GENERIC NAMES: Fluoxetine

COMMON BRANDS: Prozac, Sarafem, Prozac Weekly, Rapiflux

Fluoxetine oral capsule is a prescription drug belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). This drug is available with the brand-name Prozac and Prozac Weekly, and it is also available as a generic drug in pharmacies. Generic drugs generally cost less than brand-name versions. In a few cases, they may not be available in every strength or form as brand-name drugs.

What is Fluoxetine used for?

Fluoxetine is a drug used in the treatment of major depressive disorder, obsessive-compulsive disorder, and panic attacks. It acts by helping to restore the balance of certain natural chemical substances in the brain (neurotransmitters like serotonin). Fluoxetine may reduce anxiety, improve your mood, appetite, sleep, and energy level and may help to restore your interest in daily life.

How to use Fluoxetine?

Read the medication guide carefully provided by your pharmacist before you start taking this drug and each time you get a refill. If you have any issues, seek advice from your doctor/pharmacist.

Take this drug by mouth as instructed by your doctor, usually once a day with or without food. Take the whole capsule, and avoid chewing or crushing of the capsule. Increase the dose of the drug after 3-4 week if necessary in adults.

The dosage is based on your medical examination and response to treatment. Take this medication daily to get the most benefit from it. It is crucial to continue taking this medication as prescribed even if you feel well. Do not discontinue taking this medication without discussing with your doctor. Few conditions may become detrimental when the drug is suddenly discontinued. Your dose strength needs to be gradually reduced.

Tell your doctor if your condition worsens or continues.

What are the side effects of Fluoxetine?

See also Warning section.

Dizziness, nausea, drowsiness, anxiety, trouble sleeping, loss of appetite, sweating, tiredness, or yawning may occur. If any of these effects worsen or continue, inform your doctor immediately.

Remember that your doctor has prescribed this medicine because your doctor has found that the benefits are much higher than the risk of side effects. Several people using this medication do not have severe side effects.

Notify your doctor as soon as possible if any of these strange but severe side effects occur like unusual or severe mental/mood changes (agitation, unusually high energy/excitement, thoughts of suicide), easy bruising/bleeding, shakiness (tremor), muscle weakness/spasm, changes in sexual ability, decreased interest in sex, unusual weight loss.

Ask medical assistance as soon as possible if any of these severe but unusual symptoms like bloody/black/tarry stools, vomit that looks coffee grounds, fainting, seizures, fast/irregular heartbeat, signs of kidney problems (for example change in the amount of urine), eye pain/redness/swelling/ widened pupils, vision changes (like rainbows around lights at night, blurred vision).

In diabetic patients, fluoxetine may affect blood sugar levels. Monitor your blood sugar level frequently and inform about the results to your doctor. Your doctor may adjust your medicine, diet, and exercise when you start or stop fluoxetine.

This drug may enhance serotonin and unusually cause a severe condition called serotonin syndrome/toxicity. The risk increases if you are on other medications that increase serotonin, so inform your doctor/pharmacist about all the medicines you are using (see Drug Interactions section). Seek medical assistance immediately if you observe some of the following symptoms like hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/ diarrhea, fast heartbeat, twitching muscles, unexplained fever, unusual agitation/restlessness.

Rarely, males may experience a painful or prolonged erection lasting up to 4 or more hours. If this happens, stop using this drug and get medical assistance immediately, or permanent problems could occur.

A severe allergic reaction to this drug is uncommon. However, get medical assistance immediately if you observe any symptoms of a severe allergic reaction such as rash, itching/swelling (especially of the face/tongue/throat), trouble breathing, severe dizziness.

This is not a full record of all possible side effects. If you mark other effects not listed above, contact your doctor or pharmacist.

What are the precautions while using Fluoxetine?

Before using fluoxetine, inform your doctor/pharmacist if you are allergic to it or if you have any other allergies. This medication may contain inactive ingredients, which can cause allergic reactions or other problems. Speak to your pharmacist for further details.

Before taking this medication, inform your doctor/pharmacist about your medical history, like personal or family history of manic/bipolar-depressive disorder, personal or family history of suicide attempts, diabetes, liver problems, low sodium in the blood (like may occur while taking diuretics), severe loss of body water (dehydration), stomach/intestinal ulcers, seizures, personal or family history of glaucoma (angle-closure type).

