Fluoxetine is a similar drug without a prescription. Over-the-counter fluoxetine analogues and substitutes are cheaper and safer. Terms of sale: how is Fluoxetine dispensed - with a prescription or not

Fluoxetine-based drugs are prescribed to treat not only depression, but also many other related disorders. However, sometimes the question arises of what can replace Fluoxetine capsules, and it is not possible to quickly consult a doctor. In the article we will talk about modern analogues of Fluoxetine and the features of their use.

Brief description of the medicine

Fluoxetine is an antidepressant that belongs to the group of serotonin reuptake inhibitors (the main “happy hormone” in our body). This means that it increases the concentration of the hormone in the nervous tissue and improves the psycho-emotional state of the patient. The medicine is prescribed for:

• depression;
• obsessive-compulsive disorders (obsessive states);
• early ejaculation in men;
• bulimia (overeating in stressful situations);
• mood disorders in women during menstruation or menopause.

Why do people look for fluoxetine analogs?

There are situations when you have to quickly look for an adequate replacement for Fluoxetine: when the medicine is not at hand or its use is impossible for some reason.

Price issue

Fluoxetine cannot be classified as an expensive drug. A Russian-made drug can be found at a price of 30-50 rubles for 20 capsules. However, they are not always available in pharmacies, and imported synonyms of domestic Fluoxetine cost many times more.

Side effects

The main problem when taking Fluoxetine is the risk of developing severe side effects. Among them:

• overexcitement, insomnia;
• hand tremors, convulsions;
• nausea, vomiting, diarrhea;
• suicidal tendencies;
• headaches, balance problems;
• loss of appetite, weight loss;
• decreased sex drive;
• menstrual irregularities;
• allergic reactions.

There are analogs for the correction of depressive disorders that are less likely to cause side effects, although this primarily depends on the individual sensitivity of the body to the active substance.

Lack of the drug in pharmacies

Fluoxetine is usually available in pharmacies. However, due to the high demand and affordable price, the cheapest antidepressant options are quickly sold out, leaving only the expensive Fluoxetine. In addition, small pharmacies rarely sell prescription drugs, which include Fluoxetine.

No prescription

Lack of a prescription is another major problem for patients requiring Floxetine treatment. Even if a person receives an antidepressant on the recommendation of a doctor, he is not always able to come to the clinic on time to pick up a prescription. Sometimes you have to wait a month for an appointment with a doctor, but you need the drug right now. In such cases, you have to get out of the situation by buying over-the-counter substitutes for Fluoxetine.

How to replace Fluoxetine

Let us consider in more detail the main options for replacing Fluoxetine.

Analogs for the active substance

Direct analogues of Fluoxetine, which have almost identical instructions for use, are Prozac, Apo-Fluoxetine, Fluoxetine-Canon, Fluoxetine Lannacher. Fluoxetine Lannacher, Prozac and Apo-Fluoxetine are European analogues of higher quality. Prozac is the trade name of the original Fluoxetine, which has undergone a full range of clinical trials and is considered the safest. Its significant disadvantage is the high price - about 500 rubles. for 14 capsules.

Analogs by pharmacological group

Antidepressants - serotonin reuptake inhibitors also include Fevarin, Zoloft, Selectra, Serenata, Cipralex, Paxil. All of them are used in the treatment of depression, but they act differently on the body. Fevarin has a predominant calming effect, while Cipralex and Selectra (as well as Fluoxetine) have a stimulating effect. A balanced effect is typical for Paxil, Zoloft, Serenata.

Cheap substitutes

The most affordable analogues of Fluoxetine include:

• Amitriptyline is the cheapest antidepressant, which differs from Fluoxetine in its mechanism of action and predominant sedative and hypnotic properties. The minimum cost of 50 tablets can be 25 rubles.
• Sibazon and Phenazepam are tranquilizers, i.e. drugs that suppress anxiety. Despite the fact that antidepressants and tranquilizers have different purposes, in some cases they help relieve the same conditions. For example, both groups are effective for anxiety-depressive disorders and obsessive fears. The cost of 20 tablets of Sibazon usually does not exceed 30 rubles, 50 tablets of Phenazepam cost about 100 rubles.
• Sedatives (sedatives) - tincture, extract of valerian, motherwort, St. John's wort, Dobrokam, Validol. Medicines relieve nervous tension, calm, and improve sleep. The effect is somewhat weaker than antidepressants, but when used systematically they often help cope with mild forms of depression and anxiety disorders. All of the drugs listed are affordable.

Analogues without prescriptions

All synthetic antidepressants in Russia are sold with a prescription. Therefore, only their herbal analogues (Doppelhertz Nervotonic, Negrustin, Gelarium), freely available in pharmacies, can be classified as over-the-counter substitutes for Fluoxetine. They contain dry extract of St. John's wort, which also affects the exchange of serotonin and melatonin (a substance that normalizes sleep). Drugs in this group are used to treat mild or moderate depression, neuroses (mental instability), and low mood.

Plant-based sedatives (Persen, Dobrocam, Novo-Passit) can replace Fluoxetine in cases of anxious depression, obsessive-compulsive disorder, menopause and other changes accompanied by irritability and bad mood.

Conditional analogues of Fluoxetine, which can be bought without prescriptions, also include homeopathic sedatives: Tenoten, Nevrosed, Calm. They contain microdoses of the active substance, therefore they are completely harmless and can be used in children's practice. However, the effectiveness of homeopathic medicines has not been scientifically proven.

TOP best analogues

We bring to your attention the five best antidepressants that can successfully replace Fluoxetine, and in some cases even perform better than it:

1. Selectra contains escitalopram as an active ingredient, which (like Fluoxetine) has a stimulating effect. Due to the narrower focus of the therapeutic effect, Selectra is less likely to provoke adverse reactions, does not cause suicidal thoughts and can be used for depression of any severity.
2. Cipralex also includes escitalopram, but has a wider spectrum of action. In addition to depression, it is prescribed for obsessive-compulsive, panic and anxiety disorders.
3. Paxil is indicated for the same conditions as Cipralex, although it contains a different active ingredient - paroxetine. The frequency of undesirable effects associated with its use is lower than that of Fluoxetine, but its negative effect on the fetus during pregnancy has been proven, whereas such risks have not been identified for Fluoxetine.
4. Valdoxan is an antidepressant that primarily acts on melatonin. It is used for all types of depression, normalizes sleep and is well tolerated. Valdoxan does not affect the cardiovascular system, the genitourinary system, and does not cause addiction or withdrawal symptoms.
5. Zoloft differs from Fluoxetine in its balanced effect on the nervous system - it does not cause obvious stimulation. Zoloft has a wider list of possible adverse reactions than Fluoxetine, but the actual incidence is lower.

It seems to suit me. I finish 1 package, 3 in total. I drink it exclusively according to the doctor’s prescription, I was prescribed 1 tablet once a day. There may have been some side effects in the first 2 days, but now everything is fine. I feel much better. And yes, I managed to lose a couple of kilos.

Advantages It's cheap
Good for prolonged depression
Bouts of gluttony disappeared

Flaws No

I didn’t like that after it men’s potency dropped. my husband drank, then even smarprost didn’t help, he became even more nervous and fell into depression. not enough pleasant things

Antidepressants are a very personal matter. everything is very individual. It's not about whether the pills are good or bad, it's just about whether they're right for your body

I was dealing with a headache, went through all the circles of hell trying to find out what the reason was... The neurologist prescribed me fluoxetine (she said the cause of the headache was prolonged depression). I drank according to the instructions - it was a nightmare! I didn’t live, but existed... I ate, slept , clouded consciousness - somehow I was still working. I was thin to the bone! In general, the headaches did not go away, and I passed such a test! I beg you, don’t drink to lose weight! Let it be an extra one... I was dealing with a headache, went through all the circles of hell trying to find out what the reason was... The neurologist prescribed me fluoxetine (she said the cause of the headache was prolonged depression). I drank according to the instructions - it was a nightmare! I didn’t live, but existed... I ate, slept , clouded consciousness - somehow I was still working. I was thin to the bone! In general, the headaches did not go away, and I passed such a test! I beg you, don’t drink to lose weight! I may be overweight, but healthy!

Excellent, easy drug. You just need to drink correctly. Firstly, it develops its effect after 7-10 days / accumulation dose /, our patients often quit it during this week: “Oh, I’ve been drinking it for 7 days, it doesn’t do anything!” And he only reached the therapeutic maximum. After 10 days they notice that they started yelling... Excellent, easy drug. You just need to drink correctly. Firstly, it develops its effect after 7-10 days / accumulation dose /, our patients often quit it during this week: “Oh, I’ve been drinking it for 7 days, it doesn’t do anything!” And he only reached the therapeutic maximum. After 10 days, they notice that they are yelling less, they don’t get irritated over trifles, they sleep well, things are going well, they start taking care of themselves, they smile, they joke. You need to drink for at least 1.5-2 months, then see a doctor: decide to continue drinking if your mood is still unstable; or SLOWLY cancel in a decreasing pattern.

