Shopping on line can be easy, simple and save you lots of money. It can also take a lot of your time, frustrate you, and result in unwanted purchases. Now the same can be said for regular high street shopping, but with the vast opportunity presented by the Internet it will pay you to spend a few minutes reading this and understanding how to better optimize your Fluoxetine shopping experience:

1. Compare - without doubt the biggest advantage that the Fluoxetine offers shoppers today is the ability to compare thousands of Fluoxetine at a time. This is a great thing, but not necessarily all the time! Too much can be daunting at times so take advantage of the great comparison sites and where possible let them do the hard work for you.

2. Research - if it has been said it will be on the internet. Ignorance is no longer a justifiable reason for buying the wrong thing. Take the time to research in detail everything that you could possible want to know about

3. Testimonials - don't know anybody that has bought a Fluoxetine? Wrong! If the Fluoxetine is good the internet will let you know. Use the Internet as a friend and get testimonials before you buy.

4. Questions - Got a question about Fluoxetine then search the Forums, FAQ's, Blogs etc. Don't be afraid to ask .....

5. Reputation - Never heard of the company selling Fluoxetine? Don't worry, no reason why you should know every company in the world, but you know someone that does! Use the internet to find out what people are saying about Fluoxetine and build up a picture of their reputation for sales, returns, customer service, delivery etc.

6. Returns - still worried that even after all of the above your Fluoxetine wont be what you want? Check out the returns policy. There is so much competition now that someone, somewhere is bound to offer the terms that you are comfortable with.

7. Feedback - happy with your Fluoxetine then let people know, after all you are depending on others people input in your buying decision, so why not give a little back.

8. Security - check for the yellow padlock on the Fluoxetine site before you buy, and the s after http:/ /i.e. https:// = a secure site

9. Contact - got a question about Fluoxetine, or want to leave a comment then check out the sites contact page. Reputable companies have them and respond.

10. Payment - ready to pay for your Fluoxetine, then use your credit card or PayPal! Be aware of companies that don't accept them, there may be genuine reasons but given the huge amount of choice you have when buying online there is no reason at all not to buy via credit card or PayPal.

{{drugbox || IUPAC_name = N-methyl-3-phenyl-
3--
propan-1-amine| image = Fluoxetine-2D-skeletal.png| image2 = S-fluoxetine-3D-vdW.png| width = 200| CAS_number = 54910-89-3| ATC_prefix = N06| ATC_suffix = AB03| PubChem = 3386| DrugBank = APRD00530| C=17|H=18|F=3|N=1|O=1| molecular_weight = 309.3 g/mol (345.8 for •HCl)| bioavailability = 72%
peak at 6-8 hours| protein_bound = 94.5%| metabolism = Hepatic| elimination_half-life = 1-3 days (acute); 4-6 days (chronic); Active metabolite Norfluoxetine 4-16 days (acute and chronic)| excretion = Kidneys 80%, intestines 15%| licence_EU = Fluoxetine| licence_US = Fluoxetine| pregnancy_AU = C| pregnancy_US = C| legal_status = Rx-only| routes_of_administration = Oral-->

Fluoxetine hydrochloride (Prozac) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class.

Fluoxetine is approved for the treatment of depression (including pediatric depression), obsessive-compulsive disorder (in both adult and pediatric populations), bulimia nervosa, panic disorder and premenstrual dysphoric disorder. Other indications include hypochondriasis and body dysmorphic disorder.

Despite the availability of newer agents, it remains extremely popular. Over 23.1 million prescriptions for generic formulations of fluoxetine were filled in the United States in 2006, making it the third most prescribed antidepressant.After sertraline and escitalopram, see: . Drug Topics (March 5, 2007). Retrieved on April 14, 2007.

History According to David Wong, the work which eventually led to the discovery of fluoxetine began at Eli Lilly in 1970 as a collaboration between Bryan Molloy and Robert Rathburn.

It was known at that time that antihistamine diphenhydramine shows some antidepressant-like properties. 3-Phenoxy-3-phenylpropylamine, a compound structurally similar to diphenhydramine, was taken as a starting point, and Molloy synthesized dozens of its derivatives. Testing the physiological effects of these compounds in mice resulted in nisoxetine, a selective norepinephrine reuptake inhibitor currently widely used in biochemical experiments.

