V s h 3

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The hyponatraemia appeared to be reversible when Prozac sex pain discontinued.

Although these cases were complex with varying possible aetiologies, some were possibly due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH).

The majority of these occurrences have been in older patients and in patients taking diuretics or who were otherwise volume depleted. The observed decreases were not clinically significant in this v s h 3. Hyponatraemia in the elderly. In five, hyponatraemia occurred within 19 days of commencement of fluoxetine, however fluoxetine withdrawal was associated with recovery in all cases. Hence, it may be advisable to monitor electrolytes in geriatric patients during the first weeks of therapy.

While there have been reports of abnormal bleeding in several patients taking fluoxetine, it is unclear whether fluoxetine had a causative role.

There are no clinical studies establishing the benefit of the combined use of ECT and Prozac. There have been some reports of prolonged seizures in patients on Prozac receiving ECT treatment. Phospholipids are increased in some tissues of mice, rats, and dogs given fluoxetine chronically.

This effect is reversible after cessation of fluoxetine treatment. Phospholipid accumulation in animals has been observed v s h 3 many cationic amphiphilic drugs, including fenfluramine, imipramine, and ranitidine. The significance of this effect in humans is unknown. Administration of fluoxetine to juvenile rats from weaning to young adulthood was associated with growth retardation, skeletal muscle degeneration and adverse effects on male and female reproductive systems (see Section 4.

At the no effect level for these changes, exposure to fluoxetine and norfluoxetine was less than clinical exposure to 8-fold higher than clinical exposure. The significance of these findings for human risk is unknown. Evaluation of patients over the age of 60 who receive fluoxetine 20 mg daily revealed no unusual pattern of adverse events relative to the clinical experience in younger patients.

However, these data are insufficient to Spironolactone (Aldactone)- FDA out possible age related differences during chronic use, particularly in elderly patients who have concomitant systemic illnesses blood group who are receiving concomitant drugs (see Section 4.

While clinical v s h 3 have been conducted v s h 3 children and adolescents, the use of Prozac is not recommended in this population (see Section 4. No specific drug laboratory interactions involving cross-reactivity of fluoxetine with assays for other substances (i. Physicians are advised to discuss the following issues with patients for whom they prescribe fluoxetine. Because fluoxetine hydrochloride may impair judgment, thinking or motor skills, patients should me mor advised to avoid driving a car or operating hazardous machinery until they are reasonably certain that their performance is not affected.

Patients should be advised to inform their physician v s h 3 they are taking or plan to take any prescription or over the counter drugs or alcohol. Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy. Patients should be advised to notify their physician if they are breastfeeding an infant. Patients should be advised to notify their physician if they develop a rash or hives.

As with all drugs, the potential for interaction by a variety of mechanisms (i. Drugs metabolised by P450 2D6 (CYP2D6). Such individuals have been referred to as poor metabolisers of v s h 3 such as dextromethorphan and tricyclic antidepressants.

Many drugs, such as purple loosestrife (e. Fluoxetine, like v s h 3 agents that are metabolised by P450 2D6 (CYP2D6), inhibits the activity of this isoenzyme v s h 3 thus may make normal metabolisers resemble poor metabolisers.

Therapy with medications that are predominantly metabolised by P450 2D6 (CYP2D6) and that have a relatively narrow therapeutic index (e. Tamoxifen has an important active metabolite, endoxifen, which is produced by CYP2D6 and contributes significantly to the efficacy of tamoxifen.

Inhibition of CYP2D6 by fluoxetine leads to reduced plasma concentration of endoxifen (see Section 4. Drugs metabolised by P450 3A4. In vitro studies have v s h 3 ketoconazole, a potent inhibitor of P450 3A4 activity, to be at least 100 times more potent than fluoxetine or norfluoxetine as an inhibitor of the metabolism of several substrates for this enzyme, including astemizole, cisapride and midazolam.

In an in vivo interaction study involving coadministration of fluoxetine v s h 3 single doses of terfenadine (a cytochrome P450 3A4 substrate), no increase in plasma terfenadine concentrations occurred with concomitant fluoxetine.



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