Fluoxetine helped me. I drank for depression and also lost a lot of weight. It didn’t cause any side effects for me. I felt great, didn’t get irritated over trifles like before.

I took fluoxetine Lannacher to curb my appetite and stop worrying about trifles. Regular flu doesn't help, drinking it will only torment your liver in vain) Now I want to get off it =) I took fluoxetine Lannacher to curb my appetite and stop worrying about trifles.
Regular flu doesn't help, drinking it will only torment your liver in vain)
Now I want to get off it =)

Fluoxetine price is 28 rubles, is that expensive? I’ve been drinking it for two weeks now to lose weight, and I’m very pleased. I don’t feel like eating at all, I’m losing weight before my eyes. Thanks to this drug.

I am very pleased with the preparation. It seems to me that he was the only one who helped my daughter become humanoid. I mean, she is an alcoholic and she drank to such an extent that I thought we had lost her. And now he’s a completely different person, his nerves are back in place, no hysterics. If this drug had been prescribed earlier... I am very pleased with the preparation. It seems to me that he was the only one who helped my daughter become humanoid. I mean, she is an alcoholic and she drank to such an extent that I thought we had lost her. And now he’s a completely different person, his nerves are back in place, no hysterics. If this drug had been prescribed earlier, she might have stopped drinking altogether. Of course, she has breakdowns, but much less often, and she began to sleep like normal people at night. I tell this drug S P A S I B O

Fluoxetine is quite expensive, but for me this is important, and when I took this drug, my condition worsened, chills appeared, wild weakness, I stopped eating altogether. Wild NAUSEA, I had to switch to another drug, Neurofull, it seems to work stably and it can be combined with alcohol ( Sorry for these details but... Fluoxetine is quite expensive, but for me this is important, and when I took this drug, my condition worsened, chills appeared, wild weakness, I stopped eating altogether. Wild NAUSEA, I had to switch to another drug, Neurofull, it seems to work stably and it can be combined with alcohol ( quarrel over such details, but on weekends sometimes you really want it, and holidays, birthdays, alas, you can’t live without it) I of course know that it’s not advisable, but with other pills it’s absolutely not possible.
The doctor prescribed fluoxetine for depression. There was a difficult moment in life. I had to take this drug. But instead of helping, this drug only made my condition worse. Either I was indifferent to everything and everyone, then I became aggressive. At work they have already become afraid of me and avoid communicating with me. There were moments when she seemed to behave normally. But she could break down at any moment and scream and quarrel just because of nothing. In general, just terrible. Now I remember and it seems to me that it was a terrible dream. When I stopped taking Fluoxetine, I was off it for another two weeks. Now I just thank the Almighty that I feel normal. Because the roof wasn't completely blown off. Do not take this drug.

The pharmacological properties of Fluoxetine are based on its ability to inhibit the reuptake of serotonin into the central nervous system, the main neurotransmitter called the hormone of pleasure (or happiness).

It is he who is responsible for a good mood, the absence of tearfulness, pickiness, and boredom. The therapeutic effect of the drug improves the patient’s psycho-emotional activity and does not affect blood pressure, functional activity of the heart, and does not cause drowsiness or lethargy.

The drug is prescribed for:

• obsessive-compulsive obsessive-compulsive disorder;
• various depressions;
• sleep disorders;
• bulimia nervosa;
• anorexia;
• premenstrual dysphoria;
• alcoholism.

Pros and cons of the drug

The main advantages of the drug are:

• lack of hypnotic effect and cardiotoxic effect;
• availability in the pharmacy network;
• democratic price.

The disadvantages of the drug include the following side effects:

• allergic reaction to the main component of the drug;
• pregnancy;
• breastfeeding a baby;
• pathological processes in the liver and kidneys;
• diabetes mellitus;
• epileptic conditions.

This predominance of “cons” over “pros” is a consequence of the fact that this drug is already outdated. Today, the pharmacological industry provides patients with modern analogs of Fluoxetine, which have the ability to selectively affect the human body.

Clinical picture of overdose

Symptoms develop acutely. The signs for the initial stage are as follows:

• severe nausea and vomiting;
• excitement, which gives way to drowsiness;
• mydriasis;
• increase in heart rate to 100 per minute or more;
• small muscle twitches;
• strengthening reflexes;
• convulsive seizures.

In severe cases, rigidity develops. Deterioration of the condition in case of overdose is accompanied by:

• increased temperature;
• depression of consciousness;
• difficulty breathing.

Death occurs from respiratory and heart failure.

Two cases of death have been reported with the use of Fluoxetine.

Lethal dose

The minimum amount is 500 mg. A severe overdose occurs when the permissible concentration increases by 5 times.

Directions for use and doses

Inside, at any time, regardless of meals.

Depressive state. The initial dose is 20 mg/day in the first half of the day, regardless of meals. If necessary, the dose can be increased to 40–60 mg/day, divided into 2–3 doses (by 20 mg/day weekly). The maximum daily dose is 80 mg in 2–3 doses.

The clinical effect develops 1–2 weeks after the start of treatment; in some patients it may be achieved later.

Bulimic neurosis. The drug is used in a daily dose of 60 mg in 2-3 doses.

Use of the drug in patients of different ages. There are no data on changes in doses depending on age. Treatment of elderly patients should begin with a dose of 20 mg/day.

Accompanying illnesses. It is recommended to prescribe fluoxetine to patients with impaired liver or kidney function using low doses and lengthening the interval between doses.

Shelf life of the drug Fluoxetine

Do not use after the expiration date stated on the package.

Storage conditions for the drug Fluoxetine

In a dry place, protected from light, at a temperature not exceeding 25 °C.

Keep out of the reach of children.

Possible analogues (substitutes)

Fluoxetine (from 28.00 rubles), Apo-Fluoxetine (from 66.70 rubles), Fluoxetine Lannacher (from 112.00 rubles), Prozac (from 430.43 rubles), Bioxetine ... Show all analogues of the drug Fluoxetine-Canon » Attention: the use of analogues must be agreed with the treating physician doctor.

How dangerous is the drug?

Side effects are observed if a person abuses the medicine and takes it without consulting a doctor. In this case, one should expect damage to almost all systems and organs in the human body. The abuse of pills has had particular resonance in Canada and America.

Mode of application

Initial dose – 20 mg 1 time/day in the morning; if necessary, the dose can be increased after 3-4 weeks. Frequency of administration: 2-3 times/day.

The maximum daily oral dose for adults is 80 mg.

How to use: dosage and course of treatment

Fluoxetine is taken orally.

For depression and obsessive-compulsive disorders, the initial dose is 20 mg of fluoxetine per day (in the first half of the day), regardless of food intake. If necessary, the dose can be increased to 40–60 mg/day, divided into 2-3 doses. The maximum daily dose is 80 mg.

The clinical effect develops 1-4 weeks after the start of treatment, in some patients - later.

For bulimia nervosa, the drug is used in a daily dose of 60 mg, divided into 2-3 doses.

For patients with renal and hepatic insufficiency, as well as with low body weight, it is recommended to use lower doses - 10 mg of fluoxetine per day and lengthen the interval between doses.

The duration of treatment is determined by the attending physician and can be carried out over several years.

What does the manufacturer's official summary say?

The same “hormone of happiness” – serotonin – is actively synthesized in brain cells. At the same time, the central nervous system is not inhibited, but, on the contrary, is stimulated by auxiliary substances.

Hunger centers located in the brain are effectively blocked, resulting in a feeling of fullness and suppressing uncontrolled appetite.

As a result of complex biochemical processes triggered by the drug in the body, the following changes occur:

• The feeling of hunger and the desire to “eat up” stress with various delicacies are eliminated;
• Food portions for full saturation are halved;
• Rapid weight loss occurs;
• At the same time, physical activity increases, self-confidence arises, and a feeling of readiness to “move mountains” arises;
• Irritability and apathy due to hunger no longer bother the woman;
• Night sleep becomes calm and sound.

It would seem that Fluoxetine is an ideal means for losing weight. And it’s not for nothing that their appearance on the pharmaceutical market has transformed into a real fashionable canon. You eat little, you can follow any strict diet, while your mood remains elevated, and your physical activity and energy grow exponentially...

If everything were so perfect, the drug's manufacturers would have amassed a billion-dollar fortune instead of lawsuits against them.

CAS code

ATX

N06AB03 Fluoxetine

Therapeutic effects, pharmacokinetics

Fluoxetine is a selective reuptake inhibitor of the neurotransmitter serotonin at synapses in the structures of the central nervous system. This leads to the accumulation of serotonin in synapses, improving the conduction of nerve impulses and the development of a therapeutic effect in the form of improving a person’s mood (antidepressant effect). The main active component of the drug has virtually no effect on the reuptake of other neurotransmitters (adrenaline, dopamine). It also does not directly affect the various receptors at synapses in the brain. Unlike other antidepressants, it does not reduce the activity of postsynaptic beta-adrenergic receptors. The drug does not affect appetite, can lead to a decrease in the patient’s body weight, does not cause the development of orthostatic hypotension (a pronounced decrease in blood pressure when a person’s body position changes from horizontal to vertical) and does not have a toxic effect on the heart. A lasting therapeutic effect is usually achieved 1-2 weeks after starting the drug.

