What is Fluoxetine? Uses, effects, side effects & warnings

What is Fluoxetine?

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant. Fluoxetine blocks the absorption of serotonin by nerve cells (neurons) and aids sufferers of anxiety, depression, panic, or obsessive-compulsive disorders.

Fluoxetine is a prescribed medicine that is used in the treatment of major depression as well as bulimia nervosa (an eating disorder), obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorders (PMDD). Fluoxetine can be used with a different medication known as olanzapine (Zyprexa) to combat manic depression caused by bipolar disorders. This is also utilized to treat depression after at least two other drugs have been tried but with no success in treating the symptoms. If you are also taking the medication olanzapine (Zyprexa), be sure to read the Zyprexa medication guide along with the patient's warnings and directions included with the medication.

Warnings

Do not take fluoxetine when you are also taking pimozide, thioridazine, or if you're being treated with Methylene Blue injection. Do not take fluoxetine if you have taken an MAO inhibitor within the last fourteen days (such as isocarboxazid, rasagiline, selegiline, phenelzine, and transcypromine). Don't use fluoxetine if you are taking linezolid, thioridazine, or injections of methylene blue. It is recommended to wait at least 14 days after taking an MAO inhibitor before taking fluoxetine. You have to wait 5 weeks after stopping fluoxetine before you can begin taking thioridazine as well as an MAOI.

Many young people are prone to thoughts of suicide when they first start taking antidepressants. Be aware of fluctuations in mood or symptoms. Fluoxetine can impair judgment or thinking abilities. Take care when operating machinery. Inform your doctor about any new or worsening symptoms, for example, a change in behavior or mood such as anxiety, panic attacks, or trouble sleeping. You should also tell your doctor if you feel angry, irritable, or impulsive, aggressive, active, restless (mentally as well as physically), or more depressed, or if you are thinking about suicide or harming yourself.

Before you Take this Medication

This medicine is for you if you're allergic to fluoxetine or also take thioridazine, pimozide, or pimo. Do not take fluoxetine if you've previously taken an MAO inhibitor within the last 14 days. A potentially dangerous interaction between drugs may occur. MAO inhibitors include isocarboxazid, the linezolid drug, Methylene Blue injection, rasagiline, phenelzine, and tranylcypromine. It is recommended to wait at least 14 days after removing any MAO inhibitor before taking fluoxetine. You have to wait 5 weeks after stopping fluoxetine before you are able to take thioridazine and an MAOI.Discuss with your doctor all other antidepressants that you are taking, particularly Celexa, Cymbalta, Desyrel, Effexor, Lexapro, Luvox, Oleptro, Paxil, Pexeva, Symbyax, Viibryd, or Zoloft.

To ensure that you are safe from fluoxetine, consult your physician, whether you've ever:

The cirrhosis from the liver
Urination issues
Diabetes
Narrow-angle glaucoma
Seizures or epilepsy
Sexual issues
Bipolar Disorder (manic depression)
Suicidal or drug-related thoughts suicidal thoughts or drug abuse
Electroconvulsive Therapy (ECT)

Many young people are prone to thoughts of suicide when first starting an antidepressant. Your doctor should be able to check your progress regularly. Family members or other caregivers should be on the lookout for changes in your symptoms or mood. The older age group is more susceptible to the effects of fluoxetine. Talk to your physician about taking fluoxetine if you are expecting. Taking an SSRI antidepressant in late pregnancy could cause serious medical problems for the infant. But you could experience a relapse of depression if you discontinue using your antidepressant. Contact your doctor right away if you find yourself pregnant. If you're pregnant, your name might be placed on a pregnancy registry in order to monitor any effects of fluoxetine on the infant. If you're breastfeeding, consult your doctor if there is disturbance or fussiness, feeding issues, or a lack of weight gain in your breastfeeding baby.

How to Take Fluoxetine?

Follow the exact dosage of fluoxetine as directed by your physician. Follow all instructions on the label of your prescription and go through the entire medication guide or instruction sheet. The doctor might alter your dosage. Suck this delayed-release capsule intact, and don't crush or chew on it, break it, or break it open. Take care when measuring liquid medicines. Make use of the dosing syringe supplied or a dose-measuring device (not the kitchen spoon). It could take as long as four weeks before symptoms improve. Use the medication exactly according to the directions, and inform your doctor if you feel your symptoms don't improve.

Inform your doctor if there are any changes in your sexual function, such as loss of interest in sexual activity and difficulty having an orgasm, as well as (in males) issues with erections or Ejaculation. Certain sexual issues can be addressed. Don't stop taking fluoxetine abruptly, or you could experience uncomfortable withdrawal symptoms. Consult your physician about how to completely stop using fluoxetine. Keep at room temperature, away from heat and moisture.

