WARNING

Fluoxetine is a medication primarily used to treat depression, obsessive-compulsive disorder (OCD), bulimia nervosa, and panic disorder. Like all medications, it carries potential risks. Here are some of the common risks associated with taking fluoxetine:

• Side Effects: Common side effects may include nausea, diarrhea, headache, insomnia, dizziness, and decreased libido.
• Suicidal Thoughts and Behavior: In some cases, particularly in children, teenagers, and young adults, fluoxetine and other antidepressants may increase the risk of suicidal thoughts and behaviors, especially when starting or adjusting the dosage.
• Serotonin Syndrome: Taking fluoxetine with other medications that increase serotonin levels, such as certain other antidepressants or migraine medications, can lead to serotonin syndrome, a potentially life-threatening condition characterized by symptoms like agitation, hallucinations, rapid heart rate, fever, excessive sweating, shivering, trembling, muscle rigidity, and seizures.
• Withdrawal Symptoms: Abruptly stopping fluoxetine can lead to withdrawal symptoms such as mood changes, irritability, agitation, dizziness, numbness or tingling sensations, confusion, headache, fatigue, insomnia, and flu-like symptoms.
• Allergic Reactions: Some individuals may experience allergic reactions to fluoxetine, which can manifest as skin rash, itching or hives, swelling of the face, lips, or tongue, or difficulty breathing.
• Increased Bleeding Risk: Fluoxetine can interfere with blood clotting, increasing the risk of bleeding, particularly in individuals taking blood thinners or NSAIDs.
• Hyponatremia: In rare cases, fluoxetine can cause low levels of sodium in the blood (hyponatremia), which can lead to symptoms such as headache, weakness, confusion, difficulty concentrating, memory impairment, and even seizures or coma.
• Mania or Hypomania: Some individuals, particularly those with bipolar disorder, may experience episodes of mania or hypomania while taking fluoxetine.

It’s essential for individuals considering taking fluoxetine to discuss the potential risks and benefits with their healthcare provider. The decision to use fluoxetine should be based on a thorough evaluation of the individual’s medical history, current medications, and overall health.

Why is this medication prescribed?

Fluoxetine is a medication primarily prescribed for the treatment of depression, panic disorder, obsessive-compulsive disorder (OCD), bulimia nervosa, and premenstrual dysphoric disorder (PMDD). It belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs), which work by increasing the levels of serotonin, a neurotransmitter, in the brain. This helps alleviate symptoms associated with the aforementioned conditions.

How should this medicine be used?

Fluoxetine should be used exactly as prescribed by a healthcare provider. Here are some general guidelines for using fluoxetine:

• Dosage: Take fluoxetine exactly as prescribed by your doctor. The dosage can vary depending on the condition being treated, the severity of symptoms, and individual factors such as age and weight.
• Administration: Fluoxetine is typically taken orally in the form of capsules or tablets. It can be taken with or without food. Swallow the capsule or tablet whole with a full glass of water. Do not crush, chew, or break the capsule or tablet.
• Timing: Fluoxetine is usually taken once daily in the morning. Follow the dosing schedule provided by your doctor. If you are taking fluoxetine for depression, it may take several weeks before you start to feel the full benefits of the medication.
• Do not stop abruptly: Do not stop taking fluoxetine abruptly without consulting your doctor, even if you start to feel better. Abruptly stopping fluoxetine can lead to withdrawal symptoms. Your doctor may need to gradually decrease your dose to safely discontinue the medication.
• Missed dose: If you miss a dose of fluoxetine, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not double the dose to catch up.
• Follow-up: Attend all follow-up appointments with your doctor while taking fluoxetine. Your doctor may need to monitor your progress and adjust your dosage if necessary.
• Storage: Store fluoxetine at room temperature away from moisture and heat. Keep the medication out of reach of children.
• Caution with other medications: Inform your doctor about all other medications, supplements, and herbal products you are taking, as they may interact with fluoxetine. Some medications, such as certain antidepressants, migraine medications, and blood thinners, can interact with fluoxetine and increase the risk of side effects.

Always consult your healthcare provider if you have any questions or concerns about how to use fluoxetine safely and effectively.

Other uses for this medicine

Other uses for fluoxetine include:

• Anxiety Disorders: Fluoxetine may be prescribed for generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder.
• Binge Eating Disorder: Fluoxetine is FDA-approved for treating binge eating disorder in adults.
• Premature Ejaculation: In some cases, fluoxetine has been prescribed off-label to help with premature ejaculation.

What special precautions should I follow?

