Nilkey Davipharm tablets treat depression, panic syndrome (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Fluoxetin

Ingredient

Composition information	Content
Fluoxetin	20mg

Uses

indications

nylkey drugs are indicated in the following cases:

Depression.

Panic syndrome.

Invisible food.

Rape - obsessive impulsive disorders. The main metabolites of fluoxetin, norfluoxetin, has the same effect as fluoxetin, so the effectiveness increases very strong serotonin levels.

Although fluoxetin has the effect of rapidly increasing the serotonin concentration at the Serotoninergic slot of nerve cells, the effectiveness of improving the clinical symptoms of depression in the patient is very slow, usually from 3-5 weeks, so severe depression can not be relieved right after taking this drug.

Unlike old 3 -round antidepressants or a few other antidepressants, with Fuoxetin treatment dose only selectively inhibit the Serotonin recovery channel that has little effect on other receptors such as cheolinergic resistance, α1 - adrenergic blockers or histamine resistance. Therefore, the risk of side effects due to cholinergic resistance (dry mouth, blurred vision, urinary retention, constipation), α1 - adrenergic blockers (vertical posture hypotension) or antihistamine (drowsiness) rarely encountered when using Fluoxetin treatment.

pharmacokinetics

fluoxetin is well absorbed in the digestive tract after drinking and reaching the maximum concentration after 6 - 8 hours. Oral bioavailability is about 95%, food does not affect the absorption process of the drug.

Fluoxetin is widely distributed throughout the body and highly linked to plasma proteins (approximately 95%). And about 35 liters/kg. The drug is strongly metabolized in the liver by the CYP2D6 enzyme to Norfuoxetin is an active metabolic substance. Both fluoxetin and norfluoxetin are very slowly eliminated through the urine.

Fluoxetin's half -life, after using the only dose, about 2-3 days and norfluoxetin is 7-9 days, but after the reminded dose, the exhaust rate decreases, the half -life of Fluoxetin increases to about 4-5 days. Do not see half -life changes significantly in the elderly or patients with renal function when using Fluoxetin single dose.

However, because the drug has a relatively long and non -linear -lifetime drug after long -term use, the only dose study is not enough for the type of pharmacological ability to change in the elderly or the person who reduces the kidney function. People with alcoholic cirrhosis have half -life longer, nearly double in normal people.

The half -life change mechanism of the drug when reminded of the dose is due to fluoxetin inhibits the liver enzyme cytochrom P450 2D6. This is especially important for patients with very low liver enzymes, and this manifestation is transmitted. Patients with CYP 2D6 enzyme deficiency usually have half -life elimination and the area below the curve is tripled than normal people.

Before taking Nilkey Davipharm tablets treat depression, panic syndrome (10 blisters x 10 tablets)

How to use

fluoxetin is often used by oral.

Dosage

Treatment of depression

The starting dose is usually 20 mg/day, taken once in the morning. Some patients may take lower doses (ie 5 mg/day or 20 mg 2 or 3 days/1 time).

The maintenance dose is changed according to the clinical response of each person. Usually after a few weeks to achieve adequate treatment effect, so do not increase the dose regularly.

Treatment of panic syndrome

The starting dose is 10 mg/day, taking 1 time in the morning. After 1 week of treatment may increase the dose to 20 mg/day. If there is no sign of improvement in a few weeks of treatment, Fuoxetin dose can be increased to 60 mg/day.

Invisible food treatment

Dosage immediately 60 mg/day can be taken once in the morning or divided into several times a day.

Treatment of rapist impulse syndrome

The dose starts 20 mg/day as above. It takes a few weeks to achieve adequate treatment. The dose over 20 mg must be divided into 2 times, morning and afternoon. Some cases may need high doses of up to 80 mg/day, but it is important to always take a few weeks (4-6 weeks) to achieve treatment results with 1 given dose.

For the elderly and people with liver failure, it is necessary to reduce the initial dose and reduce the rate of dose growth. There is a risk of accumulating fluoxetin and metabolites in patients with renal function, so it is necessary to consider adjusting the dose for patients with renal impairment.

Safe and effective for children (

Elderly people usually start 10 mg daily and not exceed 60 mg per day.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose? When overdose, the symptoms are mainly nausea and vomiting. The symptoms are also provoked, mildly revived and the central nervous stimulation signs.

Handling

Mainly treat symptoms and support. Can be used for active carbon and sorbitol. Maintain respiration, heart activity and body temperature. If necessary, use anti -convulsions like diazepam. Measures of mandatory blood, mandatory diuretic or blood changes may not be effective due to large bundled integral and highly linked with protein.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using nilkey, you may experience some unwanted effects (ADR).

