Fluoxetine Lannacher
Fluoxetine Lannacher: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Fluoxetine Lannacher
ATX code: N06AB03
Active ingredient: fluoxetine (fluoxetine)
Manufacturer: GLPHARMA, GmbH (Austria)
Description and photo update: 2018-21-11
Prices in pharmacies: from 120 rubles.
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Fluoxetine Lannacher is an antidepressant.
Release form and composition
Fluoxetine Lannacher is produced in the form of capsules: size No. 3, hard gelatinous, opaque, body - beige, cap - light green; the contents of the capsules are white powder (10 pcs in a blister, 2 blisters in a cardboard box).
1 capsule contains:
- active substance: fluoxetine hydrochloride - 22.36 mg (corresponds to 20 mg fluoxetine);
- additional components: dimethicone, pregelatinized corn starch;
- capsule body and cap: titanium dioxide, gelatin, iron oxide yellow dye, patented blue V dye (for the cap).
Pharmacological properties
Pharmacodynamics
The mechanism of action of fluoxetine is based on the selective blockade of neuronal reuptake of serotonin (5-hydroxytryptamine) in the synapses of neurons of the central nervous system (CNS). As a result of the suppression of the reuptake of serotonin, the level of this neurotransmitter in the synaptic cleft increases, and its effect on the postsynaptic receptor sites is enhanced and prolonged.
Fluoxetine has a low affinity for α 1, α 2, and β-adrenergic, dopaminergic, muscarinic, H 1 -histamine, serotonin and GABA-ergic receptors. The substance eliminates dysphoria, relieves anxiety, tension and feelings of fear, helps to improve mood, and leads to a decrease in appetite. The drug ensures the reduction of obsessive-compulsive disorders (OCD), does not have a sedative effect, does not cause orthostatic hypotension, and is not cardiotoxic. A persistent clinical effect is achieved after 1–2 weeks of therapy.
Pharmacokinetics
When taken orally, the agent is well absorbed from the gastrointestinal tract (GIT). The bioavailability of the substance is not affected by food intake. The maximum concentration (C max) in blood plasma is observed after 6–8 hours. Plasma protein binding is approximately 95%, including alpha-1-acid glycoprotein and albumin. Fluoxetine is characterized by a high volume of distribution and good tissue uptake, and easily crosses the blood-brain barrier.
Metabolic transformation occurs in the liver with the participation of the isoenzyme CYP2D6 through demethylation with the formation of the main active metabolite of the substance, norfluoxetine. The metabolites of the drug are excreted by the kidneys (80%) and intestines (15%), mainly in the form of glucuronides. After reaching equilibrium plasma concentration, the half-life (T ½) of fluoxetine can be 4-6 days, after a single dose - 1-4 days. Norfluoxetine T ½ can be within 4-16 days, which is the reason for a significant accumulation of active forms and a long-term presence in the body (from 5 to 6 weeks) after discontinuation.
Indications for use
- depression of various origins;
- bulimic neurosis;
- OCD (obsessive compulsive disorder);
- premenstrual dysphoria.
Contraindications
Absolute:
- atony of the bladder;
- severe functional disorders of the kidneys [creatinine clearance (CC) less than 10 ml / min] and liver;
- age up to 18 years;
- pregnancy and lactation;
- combined administration with thioridazine, pimozide, as well as monoamine oxidase (MAO) inhibitors (including within 14 days after the latter are canceled);
- hypersensitivity to the components of fluoxetine Lannacher.
Relative (the drug should be taken with extreme caution):
- epilepsy (including history data);
- diabetes;
- excessive weight loss;
- suicidal tendencies;
- Parkinson's disease.
Instructions for the use of Fluoxetine Lannacher: method and dosage
Fluoxetine Lannacher is taken orally with or without food.
Recommended dosing regimen based on indications:
- depression: at the beginning of the course in the first half of the day 1 time per day is prescribed in a dose of 20 mg (1 capsule) with a further possible increase in the daily dose, if necessary, up to 40-60 mg (2-3 capsules), taken in 2-3 doses; the maximum daily dose should not be more than 80 mg (4 capsules);
- OCD: daily dose - 20-60 mg (1-3 capsules);
- premenstrual dysphoric disorders: daily dose - 20 mg (1 capsule);
- bulimic neurosis: daily dose - 60 mg (3 capsules), taken in 2-3 doses.
The duration of therapy is 3-4 weeks.
Side effects
- Gastrointestinal tract: taste disturbance, decreased appetite, hypersalivation or dry mouth, nausea, diarrhea, vomiting;
- CNS: sleep disturbances, headache, increased fatigue, anxiety, dizziness, asthenia, agitation, tremors, motor agitation, aggravation of suicidal tendencies, mania / hypomania;
- genitourinary system: incontinence / urinary retention, vaginitis, dysmenorrhea, delayed ejaculation, decreased libido;
- allergic reactions: skin rash, urticaria, itching, arthralgia, myalgia, fever;
- others: increased sweating, weight loss, impaired visual acuity, tachycardia, vasculitis, systemic disorders of the kidneys, lungs or liver.
