What is fluoxetine?
Fluoxetine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors
(SSRIs). Fluoxetine affects chemicals in the brain that may become unbalanced and cause depression,
panic, anxiety, or obsessive-compulsive symptoms.
Fluoxetine is used to treat major depressive disorder, bulimia nervosa (an eating disorder)
obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder (PMDD).
Fluoxetine is sometimes used together with another medication called olanzapine (Zyprexa) to
treat depression caused by bipolar disorder (manic depression). This combination is also used to treat
depression after at least 2 other medications have been tried without successful treatment of symptoms.
Fluoxetine may also be used for other purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking fluoxetine?
Do not use fluoxetine if you are using any of the following drugs:
-
pimozide (Orap);
-
thioridazine (Mellaril); or
-
an MAO inhibitor such as isocarboxazid (Marplan),
tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl,
Emsam).
Serious and sometimes fatal reactions can occur when these medicines
are taken with fluoxetine. You must wait at least 14 days after stopping an MAO inhibitor before you
can take fluoxetine. You must wait 5 weeks after stopping fluoxetine before you can take thioridazine
(Mellaril) or an MAOI.
If you have any of these other conditions, you may need a dose adjustment or special tests to
safely fluoxetine:
You may have thoughts about suicide while taking an antidepressant,
especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or
suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.
Your family or other caregivers should also be alert to changes in your mood or symptoms.
Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
FDA pregnancy category C. SSRI antidepressants may cause serious or life-threatening
lung problems in newborn babies whose mothers take the medication during pregnancy. However, you
may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are
planning a pregnancy, or if you become pregnant while taking fluoxetine, do not stop taking the
medication without first talking to your doctor.
Fluoxetine can pass into breast milk and may harm a nursing baby. Do not use this
medication without telling your doctor if you are breast-feeding a baby.
Do not give fluoxetine to anyone younger than 18 years old without a doctor's advice.
How should I take fluoxetine?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger
amounts, or take it for longer than recommended by your doctor. Follow the directions on your
prescription label.
Your doctor may occasionally change your dose to make sure you get the best results from the
medication.
Do not break, chew, or open an extended-release capsule. Swallow the pill whole. It is
specially made to release medicine slowly in the body. Breaking the pill would cause too much of the
drug to be released at one time.
Measure the liquid form of fluoxetine with a special dose-measuring spoon or cup, not a regular
table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
It may take 4 weeks or longer before you start feeling better. Do not stop using fluoxetine
without first talking to your doctor. You may have unpleasant side effects if you stop taking this
medication suddenly.
To treat premenstrual dysphoric disorder, the usual dose of fluoxetine is once daily while you
are having your period, or 14 days before you expect your period to start. Follow your doctor's
instructions.
Store fluoxetine at room temperature away from moisture and heat.
What happens if I miss a dose of fluoxetine?
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 extra medicine to make up the missed dose.
If you miss a dose of Prozac Weekly, take the missed dose as soon as you remember and take
the next dose 7 days later. However, if it is almost time for the next regularly scheduled weekly dose,
skip the missed dose and take the next one as directed.
Do not
take extra medicine to
make up the missed dose.
Where can I get more information about fluoxetine?
Your pharmacist has information about fluoxetine written for health professionals that you may read.
What are the possible side effects of fluoxetine?
Get emergency medical help if you have any of these
signs of an allergic
reaction:
skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any new or worsening symptoms such as: mood or
behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated,
hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts
about suicide or hurting yourself.
Call your doctor at once if you have any of these serious side effects:
-
severe blistering, peeling, and red skin rash;
-
very stiff (rigid) muscles, high fever, sweating, fast or
uneven heartbeats, tremors, overactive reflexes;
-
nausea, vomiting, diarrhea, loss of appetite, feeling
unsteady, loss of coordination; or
-
headache, trouble concentrating, memory problems,
weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.
Less serious side effects may include:
-
cold symptoms such as stuffy nose, sneezing, sore throat;
-
drowsiness, dizziness, feeling nervous;
-
mild nausea, upset stomach, constipation;
-
increased appetite, weight changes;
-
sleep problems (insomnia);
-
decreased sex drive, impotence, or difficulty having an
orgasm; or
-
dry mouth.
This is not a complete list of side effects and others may occur. Call your
doctor for medical advice about side effects. You may report side effects to FDA at
1-800-FDA-1088.
What is the most important information I should know about fluoxetine?
Do not take fluoxetine together with pimozide (Orap), thioridazine (Mellaril), or a
monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline
(Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
You may have thoughts about suicide when you first start taking an antidepressant, especially if
you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the
first 12 weeks of treatment.
Call your doctor at once if you have any new or worsening symptoms such as: mood or
behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated,
hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts
about suicide or hurting yourself.
SSRI antidepressants may cause serious or life-threatening lung problems in newborn
babies whose mothers take the medication during pregnancy. However, you may have a relapse of
depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or
if you become pregnant while taking fluoxetine, do not stop taking the medication without first talking to
your doctor.
What should I avoid while taking fluoxetine?
Avoid drinking alcohol, which can increase some of the side effects of fluoxetine.
Fluoxetine can cause side effects that may impair your thinking or reactions. Be careful if
you drive or do anything that requires you to be awake and alert.
What other drugs will affect fluoxetine?
Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This
includes aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin),
naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone
(Relafen), etodolac (Lodine), and others. Taking any of these drugs with fluoxetine may cause you to
bruise or bleed easily.
Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or
allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or
anxiety). They can add to sleepiness caused by fluoxetine.
Tell your doctor about all other medications you are using, especially:
-
alprazolam (Xanax);
-
clozapine (Clozaril, Fazaclo);
-
flecainide (Tambocor);
-
haloperidol (Haldol);
-
seizure medication such as phenytoin (Dilantin) or
carbamazepine (Tegretol);
-
tryptophan (also called L-tryptophan);
-
vinblastine (Velban);
-
a blood thinner such as warfarin (Coumadin);
-
almotriptan (Axert), frovatriptan (Frova), sumatriptan
(Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
-
any other antidepressants such as amitriptyline (Elavil),
escitalopram (Lexapro), imipramine (Tofranil), sertraline (Zoloft), and others.
This list is not complete and there may be other drugs that can interact with
fluoxetine. Tell your doctor about all the prescription and over-the-counter medications you use. This
includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using
a new medication without telling your doctor.
What happens if I have an overdose of fluoxetine?
