Fluoxetine

Common use

Fluoxetine is a prescription medicine used to treat major depressive disorder, bulimia nervosa (an eating disorder), obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder (PMDD). Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant. Fluoxetine inhibits the uptake of serotonin by a nerve cells (neurons) and helps people with depression, panic, anxiety, or obsessive-compulsive symptoms.

Dosage and direction

Take fluoxetine exactly as prescribed by your doctor. Swallow the delayed-release capsule whole and do not crush, chew, break, or open it. Do not stop using fluoxetine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using fluoxetine.

Precautions

Tell your doctor about all other antidepressants you take, especially Celexa, Cymbalta, Desyrel, Effexor, Lexapro, Luvox, Oleptro, Paxil, Pexeva, Symbyax, Viibryd, or Zoloft.
To make sure fluoxetine is safe for you, tell your doctor if you have ever had: cirrhosis of the liver; urination problems; diabetes; narrow-angle glaucoma; seizures or epilepsy; sexual problems; bipolar disorder (manic depression); drug abuse or suicidal thoughts; or electroconvulsive therapy (ECT).
Ask your doctor about taking fluoxetine if you are pregnant. Taking an SSRI antidepressant during late pregnancy may cause serious medical complications in the baby.
If you are breastfeeding, tell your doctor if you notice agitation, fussiness, feeding problems, or poor weight gain in the nursing baby.

Contraindications

You should not use this medicine if you are allergic to fluoxetine, if you also take pimozide or thioridazine.
Do not use fluoxetine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, and tranylcypromine. You must wait at least 14 days after stopping an MAO inhibitor before you take fluoxetine. You must wait 5 weeks after stopping fluoxetine before you can take thioridazine or an MAOI.
Report any new or worsening symptoms to your doctor, 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.
Drinking alcohol can increase certain side effects of fluoxetine.

Possible side effect

Get emergency medical help if you have signs of an allergic reaction to fluoxetine (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
Fluoxetine may cause serious side effects. Call your doctor at once if you have: blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights; fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out); low levels of sodium in the body - headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady; or severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Common fluoxetine side effects may include: sleep problems (insomnia), strange dreams; headache, dizziness, drowsiness, vision changes; tremors or shaking, feeling anxious or nervous; pain, weakness, yawning, tired feeling; upset stomach, loss of appetite, nausea, vomiting, diarrhea; dry mouth, sweating, hot flashes; changes in weight or appetite; stuffy nose, sinus pain, sore throat, flu symptoms; or decreased sex drive, impotence, or difficulty having an orgasm.

Drug interaction

Fluoxetine can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.
Using fluoxetine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.
Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with fluoxetine may cause you to bruise or bleed easily.
Tell your doctor about all your current medicines. Many drugs can affect fluoxetine, especially: any other antidepressant; St. John's Wort; tryptophan (sometimes called L-tryptophan); a blood thinner - warfarin, Coumadin, Jantoven; medicine to treat anxiety, mood disorders, thought disorders, or mental illness - amitriptyline, buspirone, desipramine, lithium, nortriptyline, and many others; medicine to treat ADHD or narcolepsy - Adderall, Concerta, Ritalin, Vyvanse, Zenzedi, and others; migraine headache medicine - rizatriptan, sumatriptan, zolmitriptan, and others; or narcotic pain medicine - fentanyl, tramadol.

Missed dose

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Overdose

Seek emergency medical attention.

Storage

Store at room temperature away from moisture and heat, away from children and pets.