Prozac capsules 20 mg No. 14

Prohibited during pregnancy

Prohibited during breastfeeding

Not suitable for children

Has restrictions for older people

Has limitations for liver problems

Prohibited for use if you have kidney problems

Prozac is a French drug intended for use in psychotherapeutic practice. The medication has a pronounced antidepressant effect, normalizes the psycho-emotional state, but increases the risk of suicidal thoughts. That is why it is necessary to strictly follow the instructions for use of Prozac, since if used incorrectly, the drug can cause severe negative reactions from the central nervous system.

What is Prozac

Prozac is a new generation foreign drug. It is widely used in EU countries, America and Russia. It should be noted that it cannot be found in all pharmacies, so sometimes patients have to either order it online or, together with their doctor, select similar products.

Pharmacological group, INN, scope of application

Prozac belongs to the group of selective antidepressants.

International nonproprietary name (INN) – Fluoxetine. The medicine is used in the psychotherapeutic field to treat depressive disorders, obsessive and panic disorders, as well as bulimia nervosa.

General information about the drug

Form, price, prescription or not

Prozac comes in the form of cream/green gelatin capsules with a white powder inside. The medicine is intended for oral administration.

The cost of the drug in pharmacies in Russian cities:

Important! Capsules are available only with a doctor's prescription.

Compound

Each capsule of the drug contains the active substance fluoxetine in a dose of 20 mg. Auxiliary components are:

• gelatin;
• microcellulose;
• povidone;
• talc;
• magnesium stearate;
• zinc dioxide;
• food coloring.

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Main characteristics

The medicine is available in the form of hard gelatin capsules, each containing 20 mg of fluoxetine hydrochloride.

Pharmacological effect

The active component fluoxetine is a bicyclic antidepressant (propylamine derivative), which belongs to the SSRI group.

The medication in minimal quantities has an effect on dopaminergic, histamine (H1), α-adrenergic and cholinergic receptors, due to which side effects after its use are minimal.

Fluoxetine increases the concentration of the neurotransmitter serotonin in the brain, thereby increasing the stimulating effect on the nervous system.

Pharmakinetics

After oral administration, it is quickly absorbed from the gastrointestinal tract (up to 95%), food intake has virtually no inhibitory effect on absorption.

Peak plasma concentrations of fluoxetine are achieved after 6–8 hours. Bioavailability after oral administration is above 60%. Fluoxetine is able to accumulate in tissues and be distributed throughout the body; it easily penetrates the BBB.

Prozac is excreted primarily by the liver and urine (in the form of metabolites - norfluoxetine and others).

Pharmacodynamics and pharmacokinetics of Prozac

Prozac is an antidepressant drug belonging to the group of selective serotonin reuptake inhibitors. In this case, fluoxetine is a kind of antagonist of muscarinic, histamine and alpha-adrenergic receptors. The drug has a slight effect on the neuronal uptake of norepinephrine and dopamine.

An important feature of the drug is that fluoxetine does not reduce the functional activity of beta-adrenergic receptors.

The main pharmacological properties of the drug are:

• improving mood;
• eliminating depressive conditions;
• relief of dysphoria;
• alleviating the condition of patients suffering from attacks of fear, panic, anxiety, irritation;
• eliminating nervous tension.

At the same time, the drug has a mild analgesic and stimulating effect. The medication does not have a sedative, cardiotoxic or hypnotic effect.

Mechanism of action

Fluoxetine is absorbed from the gastrointestinal tract. During its first passage through the liver tissue, it is metabolized very slowly. Eating does not affect the bioavailability of the substance, but may slightly reduce its absorption process.

Fluoxetine reaches its maximum plasma concentration approximately 6-8 hours after taking the capsule. The substance is 90% bound to blood plasma proteins and easily penetrates the BBB.

The half-life of the drug is 2-3 days. Fluoxetine is completely excreted from the body after 7-9 days. 80% of the substance is excreted by the kidneys, 15% – with feces.

On a note. A lasting therapeutic effect from the use of the drug is achieved within 7-14 days from the start of taking the capsules. After stopping the medication, its effect lasts for about 1 week.

