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Information about Prozac

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder, bulimia nervosa (an eating disorder) obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder (PMDD). It restores the balance of serotonin, a natural substance in the brain, which helps to improve certain mood problems. It may also be prescribed to treat bulimia nervosa and panic disorder in adults.

It may also be administered to treat other conditions as determined by your physician.

You should not use Fluoxetine in the following cases: you are allergic to any ingredient in it; 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.

In such cases it is obligatory to consult with your doctor or health care provider before taking this drug.

Before using Fluoxetine

Before using Fluoxetine you should tell your doctor if you have any medical conditions listed below: you are pregnant, planning to become pregnant, or are breast-feeding a baby; you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement; you have allergies to medicines, foods, or other substances; 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; you have a history of seizures, heart problems, liver problems, severe kidney problems, stomach or bowel bleeding, diabetes, or metabolism problems; you are dehydrated, have low blood sodium levels, or drink alcohol; you will be having electroconvulsive therapy (ECT).

Be aware that Fluoxetine may interact with some medicines. Consult with your health care provider in case you are taking any other drugs, 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.

It may not be a complete list of all interactions with other drugs. To prevent any complications you should check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Fluoxetine

Use this medicine as recommended by your doctor. Fluoxetine should be taken orally with or without food at the same time each day.

Do not stop taking Fluoxetine even if you feel well. Try not to miss any doses.

Do not stop taking Fluoxetine without medical consultation, as you may experience side effects 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.

Keep Fluoxetine at indoor temperature away from moisture and heat.

In case you miss a dose of Fluoxetine, take it as soon as possible. If it is almost time for your next intake, skip the missed dose and take it according to your regular dosing schedule. Do not take double doses to catch up. In case you miss a dose of the drug weekly, take the missed dose as soon as you remember and take the next dose 7 days later. However, if it is almost time for the next regularly scheduled weekly dose, skip the missed dose and take the next one as directed. Do not take extra medicine to catch up the missed dose.

Important safety information

Be careful when driving, operating machinery, or performing other hazardous activities as Fluoxetine usage may lead to drowsiness or dizziness. Try to avoid such activities. Alcohol and certain other medicines (eg, sleep aids, muscle relaxers) may increase the risk of unfavorable reactions while taking Fluoxetine.

You should know that improvement in your depression may start in several weeks.

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 their family members have had it.

Look after patients who use Fluoxetine closely. Contact the doctor immediately in case new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Consult with your doctor immediately in case any signs of suicidal thoughts or actions take place.

Diabetes patients should monitor their blood sugar levels closely, as Fluoxetine may affect your blood sugar. Consult with your doctor before you change the dose of your diabetes drugs.

Fluoxetine usage may cause serotonin syndrome - a possibly fatal syndrome. Your risk may be increased by taking certain medicines (eg, "triptans," MAOIs). Symptoms of syndrome are agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Consult with your doctor immediately in case you experience any of these symptoms.

In case your physician recommends you to stop using Fluoxetine, you will need to wait for a period of time before beginning to take certain other medicines (eg, MAOIs, nefazodone, thioridazine). Consult with your doctor when you should start to take your new drugs after you have stopped taking Fluoxetine.

You may have a prolonged, painful erection while taking Fluoxetine. This could happen even when you are not having sex. This problem should be treated immediately, as it could lead to permanent sexual problems, such as impotence. Consult with your doctor right away if this happens.

Seek emergency in case overdose of this medication is suspected. Symptoms of a overdose are nausea, vomiting, fever, sleepiness, rapid or uneven heartbeat, confusion, fainting, seizures, or coma.

The ELDERLY may be more sensitive to the effects of Fluoxetine, especially low blood sodium levels. Use Fluoxetine with caution in this group.

Use Fluoxetine with extreme caution in CHILDREN, as they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions. Safety and effectiveness in this group have not been proved.

Use Fluoxetine with extreme caution in CHILDREN younger than 7 years old, as safety and effectiveness in this group have not been proved.

Fluoxetine usage may lead to weight changes and growth changes in children. It is important to check their weight and growth regularly while using Fluoxetine.

PREGNANCY and BREAST-FEEDING

Fluoxetine is in FDA pregnancy category C. This medicine may be deleterious to the fetus if it is used during the last 3 months of pregnancy. In case you become pregnant, consult with your doctor and discuss the benefits and risks of taking this medicine while pregnancy. It is known that Fluoxetine passes into breast milk. Avoid breast-feeding a baby while taking Fluoxetine.

Possible side effects of Fluoxetine

You should consult with your doctor in case you have any of side effects especially bothersome listed below: anxiety; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; increased sweating; loss of appetite; nausea; nervousness; stomach upset; trouble sleeping; weakness.

Seek emergency immediately in case you have any of these severe side effects: 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.

What is the expiration date of the pills?

This information is mentioned on each blister. The expiration date is 2 years from the date of manufacture.