Sarafem: Effective Relief for Premenstrual Dysphoric Disorder
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Sarafem is a prescription medication specifically indicated for the treatment of Premenstrual Dysphoric Disorder (PMDD), a severe form of premenstrual syndrome. It contains fluoxetine hydrochloride, a selective serotonin reuptake inhibitor (SSRI) that works by restoring the balance of serotonin in the brain, which can help alleviate the intense emotional and physical symptoms associated with PMDD. This medication is designed for women whose daily functioning is significantly impaired by severe premenstrual symptoms and who require a targeted therapeutic approach under medical supervision.
Features
- Contains fluoxetine hydrochloride, a well-established SSRI
- Available in easy-to-swallow capsules in multiple strengths (10 mg, 20 mg)
- Specifically FDA-approved for the treatment of PMDD
- Can be taken with or without food for patient convenience
- Manufactured under strict quality control standards
Benefits
- Significantly reduces severe mood swings, irritability, and tension
- Decreases feelings of sadness, hopelessness, or anxiety associated with PMDD
- Helps improve overall emotional stability during the luteal phase
- May reduce physical symptoms such as bloating and breast tenderness
- Enhances daily functioning and quality of life
- Provides a targeted approach for a condition often misunderstood or misdiagnosed
Common use
Sarafem is primarily prescribed for the management of Premenstrual Dysphoric Disorder in women who meet specific diagnostic criteria. It is typically used when symptoms are severe enough to interfere with work, school, social activities, or relationships. Healthcare providers may consider Sarafem after other interventions have proven insufficient, and it is generally prescribed as part of a comprehensive treatment plan that may include lifestyle modifications and counseling.
Dosage and direction
The recommended starting dosage of Sarafem is 20 mg daily, taken either continuously throughout the menstrual cycle or limited to the luteal phase (typically the 14 days before menstruation begins). Your physician may adjust the dosage based on therapeutic response and tolerability, with a maximum recommended dose of 80 mg daily. Capsules should be swallowed whole with water and may be taken with or without food. It is important to take Sarafem at approximately the same time each day to maintain consistent blood levels.
Precautions
Patients should be monitored closely for clinical worsening, suicide risk, or unusual changes in behavior, especially when initiating therapy or changing doses. Sarafem may cause drowsiness or impair judgment, thinking, or motor skills—caution should be exercised when operating machinery or driving. Use with caution in patients with a history of seizures, mania, hyponatremia, or bleeding disorders. Regular monitoring of electrolyte levels may be necessary in at-risk populations. Discontinuation should be gradual rather than abrupt to avoid withdrawal symptoms.
Contraindications
Sarafem is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI treatment due to risk of serotonin syndrome. It is also contraindicated in patients taking pimozide or thioridazine. Sarafem should not be used in patients with known hypersensitivity to fluoxetine hydrochloride or any component of the formulation. Use is contraindicated in patients with uncontrolled narrow-angle glaucoma.
Possible side effects
Common side effects may include headache, nausea, insomnia, fatigue, drowsiness, anxiety, nervousness, sweating, and decreased libido. Less frequently, patients may experience dry mouth, indigestion, rash, or yawning. Some patients may report weight changes. Serious side effects requiring immediate medical attention include serotonin syndrome symptoms (agitation, hallucinations, fever), abnormal bleeding, seizures, angle-closure glaucoma, hyponatremia, or manic episodes.
Drug interaction
Sarafem has numerous potential drug interactions. It may increase levels of drugs metabolized by CYP2D6 (including tricyclic antidepressants, antipsychotics, and some beta-blockers). Concurrent use with other serotonergic drugs (tramadol, triptans, other SSRIs/SNRIs) increases serotonin syndrome risk. Use with NSAIDs, aspirin, or warfarin may increase bleeding risk. Sarafem may interact with tryptophan, lithium, drugs that prolong QT interval, and anticonvulsants. Always inform your healthcare provider of all medications, including over-the-counter drugs and supplements.
Missed dose
If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Consistent dosing is important for maintaining therapeutic effect, particularly when using the luteal-phase dosing regimen.
Overdose
Symptoms of overdose may include nausea, vomiting, agitation, restlessness, hypomania, seizures, and serotonin syndrome. In severe cases, cardiovascular effects such as tachycardia and ECG changes may occur. Fatalities have been reported in combination with other drugs but are rare with fluoxetine alone. Suspected overdose requires immediate medical attention. Treatment is supportive and symptomatic; there is no specific antidote.
Storage
Store at room temperature (20-25°C or 68-77°F) in a tightly closed container, protected from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly dispose of any unused medication through medication take-back programs or according to FDA guidelines.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Sarafem is available by prescription only and should be used under the direct supervision of a qualified healthcare professional. Individual results may vary. Always consult with your physician before starting, changing, or discontinuing any medication.
Reviews
Clinical studies have demonstrated Sarafem’s efficacy in significantly reducing the symptoms of PMDD compared to placebo. Many patients report substantial improvement in emotional and physical symptoms, with effects typically noticeable within the first treatment cycle. Some users note initial side effects that often diminish with continued use. Healthcare providers generally consider Sarafem an important option in the management of severe PMDD when prescribed appropriately to suitable candidates.



