Difmax Capsule 20 mg (Fluoxetine Hydrochloride)

Adult dosage

1. Depression 1) Initial treatment: The initial dose is 20 mg of fluoxetine hydrochloride, administered orally once daily in the morning. In controlled clinical trials, doses of 20～80mg per day were administered. If no improvement is observed, an increase in dose may be considered after several weeks. Doses exceeding 20mg per day should be administered twice daily (morning and noon), and the maximum dose of 80mg per day should not be exceeded. The onset of an adequate antidepressant effect may be delayed until 4 weeks or longer after starting treatment. 2) Maintenance/continuation/extended treatment: There are no definitive data on how long patients should be treated with this medicine, but psychopharmacologists generally agree that acute episodes of depression require medication treatment for several months or longer. It is unknown whether the amount of antidepressant needed to relieve symptoms is the same as the amount needed to maintain or sustain remission. 2. Bulimia nervosa Administer 60mg per day of this medicine. The daily dose should not exceed 80mg. Measure electrolyte levels before starting treatment. 3. Obsessive-compulsive disorder Administer 20～60mg per day of this medicine. The daily dose should not exceed 80mg. 4. Premenstrual dysphoric disorder Administer 20mg per day of this medicine. After 6 months of treatment, reassess whether continued treatment is necessary. - Patients with renal and/or hepatic impairment, patients receiving multiple medicines, older adults, and patients with comorbid conditions: Administer a lower dose or reduce the frequency of administration. Adjust the dose appropriately according to age and symptoms. - Switching from MAO inhibitors used to treat psychiatric disorders When discontinuing an MAO inhibitor used to treat a psychiatric disorder and starting treatment with this medicine, allow an interval of at least 14 days. Conversely, when starting an MAO inhibitor to treat a psychiatric disorder, at least 5 weeks must have elapsed after discontinuing this medicine. - Other MAO inhibitors, such as linezolid or methylene blue Patients receiving linezolid or intravenous methylene blue should not start treatment with this medicine because of the increased risk of serotonin syndrome. For patients requiring treatment for a more urgent psychiatric condition, including hospitalization or other interventions, consider administration. It may be necessary to urgently administer linezolid or intravenous methylene blue to a patient already receiving this medicine. If no alternative to linezolid or intravenous methylene blue is available and, for a particular patient, the benefits of treatment with linezolid or intravenous methylene blue are judged to outweigh the risk of serotonin syndrome, discontinue this medicine immediately and administer linezolid or intravenous methylene blue. Monitor the patient for symptoms of serotonin syndrome for 5 weeks after administration of linezolid or intravenous methylene blue, or until 24 hours after the last dose, whichever comes first. Treatment with this medicine may be restarted 24 hours after the last dose of linezolid or intravenous methylene blue. The risk associated with administration of methylene blue by non-intravenous routes (oral tablets or local injection) or intravenous administration of this medicine at a dose of 1mg/kg or less is unclear. Nevertheless, clinicians should be aware of the possibility of emergency symptoms of serotonin syndrome with these uses.