Details on Dosage

Usual Adult Dose for Bulimia:

Instant-release oral formulations 60 mg, orally at least once per day in the early morning

Comments:
Some patients might need to start at the lower dose and then titrate gradually over a period of time to the dose that is recommended.
Doses that exceed 60 mg haven't been thoroughly studied in the treatment of bulimia.

Use: A quick and regular treatment for vomiting and binge eating behaviors that are moderate to severe in patients suffering from bulimia.

Usual Adult Dose for Depression:

Oral formulations that are immediate-release:
Initial dosage: 20 mg taken orally every day in the morning. The dose can be increased over time if clinical improvement isn't observed.
Dosage for maintenance 20–60 mg daily orally
Maximum dosage daily: 80 mg oral per day

Oral capsules with delayed release:
Initial dosage: 90 mg taken orally every week, starting 7 days following the last daily dose of fluoxetine immediate-release formulations of 20 mg.

Comments:
Doses that exceed 20 mg daily can be administered in two doses: in the morning and in the afternoon.
The full effect can be delayed until four weeks after treatment.
If a good response to the oral fluoxetine every week is not sustained, then a switch back to daily doses of fluoxetine using immediate-release oral formulations must be contemplated.
Acute symptoms of Major Depressive Disorder (MDD) may require a few months or more of continuous pharmacologic treatment.
The dose required to trigger remission is the equivalent of the dose required to sustain and maintain the euthymia state.

Utilization: An acute and ongoing treatment for MDD

Usual Adult Dose for Obsessive Compulsive Disorder:

Formulations for oral immediate release:
The initial dose is 20 mg, taken orally every day in the morning. This dose can be increased after a few weeks if a sufficient improvement in clinical symptoms is not noticed.
Dose for maintenance: 20 to 60 mg daily orally
Maximum dose daily: 80 mg oral

Comments:
Doses of more than 20 mg per day can be given in doses that are divided in the morning and in the afternoon.
The full effects may be delayed until after five months of therapy.

Treatment: acute as well as regular treatment for obsessions and compulsions in patients suffering from obsessive-compulsive Disorder (OCD)

Usual Adult Dose for Panic Disorder:

Oral formulations that are immediate-release:
Initial dosage: 10 mg orally every day, increasing over a week to 20 mg once every day.
Maintenance dose of 20–60 mg daily orally
Maximum dosage: 60 mg per day.

Comments:
Doses that exceed 20 mg a day can be administered in two doses, in the morning and in the afternoon.
A dose increase could be contemplated after several weeks if improvement in the clinical condition is not seen.
Doses that exceed 60 mg/day are not being studied in a systematic manner for the treatment of panic disorder.

Treatment: Acute treatment for anxiety disorder, panic disorder, and/or agoraphobia

Usual Adult Dose for Premenstrual Dysphoric Disorder:

Formulations for oral immediate release:
Initial dose:
A continuous regimen of 20 mg at least once per day, on every day of the menstrual cycle
The Cyclic regimen is 20 mg taken orally every day, beginning 14 days before the date of menstrual flow until the first full menstrual cycle, and then repeated on every cycle.
Dosage for maintenance 20–60 mg/day for intermittent or continuous regimens
The maximum dosage is 80 mg taken orally per day.

Comments:
A daily dosage of 60 mg hasn't been found to be any more efficient than 20 mg daily.
Daily doses of more than 60 mg have not been studied in a systematic manner for patients suffering from this condition.
The daily dose of 20 mg has been found to be effective for as long as six months of treatment.

Use: Treatment for PMDD (PMDD)

Usual Pediatric Dose for Depression:

Oral formulations that are immediate-release:
Ages 8–18 years:
Initial dosage: 10–20 mg once orally every day. The daily 10 mg dose can be increased after a week to 20 mg daily.

Children with lower weights:
Initial dosage: 10 mg daily, orally. then increased to 20 mg every day after a few weeks if a sufficient improvement in clinical symptoms is not noticed.
Dose for maintenance 10–20 mg once orally every day

Comments:
The full effect can be delayed until four weeks after treatment.
Potential risks and clinical necessity should be evaluated prior to the use of this drug in children and adolescents.

Treatment: Acute as well as ongoing treatment for MDD

Usual Pediatric Dose for Obsessive Compulsive Disorder:

Oral formulations that are immediate-release:
7 to 17 years old:
Adolescents and children with higher weights:
Initial dosage: 10 mg every day orally, then increased to 20 mg every day for two weeks.
Dose for maintenance 20–60 mg daily orally
Maximum dosage: 60 mg taken orally per day.

Children with lower weights:
Initial dose: 10 mg taken orally daily, then increased after a few weeks if clinical improvement isn't observed.
Maintenance dose: 20–30 mg once orally every day.
Maximum dosage: 60 mg per day.