Fluoxetine may induce a condition that affects the heart rhythm (QT prolongation). QT prolongation can infrequently cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (like severe dizziness, fainting) that need medical attention immediately.

The chances of QT prolongation may increases if you have certain medical issues or you are on other drugs that may cause QT prolongation. Before taking amitriptyline, inform your doctor/pharmacist about all the medications you are using and if you have the following issues such as certain heart problems (slow heartbeat, heart failure, QT prolongation in the EKG), family history of some heart problems (QT prolongation in the EKG, sudden cardiac death).

Low potassium or magnesium in the blood may enhance your risk of QT prolongation. This risk may rise if you use certain drugs like diuretics (water pills) or if you have certain medical issues like severe sweating, diarrhea, or vomiting. Inform your doctor about taking amitriptyline safely.

Before surgery, inform your doctor/dentist about all the products you are using (including prescription drugs, nonprescription drugs, and herbal products).

Older adults are more prone to the side effects of this drug, mainly dizziness, drowsiness, confusion, dry mouth, constipation, difficulty urinating, and QT prolongation (see above). Dizziness, drowsiness, and confusion can enhance the risk of falling.

Avoid this medication during pregnancy, used only when needed. It may harm the fetus. Moreover, babies born to mothers who have been using this drug during the last trimester(last three months of pregnancy) may unusually develop withdrawal symptoms like breathing/feeding difficulties, seizures, muscle stiffness, or constant crying. In case, if you notice any above symptoms in your newborn baby, inform your doctor promptly.

As untreated mental/mood problems (depression, anxiety, panic disorder) can be a severe condition, do not stop taking this drug unless directed by your doctor. If you are planning a pregnancy, become pregnant, or think you may be pregnant, right away discuss with your doctor about the benefits and risks of using this medication at the time of pregnancy.

Fluoxetine passes into breast milk, and the effect on a nursing infant is unknown. Seek advice from your doctor before breastfeeding.

What are the drug Interactions of Fluoxetine?

Drug interactions may alter how your drug works or may enhance your risk for serious side effects. This list does not consist of all possible drug interactions. Keep a record of all the products you are using including prescription/nonprescription drugs and herbal products and inform your doctor/ pharmacist. Don’t start, stop, or alter the dosage of any medicines without your doctor’s consent.

Fluoxetine can stay in your body for several weeks since your last dose and may interact with many other medications. Before using any drug, inform your doctor/pharmacist if you have taken fluoxetine in the previous five weeks.

Few products that may interact with this drug including drugs removed from your body by specific liver enzymes like vinblastine, tricyclic antidepressants like desipramine/imipramine, antiarrhythmics such as propafenone/flecainide, other drugs that can cause bleeding/bruising like antiplatelet drugs(clopidogrel),”blood thinners” like warfarin, NSAIDs like ibuprofen.

Using MAO inhibitors with this drug may induce a severe (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, phenelzine, procarbazine, methylene blue, moclobemide, rasagiline, safinamide, selegiline, tranylcypromine) during therapy with this medicine. Avoid most MAO inhibitors for two weeks before and after treatment with this drug. Seek advice from your doctor when to start or stop taking this medication.

Several drugs besides fluoxetine may affect the heart rhythm (QT prolongation), like thioridazine, pimozide among others.

Aspirin can raise the risk of bleeding when used with this drug. However, if your doctor has instructed you to take low-dose of aspirin for heart attack or stroke prevention (generally at dosages of 81-325 milligrams per day), regularly take this drug unless your doctor advises you otherwise. Inform your doctor/pharmacist for further details.

The risk of serotonin toxicity/syndrome increases if you are using other drugs that increase serotonin level. Like street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressant SNRIs(duloxetine/venlafaxine), including other SSRIs such as citalopram/paroxetine, tryptophan, among others. The risk of serotonin toxicity/syndrome may be more likely when you start or change the dose of these drugs.

Inform your doctor/pharmacist if you are using other products that cause drowsiness, including marijuana, alcohol, drugs for sleep or anxiety (zolpidem, alprazolam, diazepam), antihistamines (cetirizine, diphenhydramine), muscle relaxants, and narcotic pain relievers (codeine). Check the labels on all your medicines (like an allergy or cough-and-cold products) as they may contain decongestants or ingredients that cause drowsiness. Seek advice from your pharmacist about using those products safely.

This drug may intervene with certain medical/laboratory tests (including brain scan for Parkinson’s disease), likely causing false test results. Ensure that laboratory personnel, and your doctor knows that you are using this drug.

