Fluoxetine Hydrochloride: Brands, Price & Uses in Bangladesh

Fluoxetine Hydrochloride is a selective serotonin reuptake inhibitor (SSRI) indicated for the treatment of the following conditions, with evidence strength varying by indication:

Established / Approved Indications

• Major Depressive Disorder (MDD): for the acute and maintenance treatment of major depressive episodes in adults and pediatric patients aged 8 years and older.
• Obsessive-Compulsive Disorder (OCD): for the treatment of obsessions and compulsions in adults and pediatric patients aged 7 years and older.
• Bulimia Nervosa: for the reduction of binge-eating and purging behaviors in adults.
• Panic Disorder: with or without agoraphobia, in adults.
• Premenstrual Dysphoric Disorder (PMDD): for management of PMDD symptoms in women.

Combination-Therapy Indications

• Bipolar I Disorder (Depressive Episodes): in combination with olanzapine, as a specific labeled combination regimen.
• Treatment-Resistant Depression: in combination with olanzapine, for depression that has not responded to at least two separate trials of different antidepressants at adequate dose and duration.

Fluoxetine Hydrochloride should only be used for these indications under the supervision of a qualified physician, who will confirm the diagnosis and select the appropriate regimen.

Dosage of Fluoxetine Hydrochloride must be individualized by a physician based on the indication, patient response, and tolerability. Representative adult dosing by indication is summarized below.

Pediatric Dosing

For MDD (age 8 and above) and OCD (age 7 and above), treatment is usually initiated at a low dose (e.g., 10 mg/day) with gradual titration by the physician based on weight, response, and tolerability. Pediatric use for other indications is not established.

Hepatic Impairment

A lower dose or less frequent dosing schedule should be used in patients with hepatic impairment, as clearance of Fluoxetine Hydrochloride and its active metabolite is reduced.

Administration

Fluoxetine Hydrochloride may be taken with or without food. Doses above 20 mg/day may be divided (morning and noon) to reduce nausea and insomnia. Capsules/tablets should be swallowed whole; the oral solution should be measured with an accurate measuring device.

Do not stop, increase, decrease, or share this medicine with others without consulting your physician. Abrupt discontinuation after prolonged use should be avoided; if discontinuation is necessary, the dose should be tapered gradually under medical supervision.

Common and clinically important side effects of Fluoxetine Hydrochloride include:

• Very common/common: nausea, headache, insomnia, somnolence, nervousness/anxiety (particularly early in treatment), diarrhea, dry mouth, excessive sweating, tremor, decreased appetite, and sexual dysfunction (decreased libido, delayed ejaculation, anorgasmia).
• Weight changes: weight loss is more common with short-term use; long-term use has been associated with weight changes in either direction.
• Serious but less common: serotonin syndrome (agitation, hallucinations, rapid heart rate, fever, muscle rigidity), abnormal bleeding, activation of mania/hypomania in patients with bipolar disorder, seizures, angle-closure glaucoma, hyponatremia (particularly in elderly patients), and allergic reactions/rash.
• Important safety warning: Fluoxetine Hydrochloride, like other antidepressants, carries an increased risk of suicidal thinking and behavior in children, adolescents, and young adults (up to age 24), particularly during the first few months of treatment or after dose changes. Patients of all ages should be monitored closely for worsening depression, unusual changes in behavior, or emergence of suicidal thoughts.

Because Fluoxetine Hydrochloride and its active metabolite have a long half-life, side effects and interactions may take longer to appear or resolve compared with other SSRIs.