Later, hoping to find a derivative inhibiting only serotonin reuptake, Wong proposed to re-test the series for the in-vitro reuptake of serotonin, norepinephrine and dopamine. This test, carried out by Jong-Sir Horng in May 1972, showed the compound later named fluoxetine to be the most potent and selective inhibitor of serotonin reuptake of the series.

A controversy ensued after Lilly researchers published a paper entitled "Prozac (fluoxetine, Lilly 110140), the first selective serotonin uptake inhibitor and an antidepressant drug" implicitly claiming fluoxetine to be the first selective serotonin reuptake inhibitor (SSRI). Two years later they had to issue a correction, admitting that the first SSRI was zimelidine developed by Arvid Carlsson and colleagues. (However, unlike its successful cousin, zimelidine was banned worldwide because of serious side effects.) Fluoxetine was the third SSRI on the market. Fluvoxamine (Luvox) had been marketed in Europe since 1983. Fluoxetine made its appearance on the Belgian market in 1986 and was approved for use by the Food and Drug Administration (FDA) in the United States in December 1987.

Eli Lilly's patent on Prozac (fluoxetine) expired in August, 2001,{{cite web|title=Patent Expiration Dates for Common Brand-Name Drugs|url = http://www.express-scripts.com/pharmacist/notifications/docs/genericdrugs.htm|accessdate=2007-07-20--> prompting an influx of generic drugs onto the market.

Pharmacokinetics The bioavailability of fluoxetine is relatively high (72%), and peak plasma concentrations are reached in 6 to 8 hours. It is highly plasma protein binding to plasma proteins, mostly human serum albumin.

Fluoxetine is drug metabolism in the liver by isoenzymes of the cytochrome P450 system, including CYP2D6. The role of CYP2D6 in the metabolism of fluoxetine may be clinically important, as there is great genetic variability in the function of this enzyme among people. Only one metabolite of fluoxetine, norfluoxetine (demethylation fluoxetine), is biologically active.

Fluoxetine is cleared slowly from the body; its elimination half-life ranges from 1 to 3 days—after a single dose—to 4 to 6 days (after long-term use) in healthy adults, and is prolonged in those with liver disease. The half-life of norfluoxetine is longer (16 days after long-term use). Complete excretion of the drug may take several weeks.

Dosing and administration Studies comparing fluoxetine 20, 40, and 60 mg/day to placebo indicate that 20 mg/day is sufficient to obtain a satisfactory response in major depressive disorder in most cases. Consequently, a dose of 20 mg/day, administered in the morning, is recommended as the initial dose.Prozac Medication Insert. Eli Lilly and Company Indianapolis, IN 46285, USA Literature revised December 4, 2006

At least 14 days should elapse between discontinuation of an MAOI and initiation of therapy with fluoxetine. In addition, at least 5 weeks, perhaps longer, should be allowed after stopping Prozac before starting an MAOI.

Fluoxetine comes in 10, 20, 40 and 60 mg capsules. Prozac Weekly comes in 90 mg capsules.

It may take 4 to 5 weeks or longer before the patient feels the full benefit of fluoxetine for most indications and even longer - up to 3 months (and perhaps in high doses - 60 mg or more), for obsessive compulsive disorder.

Side effects Fluoxetine is generally well tolerated. The most common side effects for patients taking Fluoxetine are as follows:



Anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, hypomania, and mania, have been reported in adult and pediatric patients being treated with Prozac for major depressive disorder as well as for other indications, both psychiatric and non-psychiatric. If these symptoms occur the medication should be reduced or cautiously withdrawn.

Since the introduction of fluoxetine, systemic events, possibly related to vasculitis and including Lupus erythematosus, have developed in patients with rash. Although these events are rare, they may be serious, involving the lung, kidney, or liver. Death has been reported to occur in association with these systemic events.

The simultaneous use of fluoxetine with triptans, tramadol or other serotonergic agents can result in a rare, but potentially life-threatening adverse drug reaction called Serotonin syndrome.

