Nodep
Generic Name
Fluoxetine
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nodep 20 mg capsule | ৳ 3.00 | ৳ 30.00 |
Description
Overview of the medicine
Nodep 20 mg Capsule contains Fluoxetine, a selective serotonin reuptake inhibitor (SSRI) antidepressant used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, and bulimia nervosa.
Uses & Indications
Dosage
Adults
Major Depressive Disorder: Initially 20 mg once daily, usually in the morning. May increase after several weeks if no clinical improvement. Max 80 mg/day.
Elderly
Lower starting doses (e.g., 10 mg/day) and slower titration may be considered due to potential for decreased clearance.
Renal_impairment
No dosage adjustment needed for mild to moderate impairment. Use with caution in severe impairment.
How to Take
Take orally, with or without food. Can be taken once daily, usually in the morning. Swallow the capsule whole, do not crush or chew.
Mechanism of Action
Fluoxetine selectively inhibits the reuptake of serotonin (5-HT) by the presynaptic neuron, thereby increasing the concentration of serotonin in the synaptic cleft and enhancing serotonergic neurotransmission in the central nervous system.
Pharmacokinetics
Onset
Therapeutic effects may take 2-4 weeks to manifest.
Excretion
Primarily excreted in urine (about 60% as metabolites).
Half life
Fluoxetine: 1-3 days; Norfluoxetine (active metabolite): 7-15 days.
Absorption
Well absorbed orally, peak plasma concentrations typically reached in 6-8 hours.
Metabolism
Extensively metabolized in the liver by CYP2D6 to norfluoxetine (active) and other inactive metabolites.
Side Effects
Contraindications
- Concomitant use with MAOIs (Monoamine Oxidase Inhibitors) or within 14 days of discontinuing MAOIs
- Hypersensitivity to Fluoxetine or any component of the formulation
- Concomitant use with Pimozide or Thioridazine
Drug Interactions
MAOIs
Risk of serious, sometimes fatal, reactions including serotonin syndrome.
Triptans
Increased risk of serotonin syndrome.
Pimozide/Thioridazine
Risk of QT prolongation and cardiac arrhythmias.
Warfarin/Anticoagulants
Increased risk of bleeding.
Tricyclic Antidepressants (TCAs)
May increase plasma levels of TCAs.
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, cardiovascular dysfunction (ranging from asymptomatic arrhythmias to ECG changes), and CNS excitation. Treatment is supportive and symptomatic; maintain airway, monitor cardiac and vital signs. Activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Fluoxetine is excreted in breast milk; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Concomitant use with MAOIs (Monoamine Oxidase Inhibitors) or within 14 days of discontinuing MAOIs
- Hypersensitivity to Fluoxetine or any component of the formulation
- Concomitant use with Pimozide or Thioridazine
Drug Interactions
MAOIs
Risk of serious, sometimes fatal, reactions including serotonin syndrome.
Triptans
Increased risk of serotonin syndrome.
Pimozide/Thioridazine
Risk of QT prolongation and cardiac arrhythmias.
Warfarin/Anticoagulants
Increased risk of bleeding.
Tricyclic Antidepressants (TCAs)
May increase plasma levels of TCAs.
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, cardiovascular dysfunction (ranging from asymptomatic arrhythmias to ECG changes), and CNS excitation. Treatment is supportive and symptomatic; maintain airway, monitor cardiac and vital signs. Activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Fluoxetine is excreted in breast milk; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the date of manufacture.
Availability
Available in pharmacies
Approval Status
Approved by regulatory authorities
Patent Status
Off-patent (generic available)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established Fluoxetine's efficacy and safety for its approved indications. Ongoing research continues to explore its use in other conditions.
Lab Monitoring
- No routine lab monitoring is generally required. However, monitor sodium levels in patients at risk for hyponatremia. Liver and renal function tests may be considered in patients with pre-existing conditions.
Doctor Notes
- Educate patients about the delayed onset of action and the importance of continuous therapy.
- Monitor for signs of suicidality, especially at the initiation of treatment or during dose adjustments.
- Assess for potential drug interactions, especially with MAOIs and other serotonergic agents.
Patient Guidelines
- Take as directed by your doctor.
- Do not stop taking this medicine suddenly without consulting your doctor, as withdrawal symptoms may occur.
- It may take several weeks to feel the full benefits.
- Report any worsening of depression or suicidal thoughts to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
May cause dizziness or drowsiness. Exercise caution when driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Avoid alcohol consumption.
- Engage in regular exercise and maintain a healthy diet.
- Practice stress management techniques.
- Ensure adequate sleep.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.