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Overdose and side effects

There were 633 registered cases of overdose while taking Prozac at the end of 2016. Most of these patients were able to successfully recover. According to the study, the minimum dose at which an overdose occurred is 80 mg.

There was also a case of overdose with an amount of 52 mg of the active ingredient per day, but no direct connection between the dosage and death was identified.

Despite the fairly large list of side effects, the main manifestations of an overdose are the following symptoms: nausea and vomiting, drowsiness, convulsions, increased heart rate.

The side effects that occur when taking Prozac are generally characteristic of drugs from the group of selective serotonin reuptake inhibitors:

1. Adverse reactions from the cardiovascular system can manifest as hot flashes, an increase in the lumen of blood vessels and a decrease in blood pressure as a result.
2. From the gastrointestinal , dry mouth, vomiting, diarrhea, changes in taste sensations and the appearance of pain in the esophagus, loss of appetite and, as a result, loss of body weight may appear.
3. The nervous system itself as fatigue and weakness; headache, dizziness and drowsiness may appear. Feelings of cold or heat may also appear, and anxiety and restlessness may increase. Less common symptoms include cramps, insomnia, decreased libido, and inability to achieve orgasm. Pupil dilation and decreased visual acuity may occur. Side effects include the risk of developing mania and hypomania, as well as disturbances in thinking, but these cases are rare.
4. From the genitourinary system, men may experience ejaculation disorders and impotence. In women, bleeding from the vagina. Both sexes may experience urinary problems: too frequent trips to the toilet and pain.
5. Allergic reactions are possible , which can manifest as skin rash and itching. The patient may also experience increased sweating, muscle and joint pain, increased body temperature and heavy breathing.

Prozac indications and contraindications

The medication is indicated for patients with:

• major depressive disorder or episodes;
• obsessive-manic states;
• bulimia nervosa.

Bulimia nervosa

In the latter case, the medicine is prescribed as part of complex therapy, and is used to reduce cravings for uncontrolled food intake, as well as to accelerate bowel cleansing.

The medication is not prescribed for:

• hypersensitivity to fluoxetine or excipients of the drug;
• any form and severity of renal failure;
• severe liver failure;
• epilepsy;
• the presence of convulsive seizures in the patient’s history (even isolated cases);
• suicidal thoughts or tendencies of the patient;
• glaucoma;
• atony of the bladder;
• benign hyperplasia of the prevesical gland.

Concomitant use of the drug with MAO inhibitors, including Linezolid, is contraindicated. The interval between the end of MAOI therapy and the start of capsule use should be at least 2 weeks.

The drug is contraindicated in children under 18 years of age, since there is no data on its safety for this category of patients. The drug is not prescribed to pregnant women and lactating mothers. If it is necessary to take medication while breastfeeding, lactation should be stopped for the period of treatment.

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Instructions for use of the drug

The drug is intended exclusively for oral administration. The capsule must not be opened, bitten or divided. It should be swallowed whole with plenty of liquid. Dose titration depends on the purpose for which it was prescribed.

Major depressive disorder or episodes

At the beginning of therapy, capsules are taken at a dose of 20 mg/day. Reception should be carried out in the morning 1 time. If necessary, the dose of the drug can be gradually increased after 3-4 weeks from the moment of its first use.

Major depressive disorder

Note. A significant increase in dose may increase or provoke side effects. But if it is not possible to achieve an adequate therapeutic response with 20 mg/day, then the number of tablets is doubled.

The maximum daily dose of Prozac is 60 mg. The duration of treatment for depressive disorders must be continued for at least six months. Prolongation of therapy can be carried out only as needed, and exclusively by the attending physician.

Obsessive-manic disorders/conditions

The recommended dose for patients with this diagnosis is 20 mg (1 capsule) 1 time / day. But despite the fact that increasing the dosage of Prozac may lead to increased side effects, it can be carried out if the therapy is ineffective. An increase in the daily number of capsules is possible only 14 days after starting to take the medicine. The maximum allowable dose is 60 mg of Prozac (3 capsules) per day.

If treatment does not achieve the expected results within 10 weeks, the doctor should reconsider the advisability of further use of the drug. If the first positive dynamics were noted, therapy is continued until a lasting effect is achieved.

