Description

Simple

A medication used to treat major depression, obsessive compulsive disorder, and panic disorders.

Clinical

A selective serotonin reuptake inhibitor used to treat major depressive disorder, bulimia, OCD, premenstrual dysphoric disorder, panic disorder, and bipolar I.

Overview

Fluoxetine is a 2nd generation antidepressant categorized as a selective serotonin reuptake inhibitor (SSRI).[2] It gained FDA approval in 1987 and although it was initially intended for the treatment of depression, today it is commonly prescribed to manage depression in addition to various other pathologies.[13]

Pharmacology

Indication

Fluoxetine is indicated for both acute and maintenance treatment of major depressive disorder, obsessive compulsive disorder, and bulimia nervosa; however, it is only indicated for acute treatment of panic disorder independent of whether agoraphobia is present.[ Read more

Pharmacodynamic

Fluoxetine blocks the serotonin reuptake transporter in the presynaptic terminal, which ultimately results in sustained levels of 5-hydroxytryptamine (5-HT) in certain brain areas.[ Read more

Mechanism of action

The monoaminergic hypothesis of depression emerged in 1965 and linked depression with dysfunction of neurotransmitters such as noradrenaline and serotonin.[13] Indeed,... Read more

Absorption

The oral bioavailability of fluoxetine is Read more

Protein binding

Approximately 94% of fluoxetine is plasma protein bound.[2]

Volume of distribution

The volume of distribution of fluoxetine and it's metabolite varies between 20 to 42 L/kg.[ Read more

Clearance

The clearance value of fluoxetine in healthy patients is reported to be 9.6 ml/min/kg.[ Read more

Half life

The half life of fluoxetine is significant with the elimination half-life of the parent drug averaging 1-3 days after acute administration, and 4-6 days after chronic administration.[12] Further, the elimination half life... Read more

Route of elimination

Fluoxetine is primarily eliminated in the urine.[15]

Toxicity

In a report that included 234 fluoxetine overdose cases, it was concluded that symptoms resulting from fluoxetine overdose were generally minor and short in duration.[ Read more

