플루옥세틴

동물 종별 용량

투여 경로

금기

• Known hypersensitivity to fluoxetine
• Concurrent use of Monoamine Oxidase Inhibitors (MAOIs), including selegiline and amitraz (found in some tick collars)
• Patients with epilepsy or a history of seizures
• Concurrent use with drugs that lower the seizure threshold (e.g., acepromazine, chlorpromazine)
• Known sensitivity to fluoxetine or other SSRIs
• History of seizures or epilepsy

이상반응

• Anorexia or decreased appetite (common, often transient)
• Lethargy or depression
• Gastrointestinal upset (vomiting, diarrhea)
• Anxiety, irritability, or restlessness
• Insomnia or hyperactivity
• Panting (dogs)
• Changes in elimination patterns (cats)
• Paradoxical aggressive behavior (in previously unaggressive animals)
• Seizures (rare but possible)
• Lethargy
• Decreased appetite
• Vomiting
• Weight loss
• Trembling
• Restlessness
• Gastrointestinal disturbances

약물 상호작용

• BUSPIRONE · Increased risk for serotonin syndrome
• CYPROHEPTADINE · May decrease or reverse the effects of SSRIs (acts as a serotonin antagonist)
• DIAZEPAM, ALPRAZOLAM · Fluoxetine may increase diazepam and alprazolam plasma levels
• DIURETICS · Increased risk for hyponatremia
• INSULIN · May alter insulin requirements (can alter blood glucose)
• ISONIAZID · Increased risk for serotonin syndrome
• MAO INHIBITORS (e.g., amitraz, selegiline) · High risk for serotonin syndrome; use contraindicated. A 5-week washout is required after stopping fluoxetine before starting an MAOI, and a 2-week washout if switching from an MAOI to fluoxetine.
• PENTAZOCINE · Serotonin syndrome-like adverse effects possible
• PHENYTOIN · Increased plasma levels of phenytoin possible
• PROPRANOLOL, METOPROLOL · Fluoxetine may increase these beta-blocker's plasma levels; atenolol may be safer to use
• TRAMADOL · SSRIs can inhibit the metabolism of tramadol to active metabolites, decreasing efficacy and increasing toxicity risk (serotonin syndrome, seizures)
• TRICYCLIC ANTIDEPRESSANTS (e.g., clomipramine, amitriptyline) · Fluoxetine may increase TCA blood levels and increase the risk for serotonin syndrome

모니터링

• Efficacy of the behavior modification plan and reduction of clinical signs
• Appetite and body weight (due to risk of anorexia)
• Signs of adverse effects (GI upset, lethargy, paradoxical aggression, seizures)
• Behavioral response and changes in aggression
• Appetite and body weight
• Signs of serotonin syndrome (tremors, agitation, hyperthermia)
• Gastrointestinal tolerance

과용량

The LD50 for rats is 452 mg/kg. **Clinical Signs of Toxicity:** * **Dogs:** Vomiting, mydriasis (dilated pupils), lethargy, hyperactivity, and seizures. Seizures have been reported at doses twice the highest recommended human dose. * **Cats:** Hypersalivation, vomiting, mydriasis, and excessive vocalization. **Treatment:** * Treatment is symptomatic and supportive. * Gut emptying techniques (emesis, activated charcoal) should be employed if recent and not contraindicated (e.g., patient is seizing or comatose). * **Diazepam** is the treatment of choice for controlling seizures. * **Cyproheptadine** can be administered as a serotonin antagonist if serotonin syndrome is suspected.