The maximum allowable treatment period is 24 weeks. Maintenance therapy is carried out using minimally effective doses.

For adults and elderly patients, Prozac is prescribed 20 mg/day. There is no data on the possibility of prolonged treatment in this case.

General instructions

Therapy, regardless of the diagnosis, begins with taking 20 mg of Prozac. For elderly patients, the dose is increased with extreme caution. Typically, the dosage increase ends at 60 mg, but if the need arises, it can be increased to a maximum of 80 mg/day.

The drug can be taken 1-2 times a day, regardless of food. After stopping the medication, fluoxetine can remain in the body for another 14 days. The doctor must take this into account when prescribing other medications to the patient.

Prozac withdrawal

The drug should be discontinued as gradually as the dosage was increased. If therapy is abruptly stopped, there is a high risk of developing withdrawal syndrome.

If symptoms worsen after stopping the medication, you should return to Prozac treatment. After some time, the doctor may begin to reduce the daily dosage of the drug until it is completely discontinued.

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Directions for use and dosage

Prozac should be taken orally with or without food.

Recommended daily doses for adult patients:

• Obsessive-compulsive disorders – 20-60 mg;
• Depression – 20 mg;
• Premenstrual dysphoric disorder – 20 mg;
• Bulimia nervosa – 60 mg.

Depending on the clinical situation, the dose can be reduced or increased. The maximum daily dose is 80 mg; higher doses have not been studied.

Patients who are taking other drugs at the same time, have concomitant diseases or impaired liver function, it is necessary to reduce the dose of fluoxetine or increase the interval between doses.

Prozac analogs

The drug Prozac has the following structural analogues:

1. Fluoxetine pilyule_nervi-530. Tablets for oral administration containing the active substance fluoxetine hydrochloride at a dose of 20 mg. The cost of this medicine is much lower than Prozac, and is 133 rubles for a pack of 20 tablets.

2. 
   Prodep – capsules with fluoxetine hydrochloride. The medication contains 20 mg of the active ingredient. It has an antidepressant and stimulating effect. Its estimated cost is 250 rubles for 10 capsules.

3. Fluxen is a structural analogue of Prozac. Dispensed in the form of capsules for oral administration. The drug is used for depression, bulimia nervosa, and manic disorder. The medicine is contraindicated during pregnancy, hypersensitivity to its substances, breastfeeding, liver or kidney failure.

Since it is not always possible to find structural analogues, the doctor may resort to prescribing Prozac substitutes based on the mechanism of action. In this case, the selection of a specific medication is carried out strictly individually for each patient, so you should not try to make a choice in favor of one or another medication on your own.

Reviews of the use of Prozac

You can find different reviews about Prozac. This is especially true for the opinions of patients. Doctors speak more positively about the drug, focusing on its therapeutic effectiveness.

Specialists

Psychotherapists speak very positively about this medicine:

Evseeva M. L. (Saratov): “Prozac is an antidepressant that has been proven over the years. Despite the fact that there is a high probability of adverse reactions while taking it, in my practice I often prescribe it to patients with depressive disorders. Clinical experience shows that in 90% of cases the drug really helps to eliminate this disorder for a long time.”

Alekseenko S.K. (Kostroma): “Prozac is one of the few fluoxetine-based drugs that can be purchased in our country. This is a very potent antidepressant, so its prescription must be justified. Uncontrolled use of capsules can lead to serious disorders and lead to dangerous consequences.”

Psychotherapists place special emphasis on the fact that you should not buy Prozac without a prescription, especially from dubious resellers, since there is a high probability of acquiring a dangerous counterfeit.

Reviews

Igor Nikolaevich, Kirov : “Prozac is a drug that quickly and effectively relieves anxiety. An endocrinologist prescribed it to me, the reason for this was a deterioration in my psycho-emotional state. The side effects indicated in the annotation did not appear in my case.”

Valery Vladimirovich, St. Petersburg : “I went to see a doctor because of depression. I had a difficult life situation that I could not cope with on my own. The doctor prescribed a comprehensive treatment. Among the prescribed medications was Prozac. Improvement occurred after completing the course. I can’t say which drug helped more than the others.”

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