Overdose
Overdose symptoms may include: vomiting, nausea, restlessness, arousal, seizure disorders, and cardiovascular disorders. In this condition, gastric lavage, activated carbon intake, symptomatic therapy are prescribed. In the event of seizures, tranquilizers are administered, measures are taken to maintain breathing and cardiac activity.
special instructions
In patients with diabetes mellitus, while taking Fluoxetine Lannacher, the threat of hypoglycemia is aggravated, and after its cancellation - hyperglycemia. As a result, it is required to adjust the dosage of insulin and / or any other hypoglycemic agent. Patients should be closely monitored until significant improvement in diabetes therapy occurs.
During the period of treatment, there may be a progressive decrease in body weight (anorexigenic effects), which should be taken into account in persons with underweight.
The drug can be taken no earlier than 14 days after stopping the use of MAO inhibitors. After the end of taking Fluoxetine Lannacher, MAO inhibitor therapy can only be started after 5 weeks.
Patients under the age of 24 with depression or other psychiatric disorders have an increased risk of suicidal ideation and suicidal tendencies during antidepressant use compared with placebo. When prescribing the drug to patients from this age group, the possible threat of suicide and the benefits of using fluoxetine should be correlated. In the course of studies, the risk of suicide did not increase in people over the age of 24, and slightly decreased in the age over 65. In view of the fact that any depressive disorder leads to an aggravation of the threat of suicide, during treatment with antidepressants, it is necessary to carefully monitor the patient's condition in order to early detection of any disorders and suicidal behavior.
During the period of taking Fluoxetine Lannacher, it is required to stop drinking alcohol.
Influence on the ability to drive vehicles and complex mechanisms
Patients receiving fluoxetine treatment are advised to refrain from driving or other complicated machinery.
Application during pregnancy and lactation
According to the instructions, Fluoxetine Lannacher is contraindicated during pregnancy.
It was found that fluoxetine penetrates into breast milk (up to 25% of the plasma level), as a result of which its intake during lactation is contraindicated.
Pediatric use
Since the efficacy and safety of the use of Fluoxetine Lannacher in children and adolescents under 18 years of age have not been established, the drug is contraindicated in patients of this age category.
With impaired renal function
The use of the drug is contraindicated in patients with severe renal impairment (CC less than 10 ml / min). With functional impairment of the kidneys of mild to moderate severity, it is required to reduce the dose and increase the interval between doses of Fluoxetine Lannacher.
For violations of liver function
In the presence of liver cirrhosis, T ½ fluoxetine increases 3-4 times. In severe liver pathologies, the drug is contraindicated. For patients with mild to moderate liver disease, it is recommended to start taking Fluoxetine Lannacher with ½ dose.
Use in the elderly
Elderly patients should start taking Fluoxetine Lannacher at a dose that is halved.
Drug interactions
- MAO inhibitors - the occurrence of serotonin syndrome is possible, the symptoms of which are diarrhea, increased sweating, chills, hyperthermia, tremor, myoclonus, hyperreflexia, impaired coordination of movement, agitation, autonomic lability, delirium, coma (the combination is contraindicated);
- tricyclic antidepressants, trazodone, maprotiline, phenytoin - there is an increase in their plasma concentration by a factor of two (with combined use, the dose of these funds must be reduced by 50%);
- preparations containing St. John's wort (Hypericum perforatum) - may aggravate the serotonergic effect, increase unwanted reactions;
- antidiabetic drugs, ethanol, diazepam, alprazolam - the effect of these drugs increases;
- tryptophan - the serotonergic properties of fluoxetine are enhanced (aggravation of motor anxiety, agitation, gastrointestinal disorders);
- centrally acting drugs leading to inhibition of the central nervous system, ethanol - their effect is enhanced and the threat of unwanted reactions increases;
- lithium preparations - the level of lithium content rises, which leads to the risk of developing toxic effects;
- anticoagulants, digitoxin (agents with a high degree of binding to proteins) - an increase in the concentration of unbound drugs in the plasma is possible and an aggravation of the risk of their side effects;
- electroconvulsive therapy - the development of prolonged seizures can be observed.
Analogs
Analogues of Fluoxetine Lannacher are: Profluzac, Apo-Fluoxetine, Flunisan, Prozac, Fluoxetine, Fluval, Fluoxetine-OBL, Fluoxetine-Canon.
Terms and conditions of storage
Store out of the reach of children and protected from light, at a temperature not exceeding 25 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Fluoxetine Lannacher
According to most reviews, Fluoxetine Lannacher is an effective drug that helps with depression, OCD, panic attacks, bulimic neuroses.
The disadvantages of the remedy include the development of adverse reactions of varying intensity, such as drowsiness, suppression of appetite, a feeling of lethargy, increased anxiety, agitation, decreased libido, and the appearance of suicidal thoughts. Some reviews indicate that the drug is addictive.
Almost all patients who have taken this antidepressant believe that it should be used solely as directed and under the supervision of a physician, and recommend not to self-medicate, using the drug in order to correct weight.
The price of Fluoxetine Lannacher in pharmacies
The approximate price for Fluoxetine Lannacher (for a pack containing 20 capsules) can be 110–140 rubles.
Fluoxetine Lannacher: prices in online pharmacies
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Drug name Price Pharmacy |
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Fluoxetine Lannacher 20 mg capsules 20 pcs. 120 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
