Fluoxetine Gel

Fluoxetine Gel
Usage
Fluoxetine gel is a compounded topical formulation of a selective serotonin reuptake inhibitor (SSRI), used in specialist-directed applications where localised or transdermal delivery may be beneficial.
It may be prescribed for:
• Localized neuropathic pain or sensory disorders
• Chronic pain syndromes where neuromodulation may help
• Transdermal delivery in patients unable to tolerate oral SSRIs
• Other practitioner-directed uses where topical serotonergic modulation is appropriate
Use should be under the supervision of a qualified healthcare professional, as this is an off-label compounded preparation.

Dosage
Dosage and frequency should be determined by the prescribing practitioner based on the condition and treatment goals.
Typical dosing considerations include:
• Apply a thin layer to the affected area once or twice daily, or as directed
• Apply to clean, dry, intact skin
• Avoid contact with eyes, mucous membranes, or broken skin
• Wash hands after application unless the hands are the treatment site
Patients should follow the specific instructions provided by their healthcare provider.

Mechanisms of Action
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI).
Its mechanisms include:
Inhibition of serotonin reuptake
Fluoxetine blocks the reuptake of serotonin (5-HT), increasing its availability.
Neuromodulation of pain pathways
Increased serotonin may help modulate peripheral and central pain signalling, potentially reducing neuropathic pain.
Local and/or systemic effects
Topical application may provide localised neuromodulatory effects, with potential for limited systemic absorption depending on formulation.

Contraindications
Fluoxetine gel should not be used in patients with:
• Hypersensitivity to fluoxetine or any component of the formulation
• Concurrent use of monoamine oxidase inhibitors (MAOIs) or within the recommended washout period
• Known contraindications to SSRI therapy

Precautions
Fluoxetine gel should be used with caution in patients with:
• Concurrent use of serotonergic medications, due to risk of serotonin syndrome
• History of psychiatric conditions, including bipolar disorder
• Hepatic impairment
• Broken or damaged skin, which may increase systemic absorption
Additional considerations include:
• Systemic absorption may occur, particularly with large application areas or prolonged use
• Possible local side effects include skin irritation or redness
• Rare systemic effects may include mood changes, agitation, or gastrointestinal symptoms
• Patients should seek medical advice if they experience confusion, restlessness, or unusual behavioural changes

Storage
• Store below 25°C unless otherwise directed
• Keep the container tightly closed when not in use
• Protect from heat, moisture, and direct light
• Do not freeze unless specifically instructed
• Keep out of reach of children and pets
Patients should follow the storage instructions provided on the dispensing label supplied by the pharmacy.