Affex

What’s the dose?

The usual dose is:

• Depression: The recommended dose is 1 capsule (20 mg) daily. Your doctor will review and adjust your dosage if necessary within 3 to 4 weeks of the start of treatment. If required, the dosage can be gradually increased up to a maximum of 3 capsules (60 mg) daily. The dose should be increased carefully to ensure that you receive the lowest effective dose. You may not feel better immediately when you first start taking your medicine for depression. This is usual because an improvement in depressive symptoms may not occur until after the first few weeks. Patients with depression should be treated for at least 6 months.
• Bulimia nervosa: The recommended dose is 3 capsules (60 mg) daily.
• OCD: The recommended dose is 1 capsule (20 mg) daily. Your doctor will review and adjust your dosage if necessary after 2 weeks of treatment. If required, the dosage can be gradually increased up to a maximum of 3 capsules (60 mg) daily. If no improvement is noted within 10 weeks, your doctor will reconsider your treatment.

Could it interact with other tablets?

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines (up to 5 weeks ago) including medicines obtained without prescription.

Affex may affect the way some other medicines work (interaction), especially the following:

• Certain MAO-inhibitors (used to treat depression). Non-selective MAO-inhibitors and MAO-inhibitors type A (moclobemide) must not be used with Affex as serious or even fatal reactions (serotonin syndrome) can occur (see section “Do not take Affex”). Some MAO-inhibitors type B (selegeline) can be used with Affex provided that your doctor monitors you closely.
• lithium, tryptophan; there is an increased risk of serotonin syndrome when these drugs are taken with Affex. Your doctor will carry out more frequent check-ups.
• phenytoin (for epilepsy); because Affex may influence the blood levels of this drug, your doctor may need to introduce phenytoin more carefully and carry out check-ups when given with Affex.
• clozapine (used to treat certain mental disorders), tramadol (a painkiller) or triptans (for migraine); there is an increased risk of hypertension (raised blood pressure).
• flecainide or encainide (for heart problems), carbamazepine (for epilepsy), tricyclic antidepressants (for example imipramine, desipramine and amitriptyline); because Affex may possibly change the blood levels of these medicines, your doctor may need to lower their dose when administered with Affex
• warfarin or other medicines used to thin the blood; Affex may alter the effect of these medicines on the blood. If Affex treatment is started or stopped when you are taking warfarin, your doctor will need to perform certain tests.
• You should not start to take the herbal remedy St John’s wort while you are being treated with Affex since this may result in an increase in side effects. If you are already taking St John’s wort when you start on Affex, stop taking St John’s wort and tell your doctor at your next visit.

Herbal supplements should be used with caution and only after informing your doctor first.

What are the possible risks or side-effects?

Some patients have had:

• a combination of symptoms (known as “serotonin syndrome”) including unexplained fever with faster breathing or heart rate, sweating, muscle stiffness or tremor, confusion, extreme agitation or sleepiness (only rarely);
• feelings of weakness, drowsiness or confusion mostly in elderly people and in (elderly) people taking diuretics (water tablets);
• prolonged and painful erection;
• irritability and extreme agitation.

If you have any of the above side effects, you should tell your doctor immediately.

If you have any of the following symptoms and they bother you, or last for some time, tell your doctor or a pharmacist.

• Whole body - chills, sensitivity to sunlight, weight loss.
• Digestive system - diarrhoea and stomach upsets, vomiting, indigestion, difficulty swallowing or a change in taste, or a dry mouth. Abnormal liver function has been reported rarely, with very rare cases of hepatitis.
• Nervous system - headache, sleep problems or unusual dreams, dizziness, poor appetite, tiredness, abnormally high mood, uncontrollable movements, fits, extreme restlessness, hallucinations, untypical wild behaviour, confusion, agitation, anxiety, nervousness, not being able to concentrate or think properly, panic attacks; or thoughts of suicide or harming yourself.
• Urogenital system and reproductive disorders - difficulty passing urine or passing urine too frequently, poor sexual performance, prolonged erections, and producing breastmilk.
• Respiratory System - sore throat, shortness of breath. Lung problems (including inflammatory processes of varying histopathology and/or fibrosis) have been reported rarely.
• Other - hair loss, yawning, blurred vision, unexplained bruising or bleeding, sweating, hot flushes, feeling dizzy when you stand up, or joint or muscle pain, low levels of sodium in the blood.

Most of these side effects are likely to disappear with continued treatment.

• In children and adolescents (8-18 years) – Affex may slow growth or possibly delay sexual maturity.
• If any of the side effects gets serious, or if you notice any side effects not listed, please tell your doctor or pharmacist.

Can I drink alcohol while taking it?

You should avoid alcohol while taking Affex.
Always ask your doctor/pharmacist however as this may depend on what other tablets you are taking.

What if I’m pregnant/breastfeeding?

Affex can be used during pregnancy but with extreme caution especially in late pregnancy.

If treatment with Affex is considered necessary, discontinuation of breast-feeding should be considered; however, if breast-feeding is continued, the lowest effective dose of Affex should be prescribed.

If you have any more questions please ask your Pharmacist.

Remember to keep all medicines out of reach of children

Please Note: We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.

References:

http://www.pnd.ie/main/showtopic.php?topic=17

http://www.drugs.com/international/affex.html

https://www.google.ie/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0ahUKEwiaxN