After taking the Fluoxetine capsule orally, the active ingredient is well absorbed into the blood (bioavailability reaches 95%). It is evenly distributed in tissues and penetrates through the blood-brain barrier into the structures of the central nervous system, where it has a therapeutic effect. Metabolized in the liver with the formation of breakdown products due to the methylation reaction, they are excreted from the body mainly in urine (85%) and less in feces (15%).

Contraindications to the use of fluoxetine

An antidepressant overdose occurs when using fluoxetine on the advice of a friend, colleague or neighbor. If the drug helped one person, then in another it will cause serious complications, even causing death. The fact is that After a short course of therapy, fluoxetine is addictive. The dosage recommended by the doctor does not cause euphoria and the person begins to take more pills.

Attempts to discontinue the drug are usually unsuccessful - withdrawal syndrome develops. It is characterized by the following features:

• visual disturbances;
• nausea, vomiting;
• dizziness;
• trembling of hands and head;
• irritability, anxiety.

Fluoxetine should not be taken by young people under 18 years of age: many of them have unstable hormonal levels. In the United States ten years ago, a young man carried out the shooting of his classmates at his school. After an examination, it was determined that he was under the influence of Prozac at the time of the shooting.

Acute and chronic renal failure are contraindications to taking the drug. You should not use fluoxetine if you have the following pathologies:

1. Increased individual sensitivity to ingredients.
2. Liver pathologies.
3. Pregnancy and lactation period.
4. Diseases of the endocrine system.
5. Epilepsy.

Taking an antidepressant in such cases will cause overdose symptoms. With these diseases, the filtration of blood from toxic compounds is impaired, and problems arise with their removal from the body. Taking just one tablet of fluoxetine will be a lethal dose for a person.

World experience

In the 1980s, a study was conducted that showed that fluoxetine was not suitable for treating depression. Moreover, the drug can cause the development of psychosis, mental disorders and other side effects. There are also unofficial statistics that prove that the drug has a negative effect on the body, pushing towards suicide more than other antidepressants.

Despite the danger, the drug continues to be prescribed for the treatment of severe forms of depression, using the excuse that it helps. Scientists from the University of Hull are convinced that the drug acts solely as a placebo and has no therapeutic effect.

The consensus remains that you cannot treat yourself with pills. The dosage must be calculated and prescribed by a doctor, otherwise addiction and side effects may occur.

Medicinal properties

This antidepressant drug promotes selective inhibition of the reuptake of a substance such as serotonin, which subsequently causes an increase in its level directly in the synaptic cleft, and an increase and prolongation of the effect on the postsynaptic receptors themselves is observed. Due to increased serotonergic transmission via negative feedback, fluoxetine helps to inhibit neurotransmitter metabolism. With prolonged use of drugs, inhibition of the activity of specific 5-HT1 receptors is recorded. The drug has a weak effect on the reuptake of substances such as dopamine and norepinephrine. At the same time, there is no direct effect on H1-histamine, seratonin, α-adrenergic receptors, as well as m-cholinergic receptors. Compared to other drugs that have an antidepressant effect, it does not provoke a decrease in the activity of the postsynaptic β-adrenergic receptors themselves.

The drug exhibits a therapeutic effect in endogenous depressive states, as well as obsessive-compulsive disorders. With regular use, dysphoria is eliminated, mood improves, excessive nervous tension, severe anxiety, and feelings of fear are relieved. In addition, anorexigenic effect is manifested, and weight loss may occur during treatment. The drug is non-cardiotoxic, does not provoke the development of orthostatic hypotension, and a strong sedative effect is not observed when taking capsules. A persistent therapeutic effect is registered after 1-2 weeks. from the start of the reception.

The contents of the capsules are quickly absorbed by the mucous membranes of the gastrointestinal tract, the highest plasma concentrations are observed after 6-8 hours. The bioavailability indicator does not exceed 60%. It is worth noting that food intake does not affect bioavailability.

The connection with plasma proteins is recorded at the level of 94.5%. The drug component is evenly distributed in organs and tissues. Steady-state plasma concentrations are achieved within several weeks.

As a result of metabolic transformations, the formation of an active metabolite, which is norfluoxetine, is observed, and several unidentified metabolites are also formed.

Approximately 80% of metabolic products are excreted by the renal system, 15% by the intestines. The half-life is 4-6 days. In persons suffering from liver cirrhosis, the elimination of the drug is prolonged by approximately 3-4 times.

"Backeffect"

Fluoxetine is a strong drug that has a powerful effect on the functioning of the brain and nervous system. It does not have fat burning or even stimulating effects. Moreover, it will not “kill” your exorbitant appetite if you just like to snack or eat a heavy meal.

It can weaken the craving for food only if it is caused by a deficiency of the “joy hormone”, i.e. has a nervous background. Competent doctors do not allow their patients to take the drug if they are not 100% sure of the nature and genesis of his disorder.

Officially, Fluoxetine is indicated for use in the following conditions:

• Chronic depression (not to be confused with blues);
• Insomnia;
• Central nervous system disorders;
• Schizophrenia;
• Migraine conditions;
• Neuroses;
• Obsessive states (in particular, fear);
• Bulimia.

If the medicine is taken by an absolutely healthy person without permission, this provokes an excess of serotonin, the consequences of which can become even more dire than with its deficiency.

Who needs to take the drug?

A widely known antidepressant is prescribed for various mental disorders. This list often includes:

• various types of depression;
• CNS disorders;
• bulimia

The drug is also prescribed to patients with alcoholism, social phobia, neuropathy through diabetes, panic attacks, autism and other mental disorders.

Analogues of the drug Fluoxetine

Analogues are determined by structure:

1. Fluval.
2. Fluoxetine hydrochloride.
3. Fluxonil.
4. Phloxet.
5. Prozac.
6. Fluid pack.
7. Portal.
8. Deprenon.
9. Prod.
10. Framex.
11. Flunisan.
12. Fluoxetine HEXAL (Lannacher; Nycomed; OBL; Canon).
13. Deprex.
14. Apo Fluoxetine.

special instructions

Before prescribing Fluoxetine capsules, the doctor must carefully read the instructions and pay attention to several features of the correct use of the drug, which include:

The active component of the drug can reduce the functional activity of the nervous system, so it is impossible to perform work that requires sufficient concentration and speed of psychomotor reactions.

With the simultaneous use of drugs that are actively metabolized in the liver, a reduction in the average therapeutic dosage of capsules may be required. Children, adolescents and young adults may experience suicidal tendencies while taking Fluoxetine capsules, which requires careful monitoring.

It is not recommended to drink alcohol while taking medication. Fluoxetine and its breakdown products are eliminated from the body over a long period of time. This is important to consider when prescribing drugs from other pharmacological groups.

In patients with concomitant diabetes mellitus, after starting the use of this drug, a pronounced decrease in blood sugar (hypoglycemia) is possible. During electroconvulsive therapy (ECT), seizures of striated skeletal muscles may develop.

In patients with suicidal tendencies while using the drug, careful monitoring is required. In patients with low body weight, it may be further reduced while taking the drug, as it can reduce appetite.

In the pharmacy chain, Fluoxetine capsules are dispensed with a doctor's prescription. To prevent complications and negative health consequences, it is not recommended to take them on your own without appropriate medical prescription.

Children, pregnancy and breastfeeding

Contraindicated during pregnancy and lactation.

Use in children

In children and adolescents with depression and other mental disorders, antidepressants, compared with placebo, increase the risk of suicidal thoughts and suicidal behavior. Therefore, the use of the drug in childhood is contraindicated.

Active substance, group

Fluoxetine, Antidepressant

Chemical name

(±)-N-Methyl-gamma-benzenepropanamine (and as hydrochloride); racemic (50/50) mixture of R- and S-enantiomers

Fluoxetine for weight loss

Fluoxetine is often prescribed for bulimic syndrome, a mental syndrome that is accompanied by a lack of satiety and uncontrolled overeating.

The use of the drug reduces appetite and relieves the constant feeling of hunger.

Thus, we can conclude that Fluoxetine can only get rid of excess weight if the reason for its gain is appetite.

However, the drug is not intended for weight loss; its main purpose is to treat depression. Decreased appetite and weight loss are side effects.

The medicine is quite powerful, and the body often reacts to its use with anaphylactic reactions and systemic disorders involving the lungs, skin, kidneys and liver in the pathological process.

How to take Fluoxetine for weight loss?

At the initial stage, diet pills are taken in a minimal dosage - one once a day. If well tolerated, you can switch to taking two tablets - one is taken in the morning, the second in the evening.

The maximum permissible dose is 4 tablets/day.

The drug begins to act after 4-8 hours; it takes about a week to remove fluoxetine from the body.

Reviews on forums confirm the effectiveness of the product - in 1-3 months people got rid of 5-13 kg without much effort. At the same time, all patients who took Fluoxetine note that it is still not worth drinking it just for the sake of losing weight, like Phenibut or Phenotropil, in the absence of indications.