Adverse Effects

Effect Regions Age Groups Incidences Evidence Type
Insomnia US
  • Kind: experimental
    • Percent: 33
  • Kind: placebo
    • Percent: 13
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 29
  • Kind: placebo
    • Percent: 11
  • Clinical Trial
    Insomnia US
  • Kind: experimental
    • Percent: 28
  • Kind: placebo
    • Percent: 22
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 26
  • Kind: placebo
    • Percent: 13
  • Clinical Trial
    Asthenia US
  • Kind: experimental
    • Percent: 21
  • Kind: placebo
    • Percent: 9
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 21
  • Kind: placebo
    • Percent: 9
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 18
  • Kind: placebo
    • Percent: 13
  • Clinical Trial
    Decreased appetite US
  • Kind: experimental
    • Percent: 17
  • Kind: placebo
    • Percent: 10
  • Clinical Trial
    Somnolence US
  • Kind: experimental
    • Percent: 17
  • Kind: placebo
    • Percent: 7
  • Clinical Trial
    Anorexia US
  • Kind: experimental
    • Percent: 17
  • Kind: placebo
    • Percent: 10
  • Clinical Trial
    Insomnia US
  • Kind: experimental
    • Percent: 16
  • Kind: placebo
    • Percent: 9
  • Clinical Trial
    Anxiety US
  • Kind: experimental
    • Percent: 15
  • Kind: placebo
    • Percent: 9
  • Clinical Trial
    Nervousness US
  • Kind: experimental
    • Percent: 14
  • Kind: placebo
    • Percent: 15
  • Clinical Trial
    Asthenia US
  • Kind: experimental
    • Percent: 15
  • Kind: placebo
    • Percent: 11
  • Clinical Trial
    Anxiety US
  • Kind: experimental
    • Percent: 14
  • Kind: placebo
    • Percent: 7
  • Clinical Trial
    Nervousness US
  • Kind: experimental
    • Percent: 14
  • Kind: placebo
    • Percent: 9
  • Clinical Trial
    Tremor US
  • Kind: experimental
    • Percent: 13
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Somnolence US
  • Kind: experimental
    • Percent: 13
  • Kind: placebo
    • Percent: 5
  • Clinical Trial
    Somnolence US
  • Kind: experimental
    • Percent: 13
  • Kind: placebo
    • Percent: 6
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 12
  • Kind: placebo
    • Percent: 7
  • Clinical Trial
    Dry Mouth US
  • Kind: experimental
    • Percent: 12
  • Kind: placebo
    • Percent: 3
  • Clinical Trial
    Anxiety US
  • Kind: experimental
    • Percent: 12
  • Kind: placebo
    • Percent: 7
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 12
  • Kind: placebo
    • Percent: 8
  • Clinical Trial
    Decreased appetite US
  • Kind: experimental
    • Percent: 11
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Yawn US
  • Kind: experimental
    • Percent: 11
  • Kind: placebo
    • Percent: <1
  • Clinical Trial
    Nervousness US
  • Kind: experimental
    • Percent: 11
  • Kind: placebo
    • Percent: 5
  • Clinical Trial
    Pharyngitis US
  • Kind: experimental
    • Percent: 11
  • Kind: placebo
    • Percent: 9
  • Clinical Trial
    Libido decreased US
  • Kind: experimental
    • Percent: 11
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Anorexia US
  • Kind: experimental
    • Percent: 11
  • Kind: placebo
    • Percent: 2
  • Clinical Trial
    Insomnia US
  • Kind: experimental
    • Percent: 10
  • Kind: placebo
    • Percent: 7
  • Clinical Trial
    Pharyngitis US
  • Kind: experimental
    • Percent: 10
  • Kind: placebo
    • Percent: 5
  • Clinical Trial
    Dyspepsia US
  • Kind: experimental
    • Percent: 10
  • Kind: placebo
    • Percent: 6
  • Clinical Trial
    Dyspepsia US
  • Kind: experimental
    • Percent: 10
  • Kind: placebo
    • Percent: 4
  • Clinical Trial
    Flu syndrome US
  • Kind: experimental
    • Percent: 10
  • Kind: placebo
    • Percent: 7
  • Clinical Trial
    Tremor US
  • Kind: experimental
    • Percent: 10
  • Kind: placebo
    • Percent: 3
  • Clinical Trial
    Dry Mouth US
  • Kind: experimental
    • Percent: 10
  • Kind: placebo
    • Percent: 7
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 9
  • Kind: placebo
    • Percent: 4
  • Clinical Trial
    Dry Mouth US
  • Kind: experimental
    • Percent: 9
  • Kind: placebo
    • Percent: 6
  • Clinical Trial
    Tremor US
  • Kind: experimental
    • Percent: 9
  • Kind: placebo
    • Percent: 1
  • Clinical Trial
    Asthenia US
  • Kind: experimental
    • Percent: 9
  • Kind: placebo
    • Percent: 5
  • Clinical Trial
    Decreased appetite US
  • Kind: experimental
    • Percent: 8
  • Kind: placebo
    • Percent: 4
  • Clinical Trial
    Nervousness US
  • Kind: experimental
    • Percent: 8
  • Kind: placebo
    • Percent: 6
  • Clinical Trial
    Sweating US
  • Kind: experimental
    • Percent: 8
  • Kind: placebo
    • Percent: 3
  • Clinical Trial
    Anorexia US
  • Kind: experimental
    • Percent: 8
  • Kind: placebo
    • Percent: 4
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 8
  • Kind: placebo
    • Percent: 6
  • Clinical Trial
    Flu syndrome US
  • Kind: experimental
    • Percent: 8
  • Kind: placebo
    • Percent: 3
  • Clinical Trial
    Sweating US
  • Kind: experimental
    • Percent: 8
  • Kind: placebo
    • Percent: 3
  • Clinical Trial
    Rash US
  • Kind: experimental
    • Percent: 7
  • Clinical Trial
    Urticaria US
  • Kind: experimental
    • Percent: 7
  • Clinical Trial
    Asthenia US
  • Kind: experimental
    • Percent: 7
  • Kind: placebo
    • Percent: 7
  • Clinical Trial

    Contraindications

    • Time Period: Avoid concomitant use. Avoid thioridazine within 5 weeks of fluoxetine discontinuation.
    • Regions: US
    • With Drugs:
        • Name: Thioridazine
        • Drugbank Id: DB00679
    • Regions: US
    • With Drugs:
        • Name: Pimozide
        • Drugbank Id: DB01100
    • Time Period: Avoid initiating fluoxetine in patient's being treated with intravenous methylene blue.
    • Regions: US
    • With Drugs:
        • Name: Methylene blue
        • Drugbank Id: DB09241
    • Time Period: Avoid initiating fluoxetine in patient's being treated with linezolid.
    • Regions: US
    • With Drugs:
        • Name: Linezolid
        • Drugbank Id: DB00601
    • Time Period: Avoid administration of monoamine oxidase inhibitors (MAOI) with fluoxetine or within 5 weeks of fluoxetine discontinuation. Avoid fluoxetine within 14 days of discontinuing a MAOI.
    • Regions: US
    • With Categories:
        • Name: Monoamine Oxidase Inhibitors
        • Drugbank Id: DBCAT001004
        • Mesh Id: D008996

    Food Interactions

    Avoid alcohol.

    Take with or without food.