Fluoxetine

What is the most important information I should know about Fluoxetine?

• While you are taking Fluoxetine you may need to be monitored for worsening symptoms of depression and/or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking Fluoxetine. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Fluoxetine. Do not stop taking Fluoxetine.
• Do not stop taking Fluoxetine without first talking to your doctor. It may take several weeks before you to start feeling better.
  

What is Fluoxetine?

• Fluoxetine is in a class of drugs called selective serotonin reuptake inhibitors. Fluoxetine affects chemicals in the brain that may become unbalanced and cause depression or mood disturbances, eating disorders, or obsessive or compulsive symptoms.
• Fluoxetine is used to treat depression, obsessive-compulsive disorders, panic disorder, and bulimia (binge eating and purging). Fluoxetine is also used to treat premenstrual dysphoric disorder (PMDD), symptoms of which occur in the week or two before a woman's menstrual period and commonly include irritability, mood swings, and tension as well as the physical symptoms of bloating and breast tenderness.
• Fluoxetine may also be used for purposes other than those listed in this medication guide.
  

What should I discuss with my healthcare provider before taking Fluoxetine?

• While you are taking Fluoxetine you may need to be monitored for worsening symptoms of depression and/or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking Fluoxetine. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Fluoxetine. Do not stop taking Fluoxetine.
• Do not take Fluoxetine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks. Serious, and sometimes fatal, reactions have occurred when these medicines have been used together. Also, do not take Fluoxetine if you are taking thioridazine (Mellaril). Dangerous, even fatal irregular heartbeats may occur if these medicines are taken together. You must wait 5 weeks after stopping Fluoxetine before taking thioridazine (Mellaril).
• Before taking Fluoxetine, tell your doctor if you
  · have liver disease;
  · have kidney disease;
  · have diabetes;
  · suffer from seizures; or
  · suffer from mania or have suicidal thoughts.
• You may not be able to take Fluoxetine, or you may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Fluoxetine is in the FDA pregnancy category C. Babies exposed to Fluoxetine and/or other drugs of the same class during the third trimester of pregnancy may develop medical complications. Discuss the risks with your doctor. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• Fluoxetine passes into breast milk and may affect a nursing infant. Do not take Fluoxetine without first talking to your doctor if you are breast-feeding a baby.
  

How should I take Fluoxetine?

• Take Fluoxetine exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with water.
• To ensure that you get the correct dose, measure the oral solution with a dose-measuring cup or spoon, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
• Fluoxetine may be taken with or without food.
• Try to take Fluoxetine at the same time each day.
• Take Prozac Weekly on the same day each week as directed by your doctor.
• Do not stop taking Fluoxetine without first talking to your doctor. It may take several weeks before you to start feeling better.
• It is important to take Fluoxetine regularly to get the most benefit.
• Your doctor may want to perform tests or schedule appointments to monitor your treatment with Fluoxetine.
• Store Fluoxetine at room temperature away from moisture and heat.
  

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication unless otherwise directed by your doctor.
  

What happens if I overdose?

• Seek emergency medical attention if an overdose is suspected.
• Symptoms of a Fluoxetine overdose include nausea, vomiting, tremor, agitation, seizures, drowsiness, hyperactivity, and enlarged pupils.
  

What should I avoid while taking Fluoxetine?

• Use caution when driving, operating machinery, or performing other hazardous activities. Fluoxetine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Use alcohol cautiously. Alcohol may increase drowsiness or dizziness while taking Fluoxetine.
  

What are the possible side effects of Fluoxetine?

• If you experience any of the following serious side effects, stop taking Fluoxetine and contact your doctor immediately or seek emergency medical treatment:
  · an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  · an irregular heartbeat or pulse;
  · low blood pressure (dizziness, weakness);
  · high blood pressure (severe headache, blurred vision);
  · chills or fever;
  · unusual bleeding or bruising;
  · a rash or hives.
• If you experience any of the following less serious side effects, continue taking Fluoxetine and talk to your doctor:
  · headache, tremor, nervousness, or anxiety;
  · difficulty concentrating;
  · nausea, diarrhea, dry mouth, or changes in appetite or weight;
  · weakness;
  · increased sweating;
  · sleepiness or insomnia; or
  · decreased sex drive, impotence, or difficulty having an orgasm.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
  

What other drugs will affect Fluoxetine?

• Do not take Fluoxetine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks. Serious, and sometimes fatal, reactions have occurred when these medicines have been used together. Also, do not take Fluoxetine if you are taking thioridazine (Mellaril). Dangerous, even fatal irregular heartbeats may occur if these medicines are taken together. You must wait 5 weeks after stopping Fluoxetine before taking thioridazine (Mellaril).
• Before taking Fluoxetine, tell your doctor if you are taking any of the following medicines:
  · a benzodiazepine such as diazepam (Valium), alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), temazepam (Restoril), triazolam (Halcion), and others;
  · a tricyclic antidepressant such as amitriptyline (Elavil), imipramine (Tofranil), doxepin (Sinequan), nortriptyline (Pamelor), and others;
  · St. John's wort;
  · a phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), and others;
  · lithium (Lithobid, Eskalith, others) or haloperidol (Haldol);
  · almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig);
  · carbamazepine (Tegretol) or phenytoin (Dilantin);
  · warfarin (Coumadin); or
  · digoxin (Lanoxin).
• You may not be able to take Fluoxetine, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with Fluoxetine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.
  

Where can I get more information?

• Your pharmacist has additional information about Fluoxetine written for health professionals that you may read.