Why are people looking for fluoxetine analogs?

Price issue

Fluoxetine is not the cheapest drug (its price is about 300 rubles) and in order to save money you have to look for more affordable analogues.

Among them are Framex and Flunat - these are more affordable medications that cost from 100 to 150 rubles, and their low price is due to their less famous name.

By-effect

Fluoxetine is a high-quality and proven drug, but it has certain disadvantages, or rather a number of side effects:

• bowel dysfunction;
• infrequent headaches that appear an hour after administration;
• increased heart rate, which can lead to tachycardia;
• overdrying of the mucous membrane;
• blurred vision;
• increased sweat secretions;
• general malaise;
• Women who took the drug experienced pain in the mammary glands and menstrual irregularities (up to several weeks);
• nausea and vomiting;
• noise in ears;
• constant feeling of fatigue;
• sleep disorders;
• depression;
• acne and allergic irritations;
• broken bones;
• sexual apathy (loss of interest in sex).

The list of contraindications is quite long and that is why most people are looking for more harmless analogues. For example, it could be Flunat or Deprex. The drugs have a natural composition and a less aggressive effect on the patient’s body.

No choice

Of course, the last reason why people turn to analogues of this drug is simply its absence on the shelves in pharmacies, since Fluoxetine is a sought-after medication.

If this medicine is not available in the pharmacy, then you should turn your attention to Profluzac and Fluval, which are identical in their action and composition.

Recipe

Rр.: Caps. Fluoxetini 0.02 No. 20

D.S. 20 mg 1 time/day.

Cross-drug interactions

The drug enhances the therapeutic effect of hypoglycemic drugs, diazepam, and alprazolam.

Fluoxetine is capable of increasing the plasma levels of maprotiline, a number of tricyclic antidepressants, and phenytoin by approximately 2 times.

Epileptic seizures may occur during electroconvulsive treatment.

Tryptophan can increase the serotonergic properties of this drug.

MAO inhibitors significantly increase the likelihood of the so-called seratonin syndrome.

Drugs that inhibit the functioning of the central nervous system increase the likelihood of developing side symptoms, and also increase the inhibitory effect on the nervous system.

When taking medications that are characterized by a high degree of binding to plasma proteins, including anticoagulants and digitoxin, an increase in the level of unbound drugs may be observed, and the likelihood of developing adverse symptoms increases.

Antidepressants do not solve the problem (suicide statistics after Prozac, global ban on Prozac)

The statistics of the disease are inexorable and show that about forty million people suffer from Prozac addiction in the world, while the mortality and suicide rates are higher than other drugs. There was a particularly large wave of indignation in Europe, America and Canada, where the drug was withdrawn from free access, it can only be obtained with a doctor’s prescription, and some countries even banned its use.

In Russia, the situation with Prozac is deplorable. Despite many deaths and an understandable predisposition to suicide, the pills were approved for free access and can be purchased at any pharmacy without a doctor's prescription. This has provoked an increase in the number of people addicted to antidepressants and is putting their lives at risk.

Possibility of toxemia

The main danger is that the substance can accumulate in the body, which leads to serious damage to the central nervous system. The appearance of nightmares and suicidal tendencies is likely.

Dosage

When deciding on fluoxetine treatment, you need to know how much medication to take. The initial therapeutic dose is 20 mg per day. It is divided into two doses, with the first dose taken in the first half of the day.

If necessary, the norm can be increased to 80 mg. In this case, the increase should be made gradually, 20 mg/day.

The maximum therapeutic effect, when the medicine begins to fully act, is achieved after 10-14 days of systematic use. Therefore, many, without waiting for this, increase the dose, which can provoke fluoxetine poisoning.

The lethal dose for a healthy adult is 10 to 20 grams. The toxic content in the bloodstream is 40 mg/l, and the causing death corresponds to 50 mg/l.

Signs of toxemia

If you do not follow the rules when taking fluoxetine, an overdose will manifest itself with the following symptoms:

As the substance is absorbed into the cells, the victim exhibits additional symptoms:

• convulsions;
• difficulty breathing;
• arterial hypotension;
• paleness of the skin;
• thready pulse;
• dizziness;
• fainting state.

The first symptoms and signs of overdose

Overdose is characterized by the following symptoms:

• nausea, vomiting,
• frequent heart rate,
• fever,
• constant desire to sleep,
• lethargy,
• loss of consciousness,
• dizziness,
• pressure reduction,
• coma.

In case of severe poisoning with the drug, cardiac arrest can occur, which can cause death.

However, it is impossible to say exactly what the lethal dose of this drug is, so suicidal people rarely choose it to commit suicide. There are only two known cases where an overdose caused death. However, in those cases, the deceased also took codeine and temazipam.

A person can have signs of intoxication individually or all at once, much depends on the body. But in any case, it is necessary to provide the victim with the necessary assistance.

Conditions for dispensing from pharmacies

On prescription.

Consequences of taking Fluoxetine

Not a single poison (drug) can be used without consequences. Fluoxetine is dangerous and leads to negative changes:

Paranoia;

Convulsions;

Muscle atrophy and anorexia;

Increased salivation;

Urinary and fecal incontinence;

Sexual dysfunctions;

• Blood clots, arrhythmia and the risk of heart attacks.

Overcoming Prozac Addiction

Narcology methods in the fight against fluoxetine will only help solve physical problems and will not help cope with a negative emotional (mental) state. The Narconon rehabilitation program will help you get rid of psychological addiction.

It takes into account all aspects of addiction, from the reasons for use to the consequences (mental degradation of a person, depression, negative thoughts).

The Narconon program also teaches a person how to cope with problems and difficulties. A person feels better, has more self-confidence, and can live a full life. And 75% of those who completed the program no longer abuse medications, including Fluoxetine, or alcohol.

Use in old age

There are no special dosing instructions for Fluoxetine-Canon for elderly patients.

Consequences of Fluoxetine - existing risks of taking

Taking the drug may cause side effects. They are polysystemic, i.e. can affect any system of the body. Clinically expressed by the following conditions:

• Manic stalking
• Suicidal tendencies
• Dizziness
• Shiver
• Convulsions
• Poor appetite
• Diarrhea
• Increased salivation
• Heart rhythm disturbance
• Urinary retention or incontinence
• Sexual dysfunction
• Allergic rashes.

Therefore, any discomfort and deviations in habitual behavior during treatment with Fluoxetine require consultation with a doctor. Such patients may need to adjust the dose of the antidepressant or replace it with another drug.

Allergic rashes are a common side effect of the drug fluoxetine.

Nosological classification (ICD-10)

Contraindications and precautions

Price: from 86 to 219 rubles.

The drug is contraindicated for use in the following cases:

• Signs of bladder atony
• Pregnancy and lactation
• Epileptic seizures
• Diagnosis of glaucoma
• BPH
• Pathologies of the renal system
• Development of convulsive syndrome
• The presence of excessive susceptibility to components.

When treating underweight individuals, possible anorexigenic effects must also be taken into account.

When taking capsules in case of diabetes, the likelihood of hypo- or hyperglycemia after discontinuation of the drug increases. Taking this into account, the dosage of hypoglycemic and insulin-containing medications must be adjusted. You will need to remain under the supervision of a doctor until positive dynamics in treatment therapy appear.

Drinking alcohol during treatment is not advisable. Particular care should be taken as alcohol enhances the inhibitory effect of the drug on the central nervous system. During the entire period of taking the drug, you should refrain from performing potentially dangerous work and driving a car.

The time interval between stopping the use of MAO inhibitor-based drugs and starting fluoxetine should be at least 2 weeks; between the completion of fluoxetine therapy and treatment with drugs including MAO inhibitors - at least 5 weeks.

In case of liver pathologies, elderly people will be prescribed ½ of the standard dose.

Pharmacology

Pharmacological action – antidepressant, anorexigenic.

Selectively inhibits the reuptake of serotonin, which leads to an increase in its concentration in the synaptic cleft, strengthening and prolonging its effect on postsynaptic receptors. By increasing serotonergic transmission, it inhibits neurotransmitter exchange through a negative feedback mechanism. With long-term use, it reduces the activity of 5-HT1 receptors. It also blocks the reuptake of serotonin in platelets. Weakly affects the reuptake of norepinephrine and dopamine. It has no direct effect on serotonin, m-cholinergic, H1-histamine and alpha-adrenergic receptors. Unlike most antidepressants, it does not cause a decrease in the activity of postsynaptic beta-adrenergic receptors.

Effective for endogenous depression and obsessive-compulsive disorders. Improves mood, reduces tension, anxiety and fear, eliminates dysphoria. It has an anorexigenic effect and can cause weight loss. In patients with diabetes mellitus it can cause hypoglycemia, and when fluoxetine is discontinued, it can cause hyperglycemia. A pronounced clinical effect for depression occurs after 1–4 weeks of treatment, for obsessive-compulsive disorders - after 5 weeks or more.

