Fluoxetine

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Administration

  • Type: Antidepressant
  • Dosage Forms: 10mg, 20mg, 40mg
  • Routes of Administration: Oral
  • Common Trade Names: Prozac

Adult Dosing

Major depressive disorder

  • 20-80mg PO qAM
    • Start 20mg PO qAM

Obsessive-Compulsive Disorder

  • 20-60mg PO qAM
    • Start 20mg PO qAM

Bulimia nervosa

  • 60mg PO qAM

Panic Disorder

  • 20mg PO qAM

Bipolar disorder, Type I

  • 20-50mg PO qPM

Cataplexy

  • 20-60mg PO qAM

Pediatric Dosing

Major depressive disorder

  • 6-7 yo
    • 10 mg PO qd
  • 8-18 yo
    • 10-20 mg PO qd

Obsessive-Compulsive Disorder

  • 7-17 yo
    • 20-60 mg PO qd

Bipolar disorder, type I

  • 10-17 yo
    • 20-50 mg PO qd

Bulimia nervosa

  • 12+ yo
    • 20-60 mg PO qd

Insomnia

  • 10-17 yo
    • 10-20 mg PO qd

PTSD

  • 7-17 yo
    • 10-20 mg PO qd

Social Anxiety Disorder

  • 5+ yo
    • 20 mg PO qd

Cataplexy

  • 5+ yo
    • 10-40 mg PO qd

Special Populations

  • Pregnancy Rating: C; Caution advised in 3rd trimester
  • Lactation risk: Consider alternative while breastfeeding

Renal Dosing

  • Adult:
    • No adjustment
  • Pediatric:
    • No adjustment

Hepatic Dosing

  • Adult:
    • Decrease dose or frequency
  • Pediatric:
    • Decrease dose or frequency

Contraindications

  • Allergy to class/drug
  • Caution:
    • Concurrent CNS depressant use
    • Alcohol use
    • Pts < 25 yo
    • Elderly
    • Pregnancy 3rd trimester
    • Hepatic impairment
    • Poor CYP2D6 metabolizer
    • Bleeding risk
    • QT prolongation
    • CHF
    • Hypomania or mania history
  • Avoid abrupt withdrawal

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 4-6 day (parent drug) and 9.3 days (active metabolite)
  • Metabolism: Liver, CYP2C19 and CYP2D6 (primary)
  • Excretion: Urine 80% (11.6% unchanged), Feces 15%

Mechanism of Action

  • Selectively inhibits serotonin reuptake

Comments

See Also

References