Comparative Pharmacology
Head-to-head clinical analysis: CELEXA versus SARAFEM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CELEXA versus SARAFEM.
CELEXA vs SARAFEM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Selective serotonin reuptake inhibitor (SSRI); potentiates serotonergic activity in the CNS by blocking reuptake of serotonin into presynaptic neurons.
SARAFEM (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI). It potentiates serotonergic activity in the CNS by inhibiting the reuptake of serotonin at the presynaptic neuronal membrane, enhancing serotonin effects in the synaptic cleft.
20 mg orally once daily initially, may increase to 40 mg once daily after at least 1 week; maximum 40 mg/day.
10-20 mg orally once daily initially, may increase to 40 mg/day after 3 weeks if needed; maximum 80 mg/day
None Documented
None Documented
Terminal elimination half-life is approximately 35 hours (range 23–45 h) in healthy adults. This long half-life allows once-daily dosing; steady state is reached in about 1 week. In elderly patients, half-life may extend to 45–90 hours.
Fluoxetine: 4-6 days after single dose, 4-16 days after chronic dosing; norfluoxetine: 4-16 days after single dose, up to 16-20 days after chronic dosing. The long half-life minimizes withdrawal symptoms and allows for once-weekly dosing.
Primarily renal: 75% as metabolites (10% as parent citalopram, 65% as desmethylcitalopram, didesmethylcitalopram, and citalopram-N-oxide). Fecal excretion accounts for approximately 20% of the dose. Biliary excretion minimal.
Primarily renal excretion of fluoxetine (10%) and its active metabolite norfluoxetine (7.5%) as unchanged drug; the remainder is excreted as conjugates and other metabolites. Approximately 2.5% is excreted in feces.
Category C
Category C
SSRI Antidepressant
SSRI Antidepressant