Well absorbed from the gastrointestinal tract. The “first pass” effect through the liver is weakly expressed. Capsules and an aqueous solution of fluoxetine are equivalent in effectiveness. After a single dose of 40 mg, Cmax of fluoxetine is achieved after 4–8 hours and is 15–55 ng/ml; when taken at the same dose for 30 days, Cmax of fluoxetine is 91–302 ng/ml, norfluoxetine - 72–258 ng /ml. At concentrations up to 200–1000 ng/ml, fluoxetine is 94.5% bound to blood proteins, including albumin and alpha1-glycoprotein. The enantiomers are equally effective, but S-fluoxetine is excreted more slowly and predominates over the R-form at steady state concentration. Easily penetrates the BBB. In the liver, enantiomers are demethylated with the participation of the CYP2D6 isoenzyme of cytochrome P450 to norfluoxetine and other unidentified metabolites, and S-norfluoxetine is equal in activity to R- and S-fluoxetine and superior to R-norfluoxetine. T1/2 of fluoxetine is 1–3 days after a single dose and 4–6 days with long-term administration. T1/2 of norfluoxetine is 4–16 days in both cases, which causes significant accumulation of substances, slow achievement of their equilibrium level in plasma and prolonged presence in the body after withdrawal. In patients with liver cirrhosis, T1/2 of fluoxetine and its metabolites is prolonged. Excreted within 1 week mainly by the kidneys (80%): unchanged - 11.6%, in the form of fluoxetine glucuronide - 7.4%, norfluoxetine - 6.8%, norfluoxetine glucuronide - 8.2%, more than 20% - hippuric acid, 46% - other compounds; 15% is excreted by the intestines. If renal function is impaired, the elimination of fluoxetine and its metabolites slows down. It is not excreted during dialysis (due to the large volume of distribution and high degree of binding to plasma proteins).

There is evidence of the effectiveness of fluoxetine in eating disorders (anorexia nervosa), alcoholism, anxiety disorders, including social phobia; diabetic neuropathy, affective, incl. bipolar disorders; dysthymia, autism, panic attacks, premenstrual syndrome, narcolepsy, catalepsy, obstructive sleep apnea syndrome, kleptomania, schizophrenia, schizoaffective disorders, etc.

Instructions for use of capsules

The highest daily dosage is 80 mg, taken twice or thrice a day.

In the case of bulimia and when prescribing medication for elderly patients, it is recommended to take 1 pill three times a day; if obsessive states occur, increased daily doses are recommended - 20-60 mg. When prescribing maintenance therapy, patients should take 20 mg of drugs per day. The duration of treatment is 3-4 weeks.

Release form

Yellow film-coated tablets in blisters of 10 pieces, 1 or 2 blisters per package.

Diagnostics

A specific clinical picture and anamnesis help in establishing the cause of an overdose. Characteristic features:

• severe vomiting;
• dilated pupils;
• increasing convulsions;
• hyperreflexia.

• presence of depression;
• taking Fluoxetine for therapy;
• alcohol abuse.

Blood tests may show neutrophils with toxic granularity. There is an increased amount of protein in the urine.

Interaction with other drugs:

Fluoxetine and its main metabolite, norfluoxetine, have long half-lives, which must be taken into account when combining fluoxetine with other drugs, as well as when replacing it with another antidepressant.
Phenytoin. Changes in the concentration of phenytoin in the blood were detected when it was combined with fluoxetine. In some cases, manifestations of intoxication were noted. Increasing the dose of phenytoin or fluoxetine when administered simultaneously should be done with caution and under the supervision of the clinical dynamics of the condition.
Serotonergic drugs. Concomitant use of serotonergic drugs (for example, tramadol and triptans) increases the likelihood of developing serotonin syndrome. Concomitant use of triptans also increases the likelihood of developing coronary vasoconstriction and arterial hypertension.
Benzodiazepines. With the simultaneous use of fluoxetine and benzodiazepines, the half-life of the latter may increase. When alprazolam and fluoxetine were taken together, an increase in the concentration of alprazolam in the blood and an increase in its sedative effect were observed.
Lithium and tryptophan. There are known cases of the development of serotonin syndrome while taking selective serotonin reuptake inhibitors (SSRIs) and lithium or tryptophan, and therefore the simultaneous administration of fluoxetine with these drugs should be carried out with caution. When fluoxetine and lithium are taken concomitantly, more frequent and careful monitoring of the clinical condition is necessary.
Medicines metabolized with the participation of the CYP2D6 isoenzyme (propafenone, carbamazepine, tricyclic antidepressants). It should be taken into account that the metabolism of fluoxetine (as well as tricyclic antidepressants, as well as selective serotonergic antidepressants) is carried out with the participation of the CYP2D6 isoenzyme of the liver cytochrome system. Simultaneous use of drugs, the main route of biotransformation of which is metabolism with the participation of the CYP2D6 isoenzyme, and having a small range of therapeutic doses (such as propafenone, carbamazepine, tricyclic antidepressants) should be carried out using minimal therapeutic doses. The above also applies if less than 5 weeks have passed since stopping fluoxetine.
Indirect anticoagulants and other drugs that affect the blood coagulation system (Non-steroidal anti-inflammatory drugs, acetylsalicylic acid). There is a known change in the anticoagulant effect (according to laboratory parameters and/or clinical manifestations) without any general characteristic trend, but with the likelihood of increased bleeding when taking fluoxetine and oral anticoagulants simultaneously. The functional state of the blood coagulation system in patients receiving warfarin should be carefully monitored when prescribing and discontinuing fluoxetine.
Electroconvulsive therapy (ECT). There have been rare reports of increased seizure duration in patients taking fluoxetine and receiving ECT, and caution is advised.
Alcohol. In experimental studies, fluoxetine did not increase blood alcohol concentrations or enhance the effects of alcohol. However, concomitant use of SSRIs and alcohol is not recommended.
Products based on the plant Hypericum perforatum. As with other SSRIs, a pharmacodynamic interaction may develop between fluoxetine and products based on the Hypericum perforatum plant, which may lead to increased undesirable effects.

Content

According to the pharmacological classification, Fluoxetine is an antidepressant drug. Its active substance fluoxetine acts on most brain receptors. The product is produced by Ukrainian and Russian pharmaceutical companies.

Composition of Fluoxetine

Pharmacological properties

The antidepressant contains a propylamine derivative, the action of which is associated with a selective blockade of the reverse neuronal uptake of serotonin in the central nervous system. The active component weakly antagonizes cholinergic, histamine and adrenergic receptors, does not reduce the functional activity of postsynaptic beta-adrenergic receptors. Taking the capsules improves mood, reduces feelings of fear and tension, and eliminates dysphoria. The drug does not cause a sedative effect and does not affect the functions of the heart and blood vessels.

Once inside, the active component is absorbed in the stomach and is poorly metabolized during the first passage through the liver. When there is food in the stomach, the rate of absorption slows down. Fluoxetine reaches its maximum in blood plasma after 7 hours, binds to albumin by 94.5%, and penetrates the meninges. Metabolism occurs by demethylation, producing the inactive metabolite norfluoxetine. The half-life of the drug is 2-3 days, the half-life of metabolites is 7-9 days. Excretion is carried out by the kidneys and intestines.

Indications for use of Fluoxetine

The instructions for use highlight the following indications for use of the medicine:

• depression of various origins, accompanied by phobias;
• bulimic neurosis;
• obsessive-compulsive disorders.

How to take Fluoxetine

The drug Fluoxetine is prescribed only to adults. Taken in an initial daily dose of 20 mg in the morning, if necessary, it is increased after 3-4 weeks to 60-80 mg. Capsules are taken 2-3 times a day. The maximum daily adult dose is 80 mg, in old age – 60 mg. For bulimic neurosis, 1 tablet is recommended three times a day, for obsessive-compulsive disorder - 20-60 mg per day. The maintenance daily dose is 20 mg.

How long does it take for the drug to start working?

After 2 weeks of constant use of the medicine, a significant improvement in the patient’s condition is noted. If the liver or kidneys fail, in old age or when taking other medications, the dose is halved. Sometimes patients are transferred to intermittent admission. Abrupt withdrawal of treatment is not recommended; the dose is reduced gradually over 1–2 weeks to avoid withdrawal syndrome. If, after stopping therapy or reducing the dosage, the patient's condition worsens, return to the previous dose. After positive dynamics appear, you can try to reduce the dose.

Duration of treatment

To eliminate depressive symptoms, you need to take pills for six months. For obsessive manic disorders, the patient is treated for 10 weeks, then continued if necessary. If there is no effect, the treatment regimen is changed. If the dynamics are positive, treatment continues with the minimum maintenance dose. Periodically, the doctor changes the dosage taking into account the patient's condition.

For bulimia nervosa and obsessive-compulsive disorder, treatment can last up to 12–24 weeks. After completion of treatment, the active component remains in the blood for another 2 weeks, which is important to consider when prescribing other medications.