In terms of special precautions for fluoxetine, here are some key considerations:

• Suicidal Thoughts and Behaviors: Individuals, especially children, adolescents, and young adults, should be closely monitored for suicidal thoughts and behaviors, particularly when starting fluoxetine treatment or adjusting the dosage.
• Serotonin Syndrome: Use caution when taking fluoxetine with other medications that increase serotonin levels, as this can lead to serotonin syndrome. Symptoms include agitation, hallucinations, rapid heart rate, fever, sweating, shivering, trembling, muscle rigidity, and seizures.
• Bleeding Risk: Fluoxetine can interfere with blood clotting and increase the risk of bleeding, especially when combined with other medications such as blood thinners or NSAIDs.
• Hyponatremia: In rare cases, fluoxetine can cause low levels of sodium in the blood (hyponatremia), which can lead to symptoms such as headache, weakness, confusion, and seizures.
• Mania or Hypomania: Individuals with bipolar disorder may experience episodes of mania or hypomania while taking fluoxetine. Close monitoring is essential in such cases.
• Pregnancy and Breastfeeding: Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding, as the safety of fluoxetine during pregnancy and breastfeeding is not well established.

Always follow your healthcare provider’s instructions and discuss any concerns or questions you may have regarding the use of fluoxetine.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with fluoxetine. However, it’s generally recommended to maintain a healthy and balanced diet while taking the medication.

What should I do if I forget a dose?

If you forget to take a dose of fluoxetine, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take extra medication to make up for a missed dose. If you have concerns or questions about missed doses, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Fluoxetine, like any medication, can cause side effects. Not everyone will experience these side effects, and their severity can vary. Common side effects of fluoxetine may include:

• Nausea: Feeling sick or queasy.
• Headache: Aching or discomfort in the head.
• Insomnia: Difficulty falling asleep or staying asleep.
• Drowsiness: Feeling tired or sleepy.
• Anxiety: Feeling nervous or tense.
• Dizziness: Feeling lightheaded or unsteady.
• Dry mouth: A lack of moisture in the mouth.
• Loss of appetite: Reduced desire to eat.
• Weight changes: Either weight loss or weight gain.
• Sexual dysfunction: Decreased libido, difficulty achieving orgasm, or erectile dysfunction.
• Sweating: Excessive perspiration.
• Tremors: Involuntary shaking of the hands or other parts of the body.
• Diarrhea or constipation: Changes in bowel habits.
• Fatigue: Feeling tired or lacking energy.
• Blurred vision: Difficulty focusing or seeing clearly.
• Rash: Skin irritation or allergic reaction.
• Muscle weakness or stiffness: Changes in muscle tone or strength.

It’s important to note that not all side effects may be listed here, and some individuals may experience side effects not mentioned. Additionally, some side effects may require medical attention, especially if they persist or worsen over time. If you experience severe or concerning side effects while taking fluoxetine, it’s essential to contact your healthcare provider for guidance.

What should I know about storage and disposal of this medication?

Here’s what you should know about storage and disposal of fluoxetine:

• Storage: Store fluoxetine at room temperature, away from moisture and heat. Keep it tightly closed in its original container, and out of reach of children and pets.
• Disposal: Dispose of unused or expired fluoxetine properly, following any specific disposal instructions provided by your healthcare provider or pharmacist. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Instead, consult your local waste disposal or recycling center for guidance on how to safely dispose of medications.

In case of emergency/overdose

In case of an overdose or emergency situation, such as accidentally taking too much fluoxetine, seek immediate medical attention or contact a poison control center (1-800-222-1222 in the United States). Symptoms of overdose may include nausea, vomiting, agitation, dizziness, rapid heartbeat, fainting, seizures, and coma.

What other information should I know?

• Inform your healthcare provider about all medications, supplements, and herbal products you are taking, as they may interact with fluoxetine.
• Avoid consuming alcohol while taking fluoxetine, as it may worsen certain side effects.
• Do not drive or operate heavy machinery until you know how fluoxetine affects you, as it may cause drowsiness or dizziness.
• Attend all follow-up appointments with your doctor to monitor your progress and adjust your treatment plan as needed.
• Keep a list of all your medications, including prescription and over-the-counter drugs, as well as any allergies you may have, and share it with your healthcare provider.
• If you have any questions or concerns about fluoxetine or its use, don’t hesitate to ask your healthcare provider or pharmacist for clarification.

Following these guidelines can help ensure the safe and effective use of fluoxetine. Always use medications as prescribed and seek medical attention if you experience any adverse reactions or emergencies.