What Are the Signs of a Prozac Overdose?

Chemical name: (+)-N-methyl-3- (p-trifluoromethylphenoxy) -3-phenylpropylamine hydrochloride.
Chemical Structure:

Baiyoujie (Fluoxetine Hydrochloride Capsule), the indications are depressive episode; obsessive-compulsive disorder; bulimia nervosa.

Drug Name

Best solution?

Drug type

Prescription drugs, medicines for medical workers' injuries

Use classification

Selective serotonin reuptake inhibitors

Biosol ingredients

Chemical name: (+)-N-methyl-3- (p-trifluoromethylphenoxy) -3-phenylpropylamine hydrochloride.
Chemical Structure:

Molecular formula: C ₁₇ H ₁₈ F ₃ NO · HCl
Molecular weight: 345.79

Baiyou Solution

This product is a hard capsule with a white powder content.

Bionic Solution Indications

Depressive episodes; Obsessive-compulsive disorder; Bulimia nervosa.

Biomax Specifications

20mg (as fluoxetine).

Dosage of Baiyou Solution

For oral administration in adults.

Depression

Adults and elderly patients: 20mg daily is recommended. If necessary, the dose of the drug is evaluated and adjusted within the first 3 to 4 weeks of treatment to achieve a clinically appropriate dose. Although higher doses may increase the possibility of adverse reactions, in some patients, as the 20 mg dose has no obvious effect, the dose can be gradually increased to the maximum dose of 60 mg (see [Clinical Trials]). Dosage adjustments must be done carefully according to the condition of each patient to maintain the lowest effective dose for the patient.

People with depression must continue treatment for at least 6 months to ensure that their symptoms disappear.

OCD

Adults and elderly patients: The recommended dose is 20 mg per day. For some patients, if the response to the 20 mg dose is insufficient after two weeks of treatment, the dose can be gradually increased to reach the maximum dose of 60 mg, but increasing the dose will increase the possibility of adverse reactions.

If no improvement is found within 10 weeks, the treatment of fluoxetine must be reconsidered. If a good therapeutic effect is obtained, the treatment can be continued, but the dosage should be adjusted according to the individual. Although there is no systematic research on how long fluoxetine treatment needs to be maintained, OCD is a chronic condition, and patients who are effective for treatment may consider extending the treatment period to more than 10 weeks. Dosage adjustments must be done carefully according to the condition of each patient to maintain the lowest effective dose for the patient. The need for treatment must be reassessed regularly. Some clinicians have advocated a combination of behavioral therapy for patients who are effective with medications. The long-term efficacy (over 24 weeks) of fluoxetine in the treatment of OCD has not been validated.

Bulimia nervosa

Adults and elderly patients: 60mg daily is recommended. Long-term efficacy (over 3 months) in patients with bulimia nervosa has not been validated.

All indications: The recommended dose can be increased or decreased as appropriate. No systematic evaluation was performed for doses above 80 mg per day.

Fluoxetine can be taken at meals or between meals and can be given in single or divided doses.

After discontinuation of the medication, the active ingredients remained in the body for several weeks. This feature must be considered at the beginning and end of treatment.

Children: Since the safety and efficacy of use in children and adolescents (under 18 years) are not yet clear, it is not recommended for use in this group.

Elderly patients: Be careful when increasing the dose, usually the daily dose should not exceed 40mg.

The maximum recommended dose is 60 mg per day.

For patients with hepatic insufficiency (see [Pharmacokinetics]) or patients taking drugs that may interact with Bioglycem® (see [Drug Interactions]), consideration should be given to reducing the dosage or frequency of medications (for example, every 2 20mg daily).

Withdrawal symptoms of discontinuation of Baiyoujie®: You must avoid abrupt withdrawal. In order to reduce the risk of withdrawal reactions (see [Precautions] and [Adverse Reactions]), the dosage of Baiyoujie® must be gradually reduced within 1 to 2 weeks when the treatment of Baiyoujie® is stopped. If the patient develops intolerance after the dose is reduced or when treatment is discontinued, consideration may be given to resuming the previous dose. After that, doctors can continue to reduce the dose at a more modest rate.

Baiyou solution for adverse reactions

As continuous treatment may reduce the intensity and frequency of adverse reactions, adverse reactions generally do not result in interruption of treatment.

Like other SSRIs, the adverse reactions are as follows:

Systemic: allergies (eg, pruritus, rash, rubella, allergic reactions, vasculitis, serum reactions, facial edema, etc.)-(see [Contraindications] and [Warnings]), chills, serotonin syndrome, photosensitivity, toxic epidermis Necrotic lysis (Lyell syndrome) is very rare, with erythema polymorphic.