Fluoxetine for weight loss

Fluoxetine tablets are often used to treat bulimic syndrome, a mental disorder in which there is no feeling of satiety and uncontrolled overeating occurs. Taking the drug reduces appetite, relieves constant hunger, and helps you lose weight if the cause of excess weight gain is bulimia. Decreased appetite and weight loss are side effects, but the medication is not intended for losing extra pounds.

If you take the drug uncontrolled, anaphylactic reactions, damage to the lungs, kidneys, skin, and liver may develop. To get rid of bulimia and lose weight, take 1 tablet. per day, if well tolerated - 2 pcs. (morning and evening), but no more than 4 pcs. per day. The drug acts within 4–8 hours and is completely eliminated from the body within a week. In 1–3 months of use you can lose 5–13 kg.

special instructions

Instructions for use of Fluoxetine suggest considering the special instructions:

1. The drug should be taken with caution in cases of impaired renal function, liver function, a history of epileptic seizures, or heart and vascular diseases.
2. In diabetes mellitus, taking pills can change the level of glucose in the blood, which leads to the need to adjust the dosage of hypoglycemic drugs.
3. With weakness, patients are more likely to develop epileptic seizures. Their duration increases with simultaneous electroconvulsive therapy.
4. In old age, the dose is reduced. The medicine is not used in children, in combination with alcohol.
5. While taking capsules, you must refrain from driving a car or operating machinery.

During pregnancy

The product is prohibited for use during pregnancy and lactation. According to research, if women in the first trimester of pregnancy received treatment with the drug, the children developed congenital anomalies in the structure of blood vessels or the heart. Taking Fluoxetine in the last trimester can lead to an increase in the duration of artificial ventilation in newborns, tube feeding, and hospitalization.

Infants develop convulsions, constant crying, hypoglycemia, nervous irritability, excitability, distress syndrome, lability of body temperature and pressure, tremor, cyanosis, vomiting, hyperreflexia, and feeding difficulties. Taking capsules during feeding is also prohibited.

Drug interactions

The antidepressant Fluoxetine can be taken 2 weeks after stopping monoamine oxidase inhibitors. If the transition to these drugs is carried out after treatment with the drug, then 5 weeks should pass. Other drug interactions:

1. The combination of a medication with drugs that inhibit brain function enhances the effect of the latter and leads to the development of seizures.
2. The combination of the drug with furazolidone, tryptophan, procarbazine leads to the development of serotonin syndrome.
3. Fluoxetine inhibits the metabolism of trazodone, tricyclic, tetracyclic antidepressants, diazepam, metoprolol, phenytoin, terfenadine, and enhances the effect of hypoglycemic agents, warfarin.
4. The combination of the drug with fluphenazine, haloperidol, maprotiline, perphenazine, metoclopramide, pericyazine, risperidone, pimozide, trifluoperazine, sulpiride can lead to dystonia, with dextromethorphan - to hallucinations, with propofol - to spontaneous movements, with phenylpropanolamine - to dizziness, hyperactivity, weight loss bodies.
5. The medication increases the concentration of lithium in plasma while taking metal salts, the level of imipramine, desipramine, digoxin.
6. The drug enhances the effects of thioridazine, flecainide, zuclopenthixol, mexiletine, propafenone.

Side effects of Fluoxetine

During treatment with the drug, side effects may develop:

• sleep disturbance, anxiety, headache, tremor, drowsiness, nervousness;
• diarrhea, nausea;
• increased sweating (hyperhidrosis);
• hypoglycemia, hyponatremia;
• decreased libido;
• suicidal thoughts, anxiety;
• arterial hypotension;
• metabolic acidosis, hepatitis, bruxism;
• allergies, itching, skin rash, alopecia, dermatitis, psoriasis, erythema;
• hyperuricemia;
• hypercholesterolemia, hypokalemia, hypocalcemia, hypothyroidism;
• lymphadenopathy;
• joint, muscle pain, arthralgia, arthritis;
• difficulty breathing, increased body temperature (hyperthermia), anorexia, chills.

Overdose

Symptoms of an overdose of Fluoxetine include vomiting, epilepsy, nausea, convulsions, agitation, anxiety, and hypomania. According to doctors, high doses of the drug in combination with temazepam, codeine, maprotiline can result in death from renal failure. The victim's stomach is washed, enterosorbents, diazepam, norepinephrine are given. Blood transfusions, peritoneal dialysis, hemodialysis, and forced diuresis are not effective against intoxication.

Contraindications

Instructions for use indicate contraindications for taking capsules:

• hypersensitivity to the components of the drug;
• pregnancy, lactation;
• glaucoma;
• epilepsy;
• bladder atony;
• convulsions;
• kidney dysfunction;
• prostate hyperplasia or adenoma.

Terms of sale and storage

The product is a prescription product and can be stored away from children at temperatures up to 25 degrees for no longer than five years.

Analogs

You can replace the drug with antidepressants that contain the same or another active ingredient. Fluoxetine analogues:

• Adepress, Rexetine - tablets based on paroxetine;
• Asentra, Serlift - tablets containing sertraline;
• Paroxetine – tablets with the active ingredient of the same name;
• Elicea, Lenuxin - tablets based on escitalopram.

Fluoxetine price

Found an error in the text?
Select it, press Ctrl + Enter and we will fix everything!

Yellow film-coated tablets in blisters of 10 pieces, 1 or 2 blisters per package.

pharmachologic effect

The drug has an anorexigenic effect, eliminates depression and relieves feelings of depression.

Pharmacodynamics and pharmacokinetics

The substance fluoxetine - what is it?

The active substance of the drug fluoxetine hydrochloride is a white (or almost white) crystalline powder, sparingly soluble in water.

What is Fluoxetine?

Fluoxetine is a selective serotonin reuptake inhibitor (SNRS). The drug belongs to the pharmacotherapeutic group “Antidepressants”.

Pharmacodynamics

The medicine is intended for oral administration. The mechanism of its action is associated with the ability to selectively (selectively) and reversibly inhibit ONZS.

The antidepressant Fluoxetine has little effect on the uptake of dopamine and norepinephrine and has a weak effect on acetylcholine receptors and H1-type histamine receptors.

Along with antidepressant, it also has a stimulating effect. After taking the tablets/capsules, the patient’s feelings of fear, anxiety and mental tension decrease, mood improves, and symptoms of dysphoria are eliminated.

Wikipedia notes that the drug does not cause orthostatic hypotension, does not have a sedative effect, and is not cardiotoxic.

It takes 3 to 4 weeks to achieve a lasting clinical effect with regular use of the drug.

Pharmacokinetic parameters:

• absorption in the digestive canal is good;
• bioavailability - 60% (orally);
• TSmax - from 6 to 8 hours;
• binding to plasma proteins (including alpha (α)-1-glycoprotein and albumin) - 94.5%;
• T½hour.

The liver is involved in the metabolism of the substance. As a result of its biotransformation, a number of unidentified metabolites are formed, as well as norfluoxetine, the selectivity and activity of which are equivalent to those of fluoxetine.

Pharmacologically inactive metabolic products are eliminated by the kidneys.

Due to the fact that the substance is excreted from the body rather slowly, the plasma concentration necessary to maintain the therapeutic effect is maintained for several weeks.

Indications for use: why are tablets and Fluoxetine prescribed?

Indications for use of Fluoxetine:

• depression (especially accompanied by fears), including when other antidepressants are ineffective;
• obsessive-compulsive disorder (OCD);
• kinorexia (to reduce uncontrollable cravings for food, the drug is used as part of complex psychotherapy).

Contraindications

The drug is not prescribed for:

* After using MAO inhibitors, Fluoxetine can be used no earlier than 14 days later; MAO inhibitors after completion of treatment with Fluoxetine are prescribed no earlier than 5 weeks later.

Side effects of Fluoxetine

General disorders that occur during the use of the drug can manifest themselves in the form of hyperhidrosis, chills, fever or sensation of cold, photosensitivity, neuroleptic syndrome, alopecia, lymphadenopathy, anorexia, erythema multiforme, which can progress to malignant exudative or develop into Lyell's syndrome.

Some patients experience symptoms of serotonin toxicity, including:

From the digestive system of organs, the following are possible: diarrhea, nausea, loss of appetite, vomiting, dysphagia, dyspepsia, change in taste, pain in the esophagus, dry mouth, dyskinesia, liver dysfunction. In isolated cases, idiosyncratic hepatitis may develop.

CNS reactions to taking pills manifest themselves in the form of: bruxism, headache, weakness, sleep disturbances (night delirium, pathological dreams, insomnia), dizziness, fatigue (hypersomnia, drowsiness); disturbances of attention, processes and concentration of thinking, memory; anxiety and associated psychovegetative syndrome, dysphemia, panic attacks, suicidal thoughts and/or attempts to take one’s own life.

The possibility of developing:

Discontinuation of drug treatment may provoke withdrawal syndrome, the main symptoms of which are: sensitivity disorders, dizziness, sleep disorders, asthenia, nausea and/or vomiting, agitation, headache, tremor.

Reviews of side effects indicate that the drug is addictive when taken uncontrolled. In some cases, the addiction is so strong that a person requires professional help to treat it.

