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Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.
The preparation contains the substance:fluoxetine
The drug is available on prescription
What is Andepin?
An antidepressant drug that belongs to the group of serotonin reuptake inhibitors.
What does Andepin contain and how does it work?
The active substance of the preparation is Fluoxetine
, belonging to the group of serotonin reuptake inhibitors (you can find the abbreviation SSRI for the determination of this group of drugs, originating from EnglishSelective serotonin reuptake inhibitor
). Serotonin is one of the neurotransmitters, substances that play an important role in communication between neurons. The place of connection of two neurons is called the synapse. The cell that transmits the information in front of the synapse releases a so-called mediator into the synaptic cleft, a substance that is captured and recognized by the cell receiving information behind the synapse. In this case, the mediator is serotonin. Some serotonin molecules are captured back by the neuron receptors in front of the synapse, what we call the reuptake. The effect of fluoxetine is to inhibit the process of reuptake of serotonin, and thus to extend the duration of serotonin in the synapse and the time of stimulation of the cell receiving the information. Nerve impulses are sent more often. Greater stimulation of serotonin-dependent cells is associated with antidepressant effects. Fluoxetine has no effect on reuptake of other mediators than serotonin, as well as does not show affinity (or very weak) for serotonin receptors other than serotonin. Therefore, its operation is defined as selective.
When to use Andepin?
The preparation is indicated:
· In the treatment of depressive disorders
· In the treatment of obsessive-compulsive disorders
· In the treatment of bulimia.
When not to use this preparation?
Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients.
MAO inhibitors (MAO is an abbreviation formonoamine
- one of the tissue enzymes) are drugs used, inter alia, in the treatment of depression with anxiety and atypical depression, as well as hypotension. This group includes, among others, moclobemide and selegiline.
Treatment with fluoxetine may be started 14 days after discontinuation of irreversible MAO inhibitors
and the day after discontinuing type A MAO reversible inhibitors. MAO inhibitors may be initiated 5 weeks after discontinuation of fluoxetine. If fluoxetine has been used for a long period and / or in large doses, the doctor will consider a longer break.
Take special care with Andepin?
Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation.In some situations it may be necessary to carry out specific check-ups.
Depression is associated with an increased risk of suicidal thoughts, mutilation and suicide. It lasts until the symptoms disappear completely. The effects of using the product may occur only after a few weeks of treatment, sometimes this time is longer. Patients should be under strict medical supervision until they recover. Other psychiatric disorders in which fluoxetine is prescribed may also be associated with an increased risk of suicidal behavior. In addition, these conditions can co-exist with severe depressive disorders. People treated with fluoxetine for reasons other than depression, as well as those who have attempted suicide and those who have a significant degree of suicidal tendency before starting treatment should be closely monitored by a physician.
The group of special risk are people under 25 years of age. Also, during the change of dosage, the patient should be covered by special medical care. Patients and those around them should pay attention to any clinical sign of disease severity, suicidal behavior or thoughts or abnormal changes in behavior, and contact their physician immediately if they occur.
Data regarding the safety of long-term use of fluoxetine in children under 18 are limited.
If you get a rash or other allergic symptoms that can not be related to another cause, you should contact your doctor immediately, who will decide if you want to stop your treatment and decide on further treatment.
Caution should be exercised if you have ever had seizures. The occurrence of convulsions or an increase in the frequency of their occurrence usually requires discontinuation of treatment (this decision is made by the physician).
Fluoxetine should be avoided in people with untreated or uncomplicated epilepsy. Patients with controlled epilepsy should be closely monitored.
In the following cases, during treatment, the patient should remain under close medical supervision:
· If you have ever had a manic condition (if you have a manic phase, your doctor will probably stop the treatment)
· If you have a heart condition
· If you are using medicines that affect your blood platelet function or may increase the risk of bleeding, as well as if you have blood coagulation problems in the past (you may experience prolonged or abnormal bleeding).
Weight loss may occur during treatment.
Diabetes should be used with caution. If you have diabetes, you may need to change your insulin
dose or oral antidiabetics (your doctor will decide).
