WARNING

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed to treat conditions such as depression, obsessive-compulsive disorder (OCD), panic disorder, and bulimia nervosa. While it can be effective for many people, it’s essential to be aware of potential risks and side effects. Here’s a brief overview:

• Common Side Effects:
  • Nausea
  • Insomnia or drowsiness
  • Weight changes
  • Sexual dysfunction
  • Dry mouth
• Serotonin Syndrome: In rare cases, taking fluoxetine can lead to serotonin syndrome, a potentially life-threatening condition. This is more likely to occur when fluoxetine is combined with other medications that also increase serotonin levels.
• Withdrawal Symptoms: Abruptly stopping fluoxetine can result in withdrawal symptoms such as dizziness, headache, fatigue, irritability, and flu-like symptoms. It’s important to taper off the medication under medical supervision.
• Suicidal Thoughts: Some individuals, particularly those under the age of 25, may experience an increase in suicidal thoughts when they first start taking fluoxetine or when there’s a change in dosage. Close monitoring is crucial, especially during the initial weeks of treatment.
• Allergic Reactions: In rare cases, people may experience allergic reactions to fluoxetine, including rash, itching, swelling, severe dizziness, or difficulty breathing. Seek medical attention if any of these symptoms occur.
• Bone Health: Long-term use of SSRIs like fluoxetine may be associated with a slightly increased risk of bone fractures, especially in older adults.
• Interaction with Other Medications: Fluoxetine can interact with other medications, including monoamine oxidase inhibitors (MAOIs), leading to serious and potentially fatal reactions. Inform your healthcare provider about all medications and supplements you are taking.
• Pregnancy and Breastfeeding: The safety of fluoxetine during pregnancy and breastfeeding is not well-established. It’s important to discuss the risks and benefits with a healthcare provider if you are pregnant or planning to become pregnant.
• Liver Function: Fluoxetine may affect liver function in some individuals. Regular monitoring may be recommended, especially for those with pre-existing liver conditions.

Always consult with a healthcare professional before starting or stopping any medication. They can provide personalized advice based on your health history and specific circumstances.

Why is this medication prescribed?

Fluoxetine is prescribed primarily for the treatment of various mental health conditions. Here are some of the common reasons why fluoxetine may be prescribed:

• Depression: Fluoxetine is widely used to treat major depressive disorder (MDD), a condition characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in daily activities.
• Obsessive-Compulsive Disorder (OCD): Fluoxetine is approved for the treatment of OCD, a mental health disorder marked by persistent, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions).
• Panic Disorder: It is used to manage panic disorder, a type of anxiety disorder characterized by recurrent and unexpected panic attacks.
• Bulimia Nervosa: Fluoxetine is prescribed to help reduce the frequency of binge-eating episodes and to promote weight stabilization in individuals with bulimia nervosa.
• Premenstrual Dysphoric Disorder (PMDD): In some cases, fluoxetine is prescribed to alleviate symptoms of PMDD, a severe form of premenstrual syndrome (PMS) that can significantly impact a person’s functioning and well-being.
• Generalized Anxiety Disorder (GAD): While not the first-line treatment, fluoxetine may be used to manage symptoms of generalized anxiety disorder, a condition characterized by excessive worry and anxiety.

How should this medicine be used?

The dosage and duration of fluoxetine treatment depend on the specific condition being treated, the individual’s response to the medication, and other factors. It’s crucial to follow the prescribed dosage and instructions provided by a healthcare professional. Typically, fluoxetine is taken orally, with or without food, usually once a day in the morning.

Here are some general guidelines for using fluoxetine:

• Consistency: Take fluoxetine at the same time each day to maintain a consistent level of the medication in your bloodstream.
• Follow Instructions: Always follow the dosage instructions provided by your healthcare provider. Do not adjust the dosage or stop taking the medication without consulting your doctor.
• Missed Dose: If you miss a dose, take it as soon as you remember. If it is close to the time of your next dose, skip the missed dose and resume your regular schedule. Do not double the dose to catch up.
• Tapering: If discontinuing fluoxetine, it’s important to do so under the guidance of a healthcare professional. Abruptly stopping the medication can lead to withdrawal symptoms.

It’s crucial to communicate openly with your healthcare provider about any side effects or concerns you may have while taking fluoxetine. They can monitor your progress and make adjustments to your treatment plan as needed.

Other uses for this medicine

Some off-label uses of fluoxetine may include:

• Anxiety Disorders: While fluoxetine is not typically the first choice for treating generalized anxiety disorder (GAD), panic disorder, or social anxiety disorder, it may be considered in certain cases.
• Post-Traumatic Stress Disorder (PTSD): Some healthcare providers may prescribe fluoxetine to individuals with PTSD to help manage symptoms such as intrusive thoughts and nightmares.
• Binge-Eating Disorder: Fluoxetine has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of bulimia nervosa, but it may also be used off-label for binge-eating disorder.

What special precautions should I follow?

