Fluoxetine belongs to the group of drugs which are called selective serotonin reuptake inhibitors or SSRIs. This antidepressant is meant to affect unbalanced chemicals in the brain that provoke anxiety, panic, depression or obsessive-compulsive symptoms.
The medicine is prescribed to people who suffer from bulimia nervosa (i.e. an eating disorder), panic disorder, depressive disorder, obsessive-compulsive disorder or premenstrual dysphoric disorder (PMDD).
In some cases Fluoxetine is used for purposes that aren't mentioned in this medication guide.
What should I discuss with my doctor before taking fluoxetine?
The beginning of the treatment using antidepressants may be marked with such symptoms as suicidal thoughts and behavior. People who are under 18 years old run a higher risk of suicidal mood, so if you belong to this category, you should consult with your doctor beforehand.
Keep from combining Fluoxetine with such medications as:
thioridazine (Mellaril);
pimozide (Orap);
monoamine oxidase inhibitors, like isocarboxazid (Marplan) or phenelzine (Nardil), selegiline (Eldepryl, Emsam) or tranylcypromine (Parnate).
In some rare cases a fatal reaction may occur, if Fluoxetine is taken with the drugs listed above. To prevent such an effect you should wait at least 2 weeks after you stopped using a monoamine oxidase inhibitor. In case you need to take thioridazine (Mellaril), wait 5 weeks after stopping the Fluoxetine treatment.
If you have one of the following symptoms, be careful while taking Fluoxetine and consult with your doctor beforehand:
bipolar disorder (manic depression);
cirrhosis of the liver;
diabetes;
a history of drug abuse and/or suicidal thoughts;
kidney disease;
seizures or epilepsy.
In case you have one of these symptoms, you shouldn't take Fluoxetine without an appropriate dosage adjustment and medical tests being passed during treatment.
Fluoxetine has FDA pregnancy category C, i.e. the drug may have a negative effect on the fetus. If you are pregnant or intend to become one, discuss the Fluoxetine treatment with your doctor.
Lab test showed that Fluoxetine may appear in breast milk, so don't keep from breastfeeding while you are under this medication.
How should I take fluoxetine?
You should keep the exact dosage and schedule while taking this drug. In some cases the dosage can be changed to get better results from the treatment.
Extended-release capsules shouldn't be opened, chewed or broken. It is recommended to swallow the pill whole, as the capsule was designed to release the drug slowly in the body. In case the capsule is broken, the amount of Fluoxetine released in your body will be too high.
You should take Fluoxetine at the same time daily.
Generally it takes about 4 days for the patient to notice an improvement. However, you shouldn't stop using the medication until the treatment is over. Otherwise you may experience various side effects.
If you suffer from premenstrual dysphoric disorder, you have to take Fluoxetine one time a day during your period. It is also possible to start taking the drug 2 weeks before the period begins.
Fluoxetine should be stored at room temperature, away from heat and moisture.
What happens if I miss a dose?
If you occasionally missed a dose of Fluoxetine, you should take it as soon as you remember. Nevertheless, once it is almost time for the next dose, it is recommended to skip the missed one and after that to return to your regular schedule. Never double the dose of Fluoxetine to catch up.
In case you take the drug weekly and missed a dose, you should take it as soon as you remember and take the next one in 7 days. But if it is almost time for the next weekly dose, make sure you skipped the missed one and took the next dose as directed. Don't take an extra dose if you missed one.
What happens if I overdose?
If you think you had too much of Fluoxetine, you should seek immediate medical attention. Fluoxetine overdose may be recognized by such symptoms as fever, nausea, vomiting, confusion, fainting, sleepiness, rapid or uneven heartbeat, seizures or even coma.
What should I avoid while taking fluoxetine?
Avoid mixing Fluoxetine with isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), thioridazine (Mellaril) and tranylcypromine (Parnate).
Give up alcohol while you are under Fluoxetine, as it may aggravate its side effects.
Don't take other drugs that cause sleepiness (e.g. muscle relaxants, cold medicines and pain medications). Otherwise these drugs will increase the effect of Fluoxetine, making you very sleepy.
Remember that this medication may result in side effects that impair your mental and physical reactions. That is why you should be very careful while driving of performing tasks that require full alertness.
What are the possible side effects of fluoxetine?
You should seek emergency medical assistance if you notice such allergy symptoms as difficulty breathing, skin rash or hives, and swelling of your lips, throat, tongue or face.
In case you suffer from the following side effects which are absolutely unusual for you and develop to a certain level of intensity, you should see the doctor immediately: mania (mental and/ or physical hyperactivity), mood changes, trouble sleeping, aggressiveness, thoughts of suicide or hurting yourself, anxiety, agitation, panic attacks, severe restlessness or irritability.
Get emergency medical attention if you noticed serious side effects, like:
agitation, confusion, sweating, fast heartbeat
tremors, shivering, muscle stiffness or twitching;
seizure (convulsions);
problems with balance or coordination;
unusual thoughts or behavior;
a red, blistering, peeling skin rash.
Less serious side effects include:
nausea, diarrhea, changes in appetite;
dry mouth, increased sweating;
sleep problems (insomnia);
feeling anxious, nervous, restless, or unable to sit still;
runny nose, sore throat, headache, flu symptoms;
weight changes;
decreased sex drive, impotence, or difficulty having an orgasm; or
drowsiness, dizziness, weakness.
Some patient experience side effects other than listed above. If you detected an unusual side effect, and especially if it is intense, you should see the doctor.
What drug(s) may interact with Fluoxetine?
Fluoxetine may interact with a wide range of drugs, some of which are listed here.
Avoid combining fluoxetine with any of the following drugs:
astemizole (Hismanal®)
cisapride (Propulsid®)
pimozide (Orap®)
terfenadine (Seldane®)
thioridazine (Mellaril®)
medicines called MAO inhibitors-phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), selegiline (Eldepryl®)
Besides the medication may also interact with:
alcohol
amphetamine
aspirin
benzodiazepines, commonly used for anxiety or sleeping problems, such as diazepam or alprazolam
buspirone
carbamazepine
certain diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine)
different medicines for migraine headache (namely almotriptan, dihydroergotamine eletriptan, ergotamine, frovatriptan, methysergide, naratriptan, rizatriptan, sumatriptan and zolmitriptan)
cimetidine
cyproheptadine
dextroamphetamine
dextromethorphan
dofetilide
ergonovine
furazolidone
linezolid
lithium
metoprolol
medicines for diabetes
medicines for mental depression
medicines for mental problems or psychotic disturbances
methylergonovine
nonsteroidal antiinflammatory drugs (NSAIDs, like ibuprofen)
phenytoin
propafenone
propranolol
St. John's wort
warfarin
What is the shelf life of the pills?
The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.