SSRIs such as fluoxetine have been associated with tardive dyskinesia and akathisia, among other extrapyramidal symptoms more commonly associated with antipsychotics.

Reproductive and developmental toxicity Other side effects may occur, including sexual dysfunction. Possible sexual side effects can include anorgasmia, reduced libido and impotence.

A U.S. National Toxicology Program-Center for the Evaluation of Risks to Human Reproduction expert panel concluded that the SSRI fluoxetine (Prozac) produces reproductive toxicity by causing reversible impaired sexual function and exhibits developmental toxicity characterized by an increased rate of poor neonatal adaptation.

Because fluoxetine is excreted in human milk, nursing while on fluoxetine is not recommended. The American Association of Pediatrics classifies fluoxetine as a drug for which the effect on the nursing infant is unknown but may be of concern.

Discontinuation of treatment During marketing of fluoxetine and other SSRIs and SNRI (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesia such as brain zaps), anxiety, confusion, headache, lethargy, lability, insomnia, and hypomania. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms. Patients should be monitored for these symptoms when discontinuing treatment with fluoxetine.

Suicide Rate On September 6, 2007, the Centers for Disease Control and Prevention reported suicide rate in United States adolescents (especially girls, 10 to 24 years old) increased 8% (2003 to 2004), the largest jump in 15 years. Specifically, in 2004 - 4,599 suicides in Americans ages 10 to 24, up from 4,232 in 2003, for a rate of 7.32 per 100,000 people that age. Before, the rate dropped to 6.78 per 100,000 in 2003 from 9.48 per 100,000 in 1990. The findings also reinforced the fact that antidepressant drugs reduce suicide risk. Psychiatrists found that the increase is due to the decline in prescriptions of antidepressant drugs like Prozac to young people since 2003, leaving more cases of serious Clinical_depression untreated. In a December 2006 study, The American Journal of Psychiatry said that a decrease in antidepressant prescriptions to minors of just a few percentage points coincided with a 14 percent increase in suicides in the United States; in the Netherlands, the suicide rate was 50% up, upon prescription drop. New York Times, Suicide Rises in Youth; Antidepressant Debate Looms

See also

References External links Scientific and medical

Commercial

Third-party

{{drugbox || IUPAC_name = N-methyl-3-phenyl-
3--
propan-1-amine| image = Fluoxetine-2D-skeletal.png| image2 = S-fluoxetine-3D-vdW.png| width = 200| CAS_number = 54910-89-3| ATC_prefix = N06| ATC_suffix = AB03| PubChem = 3386| DrugBank = APRD00530| C=17|H=18|F=3|N=1|O=1| molecular_weight = 309.3 g/mol (345.8 for •HCl)| bioavailability = 72%
peak at 6-8 hours| protein_bound = 94.5%| metabolism = Hepatic| elimination_half-life = 1-3 days (acute); 4-6 days (chronic); Active metabolite Norfluoxetine 4-16 days (acute and chronic)| excretion = Kidneys 80%, intestines 15%| licence_EU = Fluoxetine| licence_US = Fluoxetine| pregnancy_AU = C| pregnancy_US = C| legal_status = Rx-only| routes_of_administration = Oral-->

Fluoxetine hydrochloride (Prozac) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class.

Fluoxetine is approved for the treatment of depression (including pediatric depression), obsessive-compulsive disorder (in both adult and pediatric populations), bulimia nervosa, panic disorder and premenstrual dysphoric disorder. Other indications include hypochondriasis and body dysmorphic disorder.

Despite the availability of newer agents, it remains extremely popular. Over 23.1 million prescriptions for generic formulations of fluoxetine were filled in the United States in 2006, making it the third most prescribed antidepressant.After sertraline and escitalopram, see: . Drug Topics (March 5, 2007). Retrieved on April 14, 2007.

History According to David Wong, the work which eventually led to the discovery of fluoxetine began at Eli Lilly in 1970 as a collaboration between Bryan Molloy and Robert Rathburn.