As for special precautions, it’s crucial to discuss your medical history and any existing health conditions with your healthcare provider before starting fluoxetine. Here are some specific precautions:

• Allergies: Inform your healthcare provider about any allergies you may have, especially to fluoxetine or other SSRIs.
• Medication Interactions: Provide a comprehensive list of all medications, supplements, and herbal products you are taking. Fluoxetine can interact with other medications, and adjustments may be necessary.
• Medical Conditions: Inform your healthcare provider about any medical conditions you have, particularly liver disease, kidney disease, seizures, bipolar disorder, or a history of bleeding disorders.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the potential risks and benefits of fluoxetine with your healthcare provider. The decision to use fluoxetine during pregnancy must be carefully weighed.
• Suicidal Thoughts: Monitor for changes in mood, especially in the early stages of treatment, as SSRIs like fluoxetine have been associated with an increased risk of suicidal thoughts, particularly in individuals under the age of 25.
• Serotonin Syndrome: Be aware of the signs of serotonin syndrome, a rare but potentially serious condition that can occur when there is an excessive accumulation of serotonin. Symptoms may include confusion, hallucinations, rapid heartbeat, fever, and seizures.

Always take fluoxetine exactly as prescribed and attend regular follow-up appointments with your healthcare provider to monitor your progress and address any concerns. If you experience severe side effects or a worsening of symptoms, seek medical attention promptly.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with fluoxetine. However, certain lifestyle factors can impact mental health, so maintaining a healthy and balanced diet is generally advisable. Additionally, excessive alcohol consumption should be avoided, as it may increase the risk of side effects.

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: If it is close to the time of your next scheduled dose, skip the missed dose and resume your regular dosing schedule.
• Do not double up: Do not take a double dose to make up for a missed one. This can increase the risk of side effects and complications.
• Follow your regular schedule: Continue taking fluoxetine as prescribed by your healthcare provider. If you are unsure about what to do, contact your healthcare provider for guidance.

What side effects can this medication cause?

Fluoxetine, like any medication, may cause side effects. It’s important to note that not everyone will experience these side effects, and some individuals may experience only mild symptoms. Common side effects of fluoxetine include:

• Nausea: Feeling sick to your stomach is a common side effect, especially when starting the medication.
• Insomnia or Drowsiness: Fluoxetine can affect sleep patterns, leading to either difficulty falling asleep (insomnia) or increased drowsiness.
• Weight Changes: Some individuals may experience changes in appetite and weight while taking fluoxetine.
• Sexual Dysfunction: Fluoxetine may affect sexual desire, arousal, or performance.
• Dry Mouth: This is a common side effect and can often be managed by staying hydrated.
• Headache: Headaches are a relatively common side effect during the initial stages of treatment.
• Nervousness or Anxiety: In some cases, fluoxetine can increase feelings of nervousness or anxiety.
• Diarrhea or Constipation: Changes in bowel habits may occur.
• Sweating: Increased sweating, especially at night, can be a side effect.
• Tremors: Some individuals may experience slight tremors or shakiness.
• Dizziness: Fluoxetine can cause dizziness, especially when standing up quickly.

It’s essential to be aware of more serious side effects that may occur less frequently. If you experience any of the following, seek medical attention promptly:

• Serotonin Syndrome: Symptoms may include confusion, hallucinations, rapid heartbeat, fever, seizures, and muscle stiffness.
• Allergic Reactions: These can include rash, itching, swelling, severe dizziness, or difficulty breathing.
• Unusual Bleeding or Bruising: Fluoxetine may affect platelet function, so it’s important to be cautious if you notice unusual bleeding or bruising.
• Changes in Mood or Suicidal Thoughts: Particularly in the early stages of treatment, some individuals may experience an increase in depressive symptoms or suicidal thoughts.

It’s crucial to communicate openly with your healthcare provider about any side effects you experience while taking fluoxetine. They can provide guidance on managing symptoms or adjust your treatment plan if necessary. Additionally, if you have concerns about potential side effects, discuss them with your healthcare provider before starting the medication.

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

Storage and Disposal of Fluoxetine:

• Storage:
  • Store fluoxetine at room temperature, away from moisture and heat.
  • Keep the medication in its original packaging, and make sure it is tightly closed.
• Disposal:
  • Dispose of expired or unused fluoxetine in accordance with local regulations and guidelines.
  • Do not flush medications down the toilet unless instructed to do so. Check with your local pharmacy or health department for proper disposal options.

In case of emergency/overdose

In case of an overdose or emergency, seek medical attention or contact your local poison control center at 1-800-222-1222. Overdose symptoms may include nausea, vomiting, fever, rapid heartbeat, confusion, seizures, or coma.

What other information should I know?

• Regular Follow-Up: Attend regular follow-up appointments with your healthcare provider to monitor your progress and discuss any concerns or changes in symptoms.
• Avoid Alcohol: Limit alcohol consumption while taking fluoxetine, as it may increase the risk of certain side effects.
• Interactions with Other Medications: Inform your healthcare provider about all medications, supplements, and herbal products you are taking, as fluoxetine can interact with other drugs.
• Abrupt Discontinuation: Do not stop taking fluoxetine abruptly without consulting your healthcare provider. Sudden discontinuation may lead to withdrawal symptoms.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of fluoxetine with your healthcare provider.
• Medical Procedures: If you are scheduled for surgery or any medical procedure, inform your healthcare provider that you are taking fluoxetine.
• Driving and Operating Machinery: Be cautious when driving or operating machinery, especially at the beginning of treatment, as fluoxetine may cause drowsiness or dizziness.
• Monitoring for Suicidal Thoughts: Pay attention to changes in mood, especially in the early stages of treatment, and report any thoughts of self-harm to your healthcare provider.

Always follow your healthcare provider’s instructions and ask any questions you may have about fluoxetine. It’s important to have open communication with your healthcare team to ensure safe and effective use of the medication.