Other adverse reactions that patients mention in reviews are severe drowsiness, tremors, convulsions, loss of appetite, and nausea. However, there are people who did not experience any unwanted effects at all during treatment.

Instructions for use of Fluoxetine

The tablets are taken orally. Eating does not affect the absorption of the drug.

To relieve depressive symptoms, the medicine should be taken once a day, in the morning, at a dose of 20 mg. If clinically necessary, 3-4 weeks after the start of therapy, the frequency of doses is increased to 2 times a day. (tablets are taken morning and evening).

For patients with an insufficient response to treatment at a dosage of 20 mg/day, in some cases the daily dose is gradually increased. In this case, it should be divided into 3-4 doses. The highest dose for elderly and senile people is 60 mg/day.

Dosage for bulimic neurosis - 60 mg/day. (take one tablet 3 times a day), for OCD - depending on the severity of clinical symptoms - from 20 to 60 mg/day.

It must be taken into account that increasing the dose may increase the severity of side effects.

Maintenance dose - 20 mg/day.

When does the drug start working?

A significant improvement in the condition is usually observed after about 2 weeks of systematic use of the medicine.

How long should I take Fluoxetine?

It takes six months to eliminate depressive symptoms.

For obsessive manic disorders (OMD), the drug is given to the patient for 10 weeks. Further recommendations depend on the results of treatment. If there is no clinical effect, the fluoxetine treatment regimen is reviewed.

If there are positive dynamics, therapy is continued using an individually selected minimum maintenance dose. The patient's need for further treatment should be reassessed periodically.

Long-term - more than 24 weeks in patients with NMR and more than 3 months in patients with bulimia nervosa - has not been studied.

After completion of treatment with Fluoxetine, the active substance circulates in the body for another 2 weeks, which should be taken into account when stopping treatment or prescribing other medications.

Patients with insufficient liver/kidney function, elderly people with concomitant diseases, as well as patients taking other medications are prescribed half the dose of the drug. In some cases, it is advisable to transfer the patient to intermittent treatment.

If, after reducing the dose/discontinuing the drug, the patient's condition worsens, it is necessary to return to treatment with the previous effective therapeutic dose. A gradual dose reduction is resumed after positive dynamics appear.

If we compare Fluoxetine and Fluoxetine Lannacher or Fluoxetine and Fluoxetine OZONE, we can conclude that the instructions for use of Fluoxetine Lannacher and Fluoxetine OZONE contain recommendations similar to those listed above.

Overdose

An overdose of Fluoxetine is accompanied by: nausea/vomiting, convulsions, hypomania, anxiety, agitation, grand mal seizures.

A victim of an overdose should rinse the stomach, give sorbitol, enterosorbent and, for convulsions, diazepam. Monitoring of respiratory activity and parameters characterizing the functional state of the heart is also important. Subsequently, symptomatic and supportive therapy is carried out.

Interaction

Doubles the plasma concentration of tricyclic antidepressants, phenytoin, trazodone, maprotiline. When prescribing Fluoxetine in combination with tricyclic antidepressants, the dose of the latter should be reduced by 50%.

It may provoke an increase in the plasma concentration of Li+, which in turn increases the likelihood of developing its toxic effects. In case of simultaneous use, it is recommended to monitor the concentration of Li+ in the blood.

Use as an adjunct to electroconvulsive therapy may cause the development of prolonged epileptic seizures.

The serotonergic effects of the drug are enhanced in combination with tryptophan. The likelihood of developing serotonin intoxication increases if taken simultaneously with drugs that inhibit the MAO enzyme.

The likelihood of adverse reactions and increased depressant effects on the central nervous system increases in combination with drugs that depress the central nervous system.

Taking with drugs that are characterized by a high degree of protein binding may provoke an increase in the plasma concentration of unbound (free) drugs, as well as an increase in the likelihood of developing undesirable effects.

Terms of sale: how is Fluoxetine dispensed - with a prescription or not?

Fluoxetine cannot be purchased without a prescription.

Storage conditions

Tablets should be stored at temperatures below 25°C.

Best before date

special instructions

When treating patients with low body weight, anorexigenic effects should be taken into account when prescribing the drug.

Diabetics may develop hypoglycemia during treatment with Fluoxetine, and hyperglycemia after discontinuation of the drug. Taking this into account, it is recommended to make changes to the dosage regimen of insulin and/or oral hypoglycemic agents. Until the clinical picture improves, patients with diabetes mellitus should be under constant medical supervision.

During the treatment period, it is necessary to refrain from engaging in activities that require a high speed of psychomotor reactions and increased attention.

The tablets contain lactose, so they should not be taken if you have galactosemia, lactase deficiency, or glucose/galactose malabsorption syndrome.

Like other antidepressants, fluoxetine can cause mood disorders (mania or hypomania).

The central organ of drug metabolism is the liver; the kidneys are responsible for excreting metabolites. Patients with liver pathologies should be prescribed low or alternative daily doses.

In case of renal failure (with Clcr less than 10 ml/min.) after 2 months of treatment using a dose of 20 mg/day. plasma concentrations of fluoxetine/norfluoxetine are the same as in patients with healthy kidneys.

Depression is associated with an increased risk of suicidal ideation and suicide attempts. The risk remains until complete remission. Clinical experience with the drug shows that the risk of suicide increases, as a rule, in the early stages of recovery.

Patients with mental illness and depressive syndrome should be under constant supervision. In placebo-controlled studies in a group of patients receiving antidepressants, it was found that the risk of suicidal behavior is highest in people under 25 years of age.

Patients who have been switched to a lower/higher dose also require special monitoring.

The use of Fluoxetine is associated with the development of akathisia, the subjective symptoms of which are a constant need to be in motion, as well as the inability to sit or stand. These phenomena are especially pronounced in the first weeks of treatment. For patients who have developed such symptoms, the drug is prescribed in the minimum effective dose.

If discontinued suddenly, approximately 60% of patients develop withdrawal symptoms. The likelihood of their occurrence depends on the dose used, the duration of the course, and the level of dose reduction. It is recommended to reduce the dose by titration over 7-14 days.

There are reports of subcutaneous hemorrhages, such as purpura or ecchymosis, occurring during treatment with the drug. Therefore, for patients taking oral anticoagulants that affect platelet function and increase the likelihood of bleeding, as well as for patients with a history of bleeding, Fluoxetine is prescribed taking into account the possible risks.

Fluoxetine analogs

Which is better: Prozac or Fluoxetine?

The active ingredient in Prozac is fluoxetine. Therefore, when choosing one or another product, the decisive factors are price and subjective feelings. The cost of Fluoxetine is significantly lower than the cost of its analogue.

For children

Not used to treat patients under 18 years of age.

A nineteen-week clinical study showed that in depressed children aged 8-18 years, fluoxetine caused a decrease in height and body weight. The effect of the drug on achieving normal growth in adulthood has not been studied.

However, the possibility of growth retardation during puberty cannot be ruled out.

Fluoxetine and alcohol

Drinking alcohol during treatment with Fluoxetine is contraindicated.

Fluoxetine for weight loss

Fluoxetine is often prescribed for bulimic syndrome, a mental syndrome that is accompanied by a lack of satiety and uncontrolled overeating.

The use of the drug reduces appetite and relieves the constant feeling of hunger.

Thus, we can conclude that Fluoxetine can only get rid of excess weight if the reason for its gain is appetite.

However, the drug is not intended for weight loss; its main purpose is to treat depression. Decreased appetite and weight loss are side effects.

The medicine is quite powerful, and the body often reacts to its use with anaphylactic reactions and systemic disorders involving the lungs, skin, kidneys and liver in the pathological process.

How to take Fluoxetine for weight loss?

At the initial stage, diet pills are taken in a minimal dosage - one once a day. If well tolerated, you can switch to taking two tablets - one is taken in the morning, the second in the evening.

The maximum permissible dose is 4 tablets/day.

The drug begins to act after 4-8 hours; it takes about a week to remove fluoxetine from the body.

Reviews on forums confirm the effectiveness of the product - in 1-3 months people got rid of 5-13 kg without much effort. At the same time, all patients who took Fluoxetine note that it is still not worth drinking it just for the sake of losing weight, like Phenibut or Phenotropil, in the absence of indications.

During pregnancy

The safety of the drug in pregnant women has been poorly studied, and the results of some published epidemiological studies are contradictory. Some randomized and cohort studies have found no increase in the likelihood of congenital anomalies.

A prospective study conducted by ENTIS suggests an increased likelihood of developing congenital anomalies in the structure of large vessels or the heart in children whose mothers took fluoxetine in the 1st trimester of pregnancy, compared with children whose mothers did not receive this drug.

A reliable connection between taking the drug in early pregnancy and the formation of malformations in the fetus could not be established. The specific group of CVS anomalies has also not been defined.

The use of SSRIs in the last weeks of pregnancy contributes to the development of complications in newborns, in particular, an increase in the duration of mechanical ventilation and tube feeding and the duration of hospitalization.