It was known at that time that antihistamine diphenhydramine shows some antidepressant-like properties. 3-Phenoxy-3-phenylpropylamine, a compound structurally similar to diphenhydramine, was taken as a starting point, and Molloy synthesized dozens of its derivatives. Testing the physiological effects of these compounds in mice resulted in nisoxetine, a selective norepinephrine reuptake inhibitor currently widely used in biochemical experiments.

Later, hoping to find a derivative inhibiting only serotonin reuptake, Wong proposed to re-test the series for the in-vitro reuptake of serotonin, norepinephrine and dopamine. This test, carried out by Jong-Sir Horng in May 1972, showed the compound later named fluoxetine to be the most potent and selective inhibitor of serotonin reuptake of the series.

A controversy ensued after Lilly researchers published a paper entitled "Prozac (fluoxetine, Lilly 110140), the first selective serotonin uptake inhibitor and an antidepressant drug" implicitly claiming fluoxetine to be the first selective serotonin reuptake inhibitor (SSRI). Two years later they had to issue a correction, admitting that the first SSRI was zimelidine developed by Arvid Carlsson and colleagues. (However, unlike its successful cousin, zimelidine was banned worldwide because of serious side effects.) Fluoxetine was the third SSRI on the market. Fluvoxamine (Luvox) had been marketed in Europe since 1983. Fluoxetine made its appearance on the Belgian market in 1986 and was approved for use by the Food and Drug Administration (FDA) in the United States in December 1987.

Eli Lilly's patent on Prozac (fluoxetine) expired in August, 2001,{{cite web|title=Patent Expiration Dates for Common Brand-Name Drugs|url = http://www.express-scripts.com/pharmacist/notifications/docs/genericdrugs.htm|accessdate=2007-07-20--> prompting an influx of generic drugs onto the market.

Pharmacokinetics The bioavailability of fluoxetine is relatively high (72%), and peak plasma concentrations are reached in 6 to 8 hours. It is highly plasma protein binding to plasma proteins, mostly human serum albumin.

Fluoxetine is drug metabolism in the liver by isoenzymes of the cytochrome P450 system, including CYP2D6. The role of CYP2D6 in the metabolism of fluoxetine may be clinically important, as there is great genetic variability in the function of this enzyme among people. Only one metabolite of fluoxetine, norfluoxetine (demethylation fluoxetine), is biologically active.

Fluoxetine is cleared slowly from the body; its elimination half-life ranges from 1 to 3 days—after a single dose—to 4 to 6 days (after long-term use) in healthy adults, and is prolonged in those with liver disease. The half-life of norfluoxetine is longer (16 days after long-term use). Complete excretion of the drug may take several weeks.

Dosing and administration Studies comparing fluoxetine 20, 40, and 60 mg/day to placebo indicate that 20 mg/day is sufficient to obtain a satisfactory response in major depressive disorder in most cases. Consequently, a dose of 20 mg/day, administered in the morning, is recommended as the initial dose.Prozac Medication Insert. Eli Lilly and Company Indianapolis, IN 46285, USA Literature revised December 4, 2006

At least 14 days should elapse between discontinuation of an MAOI and initiation of therapy with fluoxetine. In addition, at least 5 weeks, perhaps longer, should be allowed after stopping Prozac before starting an MAOI.

Fluoxetine comes in 10, 20, 40 and 60 mg capsules. Prozac Weekly comes in 90 mg capsules.

It may take 4 to 5 weeks or longer before the patient feels the full benefit of fluoxetine for most indications and even longer - up to 3 months (and perhaps in high doses - 60 mg or more), for obsessive compulsive disorder.

Side effects Fluoxetine is generally well tolerated. The most common side effects for patients taking Fluoxetine are as follows:



Anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, hypomania, and mania, have been reported in adult and pediatric patients being treated with Prozac for major depressive disorder as well as for other indications, both psychiatric and non-psychiatric. If these symptoms occur the medication should be reduced or cautiously withdrawn.

Since the introduction of fluoxetine, systemic events, possibly related to vasculitis and including Lupus erythematosus, have developed in patients with rash. Although these events are rare, they may be serious, involving the lung, kidney, or liver. Death has been reported to occur in association with these systemic events.