Comments:
Additional dose increases can be considered following a few more weeks of improvement in the clinical picture if it is not enough.
Doses that exceed 20 mg/day can be administered in two doses: in the morning and in the afternoon.
In children with lower weight There is a limited amount of experience with doses that exceed 20 mg daily in comparison to dosages of more than 60 mg daily.
The full effects may be delayed until after five months of therapy.
Potential risks and the clinical need must be assessed prior to utilizing this drug for children and teens.

Treatment: The acute or ongoing treatment of compulsions and obsessions in patients suffering from
OCD

What Happens If I Miss a Dose?

You should take the medication as quickly as you are able, but avoid your missed dose if it's close to the time of the next dose. Don't take two doses at a time.

If you do not take the dosage of Prozac weekly and are unable to take it, simply take the dose you missed as soon as you can remember and then start the next dose 7 days later. If, however, it's nearing the time for your next dose scheduled for the week, you should skip the missed dose and instead take the next dose as directed. Do not take additional medication to make up for the missed dose.

What Happens If I Overdose?

Get medical attention in an emergency or contact the Poison Help line toll-free at 1-800-222-1222.

What Should be Avoided?

Drinking alcohol can trigger the effects of fluoxetine. Avoid driving or engaging in hazardous activities until you are aware of the effects of fluoxetine on you. Your reaction could be impaired.

Side Effects of Fluoxetine

Contact a medical professional immediately. If you are experiencing symptoms that indicate that you are experiencing an allergic reaction (hives, breathing problems, and swelling of your throat or face) or an extreme skin reaction (fever, burning eyes, sore throat, or skin rashes, the skin is red or purple with peeling and blisters),

If you notice any new or more severe symptoms, tell your physician, for example, changes in your behavior or mood, anxiety, panic attacks, or trouble sleeping, or if you are feeling uncontrollably angry, angry and aggressive, active, restless (mentally as well as physically), or more depressed, or if you are thinking about suicide or harming yourself.

Fluoxetine can cause severe adverse consequences. Consult your physician immediately if you experience:

Blurred vision blurred vision, tunnel vision, eye swelling or pain, the appearance of halos around lights
Rapid or pounding heartbeats, an eerie feeling in your chest, as well as breathlessness and abrupt fainting (like you're passing out);
Low levels of sodium in the body cause headaches, blurred or slurred speech, extreme weakening, vomiting, lack of coordination, feeling unstable, or
Serious nervous system response extremely rigid (rigid) muscles and sweating; high fever and confusion; rapid or irregular heartbeats; tremors; and a feeling that you could be struck with a stroke.

Get medical attention now if you are experiencing symptoms of serotonin disorder, like agitation, hallucinations, and sweating. Other symptoms include fever, shivering, a high heart rate, stiffness of the muscles, or twitching. Also, you may experience losing coordination, sickness, vomiting, or diarrhea.

Common side effects of fluoxetine could include:

Sleep problems (insomnia), strange dreams;
Headache, dizziness, drowsiness, and vision changes;
The shaking or tremors can make you feel nervous or anxious.
The feeling of weakness, pain, and fatigue. It can be caused by yawning, pain, or a tired feeling.
Uneasy stomach Loss of appetite diarrhea, vomiting;
Dry mouth, sweating, dry mouth, rapid flashes of heat;
Fluctuations in appetite or weight;
Nasal congestion, sinus pain, sore throat symptoms, and
Diminished sex drive, impermanence, or difficulty in having an orgasm.

This isn't a complete list of possible side effects, and other side effects could occur. Contact your physician to seek medical advice on the effects. You can report any adverse reactions to the FDA at 1-800-FDA-1088.

Interaction with Other Drugs

Fluoxetine could cause a serious heart condition. The risk is greater if you are also taking various other drugs to treat asthma, infections, or heart issues. high blood pressure, depression, cancer, mental illness, malaria, or HIV. Utilizing fluoxetine in conjunction with other drugs that cause you to become drowsy could increase the severity of this effect. Talk to your doctor prior to using opioids, sleeping pills, muscle relaxers, or medication for seizures or anxiety. Consult your physician before taking a nonsteroidal anti-inflammatory medicine (NSAID) like Ibuprofen, aspirin (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Utilizing an NSAID along with fluoxetine could cause bruises or easily bleed. Inform your doctor about all the medications you take. A variety of drugs can alter fluoxetine, including:

Any other antidepressant or similar;
John's Wort;
Tryptophan (sometimes known as L-tryptophan);
A blood thinner (Warfarin, Coumadin, Jantoven);
Medications to treat mood disorders, thoughts disorders, or mental illness: buspirone, amitriptyline, lithium, desipramine, nortriptyline, and many more;
Medications that treat ADHD or narcolepsy Adderall, Concerta, Ritalin, Vyvanse, Zenzedi, and more.
Migraine headache medicine: the drugs rizatriptan, sumatriptan, zolmitriptan, and others;
Narcotic pain medicine (fentanyl, tramadol).