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Prozac (Fluoxetine Solution) and Tofranil

Determining the interaction of Prozac (Fluoxetine Solution) and Tofranil and the possibility of their joint administration.

Check result:

Prozac (Fluoxetine Solution) <> Tofranil

Relevance: 14.11.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Talk to your doctor before using imipramine and FLUoxetine. This combination may cause sedation, dry mouth, blurred vision, constipation, and urinary retention. You could also have high levels of FLUoxetine which include altered consciousness, confusion, poor muscle coordination, abdominal cramping, shivering, dilation of the pupils, sweating, high blood pressure, and increased heart beat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using your medications without talking to your doctor first.

Professional:

GENERALLY AVOID: Coadministration with fluoxetine may significantly increase the plasma concentrations of some tricyclic antidepressants (TCAs). The proposed mechanism is fluoxetine inhibition of CYP450 2D6, the isoenzyme responsible for the metabolic clearance of many antidepressant and psychotropic drugs. Seizures and delirium have been reported, as well as a fatality attributed to fluoxetine-induced chronic amitriptyline toxicity. Pharmacodynamically, the combination of fluoxetine (or any other selective serotonin reuptake inhibitor) and a TCA may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors.

MANAGEMENT: In general, the use of fluoxetine (or other SSRIs) with TCAs should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Pharmacologic response and plasma TCA levels should be monitored more closely whenever fluoxetine is added to or withdrawn from therapy in patients stabilized on their existing antidepressant regimen, and the TCA dosage adjusted as necessary. Patients should be monitored closely for signs and symptoms of TCA toxicity (e.g., sedation, dry mouth, blurred vision, constipation, urinary retention) and/or excessive serotonergic activity (e.g., CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia). Due to the long half-life of fluoxetine and its active metabolite, norfluoxetine, the risk of interaction may persist for several weeks after discontinuation of fluoxetine.

