Fluoxetine

What Is Fluoxetine

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) widely used as an antidepressant.

What are the uses of this medicine?

Fluoxetine is indicated for the treatment of:

• Acute and maintenance treatment of Major Depressive Disorder .
• Acute and maintenance treatment of obsessions and compulsions in patients with Obsessive Compulsive Disorder (OCD).
• Acute and maintenance treatment of binge-eating and vomiting behaviors in patients with moderate to severe Bulimia nervosa.
• Acute treatment of Panic Disorder, with or without agoraphobia.

Who Should Not Use Fluoxetine?

Do not take fluoxetine if you:

• are allergic to fluoxetine hydrochloride or any of the ingredients in fluoxetine.
• take a Monoamine Oxidase Inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid.
• Do not take an MAOI within 5 weeks of stopping fluoxetine unless directed to do so by your physician.
• Do not start fluoxetine if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your physician.

Is this medicine FDA approved?

• Fluoxetine was approved for use in the United States in 1987 and it became one of the most widely used antidepressant medications, more than 20 million prescriptions being written yearly.

How should this medicine be used?

• Fluoxetine is available as tablets and capsules of 10, 20 and 40 mg and in an oral solution of 20 mg/5 mL, in multiple generic forms and under the brand names of Prozac and Sarafem.
• Fixed combinations of fluoxetine with olanzapine (Symbyax and generic forms) are also available.

What is the dosage and brand name(s) of this medicine?

A long acting formulation of 90 mg of fluoxetine has been developed for once weekly dosing (Prozac weekly). The recommended dosage of standard formulations of fluoxetine in adults is 20 mg once daily, increasing to 40 mg daily if necessary and not exceeding 80 mg daily.

This medicine is available in following brand names:

• Prozac
• Prozac Weekly
• Rapiflux
• Sarafem
• Selfemra

What side effects can this medication cause?

Common possible side effects of fluoxetine include:

• unusual dreams
• sexual problems
• loss of appetite, diarrhea, indigestion, nausea or vomiting, weakness, or dry mouth
• flu symptoms
• feeling tired or fatigued
• change in sleep habits
• yawning
• sinus infection or sore throat
• tremor or shaking
• sweating
• feeling anxious or nervous
• hot flashes
• rash

Other side effects in children and adolescents include:

• increased thirst
• abnormal increase in muscle movement or agitation
• nose bleed
• urinating more often
• heavy menstrual periods
• possible slowed growth rate and weight change. Your child’s height and weight should be monitored during treatment with fluoxetine.

What special precautions should I follow?

• All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases.

What to do in case of emergency/overdose?

Symptoms of overdose may include the following:

• unsteadiness
• confusion
• unresponsiveness
• nervousness
• uncontrollable shaking of a part of the body
• dizziness
• rapid, irregular, or pounding heartbeat
• seeing things or hearing voices that do not exist (hallucinating)
• fever
• fainting
• coma (loss of consciousness for a period of time)

Can this medicine be used in pregnancy?

• Fluoxetine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
• When treating a pregnant woman with fluoxetine, the physician should carefully consider both the potential risks of taking an SSRI, along with the established benefits of treating depression with an antidepressant.
• The decision can only be made on a case by case basis.

What should I know about storage and disposal of this medication?

• Store at Controlled Room Temperature, 20° to 25°C (68° to 77°F).
• Protect from light.

The following are antidepressant subclasses and drugs

MAO Inhibitors Isocarboxazid, Phenelzine, Tranylcypromine

SNRIs Duloxetine, Levomilnacipran, Venlafaxine

SSRIs Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Vilazodone, Vortioxetine

Tricyclics Amitriptyline, Amoxapine, Clomipramine, Desipramine, Doxepin, Imipramine, Nortriptyline, Protriptyline, Trimipramine

Miscellaneous Bupropion, Flibanserin, Mirtazapine, Nefazodone, Trazodone

• Dailymed label info on Fluoxetine
• FDA Fluoxetine