section name header

Pronunciation

floo-OX-uh-teen

Classifications

Therapeutic Classification: antidepressants

Pharmacologic Classification: selective serotonin reuptake inhibitors ssris

Indications

BEERS REMS


Unlabeled Use:

Action

  • Selectively inhibits the reuptake of serotonin in the CNS.
Therapeutic effects:
  • Antidepressant action.
  • Decreased behaviors associated with:
  • Decreased mood alterations associated with PMDD.

Pharmacokinetics

Absorption: Well absorbed after oral administration.

Distribution: Crosses the blood-brain barrier.

Protein Binding: 94.5%.

Metabolism/Excretion: Converted by the liver to norfluoxetine (primarily by the CYP2D6 isoenzyme), another antidepressant compound; the CYP2D6 enzyme system exhibits genetic polymorphism (7% of population may be poor metabolizers and may have significantly fluoxetine concentrations and an risk of adverse effects). Fluoxetine and norfluoxetine are mostly metabolized by the liver; 12% excreted by kidneys as unchanged fluoxetine, 7% as unchanged norfluoxetine.

Half-Life: 1–3 days (norfluoxetine 5–7 days).

Time/Action Profile

(antidepressant effect)

ROUTEONSETPEAKDURATION
PO1–4 wkunknown2 wk



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: chest pain, palpitations, QT interval prolongation, TORSADES DE POINTES

Derm: sweating, pruritus, erythema nodosum, flushing, rash

EENT: mydriasis, stuffy nose, visual disturbances

Endo: SIADH, dysmenorrhea, hot flush

F and E: hyponatremia

GI: diarrhea, abdominal pain, abnormal taste, anorexia, constipation, dry mouth, dyspepsia, nausea, vomiting, weight loss

GU: libido, delayed/absent orgasm, ejaculatory delay/failure, erectile dysfunction, urinary frequency

Hemat: BLEEDING

MS: arthralgia, back pain, myalgia

Neuro: anxiety, drowsiness, headache, insomnia, nervousness, tremor, abnormal dreams, dizziness, fatigue, hypomania, mania, NEUROLEPTIC MALIGNANT SYNDROME, SEIZURES, SUICIDAL THOUGHTS, weakness

Resp: cough

Misc: fever, flu-like syndrome, hypersensitivity reactions, SEROTONIN SYNDROME

Interactions

Drug-drug:

Drug-Natural Products:

Route/Dosage

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

PROzac, Sarafem

Pill Image

fluoxetine_-hcl_195-8964.jpg

Code

NDC Code