Fluoxetine-Canon
Fluoxetine-Canon: 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-Kanon
ATX code: N06AB03
Active ingredient: fluoxetine (Fluoxetine)
Producer: CJSC "Kanonfarma production" (Russia)
Description and photo update: 2019-08-07
Prices in pharmacies: from 108 rubles.
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Fluoxetine-Canon is a selective serotonin reuptake inhibitor (SSRI), antidepressant.
Release form and composition
The drug is produced in the form of capsules: size No. 3, blue; content - a mixture of powder and granules of white or white with a yellowish tinge (in a cardboard box 1, 2, 3 or 5 blister contour packs of 10 capsules; 1, 2 or 3 blister contour packs of 15 capsules and instructions for use of Fluoxetine-Canon) …
Composition of 1 capsule:
- active substance: fluoxetine (in the form of fluoxetine hydrochloride) - 20 mg;
- auxiliary components: lactose monohydrate (milk sugar), corn starch, magnesium stearate;
- capsule shell: gelatin, titanium dioxide, indigo carmine.
Pharmacological properties
Pharmacodynamics
Fluoxetine is an antidepressant. Selectively inhibits the reuptake of serotonin, which causes an increase in its concentration in the synaptic cleft, strengthening and prolongation of the effect on postsynaptic receptors.
By increasing serotonergic transmission, fluoxetine-Canon inhibits the metabolism of a neurotransmitter through a negative feedback mechanism. With prolonged use, it inhibits the activity of 5-HT1 receptors. The reuptake of dopamine and norepinephrine is weakly affected. It has no direct effect on H1-histamine, m-cholinergic, serotonin and alpha-adrenergic receptors. Unlike most antidepressant drugs, fluoxetine does not decrease the activity of postsynaptic beta-adrenergic receptors.
Effective for obsessive-compulsive disorders (OCD) and endogenous depression. Reduces fear, tension and anxiety, eliminates dysphoria, improves mood.
Has anorexigenic effect, may cause weight loss. Not cardiotoxic. Does not have a sedative effect, does not cause orthostatic hypotension.
A stable clinical effect develops within 1–2 weeks of treatment.
Pharmacokinetics
After oral administration, fluoxetine is well absorbed. When using Fluoxetine-Canon at a dose of 40 mg, the maximum concentration (Cmax) is achieved within 6-8 hours and varies in the range from 15 to 55 ng / ml. Bioavailability is more than 60%, this indicator does not depend on food intake.
It is characterized by a high bond with plasma proteins (including albumin and alpha1-acid glycoprotein) - 94.5%. Distributed throughout the body. Easily penetrates the blood-brain barrier. Equilibrium plasma concentration (Css) is established within several weeks of treatment.
It is extensively metabolized to form the active metabolite of norfluoxetine and several other metabolites, which could not be identified. Fluoxetine is an inhibitor of CYP3A3, CYP3A7, CYP3A5, CYP3A2 and CYP2C19 isoenzymes.
It is excreted by the kidneys (80%) and through the intestines (15%) mainly in the form of metabolites, especially in the form of glucuronides. After reaching Css, the half-life (T 1/2) of fluoxetine is 4–6 days. T 1/2 of norfluoxetine is 4-16 days both after a single dose and after reaching Css. In patients with liver cirrhosis, T 1/2 increases 3-4 times.
Indications for use
Fluoxetine-Canon is prescribed for adult patients with the following disorders:
- depression of various etiologies;
- obsessive compulsive disorder;
- bulimia nervosa.
Contraindications
Absolute:
- severe renal failure [creatinine clearance (CC) less than 10 ml / min];
- liver failure;
- hyperplasia of the prostate;
- angle-closure glaucoma;
- atony of the bladder;
- lactase deficiency, lactose intolerance, glucose-galactose malabsorption;
- age up to 18 years;
- simultaneous use of thioridazine and a period of 5 weeks after its cancellation;
- combined appointment of pimozide;
- joint intake of monoamine oxidase inhibitors (MAO) and a period of 14 days after their cancellation;
- hypersensitivity to any component of Fluoxetine-Canon.
During pregnancy, an antidepressant is contraindicated, except in cases of urgent need, when the expected benefits clearly outweigh the possible risks.
Fluoxetine-Canon should be used with caution in patients with suicidal tendencies, epileptic seizures, hyponatremia, diabetes mellitus, renal and hepatic insufficiency, as well as breastfeeding women.
Fluoxetine-Canon, instructions for use: method and dosage
Fluoxetine-Canon capsules should be taken orally. Meal time does not matter.
Recommended dosage regimens:
- depression: treatment begins with a daily dose of 20 mg once a day. If necessary, it is increased every week by 20 mg, but not more than up to 80 mg per day, divided into 2-3 doses;
- obsessive-compulsive disorder: 20-60 mg per day;
- bulimia nervosa: 20 mg 3 times a day.
