API

Fluoxetine (20mg)

Drug classification

Antidepressant (selective serotonin reuptake inhibitor, SSRI)

Dosage form

Tablet

API strength per dosage

20 mg

Dose

Adults: 20 mg once daily, may increase after several weeks if needed (maximum 60 mg/day). Pediatrics (≥8 years, depression): Start 10 mg once daily, may increase to 20 mg after 1–2 weeks. Elderly/hepatic impairment: Start at lower doses; titrate cautiously.

Mechanism of action

Selectively inhibits the serotonin transporter (SERT), blocking presynaptic reuptake of serotonin (5-HT) in the central nervous system, thereby increasing synaptic serotonin concentrations and enhancing serotonergic neurotransmission. No significant direct action on norepinephrine or dopamine transporters, nor on monoamine oxidase enzymes.

Indications

Treatment of DepressionTreatment of Panic disorderTreatment of Obsessive-compulsive disorder

Side effects

Erectile dysfunction Indigestion Influenza like syndrome Loss of appetite Depression Low sexual desire Nausea Sore throat Sweating Tremors Weakness Yawning Abnormal dreams Delayed ejaculation Dryness in mouth Insomnia difficulty in sleeping Nervousness Sleepiness Sinus infection

Pregnancy category

Precautions

History of seizures, bipolar disorder, suicidal ideation, hepatic impairment, diabetes, bleeding disorders, concomitant MAOIs or serotonergic drugs, pregnancy, breastfeeding, abrupt discontinuation, angle-closure glaucoma, hyponatremia risk, elderly patients, QT prolongation, driving or operating machinery, monitor for serotonin syndrome.

Contraindications