Digestive system: gastrointestinal disorders (eg diarrhea, nausea, vomiting, indigestion, difficulty swallowing, upset taste), dry mouth. Abnormal liver function tests are rarely reported, and hepatitis is rarely reported.

Nervous system: headache, abnormal sleep (e.g., abnormal dreams, insomnia), dizziness, anorexia, fatigue (e.g., drowsiness, drowsiness), euphoria, transient motor abnormalities (e.g., convulsions, ataxia, tremor, myoclonus) ), Seizures and rare psychotic restlessness / sedation (see [Precautions]). Hallucinations, manic reactions, confusion, agitation, anxiety and related symptoms (e.g., nervousness), diminished attention and thinking ability (e.g., disintegration of personality), panic attacks, suicidal ideas and behaviors (these symptoms can be caused by underlying diseases ), Serotonin syndrome is very rare.

Genitourinary system: urinary retention, frequent urination.

Reproductive disorders: sexual dysfunction (delayed or lack of ejaculation, lack of orgasm), persistent penile erection, lactation.

Others: hair loss, yawning, visual abnormalities (eg, blurred vision, dilated pupils), bruising (see [Notes]), sweating, vasodilation, arthralgia, myalgia, orthostatic hypotension, ecchymosis, others Hemorrhagic manifestations (eg, gynecological bleeding, gastrointestinal bleeding, and other skin or mucosal bleeding) are rarely reported (see [Caution], bleeding).

Transient hyponatremia: Very few patients develop transient hyponatremia (including blood sodium below 110mmol / L) and stop reversing when fluoxetine is discontinued. In some cases, it may be caused by imbalance of secretion of antidiuretic hormone. Most reports have been found in the elderly, patients taking diuretics, or patients with other causes of fluid depletion.

Respiratory system: pharyngitis, difficulty breathing. Pulmonary adverse events, including different histopathological inflammatory processes and / or fibrosis, are rarely reported. Dyspnea may be the only symptom that comes first.

Withdrawal symptoms when fluoxetine treatment is stopped: Withdrawal of fluoxetine usually results in withdrawal symptoms. Dizziness, sensory disturbances (including paresthesias), sleep disturbances (including insomnia and dreaming), fatigue, anxiety or anxiety, nausea and / or vomiting, tremors and headaches are the most commonly reported adverse reactions. These symptoms are generally mild to moderate and self-limited, however in some patients these symptoms may be severe and / or prolong the remission time (see [Precautions]). Therefore, it is recommended to reduce the dose gradually when Baiyoujie® treatment needs to be stopped (see [Dosage and Administration] and [Precautions]).

Baiyou lifting taboos

Patients who are allergic to fluoxetine or any of its components are contraindicated.

Monoamine oxidase inhibitor (MAOI): It has been reported that patients receiving selective serotonin reuptake inhibitors (SSRI) who are concurrently treated with monoamine oxidase inhibitor (MAOI), and who have recently discontinued SSRI treatment and started MAOI treatment , Sometimes even deadly reactions. The treatment of fluoxetine must begin 2 weeks after the irreversible MA OI withdrawal, and the day after the reversible MAOI-A withdrawal.

Some cases show similar blood serotonin syndrome (similar to neuroblocker malignant syndrome). Cyproheptadine or dantraline may be useful for such patients. Responses to patients with combined MAOI include fever, stiffness, myoclonus, instability of the autonomic nervous system with rapid fluctuations in vital signs, and changes in mental state, including extreme agitation, which may develop into delirium and coma.

Therefore, fluoxetine cannot be used with non-selective MAOI. Similarly, monoamine oxidase inhibitor therapy should be started at least 5 weeks after discontinuation of fluoxetine. If you take long-term fluoxetine and / or take higher doses, it may take longer.

Combining fluoxetine with reversible MAOI (eg, morphobexamide) is not recommended. Fluoxetine treatment can begin the day after reversible MAOI discontinuation.

