Fluoxetine
Fluoxetine 10/20/40/60mg

Fluoxetineis used for:

Treating depression or obsessive-compulsive disorder (OCD) in adults and children. It is used to treat bulimia nervosa and panic disorder in adults. It may also be used for other conditions as determined by your doctor.

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI). It works by restoring the balance of serotonin, a natural substance in the brain, which helps to improve certain mood problems.

Do NOT use Fluoxetineif:

• you are allergic to any ingredient in Fluoxetine
• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine), selegiline, or St. John's wort within the last 14 days
• you are taking a fenfluramine derivative (eg, dexfenfluramine), an H₁ antagonist (eg, astemizole, terfenadine), nefazodone, pimozide, a serotonin norepinephrine reuptake inhibitor (SNRI) (eg, venlafaxine), sibutramine, thioridazine, or tryptophan

Contact your doctor or health care provider right away if any of these apply to you.

Before using Fluoxetine :

Some medical conditions may interact with Fluoxetine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
• if you have a history of seizures, heart problems, liver problems, severe kidney problems, stomach or bowel bleeding, diabetes, or metabolism problems
• if you are dehydrated, have low blood sodium levels, or drink alcohol
• if you will be having electroconvulsive therapy (ECT)

Some MEDICINES MAY INTERACT with Fluoxetine. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anorexiants (eg, phentermine), fenfluramine derivatives (eg, dexfenfluramine), linezolid, MAOIs (eg, phenelzine), metoclopramide, nefazodone, selegiline, serotonin 5-HT₁ receptor agonists (eg, sumatriptan), sibutramine, SNRIs (eg, venlafaxine, St. John's wort, trazodone, or tryptophan because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur
• Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased
• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased
• Tramadol because the risk of seizures may be increased
• Cyclobenzaprine or H₁ antagonists (eg, astemizole, terfenadine) because severe heart problems, including irregular heartbeat, may occur
• HIV protease inhibitors (eg, ritonavir) because they may increase the risk of Fluoxetine's side effects
• Cyproheptadine because it may decrease Fluoxetine's effectiveness
• Aripiprazole, benzodiazepines (eg, alprazolam), beta-blockers (eg, propranolol), carbamazepine, clozapine, dextromethorphan, digoxin, flecainide, haloperidol, hydantoins (eg, phenytoin), lithium, norepinephrine reuptake inhibitors (eg, atomoxetine), phenothiazines (eg, chlorpromazine, thioridazine), pimozide, propafenone, risperidone, tricyclic antidepressants (eg, amitriptyline), or vinblastine because the risk of their side effects may be increased by Fluoxetine

This may not be a complete list of all interactions that may occur. Ask your health care provider if Fluoxetine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Fluoxetine:

Use Fluoxetine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Fluoxetine comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Fluoxetine refilled.
• Take Fluoxetine by mouth with or without food.
• Taking Fluoxetine at the same time each day will help you remember to take it.
• Continue to take Fluoxetine even if you feel well. Do not miss any doses.
• Do not suddenly stop taking Fluoxetine without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Fluoxetine and whenever a change in dose is made.
• If you miss a dose of Fluoxetine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Fluoxetine.

Important safety information:

• Fluoxetine may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Take Fluoxetine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Check with your doctor before you drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are taking Fluoxetine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose, change your dose, or take Fluoxetine for longer than prescribed without checking with your doctor.
• Children and teenagers who take Fluoxetine may be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who have had suicidal thoughts or actions in the past. The risk may also be greater in patients who have had bipolar (manic-depressive) illness, or if a family member has had it. Watch patients who take Fluoxetine closely. Contact the doctor at once if new, worsened, or sudden symptoms, such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual changes in mood or behavior, occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
• Diabetes patients - Fluoxetine may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
• Serotonin syndrome is a possibly fatal syndrome that can be caused by Fluoxetine. Your risk may be greater if you take Fluoxetine with certain other medicines (eg, "triptans," MAOIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
• If your doctor tells you to stop taking Fluoxetine, you will need to wait for several weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone, thioridazine). Ask your doctor when you should start to take your new medicines after you have stopped taking Fluoxetine.
• Fluoxetine may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.
• Use Fluoxetine with caution in the ELDERLY; they may be more sensitive to its effects, especially low blood sodium levels.
• Caution is advised when using Fluoxetine in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.
• Fluoxetine should be used with extreme caution in CHILDREN younger than 7 years old; safety and effectiveness in these children have not been confirmed.
• Fluoxetine may cause weight changes. CHILDREN and teenagers may need regular weight and growth checks while they take Fluoxetine.
• PREGNANCY and BREAST-FEEDING: Fluoxetine may cause harm to the fetus if it is used during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Fluoxetine while you are pregnant. Fluoxetine is found in breast milk. Do not breast-feed while you are taking Fluoxetine.

Possible side effects of Fluoxetine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Anxiety; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; increased sweating; loss of appetite; nausea; nervousness; stomach upset; trouble sleeping; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; black or bloody stools; chest pain; confusion; exaggerated reflexes; excessive sweating; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; increased urination; joint or wrist aches or pain; loss of coordination; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent or severe ringing in the ears;persistent, painful erection; red, swollen, blistered, or peeling skin; seizures; severe or persistent anxiety or trouble sleeping; significant weight loss; stomach pain; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual hoarseness; unusual or severe mental or mood changes; unusual swelling; vision changes; worsening of depression.