Fluoxetine: Price, Dosage & Where to Buy

Fluoxetine is an antidepressant in the selective serotonin reuptake inhibitor (SSRI) class, commonly prescribed for major depressive disorder. It is used for both initial treatment and ongoing treatment to help maintain improvement in depression. Fluoxetine requires a prescription in the United Kingdom and is available in oral capsule, tablet and liquid forms.

Fluoxetine is indicated for initial and maintenance treatment of major depressive disorder in adults and children aged 8 to 18 years. It is also indicated for initial and maintenance treatment of obsessive compulsive disorder (OCD), including obsessions and compulsions, in adults and children aged 7 to 17 years. In adults with moderate to severe bulimia nervosa, it is used to treat binge-eating and vomiting behaviours, including ongoing maintenance treatment.

Fluoxetine is also indicated for initial treatment of panic disorder in adults, with or without agoraphobia. The continuing usefulness of treatment should be periodically reviewed by the prescriber.

The label lists oral capsules containing 10 mg, 20 mg and 40 mg, and delayed-release capsules containing 90 mg. The label lists oral tablets containing 10 mg, 20 mg and 60 mg, and liquid and solution forms containing 20 mg/5 mL. The usual starting dose is 20 mg/day in the morning for adults with major depressive disorder or OCD.

The label lists initial doses of 10 to 20 mg/day for children with major depressive disorder and 10 mg/day for children with OCD. The label lists 60 mg/day in the morning for adult bulimia nervosa and an initial dose of 10 mg/day for adult panic disorder. The label lists a maximum of 80 mg/day for adult major depressive disorder and OCD.

The label lists lower or less frequent dosing for people with hepatic impairment, older people, and those with concurrent disease or multiple medicines. Dose changes require prescriber assessment, and their full effect on blood levels may not be reflected for several weeks.

Fluoxetine belongs to a group of antidepressants called selective serotonin reuptake inhibitors. Serotonin is a chemical messenger that helps nerve cells communicate and is involved in regulating mood and emotions. After serotonin carries a message, it is normally absorbed back into the nerve cell that released it.

SSRIs reduce this reabsorption, making serotonin available for longer between nerve cells. The resulting changes in nerve signalling develop gradually, so improvement in symptoms is not necessarily immediate.

Fluoxetine should be used during pregnancy only when the potential benefit justifies the potential risk to the baby. Studies of exposure early in pregnancy have produced inconsistent findings, and a causal relationship with congenital malformations has not been established. Exposure later in pregnancy has been associated with newborn complications and a possible increased risk of persistent pulmonary hypertension.

Use in the month before delivery may increase postpartum bleeding risk. Stopping antidepressant treatment during pregnancy can increase the risk of depression returning, so decisions require individual medical assessment. Fluoxetine passes into human milk, and breast-feeding during treatment is not recommended by the label.

Fluoxetine remains in the body for a long time, so a missed dose does not mean its effects immediately disappear. Follow the missed-dose advice in the medicine leaflet or ask a pharmacist, especially if the formulation or schedule is unclear. A missed dose should not be compensated for with a double dose.

The label specifies storage at 20° to 25°C and protection from light. It specifies a tight, light-resistant container with a child-resistant closure to maintain quality and limit access by children.