Precautions

In clinical trials, children and adolescents under 18 years of age were more likely to experience suicide-related behaviors (suicide attempts and suicidal thoughts), hostile behaviors (mainly aggressive, antagonistic behaviors, and anger) compared with placebo control groups. ). Baiyoujie is only suitable for the treatment of moderate to severe depression in children and adolescents aged 8 to 18 years, and is not used for other indications. If Baiyoujie treatment should be given according to clinical needs, the performance of suicidal symptoms should be carefully observed during the treatment. There is limited data on long-term drug safety in adolescents, including the effects on growth, sexual maturity, cognitive, emotional, and behavioral development. (See [Pharmacology and Toxicology])

A 19-week clinical study found that taking fluoxetine reduced height and weight gain in adolescents (see [Adverse Reactions]). It has not been determined whether fluoxetine affects these individuals to reach the height of a normal adult. The possibility of fluoxetine's effects on adolescent development cannot be ruled out (see [Pharmacology and Toxicology] and [Adverse Effects]). During and after treatment, attention should be paid to monitoring the growth and development indicators of adolescents (including height, weight and TANER development stage). If one of them is found to lag behind normal development, it should be referred to a pediatrician.

Cases of mania and mild mania are often found in pediatric clinical trials (see [Adverse Reactions]). Regular monitoring of the occurrence of mania and mild mania is recommended. If mania occurs, discontinue treatment immediately.

Physicians should discuss the pros and cons of treatment with children / adolescents and / or their parents in detail when prescribing.

Rash and allergic reactions: Rash, allergic reactions and further systemic reactions, sometimes very severe (including skin, kidney, liver and lungs), have been reported. If a rash or other possible allergic phenomenon does not determine the cause, you should stop taking Bioglycemic ®.

Convulsive seizures: Convulsive seizures are a potential danger for antidepressants. Therefore, like other antidepressants, fluoxetine should be used with caution in patients with a history of seizures. Patients with seizures or increased seizure frequency should discontinue fluoxetine. Fluoxetine should be avoided in patients with unstable convulsions / epilepsy. If used in patients with well-controlled epilepsy, attention should be paid to monitoring.

Mania: Antidepressants should be used with caution in patients with a history of mania / mild mania. As with all antidepressants, patients develop mania and fluoxetine should be discontinued immediately.

Liver / renal function: Fluoxetine is mainly metabolized in the liver and excreted through the kidneys. For patients with liver dysfunction, the dosage should be reduced, such as taking medicine every other day. When 20 mg of fluoxetine was given daily for 2 consecutive months, the levels of fluoxetine and norfluoxetine in the plasma of patients with severe renal failure (GFR [10ml / min)) did not differ from those with normal renal function.

Heart disease: An electrocardiogram of 312 patients taking fluoxetine was evaluated in a double-blind trial. No cardiac block was seen. However, clinical studies of taking fluoxetine in patients with acute heart disease are limited, so such patients should be used with caution.

Weight loss: Fluoxetine may cause weight loss, but is usually proportional to baseline weight.

Diabetes: Taking SSRI in diabetic patients can affect blood glucose levels. Hypoglycemia may occur during taking Baiyoujie®, followed by hyperglycemia after discontinuation. The dosage of insulin and oral hypoglycemic agents should be adjusted.

Suicide / Suicide Concept: Depression is linked to suicide concepts, self-harm, and an increased risk of suicide (suicide-related events). This risk does not end until significant symptoms have resolved. Symptoms do not improve in the first few weeks or longer of treatment, during which time patients should be closely monitored until symptoms improve. Clinical experience has shown that the risk of suicide may increase during the early stages of disease recovery.

Other mental illnesses treated with Bioglycem® may also be associated with an increased risk of suicide-related events. In addition, these mental illnesses may accompany depression. The precautions in the treatment of patients with depression also apply to the treatment of patients with other mental disorders.

Patients with a history of suicide-related events, or those who show significant suicidal concepts before treatment begins, have a higher risk of developing suicidal concepts or suicidal tendencies and should be carefully monitored during treatment. In addition, the risk of suicidal behavior may increase among young adults.

Patients (and their caregivers) should be alert to these events and seek medical attention as soon as these symptoms appear.

Inability to Sit / Psychomotor Disturbance: The use of fluoxetine is associated with the occurrence of insomnia, manifested as a subjective aversion or irritability, and frequent exercise accompanied by inability to sit or stand. It most likely occurs during the first few weeks of treatment. Increasing the dose of the drug to patients who experience these symptoms can be harmful.

Withdrawal symptoms after stopping SSRI treatment: Withdrawal symptoms often occur when treatment is stopped, especially when abruptly stopped. (See [Adverse Reactions]). In clinical trials, the incidence of adverse events in patients who discontinued treatment was approximately 60% in both the fluoxetine and placebo groups. Of these adverse events, 17% were serious in the fluoxetine group and 12% were severe in the placebo group.

