Deplex
Generic Name
Fluoxetine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| deplex 5 mg capsule | ৳ 0.56 | N/A |
Description
Overview of the medicine
Deplex 5 mg Capsule contains Fluoxetine, a selective serotonin reuptake inhibitor (SSRI) used to treat depression, obsessive-compulsive disorder (OCD), bulimia nervosa, and panic disorder. This low dose may be used for titration or specific indications like Premenstrual Dysphoric Disorder (PMDD).
Uses & Indications
Dosage
Adults
Initial: 5-10 mg daily. Usual: 20 mg daily, may be increased up to 60 mg daily depending on response and indication. 5 mg capsule is often used for titration or specific indications like PMDD, where 5-10 mg daily may be prescribed.
Elderly
Lower initial doses (e.g., 5-10 mg daily) and slower titration may be required due to decreased renal and hepatic function. Maximum 60 mg daily.
Renal_impairment
No specific dosage adjustment for mild to moderate impairment. Use with caution in severe renal impairment (CrCl <10 mL/min) or consider alternative medications.
How to Take
Take orally, usually once daily in the morning, with or without food. Swallow the capsule whole with water. Do not crush or chew.
Mechanism of Action
Fluoxetine selectively inhibits the reuptake of serotonin (5-HT) into presynaptic neurons in the central nervous system, thereby increasing the concentration of serotonin in the synaptic cleft.
Pharmacokinetics
Onset
Therapeutic effects may take 2-4 weeks to become apparent.
Excretion
Primarily excreted renally.
Half life
Fluoxetine: 1-3 days; Active metabolite (norfluoxetine): 4-16 days.
Absorption
Well absorbed orally, peak plasma concentrations typically reached in 6-8 hours.
Metabolism
Extensively metabolized in the liver by cytochrome P450 enzymes (primarily CYP2D6) to norfluoxetine.
Side Effects
Contraindications
- Hypersensitivity to Fluoxetine or any component
- Concomitant use with MAO inhibitors (MAOIs) or within 14 days of discontinuing an MAOI
- Concomitant use with Thioridazine or Pimozide
- Concomitant use with Linezolid or Methylene Blue (IV)
Drug Interactions
MAOIs
Risk of serotonin syndrome (hyperthermia, rigidity, myoclonus, autonomic instability, mental status changes).
Warfarin, NSAIDs
Increased risk of bleeding due to effects on platelet function.
Thioridazine, Pimozide
Increased risk of QT prolongation and ventricular arrhythmias.
Tricyclic Antidepressants (TCAs), Antipsychotics
Increased plasma concentrations of co-administered drugs due to CYP2D6 inhibition.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms include nausea, vomiting, seizures, serotonin syndrome, agitation, and coma. Management involves symptomatic and supportive measures. Activated charcoal may be considered. Close monitoring of cardiac and respiratory function is crucial.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if potential benefit justifies potential risk to the fetus. Not recommended during breastfeeding as Fluoxetine and its metabolite are excreted into breast milk.
Side Effects
Contraindications
- Hypersensitivity to Fluoxetine or any component
- Concomitant use with MAO inhibitors (MAOIs) or within 14 days of discontinuing an MAOI
- Concomitant use with Thioridazine or Pimozide
- Concomitant use with Linezolid or Methylene Blue (IV)
Drug Interactions
MAOIs
Risk of serotonin syndrome (hyperthermia, rigidity, myoclonus, autonomic instability, mental status changes).
Warfarin, NSAIDs
Increased risk of bleeding due to effects on platelet function.
Thioridazine, Pimozide
Increased risk of QT prolongation and ventricular arrhythmias.
Tricyclic Antidepressants (TCAs), Antipsychotics
Increased plasma concentrations of co-administered drugs due to CYP2D6 inhibition.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms include nausea, vomiting, seizures, serotonin syndrome, agitation, and coma. Management involves symptomatic and supportive measures. Activated charcoal may be considered. Close monitoring of cardiac and respiratory function is crucial.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if potential benefit justifies potential risk to the fetus. Not recommended during breastfeeding as Fluoxetine and its metabolite are excreted into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, Hospitals
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of fluoxetine for its approved indications across various populations, including specific studies on mood disorders and anxiety conditions.
Lab Monitoring
- Monitor for hyponatremia, especially in elderly and those on diuretics.
- Monitor hepatic function in patients with liver impairment.
- Monitor for signs of serotonin syndrome.
Doctor Notes
- Counsel patients about delayed onset of action and the importance of continuous therapy. Emphasize that dose adjustment should only be done under medical supervision.
- Monitor for suicidal ideation, especially at the initiation of treatment or dose changes, particularly in younger patients.
- Caution advised with concomitant use of drugs affecting serotonin levels (e.g., triptans, opioids) or increasing bleeding risk (e.g., NSAIDs, anticoagulants).
- Advise patients to report any unusual symptoms or side effects promptly.
Patient Guidelines
- Take as directed by your doctor.
- Do not stop taking this medicine abruptly, as withdrawal symptoms may occur. Gradually reduce the dose under medical supervision.
- Be aware that it may take several weeks for the full antidepressant effect to be felt.
- Report any worsening of depression, suicidal thoughts, or unusual changes in behavior to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness, drowsiness, or impaired judgment. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Maintain a healthy diet and regular exercise.
- Avoid alcohol consumption.
- Engage in stress-reducing activities like meditation or yoga.
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