Mental health medication

Provided by You Health for patients

Generic for Prozac® (Fluoxetine)

In this medication overview
  1. Usage

    How to get the most out of your treatment

  2. Warnings

    Important safety information

  3. Side Effects

    What to look out for when using your treatment

Fluoxetine is a prescription medicine used to treat major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder, bulimia nervosa, and premenstrual dysphoric disorder (PMDD). (may also be helpful when prescribed “off-label” for body dysmorphic disorder, dysthymia, or posttraumatic stress disorder (PTSD).)

Usage

Take as prescribed
The delayed release form should be swallowed whole. Do not break, crush or chew it.
Do not abruptly stop taking fluoxetine without first checking with your healthcare provider, even when you feel better. Abruptly stopping can cause discontinuation symptoms including: vomiting, irritability, dizziness, headaches, sensation of tingling skin, or nightmares. Studies have shown that a taper can reduce possible discontinuation symptoms. Your healthcare provider can provide individualized guidance on tapering your medication. If you choose to discontinue fluoxetine without consulting your provider, the following are general tapering guidelines for fluoxetine:
  • If you are taking fluoxetine 80mg (equivalent to two 40mg capsules), take 1 capsule (40mg) daily for 1 week, then 1 capsule (40mg) every other day for 1 week, then you may stop your medication.
  • If you are taking fluoxetine 60mg (equivalent to three 20mg capsules), take 2 capsules (40mg) daily for 1 week, then 1 capsule daily for 1 week, then you may stop your medication.
  • If you are taking fluoxetine 40mg, take 1 capsule (40mg) every other day for 1 week, then you may stop your medication.
  • If you are taking fluoxetine 20mg, take 1 capsule (20mg) every other day for 1 week, then you may stop your medication.
Monitor for improvements
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.

Warnings

SUICIDALITY AND ANTIDEPRESSANT DRUGS
Fluoxetine and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. Watch for these changes and inform your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Pay particular attention to such changes when Fluoxetine is started or when the dose is changed.
IMPORTANT SAFETY INFORMATION
Do not take Fluoxetine if you:
  • Are allergic to Fluoxetine, or any of the ingredients in Fluoxetine
  • Take any medicines called monoamine oxidase inhibitor (MAOI), or if you have stopped taking an MAOI within the last 14 days
  • Taking tamoxifen
  • Are drinking alcohol
  • Are using or abusing recreation drugs or prescription medications
Before you take Fluoxetine, tell your healthcare provider if you:
  • Have thoughts of suicide or harming yourself
  • Have a history of psychiatric or medical problems, including bipolar disorder
  • Have taken any medication in the past for your condition, whether effective or not
  • Have suffered adverse or side effects from previous medication therapies
  • Are receiving any non-medication treatment, such as talk therapy
  • Drink alcohol or use/abuse recreational or prescription drugs
  • Are pregnant, plan to become pregnant, or are breastfeeding
Inform your healthcare provider
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.
Fluoxetine may affect the way other medicines work, and other medicines may affect the way Fluoxetine works, causing side effects. Especially tell your healthcare provider if you take any of the following:
  • Aspirin, nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen)
  • Warfarin, and other anticoagulants
  • Any other serotonergic medications, migraine medications (triptans), pain medications (tramadol), antibiotic linezolid, amphetamines
  • Anticonvulsants (phenytoin, carbamazepine)
  • Antipsychotics (haloperidol, aripiprazole)
  • Atomoxetine
  • Tricyclic antidepressants (imipramine, desipramine)
  • Beta blockers (metoprolol, propranolol)
  • Tamoxifen
Fluoxetine is a prescription medicine used to treat major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder, bulimia nervosa, and premenstrual dysphoric disorder (PMDD). (may also be helpful when prescribed “off-label” for body dysmorphic disorder, dysthymia, or posttraumatic stress disorder (PTSD)).
Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
Medication disposal

If you no longer need your medication, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.


If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can visit FDA- Disposal of Unused Medicines for more information or follow these simple steps to dispose of most medicines in your trash at home:
  • Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
  • Place the mixture in a container such as a sealed plastic bag;
  • Throw away the container in your trash at home; and
  • Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.

Side effects

Fluoxetine can cause serious side effects and should be reported to your provider immediately. Rarely reported side effects include:
  • Low sodium blood levels (symptoms may include headache, weakness and difficulty remembering or concentrating)
  • Angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye)
  • Serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death)
  • Increased bleeding (gums)
  • Seizure
  • Teeth grinding
  • QT prolongation and ventricular arrhythmia including Torsades de Pointes (changes in the electrical activity of your heart; symptoms may include fast, slow or irregular heartbeat, shortness of breath, and dizziness or fainting)
  • Increased risk of bleeding events when combined with use of aspirin, nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen), warfarin, and other anticoagulants
During treatment with this medication, common side effects of this medication may go away as your body adjusts to the medication. The most common side effects of Fluoxetine are:
  • Headache
  • Nausea
  • Diarrhea
  • Dry mouth
  • Increased sweating
  • Feeling nervous
  • Restless
  • Fatigued
  • Sleepy or having trouble sleeping (insomnia).
  • Sexual side effects, such as problems with orgasm or ejaculatory delay often do not diminish over time.
Where to find more side effects information
For more information, read the drug information that comes with your medication, ask your healthcare provider, or ask your pharmacist.