The risk of withdrawal symptoms may be determined by several factors, including the duration and dose of treatment, and the rate at which the dose is reduced. Dizziness, sensory disturbances (including paresthesias), sleep disturbances (including insomnia and dreaming), fatigue, anxiety or anxiety, nausea and / or vomiting, tremor and headache are the most commonly reported withdrawal reactions. These symptoms are generally mild to moderate, however in some patients these symptoms can be very severe. These symptoms usually occur in the first few days after stopping treatment. These symptoms are generally self-limiting and usually resolve within 2 weeks, but may be prolonged (2-3 months or more) in some individuals. Therefore, when stopping treatment, the dosage should be gradually reduced according to the needs of the patient for at least 1 to 2 weeks (see "Symptoms of withdrawal of Baiyoujie ® when discontinued", [Dosage and Administration]).

Bleeding: Skin bleeding, such as bruising and purpura, has been reported in patients taking SSRI. In patients taking Baiyoujie®, stasis was reported as a rare adverse event. Other bleeding manifestations (eg, gynecological bleeding, gastrointestinal bleeding, and other skin or mucosal bleeding) are reported as rare. Patients taking SSRI should be reminded to take special care, especially in combination with oral anticoagulants. Drugs known to affect platelet function (such as atypical antipsychotics such as clozapine, phenothiazines, and most tricyclic anticoagulants) Depressants, aspirin, non-steroidal anti-inflammatory drugs), or in combination with other drugs that increase the risk of bleeding, or for patients with a history of bleeding disorders.

Electroconvulsive therapy (ECT): Prolonged seizures are rarely reported in patients taking fluoxetine when receiving electroconvulsive therapy, but caution is also required.

St. John's wort: When selective serotonin reuptake inhibitors and herbal preparations are used together with herbs including St. John's wort (Forsythia suspensa), it may lead to enhanced serotoninergic effects, such as the appearance of serotonin syndrome.

Occasionally, serotonin syndrome or nerve block malignant syndrome-like adverse events have been reported to be related to fluoxetine treatment, especially when used in combination with other serotoninergic (such as L-tryptophan) and / or antipsychotic drugs. Because these syndromes can lead to potentially life-threatening situations, if these adverse events (represented by a set of symptoms such as high fever, rigidity, muscle spasms, autonomic nerve instability accompanied by rapid fluctuations in possible vital signs, mental state Changes, including confusion, irritability, and extreme anxiety to delirium and coma), should stop fluoxetine treatment and start supportive symptomatic treatment.

Impact on driving and machine operation

Although it has not been seen that Baiyoujie® affects normal people's psychomotor behavior, any psychoactive drug may affect people's judgment and skills. Patients should therefore be warned to avoid driving or operating dangerous machinery until the patient is fairly confident that their behavior is not affected.

Biomax solution for pregnant and lactating women

Pregnant women: Numerous data indicate that fluoxetine has no teratogenic effects on humans. Fluoxetine can be used during pregnancy, but care must be taken, especially before the third trimester or before the start of childbirth. Because fluoxetine has been reported to have the following effects on newborns: irritability, tremor, hypotonia, persistent crying, difficulty sucking or sleeping. These symptoms suggest a serotonergic effect or withdrawal syndrome. The duration and duration of these symptoms may be related to the longer half-life of fluoxetine (4-6 days) and its active metabolite norfluoxetine (4-16 days).

Lactation: Fluoxetine and its metabolites can be secreted into breast milk. Adverse events in infants have been reported. If fluoxetine must be taken, breastfeeding should be stopped; however, if breastfeeding is to be continued, fluoxetine should be taken at the lowest effective dose.

Baiyoujie children medication

Because its safety and efficacy in children and adolescents (under 18 years of age) are not clear, its use in this population is not recommended.

Baiyoujie elderly medicine

Increasing the dose should be cautious, the daily dose should generally not exceed 40mg. The highest recommended dose is 60 mg. See [Usage and Dosage].

Bioglycemic Drug Interactions

Half-life: When considering the interaction of pharmacokinetics and pharmacodynamics (such as when switching from fluoxetine to other antidepressants), keep in mind the long half-life of fluoxetine and norfluoxetine. (See [Pharmacokinetics])

Monoamine oxidase inhibitors: see [taboo].

Not recommended for combined use: MAOI-A.

A prudent combination: MAOI-B (selegiline): risk of serotonin syndrome. Clinical monitoring is recommended.