The simultaneous use of fluoxetine with triptans, tramadol or other serotonergic agents can result in a rare, but potentially life-threatening adverse drug reaction called Serotonin syndrome.

SSRIs such as fluoxetine have been associated with tardive dyskinesia and akathisia, among other extrapyramidal symptoms more commonly associated with antipsychotics.

Reproductive and developmental toxicity Other side effects may occur, including sexual dysfunction. Possible sexual side effects can include anorgasmia, reduced libido and impotence.

A U.S. National Toxicology Program-Center for the Evaluation of Risks to Human Reproduction expert panel concluded that the SSRI fluoxetine (Prozac) produces reproductive toxicity by causing reversible impaired sexual function and exhibits developmental toxicity characterized by an increased rate of poor neonatal adaptation.

Because fluoxetine is excreted in human milk, nursing while on fluoxetine is not recommended. The American Association of Pediatrics classifies fluoxetine as a drug for which the effect on the nursing infant is unknown but may be of concern.

Discontinuation of treatment During marketing of fluoxetine and other SSRIs and SNRI (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesia such as brain zaps), anxiety, confusion, headache, lethargy, lability, insomnia, and hypomania. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms. Patients should be monitored for these symptoms when discontinuing treatment with fluoxetine.

Suicide Rate On September 6, 2007, the Centers for Disease Control and Prevention reported suicide rate in United States adolescents (especially girls, 10 to 24 years old) increased 8% (2003 to 2004), the largest jump in 15 years. Specifically, in 2004 - 4,599 suicides in Americans ages 10 to 24, up from 4,232 in 2003, for a rate of 7.32 per 100,000 people that age. Before, the rate dropped to 6.78 per 100,000 in 2003 from 9.48 per 100,000 in 1990. The findings also reinforced the fact that antidepressant drugs reduce suicide risk. Psychiatrists found that the increase is due to the decline in prescriptions of antidepressant drugs like Prozac to young people since 2003, leaving more cases of serious Clinical_depression untreated. In a December 2006 study, The American Journal of Psychiatry said that a decrease in antidepressant prescriptions to minors of just a few percentage points coincided with a 14 percent increase in suicides in the United States; in the Netherlands, the suicide rate was 50% up, upon prescription drop. New York Times, Suicide Rises in Youth; Antidepressant Debate Looms

See also

References External links Scientific and medical

Commercial

Third-party



Fluoxetine ( Prozac ) info
Rival perspectives on fluoxetine (Prozac)

Fluoxetine
About fluoxetine This belongs to the group of medicines known as selective serotonin re-uptake inhibitors.

intentional fluoxetine overdose - Patient UK resources
intentional fluoxetine overdose - also known as or related to intentional fluoxetine overdose (disorder) - medical resources available from Patient UK

Fluoxetine - Wikipedia, the free encyclopedia
Fluoxetine hydrochloride (Prozac) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. Fluoxetine is approved for the treatment of clinical depression ...

Fluoxetine ( Prozac )
Fluoxetine: a review on evidence based medicine by Rossi A, Barraco A, Donda P. Ann Gen Hosp Psychiatry. 2004 Feb 12;3(1):2. ABSTRACT B ackground Fluoxetine was the first molecule ...

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Prozac: a tenth anniversary celebration ... Fluoxetine tenth anniversary update: the progress continues by Stokes PE, Holtz A

Prozac (fluoxetine)
Prozac capsules and liquid contain the active ingredient fluoxetine, which is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). (NB. Fluoxetine is ...

Fluoxetine hydrochloride
Fluoxetine hydrochloride. Fluoxetine hydrochloride - Medicine Guide. Fluoxetine hydrochloride (Floo-ox-et-een hi-droh-clor-ride) is a medicine which is used in bulimia nervosa ...

Generic Fluoxetine | Turkey travel reviews | Cheap european tours ...
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fluoxetine - Hutchinson encyclopedia article about fluoxetine
Antidepressant drug that functions mainly by boosting levels of the neurotransmitter serotonin in the brain. Side effects include nausea and loss of libido.

 

Fluoxetine



 
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