In all cases, depending on the clinical picture, the doctor may recommend an increase or decrease in the daily dose of Fluoxetine-Canon. The effectiveness of the systematic use of the drug in a daily dose of more than 80 mg has not been studied.
Patients with concomitant diseases, patients with functional impairment of the liver or taking other medications, reduce the dose of fluoxetine or increase the intervals between doses.
Side effects
- nervous system: fatigue (drowsiness, asthenia), sleep disturbances (unusual dreams, insomnia), dizziness, abnormal movements (tremor, twitching, myoclonus, bucclossal syndrome, ataxia), seizures, impaired concentration and thinking processes (including depersonalization), anxiety, and its manifestations (nervousness, anxiety, agitation, palpitations), manic disorders, anorexia;
- cardiovascular system: heart palpitations, arrhythmias;
- metabolic and nutritional disorders: weight loss;
- digestive system: gastrointestinal disturbances (taste perversion, dysphagia, diarrhea, dyspepsia, nausea, vomiting); very rarely - idiosyncratic hepatitis;
- hematopoietic and lymphatic system: ecchymosis;
- endocrine system: abnormal secretion of antidiuretic hormone;
- respiratory system: yawning;
- musculoskeletal system: bone pain, leg cramps, bursitis, arthritis, arthrosis, rheumatoid arthritis, myopathy, myasthenia gravis, osteoporosis, osteomyelitis;
- genitourinary system: urinary disorders (including changes in the frequency of urination), prolonged erection or priapism, sexual dysfunction (delay or absence of ejaculation, decreased libido, impotence, anorgasmia);
- sense organs: impaired visual perception (blurred vision, mydriasis);
- hypersensitivity reactions: urticaria, skin rashes, pruritus, vasculitis, angioedema, anaphylactic reactions, serum-like syndrome, photosensitivity, exudative erythema multiforme, serotonin syndrome (characterized by a complex of clinical manifestations, including changes in the mental state and neuromuscular system), disorders; autonomic nervous system
- others: alopecia, sweating, chills, dry mouth, vasodilation.
Overdose
Overdose is usually manifested by increased side effects, nausea, vomiting, drowsiness, convulsions, tachycardia. In serious cases (including with the simultaneous use of other drugs), delirium, a condition similar to neuroleptic malignant syndrome, pyrexia, mania, stupor, fainting, decreased blood pressure, prolongation of the QT interval, ventricular tachyarrhythmia (incl. fibrillation / flutter of the ventricles), coma, cardiac arrest.
special instructions
Fluoxetine has anorexigenic effect, which should be taken into account when prescribing the drug to patients with underweight. Close monitoring is recommended for progressive weight loss.
Taking fluoxetine in diabetic patients increases the risk of hypoglycemia. After its cancellation, hyperglycemia may occur. In this regard, it is necessary to adjust the dose of insulin and / or oral hypoglycemic agent at the beginning of antidepressant therapy and after its cancellation. Careful medical supervision is required.
Patients receiving MAO inhibitors can be prescribed Fluoxetine-Canon no earlier than 14 days after their cancellation. It is allowed to start using MAO inhibitors at least 5 weeks after the antidepressant is discontinued.
Careful observation during the period of treatment, especially at the initial stage, is required to establish for persons with suicidal tendencies. Patients who have previously received other antidepressants, as well as patients who develop anxiety, excessive fatigue, and hypersomnia (excessive sleepiness), are at the highest risk of suicide.
In children, adolescents and young people (under the age of 24) with depression and other mental disorders, antidepressants increase the risk of suicidal tendencies, therefore, before prescribing any antidepressant drug in patients of this age group, the doctor should weigh the expected benefit with the possible threat of suicide. In short-term studies, the risk was not increased in people over 24 years old, and in the elderly (over 65 years old) it decreased slightly. It should be borne in mind that any depressive state in itself is associated with an increased risk of suicidal attempts, which persists until a stable remission occurs. In this regard, during the use of Fluoxetine-Canon, it is recommended to establish careful monitoring of patients in order to identify possible changes / behavioral disorders and suicidal tendencies in time. The physician should urge the patient to immediately report any feelings or thoughts of concern.
Prolonged epileptic seizures are possible during electroconvulsive therapy in patients receiving fluoxetine. Fluoxetine-Canon should be used with caution in the treatment of patients with a history of epileptic seizures.
It was reported about a decrease in the concentration of sodium ions in the blood plasma (in some cases below 110 mmol / l). Such cases were mainly observed in the elderly and patients receiving diuretics.
In patients taking fluoxetine, cases of skin rash, anaphylactic reactions and progressive systemic disorders, sometimes serious, involving the skin, lungs, liver and kidneys, are known. If skin rashes or other suspected allergic reactions appear, the cause of which cannot be established, Fluoxetine-Canon should be canceled.