Serotoninergic drugs: combined with serotoninergic drugs (such as serotonin norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), tramadol, sumatriptan) May increase the risk of serotonin syndrome. Concomitant use with sumatriptan poses additional risks such as coronary vasoconstriction and hypertension.

Lithium and tryptophan: Serotonin syndrome has been reported when lithium and tryptophan are used in combination with SSRIs. Therefore, the combined use of Baiyoujie® with these drugs should be used with caution. Closer and more frequent clinical monitoring is required when fluoxetine is taken simultaneously with lithium salts.

CYP2D6 isoenzyme: Similar to tricyclic antidepressants and other selective serotonergic antidepressants, fluoxetine also passes through the liver cytochrome CYP2D6 isoenzyme system. Therefore, fluoxetine is combined with drugs that are also metabolized by this system Application may lead to drug interactions. If other drugs that are taken at the same time are mainly metabolized by the CYP2D6 isoenzyme system and the treatment range is narrow (such as flukanib, encarni, carbamazepine, and tricyclic antidepressants), the initial or therapeutic dose should be reduced To the lower limit of the treatment range. This principle also applies if you have taken BioGel® in the last 5 weeks.

Oral anticoagulants: When fluoxetine is used in combination with oral anticoagulants, the anticoagulant effect changes (test values and / or clinical signs and symptoms), of different types, but including increased bleeding symptoms-occasionally Report. Patients who are taking warfarin should be carefully monitored for coagulation status when starting or stopping fluoxetine treatment. (See [Precautions], bleeding)

Electroconvulsive therapy (ECT): Prolonged seizures in patients receiving fluoxetine when receiving electroconvulsive therapy are rarely reported, but caution is also required.

Alcohol: In regular trials, Bioglycemic® does not increase blood alcohol levels or enhance the effects of ethanol. However, it is not advisable to drink alcohol while SSRI is being treated.

St. John's wort: Like other SSRIs, Bioglycem® and the herb St. John's wort (St. John's wort) may have pharmacodynamic interactions which can lead to increased adverse reactions.

Baiyoujie overdose

Overdose of fluoxetine alone is usually mild. Symptoms of overdose include nausea, vomiting, seizures, cardiovascular dysfunction (from asymptomatic arrhythmia to cardiac arrest), pulmonary dysfunction, and central nervous system dysfunction ( (From excitement to coma). Reports of death from overdose of this product alone are extremely rare. Monitoring of the heart and vital signs is recommended, supplemented by general symptomatic and supportive care. No specific antidote for this product.

Forced diuresis, dialysis, blood perfusion, and fluid exchange are not ideal. The combined effect of activated carbon and sorbitol is the same as or even better than emetic and gastric lavage. When dealing with overdose, consider the possibility of taking multiple drugs at the same time. Patients who have taken or are taking this product at the same time have taken an excessive amount of tricyclic drugs at the same time, and should observe closely and extend the observation period.

Baiyoujie clinical trial

Depressive episodes: Clinical trials were conducted in patients with depressive episodes with placebo and active drug controls. According to the Hamilton Depression Scale (HAM-D), Bioglycem® shows very significant effectiveness compared to placebo. In these studies, Bioglycem® resulted in higher efficacy (defined as a 50% reduction in the HAM-D score) and response rate compared to placebo.

Dose-response relationship: In the study of fixed-dose patients with depression, the dose-response curve was flat, suggesting that the use of drugs higher than the recommended dose cannot improve the effectiveness of the drug. However, clinical experience has shown that increasing the dose may be beneficial for some patients.

Obsessive-compulsive disorder: In short-term clinical trials (less than 24 weeks), fluoxetine is significantly more effective than placebo. A dose of 20 mg per day is effective, but higher doses (40 to 60 mg per day) show higher effectiveness. In long-term studies (the extension of three short-term treatments and a relapse prevention study), no efficacy has been shown.

Bulimia nervosa: In short-term studies (under 16 weeks), outpatients with bulimia nervosa who meet the criteria for the third edition of the Handbook of Diagnostic Statistics of Mental Disorders take 60 mg of fluoxetine daily, compared with the placebo group It has a significant effect on the reduction of overeating and catharsis behavior. However, no conclusions have been drawn on long-term efficacy.

Baiyou Pharmacology and Toxicology

Pharmacological action

Fluoxetine has an antidepressant effect, which is speculated to be related to its inhibition of 5-HT reuptake in central neurons. Animal test results show that fluoxetine inhibits 5-HT reuptake more strongly than norepinephrine. At clinically relevant doses, fluoxetine can inhibit 5-HT reuptake by human platelets.