Common, ADR> 1/100

Neurological: fatigue, dizziness, sweating, impotence, unable to ejaculate, reduce sex.

Mental: restlessness, insomnia, fear. digestive: nausea, diarrhea, anorexia.

Skin and subcutaneous tissue: skin rash, itching, tremor.

Uncommon, 1/1000

Neurological: headache.

digestive: vomiting, digestive disorders, dry mouth.

Skin and subcutaneous tissue: urticaria.

Steamed cough: bronchospasm/Hen -shaped reaction.

urinary tract: urinary retention.

Rare, ADR

Neurological: fainting, suburban reactions, movement disorders, Parkinson's syndrome, paresthesia, epilepsy, serotonin syndrome.

skin and subcutaneous tissue: lumpy, pustules, rash, lupus erythematosus, hepatitis, jaundice.

Respiratory: Pulmonary fibrosis, laryngeal edema.

Metabolism: Hemorrhage reduction.

immune: serum disease. Cardiovascular: arrhythmia, fast vessels, vasculitis.

Endocrine: Reduce or increase thyroid function, increase blood prolactin, masculine breast enlargement, dairy secretion.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

plastic contraindicated in the following cases:

Hypersensitivity to fluoxetin or any ingredients of the drug.

The patient is taking Mao inhibitors (using these two drugs must be at least 5 weeks apart).

People with a history of epilepsy.

breastfeeding women.

Be cautious when used

Avoid using the drug simultaneously with monoamin oxydase inhibitors (Mao). Only start to use Mao inhibitors when fluoxetin has been completely eliminated (at least 5 weeks). Be careful to reduce the dose for patients with liver disease or reduce liver function.

Fluoxetin should be cautious when used for children or teenagers under 18 years of age because the drug is related to suicide behavior (intentionally suicide or suicide).

The drug can cause drowsiness, reduce the ability to consider, judge, think or mobilize, so be careful when driving, operating the machine or jobs that need to be alert.

The drug can cause dizziness or headache, so do not stand up suddenly while in a lying position or sitting.

Fluoxetin can cause hypoglycemia in diabetes patients.

Caution for patients with a history of epilepsy, due to fluoxetin can lower the threshold of epilepsy.

The ability to drive and operate machinery

The drug can cause drowsiness, reduce the ability to consider, judge, think or mobilize, so be cautious when driving, operating the machine or jobs that need to be alert.

Pregnancy

The safety of fluoxetin for pregnant women has not been determined; This drug must be avoided during pregnancy, unless there is no other drug.

The period of breastfeeding

fluoxetin and norfluoxetin are distributed into breast milk, so it can affect breastfed babies. Fluoxetin should not be used for mothers who are breastfeeding or should not breastfeed while taking the drug.

Drug interaction

should not be used simultaneously fluoxetin with monoamine inhibitors such as furazolidon, processbazin and Selegilin, because they can cause confusion, agitation, symptoms in the digestive tract, high fever, severe seizures or hypertension attacks.

Fluoxetin strongly inhibits the liver enzymes cytochrom P450 2D6. Simultaneous treatment with metabolic drugs thanks to this enzyme and narrow treatment index (for example, Flecainid, Encainid, Vinblastin, Carbamazepin and 3 -round antidepressants) must start or adjust these drugs at low doses. This also applies if fluoxetin was used within the previous 5 weeks.

Using fluoxetin with serotonin release stimulants can cause serotonin syndrome such as agitation, hallucinations, coma, body temperature, nausea, vomiting, diarrhea. The concentration of 3 -round antidepressants, Maprotilin or Trazodon in plasma can be doubled when used simultaneously with fluoxetin. Some physicians recommend reducing about 50% of the dose of these drugs when used simultaneously with fluoxetin.

Simultaneous use of Fluoxetin with Diazepam can last half -life of diazepam in some patients, but physiological and mental mental response may not be affected.

Electric shock treatment: Prolonged convulsions when treated simultaneously with fluoxetin. Concomitant use with neurological effects may increase the risk of side effects. Legged drugs with plasma proteins such as anticoagulants, digitalis or digitoxin, simultaneously used with fluoxetin may be out of the protein bonding position, increasing the concentration of freelance drugs in plasma and increased side effects.

Phenytoin concentration may be increased when used simultaneously with fluoxetin, leading to poisoning, so closely monitoring phenytoin concentrations in plasma.

Use fluoxetin simultaneously with lithiums that can or increase or decrease the level of lithium in the blood, and there have been cases of lithium poisoning occurred. Therefore, lithium concentration should be monitored.

Storage

In a dry place, avoid light, the temperature does not exceed 30 ° C.

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