This drug is primarily used to treat symptoms related to depression. During treatment, there may be an increase in suicidal thoughts or behavior, especially in young patients aged 18 to 24, who should be closely monitored. Before taking this medication, it is essential to confirm whether the patient is allergic to this medication or its components and to avoid use in patients with severe kidney dysfunction or those taking certain other medications. Patients with a history of seizures should use this drug with caution, and if seizures occur or frequency increases, treatment should be immediately discontinued. In patients with depression who are at a high risk of suicide, careful monitoring is needed during the initial dose of this drug, as there may be a worsening of symptoms or suicidal tendencies. This medication can affect heart rhythms, so it is advisable for patients with heart disease or related risk factors to undergo an electrocardiogram before administration. Patients with liver or kidney dysfunction need to adjust the dosage of this medication, and diabetic patients should regularly check their blood glucose control. This drug can increase intraocular pressure, so patients at risk for glaucoma should exercise caution. Common side effects include headaches, nausea, insomnia, fatigue, and diarrhea, while serious allergic reactions or skin rashes and bleeding may occur rarely. Sudden discontinuation of this medication can lead to withdrawal symptoms such as dizziness, sensory abnormalities, anxiety, and headaches, so the dosage should be gradually reduced according to the physician's instructions. This medication interacts with other drugs, so patients taking other medications or starting any new treatments should consult their physician or pharmacist. Women who are pregnant or breastfeeding should carefully consider taking this medication, as it may affect the fetus or newborn, and it is recommended to stop breastfeeding if under treatment. The safety and efficacy of this drug in children or adolescents have not been sufficiently proven, so it is generally not used in this population. Particular caution is needed for elderly patients, as the risk of adverse reactions may increase depending on other diseases or medications. In case of overdose, serious symptoms such as vomiting, seizures, and heart problems may occur, requiring immediate medical attention. Keep this medication out of reach of children, and it is best not to transfer it to other containers. During treatment, caution is advised when driving or operating dangerous machinery, and alcohol consumption should be avoided.

Headache, nausea, insomnia, fatigue, diarrhea, anaphylactic reaction, serum sickness, abnormal secretion of antidiuretic hormone, decreased appetite, hyponatremia, anxiety, irritability, restlessness, tension, decreased libido, sleep disorders, abnormal dreams, depersonalization, elevated mood, happy mood, thought disorder, abnormal libido, bruxism, hypomania, mania, hallucinations, restlessness, panic attacks, suicidal thoughts and behaviors, confusion, attention disorder, dizziness, taste disturbances, somnolence, drowsiness, tremors, psychomotor agitation, movement disorders, ataxia, balance disorders, tonic muscle spasms, seizures, inability to sit still, buccoglossal syndrome, serotonin syndrome, memory impairment, blurred vision, pupil dilation, palpitations, ventricular arrhythmia, QT prolongation, flushing, hypotension, vasculitis, vasodilation, yawning, dyspnea, pharyngitis, lung-related events, nosebleeds, vomiting, dyspepsia, dry mouth, dysphagia, esophageal pain, gastrointestinal bleeding, specific hepatitis, rash, urticaria, pruritus, hyperhidrosis, hair loss, increased tendency for bruising, diaphoresis, angioedema, petechiae, phototoxic reactions, purpura, erythema multiforme, arthralgia, muscle cramps, myalgia, pollakiuria, dysuria, urinary retention, urinary disorders, gynecological bleeding, erectile dysfunction, ejaculation disorders, sexual dysfunction, galactorrhea, hyperprolactinemia, priapism, anxious mood, chills, lethargy, abnormal mood, feeling cold, feeling hot, mucosal bleeding, weight loss, abnormal liver function tests, fractures, withdrawal symptoms, dizziness, sensory disturbances, sleep disorders, weakness, restlessness, anxiety, tremors, headache, aplastic anemia, atrial fibrillation, cataracts, cerebrovascular accident, cholestatic jaundice, movement disorders, eosinophilic pneumonia, epithelial necrosis, nodular erythema, exfoliative dermatitis, gynecomastia, cardiac arrest, liver failure, hyperprolactinemia, hypoglycemia, immune-related hemolytic anemia, renal failure, movement disorders, optic neuritis, pancreatitis, pancytopenia, pulmonary embolism, pulmonary hypertension, thrombocytopenia, thrombocytopenic purpura, ventricular tachycardia, vaginal bleeding, aggressive behavior

This medication should be stored in a tightly closed container to prevent exposure to air or moisture. The safest storage temperature is between 1 and 30 degrees Celsius (room temperature).

Appearance

A hard capsule with a green upper part and a yellowish lower part filled with white or grayish-white powder

Package unit

30 capsules/bottle, 200 capsules/bottle