WARNINGS:

Antidepressant drugs are used to treat a variety of conditions, for example, depression and mental/mood disorders. These medications help to prevent suicidal attempts/ thoughts and provide other significant benefits. However, a small number of people (particularly people below 25 years ) who use antidepressants for any condition may observe worsening depression, other mental/ mood symptoms, or suicidal thoughts/attempts. However, it is necessary to seek advice from your doctor about the risks and benefits of the antidepressant medication.

Inform your doctor/physician immediately if you notice worsening of depression/other psychiatric conditions, unexpected behavior changes (possible like suicidal thoughts/attempts), or other mental/mood changes (new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, severe restlessness, impulsive actions, very rapid speech). Carefully observe these symptoms when a new antidepressant drug is started or when the dose is altered.

What are the forms and strengths of Fluoxetine?

Generic: Fluoxetine
Form: Oral capsule
Strengths: 10mg, 20mg, 40mg
Form: Oral delayed-release capsule
Strength: 90mg

Brand: Prozac
Form: Oral capsule
Strengths: 10mg, 20mg, 40mg

Brand: Prozac Weekly
Form: Oral delayed-release capsule
Strength: 90mg

What is the dosage of Fluoxetine?

For Bulimia Nervosa:

Adults (18 to 64 years):

Typical dosage is 60mg per day taken in the morning.

Pediatric:

Children (0 to 17 years):

This drug is not studied in children for this condition. Avoid in people younger than 18 years.

Geriatric:

Older adults (65 years and older):

Your doctor may initially prescribe you a lower dosage or a different schedule. This can help maintain normal levels of this drug in your body and reduce the risk of side effects.

For Major Depressive Disorder:

Adult dosage (18 to 64 years):

Typical dosage: 20–80mg per day.
Maximum dosage: 80mg per day.
Initial dosage: 20mg per day in the morning.

Alternative dosage: Once per week. In this case, your doctor may stop your daily dose of the immediate-release capsules and switch you over to the delayed-release capsules. You’ll take 90mg once a week. You may start taking it seven days after your last daily dose of fluoxetine.

Pediatric:

Children (8 to 17 years):

Typical dosage: 10–20mg per day.
Initial dosage: After your child takes 10mg per day for once a week, your doctor may increase their dosage to 20mg per day.

Children (ages 0–7 years):

This drug must be avoided in children younger than 8 years for this condition.

Geriatric

Older adults (65 years and older):

Your doctor may initially prescribe you a lower dosage or a different schedule. This can help maintain normal levels of this drug in your body and reduce the risk of side effects.

For Obsessive-Compulsive Disorder:

Adult dosage (18 to 64 years):

Typical dosage: 20–60mg per day.
Maximum dosage: 80mg per day.
Initial dosage: 20mg per day taken in the morning.

Pediatric:

Children (13 to 17 years, and higher weight children):

Typical dosage: 20–60mg per day.
Initial dosage: 10mg per day. After two weeks, your doctor may likely increase your child’s dosage to 20mg per day.

Children (7 to 12, and lower weight children):

Typical dosage: 20–30mg per day.
Initial dosage: 10mg per day.

Children (0 to 6 years):

This drug should be avoided in children younger than 7 years for this condition.

Geriatric:

Older adults (65 years and older):

Your doctor may initially prescribe you a lower dosage or a different schedule. This can help maintain normal levels of this drug in your body and reduce the risk of side effects.

For Panic Disorder:

Adult dosage (18 to 64 years):

Typical dosage: 20–60mg per day.
Initial dosage: 10mg per day. After a week, your doctor/physician will likely increase your dosage to 20mg per day.

Pediatric:

Children (0 to 17 years):

This drug is not studied in children for this condition. Avoid in people younger than 18 years.

Geriatric:

Older adults (65 years and older):

Your doctor may initially prescribe you a lower dosage or a different schedule. This can help maintain normal levels of this drug in your body and reduce the risk of side effects.

Disclaimer

TheMedPharma has made every effort to make sure that all the information is factually correct, comprehensive, and up-to-date. However, this website should not be considered as a substitute for the advice, knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or licensed health care professional before taking any medication. The drug information contained herein is subjected to changes if required. The lack of warnings or other information for a given drug does not mean that the drug or its combination is safe, effective or appropriate for use in all patients.