before menstruation

Use/Common Side Effects (CSE)

• Use: Depression (also geriatric), OCD, bulimia nervosa, panic disorder
• CSE: Anxiety, drowsiness, headache, insomnia, nervousness, diarrhea, sexual dysfunction, ↑ sweating, pruritus, tremor

Geriatric & Dose Considerations

• Starting dose: 10 mg/d (not to exceed 60 mg); Caution with hepatic/renal impairment and with multiple medications (long T½); Elderly at risk for excessive CNS stimulation, sleep disturbances, and agitation.

Classification

• Antidepressant [SSRI]

Assessment Cautions

• Serious fatal reactions with MAOIs, long washout needed. Caution: Hepatic/renal/pregnancy/seizures.
  Peds/Adol (18–24 y): May increase risk of suicidal thinking and behavior; must closely monitor