Prodep - Capsule Fluoxetine - 20mg 10 Capsule(s) / Strip Sun Pharmaceutical (Bangladesh) Ltd. Introduction: Prodep is a type of antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) group of medicines. It is widely prescribed to treat depression and other mental health conditions like panic disorder and obsessive-compulsive disorder. Prodep helps many people to recover from depression by improving their mood and relieving anxiety and tension. It is also used to treat bulimia nervosa (an eating disorder), where it reduces binge-eating and purging (vomiting). The dose and how often you need it will be decided by your doctor so that you get the right amount to control your symptoms. Your doctor may start you... Uses of Prodep: DepressionPanic disorderObsessive-compulsive disorderBulimia nervosa Side effects of Prodep: Erectile dysfunctionIndigestionInfluenza like syndromeLoss of appetiteLow sexual desireNauseaSore throatSweatingTremorWeaknessYawningAbnormal dreamsDelayed ejaculationDryness in mouthInsomnia (difficulty in sleeping)NervousnessSleepinessSinus infection How to use Prodep: Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Prodep may be taken with or without food, but it is better to take it at a fixed time. How Prodep works: Prodep is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It works by increasing the levels of serotonin, a chemical messenger in the brain. This improves mood and physical symptoms of depression and also relieves symptoms of panic and obsessive disorders. Indication: Panic disorder, Obsessive compulsive disorder, Trichotillomania, Premenstrual dysphoric disorder, Major depression, Post-traumatic stress disorder, Bulimia nervosa, Body dysmorphic disorder, Binge eating disorder Administration: May be taken with or without food. Adult Dose: Oral Depression Adult: Initially, 20 mg once daily. May gradually increase up to max 80 mg daily in 2 divided doses, if no clinical response after several wk. Bulimia nervosa Adult: 60 mg daily as a single or in divided doses. Hepatic impairment: Reduce dose and/or dosing frequency. Obsessive compulsive disorder Adult: Initially, 20 mg once daily, increased up to 60 mg daily if no clinical response after several wk. Max: 80 mg daily in 2 divided doses. Premenstrual dysphoric disorder Adult: 20 mg daily continuously. Alternatively, 20 mg daily to be started 14 days before menstruation and continued until... Child Dose: Oral Depression Child: >8 yr Initially, 10 mg daily, may increase to 20 mg daily after 1-2 wk. Low wt childn: Initially, 10 mg daily, may increase to 20 mg daily after several wk, only if clinical response is insufficient. Obsessive compulsive disorder Child: >7 yr Initially, 10 mg daily, may increase to 20 mg daily after 2 wk; increase further up to 60 mg daily after several wk as necessary. Low-wt childn: Initially, 10 mg daily, may increase to 20-30 mg daily after several wk, if required. Renal Dose: Renal impairment: Use caution; drug accumulation may occur with severe renal impairment Contraindication: Severe renal or hepatic failure; hypersensitivity; lactation; concomitant MAOIs or within 2 wk of MAOI withdrawal. Mode of Action: Fluoxetine is a potent and highly selective inhibitor of serotonin (5-HT) re-uptake. No affinity for adrenoceptors or histamine, GABA-B, or muscarinic receptors. Precaution: Unstable epilepsy, liver and renal impairment, cardiac disease, diabetes, electroconvulsive therapy, bleeding disorders, closed-angle glaucoma; pregnancy. May impair performace of skilled tasks; withdraw gradually. Close monitoring of clinical worsening and behavioural changes during the 1st few mth of treatment or when there are dose changes. Lactation Excreted in milk; avoid (AAP states effect on nursing infants is unknown but may be of concern) Side Effect: >10% Headache (20-25%),Nausea (12-29%),Insomnia (10-33%),Anorexia (4-17%),Anxiety (6-15%),Asthenia (10-15%),Diarrhea (8-18%),Nervousness (8-14%),Somnolence (5-17%),Tremor (3-13%),Weakness (7-21%) 1-10% Dizziness (9%),Dry mouth (6-10%),Dyspepsia (6-10%),Sweating (5-10%),Decreased libido (2-5%),Abnormal taste (>1%),Agitation (>1%),Chest pain (>1%),Chills (>1%),Confusion (>1%),Ear pain (>1%),Hypertension (>1%),Increased appetite (>1%),Palpitation (>1%),Sleep disorder (>1%),Tinnitus (>1%),Urinary frequency (>1%),Vomiting (>1%),Weight gain (>1%) Frequency Not Defined Dysglycemia in patients with DM Risk of seizure with concomitant electroconvulsive therapy (rare) Potentially Fatal: Rarely, systemic events possibly related to vasculitis have been reported in patients with rash but may be serious involving lungs, kidney and liver. Pregnancy Category Note: Pregnancy category: C Treatment of pregnant women during the first trimester: There are no adequate and well-controlled clinical studies on the use of fluoxetine in pregnant women, but 1 prospective cohort study conducted by the European Network of Teratology Information Services reported an increased risk of cardiovascular malformations in infants born to women (N = 253) exposed to fluoxetine during the first trimester of pregnancy, compared with infants of women (N = 1359) who were not exposed to fluoxetine Use late in the third trimester associated with complications in newborns and may require prolonged hospitalization, respiratory support, and tube feeding... Interaction: May cause transient shift in plasma conc of tightly protein bound drugs e.g. warfarin and digoxin, resulting in adverse effects. T1/2 of diazepam is prolonged. Avoid concurrent use with clopidogrel. Potentially Fatal: Serious reactions when combined with MAOIs; at least 14 days should elapse after MAOIs withdrawal before starting fluoxetine treatment or at least 5 wk should elapse after fluoxetine treatment before starting MAOIs therapy. Two-fold increase in plasma levels of other antidepressants when combined with fluoxetine. Monitor lithium levels when combined.