The use of the preparation may lead to akathisia in some people (state of anxiety, inability to refrain from performing movements), especially in the first weeks of treatment. In this case, your doctor will probably not increase your dose.
Do not stop the treatment suddenly because withdrawal reactions may occur. Typical symptoms include: dizziness, sensory disturbances (including paraesthesia), sleep disorders (including insomnia and intense dreams), weakness (asthenia), agitation or anxiety, nausea and / or vomiting, tremor and headache. If discontinuation of the preparation is required, the dose should be gradually reduced, strictly following the instructions of the physician.
Rare cases of prolonged seizures have been reported in patients treated with fluoxetine who have been treated with electroconvulsive therapy. For this reason, the treatment should be carried out with exceptional precautions. You should tell your doctor if you have used this method of treatment in the past.
If you experience symptoms such as:
· Muscle clonic convulsions
· Disorders of the autonomic nervous system with possible rapid fluctuations in vital functions
· Changes in consciousness including confusion
· Extreme agitation leading to delirium and coma
you should immediately consult a doctor, because their cause may be a so-called "serotonin syndrome", a condition that is life-threatening.The serotonin syndrome requires immediate medical attention.
During the concomitant use of fluoxetine and herbal preparations containing St. John's Wort (Hypericum perforatum
), side effects such as serotonin syndrome may increase.
Additional information about the other ingredients of the preparation:
the preparation contains lactose; people with galactose intolerance, lactase deficiency or malabsorption of Glucose
-galactose should not use it;
Does this preparation affect the ability to drive vehicles?
The preparation may affect your ability to drive or use machines / machines. Psychoactive drugs can impair the ability to make decisions and reactions in emergency situations. Be careful!
Dosage of Andepin
The preparation is in the form of tablets for oral use. Do not exceed the recommended doses because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts regarding the use of the preparation, consult a physician.
Adults and the elderly:
Usually 20 mg daily is used.
Usually 20 mg daily is used. If necessary, your doctor may decide to increase the dose to a maximum of 60 mg a day. If, after a few weeks of using the medicine, you do not improve your health, your doctor will probably increase the dose.
Usually 60 mg daily is used.
No dosage adjustment is necessary for people with impaired renal function.
In people with liver dysfunction, it is recommended to use smaller doses or to keep longer intervals between consecutive doses (eg 20 mg every other day), the doctor always decides about the change in dosage.
The preparation is usually not used in children and adolescents up to 18 years of age.
Method of administration:
The product should be used once (in the case of 20 mg daily) or twice daily (in the case of doses greater than 20 mg daily) - in the morning and at noon; during a meal or between meals, with a sufficient amount of liquid.
Can I use Andepin during pregnancy and breastfeeding?
During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or planning to become pregnant, consult your doctor before using the product.
The preparation can be used during pregnancy only if the doctor considers that the benefits for the mother outweigh the risks to the child.
If fluoxetine therapy is necessary, discontinuation of breast-feeding should be considered.
Can I use other preparations in parallel?
Tell your doctor about all medicines you have recently taken, including those that are over the counter.
Concomitant use of fluoxetine with MAO inhibitors is contra-indicated (risk of serotonin syndrome).
Caution should be exercised when using the preparation in combination:
· With drugs that affect the CNS (phenytoin, carbamazepine, Haloperidol
, clozapine, diazepam, alprazolam, lithium, imipramine, desimipramine), due to changes in their concentration in blood plasma and the need for a doctor to adjust the dose
· With serotonergic agents, because there is an unfavorable increase in serotonin receptors
· With lithium and tryptophan, due to the effect of fluoxetine
· With drugs metabolised by cytochrome P-450 CYP2D6 isoenzyme (eg flecainide, enkainide, vinblastine, carbamazepine and tricyclic antidepressants); your doctor will probably reduce the dose of these medicines
· With oral anticoagulants, because it is possible to change their action (for example, increased bleeding), blood coagulation factors should be monitored, especially at the beginning and end of treatment
· With St. John's wort, because the risk of side effects of fluoxetine increases.
You should not drink alcohol during treatment.
