Fluotex

Fluotex - Depression | Obsessive-Compulsive

This article was medically reviewed by M.Pharm, Marko Tanaskovic on August 12, 2018. To read more about an author, click here.

Fluotex is a medicine that contains fluoxetine as an active substance. It belongs to the selective serotonin reuptake inhibitors. It works by increasing serotonin levels in the blood, which improves mood and symptoms of depression.

Fluotex is used to treat major depressive episodes (so-called major depression), obsessive-compulsive disorders, and a condition called bulimia nervosa (pathological overeating).

Warnings and precautions

Fluotex is contraindicated in patients who are taking or have recently taken (in the past 2 weeks) monoamino oxidase inhibitors because the concomitant use with these medicines increases the risk of serotonin syndrome. If you have been using an MAO inhibitor, it is necessary to wait at least 5 weeks before you can start using Fluotex. Symptoms of serotonin syndrome are anxiety, tachycardia (rapid heart rate), hypertension (high blood pressure), diarrhea, increased sweating, confusion, headache and fever. Serious forms of serotonin syndrome include arrhythmias which can endanger the patient's life!

Symptoms similar to those of neuroleptic-malignant syndrome (NMS-like symptoms) have also been reported, such as: dysphagia, hyperthermia, difficulty breathing, and tremor. The risk of serotonin and NMS-like symptoms is significantly higher in patients who are already taking other drugs, such as:

  • Triptans - medicines used for the treatment of migraine, such as: sumatriptan, almotriptan, rizatriptan, eletriptan, zolmitriptan, and others.
  • MAO inhibitors, such as moclobemide, linezolid, isocarboxamide, tranylcypromine, selegiline, and phenelzine.
  • 5-hydroxytryptophan - a medicine used to suppress appetite and as an antidepressant.
  • 5-HT3 receptor antagonists - medicines used for the prevention of nausea caused by chemotherapy, such as: dolasetron, palosetron, granisetron, ondansetron, and others.
  • Opioid analgesics, such as: pentazocine, tramadol, alfentanil, fentanyl, and others.
  • Ergotamine and its derivatives.

For this reason, concomitant administration with these drugs is absolutely contraindicated.

Studies have shown that Fluotex can increase the risk of suicidal thinking in patients under the age of 18. If you are experiencing suicidal thoughts, you must contact your doctor immediately. The patient's family should also be alert and watch for worsening depression and suicidal thoughts.

Sometimes, this medicine can cause a worsening of depression symptoms. If you are experiencing a worsening of symptoms, you should contact your doctor immediately.

Fluotex must be used with caution in the following conditions:

  • Epilepsy.
  • Diabetes.
  • Cardiac diseases.
  • Impaired liver function.
  • History of suicidal thoughts.

Fluotex, Pregnancy and Breastfeeding

A prospective study published in the British Journal of Clinical Pharmacology examined the effects of fluoxetine during pregnancy. In one group, 253 pregnant women have used fluoxetine during pregnancy and in another group, 1359 pregnant women have not used this medication during pregnancy. An increased risk of cardiovascular malformations in the fetus was observed in the group who used fluoxetine. There is an increased risk of persistent pulmonary hypertension in the newborns if this medicine is used during the last trimester of pregnancy.

Therefore, Fluotex should only be used during pregnancy if your gynecologist estimates that the benefit to you is greater than the potential risk for the fetus.

You must stop breastfeeding while taking this medicine.

Dosage

Fluotex comes in the form of hard capsules and the recommended initial dose for depression treatment is 20 mg once daily. The dose may be gradually increased until the appropriate effect is achieved. Keep in mind that it takes some time (about 4 weeks) for this medicine to start working. The therapy is long-lasting and usually lasts at least 6 months.

Usual recommended dose in the treatment of bulimia nervosa is 60 mg daily, while the recommended dose in the treatment of obsessive-compulsive disorders is 20-60 mg daily.

Interactions

Beside the interactions mentioned earlier (see Precautions), Fluotex should not be administered concurrently with any of the following drugs:

  • Dextromethorphan - a medicine used to treat cough. Fluotex can increase the effects of dextromethorphan, which increases the risk of side effects (dizziness, difficulty breathing and drowsiness).
  • Tricyclic antidepressants, such as: doxepin, amitriptyline, imipramine, amoxapine, and nortriptyline. Simultaneous administration with these medicines increases the risk of side effects, such as blurred vision, sedation, confusion, muscle coordination, high blood pressure, and tachycardia.
  • Amphetamine - a medicine used to treat narcolepsy. Fluotex can increase the effect of this medicine, which increases the risk of side effects such as nervousness and anxiety. Simultaneous administration also increases the risk of serotonin syndrome.
  • Sotalol - a medicine used to treat arrhythmias. Simultaneous administration with this medicine increases the risk of arrhythmias.
  • Bepridil - a medicine used to treat angina. Simultaneous administration with this medicine increases the risk of arrhythmias.
  • Non-steroidal anti-inflammatory drugs, such as: ibuprofen, ketoprofen, diclofenac, flurbiprofen, indomethacin, sulindac, and others. Simultaneous administration increases the risk of bleeding.
  • Anticoagulant drugs, such as warfarin. Simultaneous administration increases the risk of bleeding.
  • Pimozide - antipsychotic drug. Simultaneous administration can lead to serious arrhythmias, and is therefore absolutely contraindicated.
  • Thioridazine - a medicine used to treat schizophrenia. Thioridazine should not be used within 5 weeks of discontinuation of Fluotex capsules. Simultaneous administration may increase blood concentrations of thioridazine in the blood, which increases the risk of serious cardiac arrhythmias that may have a fatal outcome!
  • Benzodiazepines, such as: diazepam and alprazolam. Fluotex increases the concentration of these drugs in the blood which increases the risk of side effects.
  • Drugs used to treat epilepsy, such as: phenytoin and carbamazepine. Fluotex increases the concentration of these drugs in the blood, thus increasing the risk of side effects.

It is very important to inform your doctor about all the medicines you are taking, as Fluotex can interact with many medications.

Side effects

Fluotex can cause the following side effects:

  • Serotonin syndrome.
  • Symptoms similar to neuroleptic-malignant syndrome.
  • Diarrhea.
  • Stomach pain.
  • Hepatitis.
  • Anxiety.
  • Confusion.
  • Suicidal thoughts.
  • Hallucinations.
  • Difficulty in urinating.
  • Sore throat.
  • Decreased appetite.
  • Insomnia.
  • Arthralgia and myalgia.

Tell your doctor if you are experiencing any side effects.

References

  1. FDA
  2. NCBI

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