Fluoxetine

What is flouxetine?

Fluoxetine is used to treat depression, obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), some eating disorders, and panic attacks (sudden, unexpected attacks of extreme fear and worry about these attacks). Fluoxetine is also used to relieve the symptoms of premenstrual dysphoric disorder, including mood swings, irritability, bloating, and breast tenderness. It is also used along with olanzapine (Zyprexa) to treat depression that did not respond to other medications and episodes of depression in people with bipolar I disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Fluoxetine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.

How should this medicine be used?

Fluoxetine comes as a capsule, a tablet, a delayed-release (releases the medication in the intestine) capsule, and a solution (liquid) to take by mouth. Fluoxetine may be taken with or without food. Fluoxetine capsules, tablets, and liquid are usually taken once a day in the morning or twice a day in the morning and at noon. Fluoxetine delayed-released capsules are usually taken once a week. Take fluoxetine at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take fluoxetine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the delayed-release capsules whole; do not cut, crush, or chew them.

Your doctor may start you on a low dose of fluoxetine and gradually increase your dose.

It may take 4 to 5 weeks or longer before you feel the full benefit of fluoxetine. Continue to take fluoxetine even if you feel well. Do not stop taking fluoxetine without talking to your doctor. If you suddenly stop taking fluoxetine, you may experience withdrawal symptoms such as mood changes, irritability, agitation, dizziness, numbness or tingling in the hands or feet, anxiety, sweating, confusion, headache, tiredness, and difficulty falling asleep or staying asleep. Your doctor will probably decrease your dose gradually.

What special precautions should I follow?

Before taking fluoxetine,

• tell your doctor and pharmacist if you are allergic to fluoxetine, any other medications, or any of the ingredients in fluoxetine capsules, tablets, or solution. Ask your pharmacist for a list of the ingredients.
• tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past two weeks: pimozide (Orap), thioridazine, or a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Emsam, Zelapar), and tranylcypromine (Parnate) Y If you stop taking fluoxetine, you should wait at least 5 weeks before you begin to take thioridazine or a monoamine oxidase inhibitor.
• some medications should not be taken with fluoxetine. Other medications may cause dosing changes or extra monitoring when taken with fluoxetine. Make sure you have discussed any medications you are currently taking or plan to take before starting fluoxetine with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking fluoxetine, please get the advice of your doctor or pharmacist.
• the following nonprescription or herbal products may interact with fluoxetine: St. John's wort; tryptophan. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking fluoxetine. Do not start any of these medications while taking fluoxetine without discussing with your healthcare provider.
• tell your doctor if you or anyone in your family has or has ever had a prolonged QT interval (a rare heart problem that may cause irregular heartbeat, fainting, or sudden death). Also tell your doctor if you have a low level of potassium, magnesium, or sodium in your blood or are being treated with electroshock therapy (procedure in which small electric shocks are administered to the brain to treat certain mental illnesses). Tell your doctor if you have recently had a heart attack and if you have or have ever had a slow or irregular heartbeat, heart failure, or any other heart problems; high blood pressure; bleeding problems; a stroke; diabetes; seizures; or liver or kidney disease.
• tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breastfeeding. If you become pregnant while taking fluoxetine, call your doctor. Fluoxetine may cause problems in newborns following delivery if it is taken during the last months of pregnancy.
• you should know that fluoxetine may make you drowsy and may affect your judgment, thinking, and movements. Do not drive a car or operate machinery until you know how this medication affects you.
• remember that alcohol can add to the drowsiness caused by this medication.
• you should know that fluoxetine may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.

What side effects can this medication cause?

Fluoxetine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nervousness
• anxiety
• difficulty falling asleep or staying asleep
• nausea
• diarrhea
• dry mouth
• heartburn
• yawning
• weakness
• uncontrollable shaking of a part of the body
• loss of appetite
• weight loss
• unusual dreams
• stuffy nose
• sexual problems in males; decreased sex drive, inability to get or keep an erection, or delayed or absent ejaculation
• sexual problems in females; decreased sex drive, or delayed orgasm or unable to have an orgasm
• excessive sweating
• headache, confusion, weakness, difficulty concentrating, or memory problems

Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS section, call your doctor immediately:

• rash
• hives or blisters
• itching
• fever
• joint pain
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• difficulty breathing or swallowing
• agitation, fever, sweating, confusion, fast or irregular heartbeat, shivering, severe muscle stiffness or twitching, hallucinations, loss of coordination, nausea, vomiting, or diarrhea
• fast, slow, or irregular heartbeat
• shortness of breath
• dizziness or fainting
• seizures
• abnormal bleeding or bruising

Fluoxetine may decrease appetite and cause weight loss in children. Your child's doctor will watch his or her growth carefully. Talk to your child's doctor if you have concerns about your child's growth or weight while he or she is taking this medication. Talk to your child's doctor about the risks of giving fluoxetine to your child.

Fluoxetine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

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
• seizures
• coma (loss of consciousness for a period of time)

🔗 Reference: https://medlineplus.gov/druginfo/meds/a689006.html