There are references to the development of apnea, respiratory distress syndrome, convulsions, hypoglycemia, lability of body temperature and blood pressure, tremor, hyperreflexia, vomiting, cyanosis, difficulties with adequate nutrition, constant crying, excitability, nervous irritability.

The listed pathological conditions may be a consequence of SSRI withdrawal syndrome or a manifestation of their toxic effects.

Reviews of Fluoxetine

Reviews from patients taking Fluoxetine (APO, Lannacher, Kanon) leave the impression of the effectiveness of this drug for depression, bulimic neuroses and OCD.

The forums also often discuss the possibility of using the drug to control appetite and correct weight.

Reviews from doctors about Fluoxetine for weight loss are clear: the medicine can be used to combat extra pounds only if the cause of weight gain is a mental disorder.

When excess weight is a consequence of overeating caused by depression or stress, the drug allows you to completely get rid of bouts of gluttony in 2-3 weeks and remove up to 5 kg in just the first month.

Reviews of those losing weight about Fluoxetine (Lannacher, OZONE, etc.) allow us to conclude that not everyone succeeds in losing weight on this drug: for some, their appetite disappears completely (even to the point of disgust in food), for others it remains the same.

However, in most cases, the drug has quite serious side effects: many people who took it noted a decrease in libido and a deterioration in sex life, a feeling of lethargy, severe pain, drowsiness, increased aggression, and the appearance of suicidal thoughts.

In addition, for many losing weight, the disadvantages of the drug are the need to stop driving and drinking alcohol, as well as the fact that Fluoxetine is highly addictive.

Summarizing the reviews, we can draw the following conclusions: Fluoxetine is primarily a medicine for depression and can be taken only if indicated and only under the supervision of a doctor.

How much does Fluoxetine cost?

The price in Ukraine for Fluoxetine tablets is from 11 UAH per package No. 10. The price of Fluoxetine in package No. 20 is from 18 UAH.

The price of Fluoxetine in Russian pharmacies depends on which company produced the drug and varies from 27 to 255 rubles. For example, the price of Fluoxetine Lannacher in St. Petersburg is from 112 to 145 rubles per package No. 20, and the price of the drug produced by OZON LLC is rubles.

You can buy Apo-Fluoxetine in Moscow or St. Petersburg for rubles.

The cost of the drug in Belarus is about 120 thousand rubles.

Do I need a prescription for the drug? Undoubtedly it is needed. After all, Fluoxetine is far from a harmless pill. Side effects from uncontrolled use of the drug can be quite serious.

Due to the fact that the drug is not available without a prescription, many are interested in the question of how to buy Fluoxetine online. The attitude towards prescription drugs in online pharmacies is no less strict than in regular ones.

In most cases, when receiving pills, it is enough to show the courier a prescription written by a doctor, but some pharmacies do not deliver prescription drugs, so you need to go in person to pick up the medicine.

• Online pharmacies in Russia Russia
• Online pharmacies in Ukraine Ukraine
• Online pharmacies in Kazakhstan Kazakhstan

WER.RU

ZdravZone

Pharmacy IFC

Pharmacy24

PaniPharmacy

BIOSPHERE

An excellent drug, I lost more than 10 kg in the first two months with its help. and I feel great. There is no depression or excessive hunger.

Vita: I am very grateful to Anna (Anna, Anulya is her nickname on VKontakte) for helping.

Dana: The drug is good, it takes a long time to take, but due to this you are cured as needed.

Ekaterina: Hello, I have the same problem, a purulent chic was cut out on my buttock a month ago! All .

Valeria: Zerkalin helps relieve even severe inflammation. It may not completely remove acne (this.

All materials presented on the site are for reference and informational purposes only and cannot be considered a treatment method prescribed by a doctor or sufficient advice.

We choose fluoxetine analogues depending on the goal

Fluoxetine is a strong antidepressant intended for drug therapy for obsessive and depressive conditions, which are accompanied by anxiety and fear.

Systematic use of this drug helps patients overcome apathy, improve mood, normalize appetite and sleep, and reduce feelings of fear and tension.

First acquaintance with the medicine

The active ingredient of the drug is fluoxetine hydrochloride.

The pharmacological properties of Fluoxetine are based on its ability to inhibit the reuptake of serotonin into the central nervous system, the main neurotransmitter called the hormone of pleasure (or happiness).

It is he who is responsible for a good mood, the absence of tearfulness, pickiness, and boredom. The therapeutic effect of the drug improves the patient’s psycho-emotional activity and does not affect blood pressure, functional activity of the heart, and does not cause drowsiness or lethargy.

The drug is prescribed for:

Pros and cons of the drug

The main advantages of the drug are:

• lack of hypnotic effect and cardiotoxic effect;
• availability in the pharmacy network;
• democratic price.

The disadvantages of the drug include the following side effects:

• dizziness and headache;
• asthenia;
• increased sweating;
• decreased libido;
• the appearance of pain in the bones and mammary glands;
• noise in ears;
• stool instability;
• rashes on the skin;
• dry mouth;
• disturbances of taste and olfactory sensations;
• decreased vision.

• allergic reaction to the main component of the drug;
• pregnancy;
• breastfeeding a baby;
• pathological processes in the liver and kidneys;
• diabetes mellitus;
• epileptic conditions.

This predominance of “cons” over “pros” is a consequence of the fact that this drug is already outdated. Today, the pharmacological industry provides patients with modern analogs of Fluoxetine, which have the ability to selectively affect the human body.

Why are people looking for fluoxetine analogs?

Price issue

Fluoxetine is not the cheapest drug (its price is about 300 rubles) and in order to save money you have to look for more affordable analogues.

Among them are Framex and Flunat - these are more affordable medications that cost from 100 to 150 rubles, and their low price is due to their less famous name.

By-effect

Fluoxetine is a high-quality and proven drug, but it has certain disadvantages, or rather a number of side effects:

• bowel dysfunction;
• infrequent headaches that appear an hour after administration;
• increased heart rate, which can lead to tachycardia;
• overdrying of the mucous membrane;
• blurred vision;
• increased sweat secretions;
• general malaise;
• Women who took the drug experienced pain in the mammary glands and menstrual irregularities (up to several weeks);
• nausea and vomiting;
• noise in ears;
• constant feeling of fatigue;
• sleep disorders;
• depression;
• acne and allergic irritations;
• broken bones;
• sexual apathy (loss of interest in sex).

The list of contraindications is quite long and that is why most people are looking for more harmless analogues. For example, it could be Flunat or Deprex. The drugs have a natural composition and a less aggressive effect on the patient’s body.

No choice

Of course, the last reason why people turn to analogues of this drug is simply its absence on the shelves in pharmacies, since Fluoxetine is a sought-after medication.

If this medicine is not available in the pharmacy, then you should turn your attention to Profluzac and Fluval, which are identical in their action and composition.

Analogues in terms of active substance, composition, action

The active substance fluoxetine hydrochloride has the following analogues:

Similar medications in composition and effects on the body:

• Portal, composition: fluoxetine and vitamin supplements;
• Prodep, composition: fluoxetine and calcium;
• Prozac, composition: fluoxetine and sedatives.

Unlike Fluoxetine, almost all similar drugs contain fewer impurities, which means they are more harmless.

TOP - 15 best analogues

• Apo-Fluoxetine is an antidepressant that has a calming effect and improves mood;
• Bioxetine is a fairly effective selective inhibitor; it is often prescribed for neuroses, since it has practically no side effects;
• Deprex is a product that contains the active substance fluoxetine, which has a sedative and invigorating effect for neuralgia;
• Deprenon is a potent depressant (prescribed for serious mental disorders);
• Portal is an antidepressant in capsule form, which, thanks to its natural composition, has proven itself well as a medicine in the fight against bulimia nervosa;
• Prodep is an antidepressant, a selective serotonin reuptake inhibitor, which improves mood, reduces tension, anxiety and fear;
• Prozac is a natural medicine used for depression (regardless of the degree of depressive disorder - mild, moderate, severe), bulimia, anorexia, alcoholism, obsessive-compulsive disorder;
• Profluzak is a strong antidepressant used in the fight against psychological and nervous conditions;
• Flunate is an adjuvant drug based on fluoxetine, which enhances the effects of Alprazolam, Diazepam and ethanol;
• Fluval is not the most popular, but nevertheless a worthy analogue of Fluoxetine, which is used in conjunction with electroconvulsive therapy;
• Framex is an antidepressant that should only be taken under medical supervision, since when used together with other medications it can increase blood concentration, which can lead to adverse consequences;
• Fluoxetine-Canon is a potent sedative used for violent nervous disorders;
• Floxet is a complete analogue of Fluoxetine, which is used for depression and other disorders;
• Fluoxetine-Lannacher is a selective inhibitor that is used for bulimia nervosa and anorexia;
• Fluoxetine - Nycomed is a sedative based on the parent medication.

A question of price and free access

Cheap analogues of the antidepressant Fluoxetine:

Over-the-counter analogues of Fluoxetine:

This section was created to take care of those who need a qualified specialist, without disturbing the usual rhythm of their own lives.