Состав и форма выпуска Флуоксетин капсулы: 1 капсула содержит флуоксетина 10 или 20 мг.
Фармакологические свойства
Фармакологическое действие - антидепрессивное, анорексигенное.
Показания к применению
Депрессии (независимо от степени депрессивного расстройства слабая, умеренная, тяжелая), булимия, анорексия, алкоголизм, навязчивые состояния.
Противопоказания
Атония мочевого пузыря. Выраженное нарушение функции почек. Одновременное назначение ингибиторов мао. Глаукома. Аденома предстательной железы. Судорожный синдром различного генеза. Эпилепсия. Беременность. Лактация (грудное вскармливание). Повышенная чувствительность к препарату
Применение при беременности и в период грудного вскармливания
При беременности следует назначать только в случае крайней необходимости. При использовании флуоксетина во время беременности отмечены повышение риска преждевременных родов, аномалии развития и низкая адаптация новорожденных (в т.ч. затруднение дыхания, цианоз, возбудимость).
Способ применения и дозы
При депрессиях различного генеза начальная доза Флуоксетина 20 мг 1 раз/сут в первой половине дня. При необходимости доза препарата может быть увеличена. Максимальная суточная доза - 80 мг в 2-3 приема. При булимии и для пожилых пациентов препарат назначают по 20 мг 3 раза/сут, при навязчивых состояниях - 20-60 мг/сут. Поддерживающая терапия - 20 мг/сут. Курс лечения - 3-4 нед.
Побочное действие
Со стороны ЦНС головная боль, нервозность, нарушение сна, усиление тревоги, повышеннаяутомляемость. Со стороны ЖКТ тошнота, диарея, сухость во рту, рвота, снижение аппетита. Аллергические реакции в виде кожной сыпи, ангионевротического отека, крапивницы, зуда. Прочие снижение либидо, чувство жара, гипонатриемия.
Передозировка
Симптомы: тошнота, рвота, возбуждение, беспокойство, гипомания, судороги, большие эпилептические припадки. Описано два летальных исхода от острой передозировки флуоксетина (в комбинации с мапротилином, кодеином, темазепамом). Лечение: промывание желудка, прием активированного угля, сорбита, мониторирование ЭКГ, симптоматическая и поддерживающая терапия, при судорогах - диазепам. Специфического антидота нет. Форсированный диурез, перитонеальный диализ, гемодиализ, переливание крови неэффективны.
Особые указания
У больных с сахарным диабетом возможно развитие гипогликемии во время терапии флуоксетином и гипергликемии после его отмены. На фоне проведения электросудорожной терапии возможно развитие продолжительных эпилептических припадков. После применения ингибиторов МАО назначение флуоксетина допускается не ранее 14 дней. Не следует применять ингибиторы МАО и/или тиоридазин ранее, чем через 5 недель после отмены флуоксетина. При развитии, на фоне приема флуоксетина, судорожных припадков препарат следует отменить. При лечении больных с дефицитом массы тела следует учитывать анорексигенные эффекты (возможна прогрессирующая потеря массы тела). После отмены препарата его терапевтическая концентрация в сыворотке крови может сохраняться в течение нескольких недель. Во время лечения флуоксетином не допускается прием алкогольных напитков. Прием флуоксетина может негативно сказываться на выполнении работы, требующей высокой скорости психических и физических реакций (управление механическими транспортными средствами, механизмами, работа на высоте и т.п.).
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