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How to dissolve fluoxetine

From: Cdbojrab@aol.com (Christopher D. Bojrab, M.D.)
Date: Thu, 16 Mar 1995 23:21:21 -0500
Subject: What to dissolve fluoxetine in

Lilly recommends dissolving the pulvules in water, Lemon-Lime Gatorade, apple juice, or Ocean Spray Cran-Grape. Thus prepared the solution will be stable in a refrigerator for 14 days.

From: jejoy@gnn.com (James E Joy)
Date: Fri, 17 Mar 1995 00:57:37 -0500
Subject: What to dissolve fluoxetine in

Have looked into this with Dista (manufacturer) and was advised that cranberry juice was ideal, for up to two weeks when refrigerated. Used a lot with kids. pH fairly acidic, said to be preferable to apple juice.

Date: Fri, 17 Mar 1995 09:07:53 -0600
From: crismonl@MAIL.utexas.edu (M. Lynn Crismon)
Subject: What to dissolve fluoxetine in

Folks at Lilly say that fluoxetine in orange juice is stable for up to two weeks. Cranberry juice has also ben used, and know one group who nicknames this "Cranzac!"

From: Cdbojrab@aol.com (Christopher D. Bojrab, M.D.)
Date: Fri, 12 Jan 1996 20:54:17 -0500
Subject: Instructions for diluting fluoxetine

The following is something I made to give to patients when I start them on fluoxetine for panic disorder (usually initially with clonazepam). They have found it very useful to have something to take home and to refer to, and it saves me from having to write it out for each patient individually.

Instructions for diluting Prozac

Prozac is very effective in treating depression, anxiety, and panic disorder.

Prozac is available in 10 and 20 mg capsules and as a liquid solution of 20 mg per 5 ml/cc. The standard 20 mg capsules are the least expensive dosage form on a cost per dose basis. Most people are able to take the 20 mg capsule from day one with few or no side-effects.

However, some patients, especially those with significant anxiety, may experience a boost of energy which feels like increased anxiety if they start at a "normal" dose. It is often helpful to start lower. Some people begin at a dose of 5 mg per day and increase their daily dose by 5 mg each week, working up to a dose of 20 mg by the fourth week. Others are able to increase their dose more rapidly, some proceed more slowly.

Below are directions for diluting Prozac to decrease the likelihood of side-effects. These recommendations are made purely for your comfort and convenience.

Prozac can be very irritating to the eyes! Avoid getting the powder contents of the capsules near your eyes and thoroughly wash your hands after handling the powder contents.

Option A:

  1. Obtain a 100 ml (100 cc) bottle, available at most pharmacies.

  2. Fill the bottle with water, Gatorade, apple juice, or Ocean Spray Cran-Grape juice to the 100 ml/cc mark.

  3. Open five 20 mg Prozac capsules and empty their contents into the bottle, discarding the gelatin capsules.

  4. Shake well and refrigerate. This mixture will remain stable for at least 14 days in the refrigerator.

This dilution of five 20 mg capsules in 100 ml/cc of liquid will give a concentration of 1 mg Prozac per 1 ml/cc of liquid. This will allow easy dosing using either an oral syringe or a teaspoon (1 teaspoon = 5 ml/cc liquid = 5 mg Prozac).

Option B:

Dissolve the contents of one 20 mg capsule in a glass of water, Gatorade, apple juice, or Ocean Spray Cran-Grape juice. Stir until the powder is dissolved.

For a 5 mg dose: drink 1/4 of the glass.
For a 10 mg dose: drink 1/2 of the glass.
For a 15 mg dose: drink 3/4 of the glass (and discard the rest).

Date: 13 Jan 96 09:53:42 EST
From: "Kip Doran M.D." <74444.3204@compuserve.com>
Subject: Instructions for diluting fluoxetine

When I instruct patients (verbally so far, but I like your use of written instructions better) on the procedure for single capsule dilution, I suggest they use a glass or plastic ( but not metal) *measuring cup* to mix and measure. I found that people have very different (and sometimes oddly shaped) glassware at home. Guessing at 1/4 of some irregularly shaped glass can be a challenge. Most of the time it wouldn't make a difference, but in those patients sensitive to the stimulating (and at times panicogenic) effects of Prozac, the difference between 2 and 4 mg of the drug can sometimes be crucial to successful upward titration. Also I think that the visual ability to know *exactly* how much they are taking can be reassuring to these patients, who often may have been over stimulated by traditional doses of Prozac or other antidepressants in previous attempts.

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[dr. bob] Dr. Bob is Robert Hsiung, MD, dr-bob@uchicago.edu

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