During the period of therapy, it is strongly recommended to refrain from drinking alcoholic beverages.
Influence on the ability to drive vehicles and complex mechanisms
At the time of therapy, patients are advised to abandon driving and performing types of work with potentially dangerous consequences that require speed of reactions and / or increased attention.
Application during pregnancy and lactation
During pregnancy, Fluoxetine-Canon is contraindicated, except in cases of urgent need, when the expected benefit is definitely higher than the possible risks.
Fluoxetine passes into breast milk, therefore, it should be used with caution during lactation, after assessing the benefits and risks.
The influence of Fluoxetine-Canon on the process of delivery in humans is not known.
Pediatric use
Fluoxetine-Canon is not prescribed for patients under 18 years of age.
With impaired renal function
Severe renal failure (CC less than 10 ml / min) is a contraindication to the administration of Fluoxetine-Canon capsules.
An antidepressant should be used with caution in mild to moderate renal impairment.
For violations of liver function
Fluoxetine-Canon should be used with caution in case of severe liver dysfunction. Lower doses of fluoxetine or longer intervals between doses are recommended.
Use in the elderly
There are no special instructions for dosing Fluoxetine-Canon for elderly patients.
Drug interactions
Fluoxetine and its main metabolite have long half-lives, which must be taken into account when using any drugs at the same time, as well as when replacing Fluoxetine-Canon with another antidepressant.
Possible drug interactions while using the following substances / drugs with fluoxetine:
- benzodiazepines: their half-life may be increased. It has been established that fluoxetine increases the content of alprazolam in the blood and enhances its sedative effect;
- phenytoin: a change in its plasma concentration is possible, cases of intoxication are known. With the simultaneous use of drugs, it is necessary to increase their doses with extreme caution and under the control of the patient's condition;
- indirect anticoagulants and other drugs that affect the blood coagulation system (for example, acetylsalicylic acid, nonsteroidal anti-inflammatory drugs): the anticoagulant effect changes, which is fraught with increased bleeding. When using warfarin, it is necessary to carefully monitor the state of the blood coagulation system;
- lithium and tryptophan: SSRIs increase the risk of developing serotonin syndrome, which requires caution, more intensive and careful monitoring of the patient's clinical condition;
- serotonergic drugs (eg tramadol, triptans): the risk of developing serotonin syndrome increases. Triptans can contribute to the narrowing of the coronary vessels and cause hypertension;
- Hypericum perforatum preparations: possible increased side effects;
- electroconvulsive therapy: the duration of seizures may increase. Special care is required;
- drugs metabolized with the participation of the CYP2D6 isoenzyme and having a small interval of therapeutic doses (tricyclic antidepressants, propafenone, carbamazepine): adverse reactions may develop. The drugs should be prescribed in minimal therapeutic doses while using fluoxetine and within 5 weeks after its withdrawal;
- ethanol: In experimental studies, fluoxetine did not increase blood ethanol levels or potentiate its effects, but concurrent alcohol and SSRIs are not recommended.
Analogs
Fluoxetine-Canon analogs are Adepress, Alventa, Amitriptyline, Asentra, Brintellix, Velaxin, Dapfix, Zoloft, Caliksta, Clofranil, Lyudiomil, Mirzaten, Noxibel, Oprah, Paroxetine, Prozac, Sancipam, Serenata, Felixcozam, Trittilekosam, Trittileksam, Acipey (ACP), Efevelon and others.
Terms and conditions of storage
Store in a dry, dark place at temperatures up to 25 ° C. Keep out of the reach of children.
Shelf life is 4 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Fluoxetine-Canon
Patients leave mostly positive reviews about Fluoxetine-Canon, noting its high efficiency in various depressive conditions. Reportedly, the drug eliminates anxiety and nervousness, restores calmness and balance, improves sleep, increases stress resistance and performance. At the same time, you can find messages that describe the opposite effect: increased depression, tearfulness, increased aggression, etc.
Adverse reactions include distraction, drowsiness, apathy, decreased libido, tachycardia, dyspeptic disorders, and weight loss.
Fluoxetine has anorexigenic properties, so many women take it for the purpose of losing weight, which is strictly prohibited by doctors, since undesirable effects may develop. This is confirmed by many girls who, while taking Fluoxetine-Canon, developed depression inappropriately and, on the contrary, increased their appetite.
The price of Fluoxetine-Canon in pharmacies
The approximate price for Fluoxetine-Canon for a package containing 30 capsules of 20 mg each is 105-134 rubles.
Fluoxetine-Canon: prices in online pharmacies
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Drug name Price Pharmacy |
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Fluoxetine-Canon 20 mg capsules 30 pcs. 108 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!