The anticholinergic, sedative, and cardiovascular effects of classic tricyclic antidepressants are related to their antagonistic effects on muscarinic, histaminergic, and 1-adrenergic receptors. In vitro receptor binding tests showed that the binding force of fluoxetine to the above receptors and other membrane receptors on brain tissue was significantly weaker than that of tricyclic antidepressants.

Toxicology research

The results of the genotoxic fluoxetine and its metabolite norfluoxetine in the Ames test, rat liver cell DNA repair test, mouse lymphoma test, and Chinese hamster bone marrow cell sister chromosome exchange test were all negative.

Reproductive toxicity rats did not show any effects on fertility at the doses of fluoxetine of 7.5 and 12.5 mg / kg / day (calculated as mg / m2, equivalent to 0.9 and 1.5 times the maximum human recommended dose of 80 mg [MRHD], respectively). Adverse effects.

In the embryo-fetal developmental toxicity test, no teratogenicity was seen when the doses of rats and rabbits reached 1 2.5 and 15 mg / kg / day (calculated as mg / m2, equivalent to 1.5 and 3.6 times the MRHD, respectively). .

In the perinatal toxicity test, rats were given 12 mg / kg / day during pregnancy (calculated as mg / m2, which is 1.5 times the MRHD) or 7.5 mg / kg / day during pregnancy and lactation (mg / kg) m2, which is equivalent to 0.9 times the MRHD), it can be seen that the number of stillbirths increases, the weight of the pups decreases and the mortality of the pups increases in the first 7 days after birth. When rats were given 12 mg / kg / day during pregnancy, no neurodevelopmental toxicity was seen in surviving pups. The unaffected dose for the pups' death is 5 mg / kg / day (calculated as mg / m2, which is equivalent to 0.6 times the MRHD).

In the carcinogenicity test of carcinogenic rats and mice, fluoxetine was administered in an admixture manner at 10 and 12 mg / kg / day, respectively (calculated as mg / m2, equivalent to 1.2 and 0.7 times the MRHD, respectively). In 2014, no increase in tumor incidence was seen.

Biogum Pharmacokinetics

Absorption-Fluoxetine is well absorbed orally. Eating does not affect the bioavailability of the drug.

Distribution-Fluoxetine binds to a large amount of plasma proteins (about 95%) and is widely distributed (distribution volume 20 ~ 40L / kg). Steady-state plasma concentrations were reached after several weeks of administration. Steady-state plasma concentrations after continuous administration were similar to those for 4 to 5 weeks.

Metabolism-Fluoxetine is consistent with non-linear pharmacokinetic properties with liver first-pass effects. Peak plasma concentrations were reached 6 to 8 hours after taking the drug. Fluoxetine is mainly metabolized by the CYP2D6 enzyme. Fluoxetine is mainly metabolized by the liver, and demethylfluoxetine is produced by demethylation.

The elimination half-life of clear-fluoxetine is 4-6 days, and norfluoxetine is 4-16 days. The long half-life allows the effect to be maintained for 5 to 6 weeks after discontinuation. This product is mainly (about 60%) excreted by the kidneys. Fluoxetine can be secreted into breast milk.

Elderly population at high risk: Compared with younger patients, the kinetic parameters of healthy older people have not changed.
Hepatic insufficiency: Due to liver insufficiency (alcoholic cirrhosis), the half-lives of fluoxetine and norfluoxetine increase to 7 and 12 days, respectively. Consideration should be given to lower doses or to reduce the frequency of dosing.
Renal insufficiency: After a single dose of fluoxetine was given to patients with mild, moderate and complete renal insufficiency (no urine), there were no differences in kinetic parameters compared with healthy volunteers. After repeated dosing, an increase in steady-state plasma concentration was observed.

Baiyou solution storage

Store below 25 ° C at room temperature.

Best Pack

Aluminum plastic packaging, 7 capsules / box, 28 capsules / box.

Validity period of Baiyou solution

36 months.

Best Practice Solution Standards

Import drug registration standard JX20060149

Baiyou solution approval number

National Medicine Standard J20080016

Baiyou Solution Production Enterprise

Eli Lilly and Company Ltd

Baiyou Solution Packaging Enterprise

Eli Lilly Suzhou Pharmaceutical Co., Ltd.

Best Buy Approval Date

December 11, 2007

Best Buy Revision Date

March 31, 2008 January 22, 2009 December 10, 2009