References

Preskorn SH, Beber JH, Faul JC, Hirschfeld RM "Serious adverse effects of combining fluoxetine and tricyclic antidepressants." Am J Psychiatry 147 (1990): 532
Bergstrom RF, Peyton AL, Lemberger L "Quantification and mechanism of the fluoxetine and tricyclic antidepressant interaction." Clin Pharmacol Ther 51 (1992): 239-48
Paul KL, Bhatara VS "Anticholinergic delerium possibly associated with protriptyline and fluoxetine." Ann Pharmacother 31 (1997): 1260-1
von Ammon Cavanaugh S "Drug-drug interactions of fluoxetine with tricyclics." Psychosomatics 31 (1990): 273-6
Elyazigi A, Chaleby K, Gad A, Raines DA "Steady-state kinetics of fluoxetine and amitriptyline in patients treated with a combination of these drugs as compared with those treated with amitriptyline alone." J Clin Pharmacol 35 (1995): 17-21
Vaughan DA "Interaction of fluoxetine with tricyclic antidepressants." Am J Psychiatry 145 (1988): 1478
Riesenman C "Antidepressant drug interactions and the cytochrome p450 system: a critical appraisal." Pharmacotherapy 15 (1995): s84-99
von Moltke LL, Greenblatt DJ, Cotreau-Bibbo MM, Duan SX, Harmatz JS, Shader RI "Inhibition of desipramine hydroxylation in vitro by serotonin-reuptake-inhibitor antidepressants, and by quinidine and ketoconazole: a model system to predict drug interactions in vivo." J Pharmacol Exp Ther 268 (1994): 1278-83
Muller N, Brockmoller J, Roots I "Extremely long plasma half-life of amitriptyline in a woman with the cytochrome P450IID6 29/29-kilobase wild-type allele: a slowly reversible interaction with fluoxetine." Ther Drug Monit 13 (1991): 533-6
Leroi I, Walentynowicz MA "Fluoxetine-imipramine interaction." Can J Psychiatry 41 (1996): 318-9
Laird LK "Issues in the monopharmacotherapy and polypharmacotherapy of obsessive-compulsive disorder." Psychopharmacol Bull 32 (1996): 569-78
Mathew NT, Tietjen GE, Lucker C "Serotonin syndrome complicating migraine pharmacotherapy." Cephalalgia 16 (1996): 323-7
Harvey AT, Preskorn SH "Interactions of serotonin reuptake inhibitors with tricyclic antidepressants." Arch Gen Psychiatry 52 (1995): 783-4
Corkeron MA "Serotonin syndrome - a potentially fatal complication of antidepressant therapy." Med J Aust 163 (1995): 481-2
Westermeyer J "Fluoxetine-induced tricyclic toxicity: extent and duration." J Clin Pharmacol 31 (1991): 388-92
DeMaso DR, Hunter TA "Combining fluoxetine with desipramine." J Am Acad Child Adolesc Psychiatry 29 (1990): 151
Preskorn SH, Alderman J, Chung M, Harrison W, Messig M, Harris S "Pharmacokinetics of desipramine coadministered with sertraline or fluoxetine." J Clin Psychopharmacol 14 (1994): 90-8
Wilens TE, Biederman J, Baldessarini RJ, McDermott SP, Puopolo PR, Flood JG "Fluoxetine inhibits desipramine metabolism." Arch Gen Psychiatry 49 (1992): 752
Mills KC "Serotonin syndrome: A clinical update." Crit Care Clin 13 (1997): 763
Downs JM, Downs AD "Effect of fluoxetine on metabolism of tricyclic antidepressants in the lungs." Am J Psychiatry 146 (1989): 814-5
Aranow AB, Hudson JI, Pope HG, et al "Elevated antidepressant plasma levels after addition of fluoxetine." Am J Psychiatry 146 (1989): 911-3
Ciraulo DA, Shader RI "Fluoxetine drug-drug interactions: I. Antidepressants and antipsychotics." J Clin Psychopharmacol 10 (1990): 48-50
Gillman PK "Fluoxetine (prozac)." Med J Aust 159 (1993): 492
Schraml F, Benedetti G, Hoyle K, Clayton A "Fluoxetine and nortriptyline combination therapy." Am J Psychiatry 146 (1989): 1636-7
Ereshefsky L, Riesemman C, Lam YW "Antidepressant drug interactions and the cytochrome P450 system. The role of cytochrome P450 2D6." Clin Pharmacokinet 29(Suppl 1) (1995): 10-8; discussion 18-9
Fischer P "Serotonin syndrome in the elderly after antidepressive monotherapy." J Clin Psychopharmacol 15 (1995): 440-2
Crewe HK, Lennard MS, Tucker GT, Woods FR, Haddock RE "The effect of selective serotonin re-uptake inhibitors on cytochrome P4502D6 (CYP2D6) activity in human liver microsomes." Br J Clin Pharmacol 34 (1992): 262-5
Taylor D "Selective serotonin reuptake inhibitors and tricyclic antidepressants in combination - interactions and therapeutic uses." Br J Psychiatry 167 (1995): 575-80
Bell IR, Cole JO "Fluoxetine induces elevation of desipramine level and exacerbation of geriatric nonpsychotic depression." J Clin Psychopharmacol 8 (1988): 447-8
Vandel S, Bertschy G, Bonin B, et al. "Tricyclic antidepressant plasma levels after fluoxetine." Neuropsychobiology 25 (1992): 202-7
Nijhawan PK, Katz G, Winter S "Psychiatric illness and the serotonin syndrome: an emerging adverse drug effect leading to intensive care unit admission." Crit Care Med 24 (1996): 1086-9
Sternbach H "Fluoxetine-clomipramine interaction." J Clin Psychiatry 56 (1995): 171-2
Preskorn SH, Baker B "Fatality associated with combined fluoxetine-amitryptyline therapy." JAMA 277 (1997): 1682
Downs JM, Dahmer SK "Fluoxetine and elevated plasma levels of tricyclic antidepressants." Am J Psychiatry 147 (1990): 1251
Ciraulo DA, Shader RI "Fluoxetine drug-drug interactions. II." J Clin Psychopharmacol 10 (1990): 213-7
Nierenberg DW, Semprebon M "The central nervous system serotonin syndrome." Clin Pharmacol Ther 53 (1993): 84-8
Popli AP, Baldessarini RJ, Cole JO "Interactions of serotonin reuptake inhibitors with tricyclic antidepressants." Arch Gen Psychiatry 51 (1994): 666-7
Martin TG "Serotonin syndrome." Ann Emerg Med 28 (1996): 520-6
Sternbach H "The serotonin syndrome." Am J Psychiatry 148 (1991): 705-13

Prozac (Fluoxetine Solution)

Generic Name: fluoxetine

Brand name: Prozac, Prozac Weekly, Sarafem, Rapiflux, Selfemra, PROzac Pulvules

Synonyms: Prozac, Prozac Capsules

What is Prozac (Fluoxetine Solution)?

Tofranil

Generic Name: imipramine

Brand name: Tofranil, Tofranil-PM

Synonyms: n.a.

What is Tofranil?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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