What side effects can occur?
Like all medicines, Andepin can also cause side effects, although it will not occur in all patients who use this medicine.Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects. If in doubt about any side effects, consult a physician.
During treatment with fluoxetine, the severity of side effects may decrease.
Very often you may experience: insomnia (including early morning awakening, initial insomnia, insomnia central), headaches, diarrhea, nausea, tiredness (including asthenia).
Often may occur: decreased appetite (including anorexia), anxiety, anxiety, nervousness, tension, decreased libido (including loss of libido), sleep disorders, unusual dreams (including nightmares), attention disorders, dizziness, taste disorders, lethargy, drowsiness (increased drowsiness, sedation), tremors, convulsions, blurred vision, palpitations, paroxysmal redness of the face (including hot flushes), yawning, vomiting, dyspepsia
, dry mouth, rash (including erythema, exfoliative erythema, red prickly, rash, erythema erythema, blush erythema, erythema multiforme, erythematous erythema, maculopathy, redulent rash, follicular erythema, umbilicus erythema), urticaria, pruritus, hyperhidrosis, joint pain, frequent urination (including pollakiuria), gynecological bleeding (including cervical hemorrhage, uterine dysfunction, uterine bleeding, reproductive bleeding, abnormal irregular month nursing, menorrhagia, uterine haemorrhage, excessive frequent menstruation, postmenopausal bleeding, uterine hemorrhage, vaginal haemorrhage), erectile dysfunction, ejaculation disorders (including no ejaculation, ejaculation disorders, premature ejaculation, delayed ejaculation, reverse ejaculation), nervousness, chills, weight loss.
Uncommon may occur: loss of self-esteem (depersonalization), elevated mood, euphoria, thinking disorders, orgasmic disorders (lack of orgasm), bruxism, psychomotor agitation, dyskinesia, ataxia, balance disorders, myoclonus,
mydriasis, hypotension, dyspnoea, dysphagia, alopecia, increased tendency to bruise, cold sweat, muscle tremors, difficulty urinating, sexual dysfunction, malaise, unusual well-being, feeling cold, feeling hot.
Rarely may occur: Anaphylactic reactions
, serum sickness, hyponatremia, mild manic state (hypomania), mania, hallucinations, agitation, panic attacks, convulsions, akathisia, cheek-language syndrome, ventricular arrhythmia including ventricular polymorphic tachycardia , prolonged QT interval of electrocardiogram, vasculitis, vasodilation, pharyngitis, esophageal pain, angioneurotic edema
, petechiae, hypersensitivity to light, purpura, haemorrhagic diathesis, urinary retention, galactorrhoea, prolactin secretion.
Very rarely may occur: thrombocytopenia, idiosyncratic hepatitis.
In addition, the following may occur with an unknown frequency: abnormal secretion of the antidiuretic hormone that reduces urine volume, suicidal thoughts or self-mutilation (these symptoms may be caused by the underlying disease), drowsiness, stuttering, serotonin syndrome, memory problems, dizziness, confusion, tinnitus, photosensitivity, orthostatic hypotension, pulmonary events (inflammatory processes of various histopathology and / or fibrosis), nosebleeds, Gastrointestinal bleeding
(including bleeding most frequently from gums, bloody vomiting, rectal bleeding, hemorrhagic diarrhea, blood in stool , gastric ulcer), erythema multiforme (Stevens and Johnson syndrome or toxic epidermal necrolysis syndrome (Lyell's syndrome), muscle pain, urination disorders, priapism (prolonged, painful erection without sexual arousal), mucosal haemorrhage, abnormalities may develop wyn and liver function tests.
There have been reports of cases of suicidal thoughts and behavior during the use of the preparation, as well as a short time after its withdrawal (more frequent in children and adolescents than in adults).
Other preparations on the Polish market containing fluoxetine
Fluoxetine EGIS (hard capsules)
Fluoxetin Polpharma (hard capsules)
Fluoxetine Vitabalans (coated tablets)
Fluxemed (hard capsules)
Seronil (hard capsules)
Seronil (coated tablets)