FLUTIN
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Description

Composition
Each capsule contains:
Fluoxetine hydrochloride equivalent to 20 mg Fluoxetine base.

Therapeutic Indications
FLUTIN is indicated for the treatment of :
Depression.
Obsessive-Compulsive Disorder (OCD).
Fluoxetine has been investigated in treatment of obesity and bulimia nervosa.

Dosage and Administration
(For Adults Only).
Depression:
Recommended initial dose is 20 mg/day in the morning. Consider a dose increase after several weeks if there is no clinical improvement up to 80 mg/day which is the maximum daily dose.
Obsessive-Compulsive Disorder (OCD):
Recommended initial dose is 20 mg/day in the morning. Consider a dose increase after several weeks if there is no clinical improvement up to 60 mg/day.
Obesity and Bulimia nervosa: Fluoxetine has been investigated in treatment of at a dose of 20-60 mg/day.
FLUTIN should be given in a lower dose e.g.: alternate day dosing in patients with significant hepatic dysfunction or mild to moderate renal failure.

Contraindications
Hypersensitivity to fluoxetine.
Cases of severe hepatic or renal function impairment.
Warnings and Precautions
FLUTIN should be used with caution in patients with epilepsy and should be discontinued in any patient who develops seizures.
FLUTIN may alter glycaemic control.
Hypoglycaemia may occur during therapy with Flutin and hyperglycaemia may occur following discontinuation. Insulin and/or oral hypoglycaemic dosage may need to be adjusted when FLUTIN is started or discontinued.
FLUTIN should be avoided during pregnancy and lactation. Fluoxetine studies on pregnant or nursing mothers have not yet been established, so it is used only if clearly needed.

Drug Interactions
At least 2 weeks should elapse between discontinuation of a MAOI and initiation of therapy with FLUTIN. Also 5 weeks should elapse between discontinuation of FLUTIN and initiation of therapy with MAOI.
Concurrent use of FLUTIN with tricyclic antidepressants and Trazodone results in increase in their plasma concentrations.
Concurrent use of FLUTIN and lithium may increase lithium level with possible neuxotoxicity. Lithium level should be monitored.
Concurrent use of FLUTIN and Dextromethorphan may result in hallucinations.
The half-life of concurrently administered diazepam with fluoxetine) can be prolonged. Also Fluoxetine has been reported to increase alprazolam plasma concentration which may be accompanied by increased psychomotor impairment.
As FLUTIN metabolism involves the hepatic cytochrome P450 2D6, concomitant therapy with drugs also metabolised by this enzyme system results in increase in their serum concentrations and their dose should be adjusted when beginning or discontinuing FLUTIN treatment e.g.: as with antipsychotics, beta-blocker: metoprolol and Type 1C antiarrhythmics: propafenone, flecanide and encainide.