fluoxetine

fluoxetine is available as a 10 mg, 20 mg, 40 mg oral capsule, a 10 mg, 20 mg, 60 mg oral tablet, and a 20 mg/5 ml oral solution.

fluoxetine is an SSRI that is used to treat:
Major depressive disorder (MDD)
Obsessive-compulsive disorder (OCD)
Bulimia
Panic disorder
Depression from bipolar 1 disorder
Treatment resistant depression

fluoxetine is a selective serotonin reuptake inhibitor (SSRI). It works mainly by raising the levels of serotonin, a chemical in your brain. Serotonin plays an important role in regulating your mood and emotions.

fluoxetine is typically taken starting at 10 mg to 20 mg by mouth once daily. The maximum recommended dose is up to 80 mg daily total.

fluoxetine is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication in the following:
Serotonin Syndrome and MAOIs: Do not use MAOIs intended to treat psychiatric disorders with fluoxetine or within 5 weeks of stopping treatment with fluoxetine. Do not use fluoxetine within 14 days of stopping an MAOI intended to treat psychiatric disorders. In addition, do not start fluoxetine in a patient who is being treated with linezolid or intravenous methylene blue.
Pimozide: Do not use. Risk of QT prolongation and drug interaction.
Thioridazine: Do not use. Risk of QT interval prolongation and elevated thioridazine plasma levels. Do not use thioridazine within 5 weeks of discontinuing fluoxetine. Do not use thioridazine within 5 weeks of discontinuing fluoxetine.
When using fluoxetine and olanzapine in combination, also referto the Contraindications section of the package insert for Symbyax.

• Common side effects of fluoxetine:
• Difficulty falling asleep
• Nausea
• Headache
• Weakness
• Diarrhea
• Low appetite
• Drowsiness
• Anxiety
• Nervousness
• Tremor
• Dry mouth
• Throat pain
• Yawning
• Low sex drive

Serious side effects are rare with fluoxetine. Contact your healthcare provider immediately if you experience any of the following.

Suicidal thoughts or behaviors
Serotonin syndrome: fast heart rate, dizziness, sweating, flushing, tremor (shakiness), muscle stiffness, muscle twitching or spasms, uncoordinated movement, distress, seizures, distress, hallucinations, coma
Seizures
Allergic reactions: hives, rash, blisters, swelling of the lips or tongue, difficulty breathing
Abnormal heart rhythm (QT prolongation): chest pounding, short of breath, chest pain, feeling faint or lightheaded
Severe bleeding: bruising that doesn’t improve, black-colored stools, pink or red-colored urine, coughing up or vomiting blood, or unusual bleeding from the nose or gums
Low blood sodium levels: nausea, fatigue, headache, confusion, disoriented, hallucinations (seeing things that aren’t real), seizures, unconsciousness

The following medications may interact with fluoxetine:

• Monoamine Oxidase Inhibitors (MAOIs)
• Drugs Metabolized by CYP2D6: Fluoxetine is a potent inhibitor of CYP2D6 enzyme pathway.
• Tricyclic Antidepressants (TCAs): Monitor TCA levels during coadministration with fluoxetine or when fluoxetine has been
• recently discontinued.
• CNS Acting Drugs: Caution should be used when taken in combination with other centrally acting drugs.
• Benzodiazepines: Diazepam – increased t½, alprazolam – further psychomotor performance decrement due to increased levels.
• Antipsychotics: Potential for elevation of haloperidol and clozapine levels.
• Anticonvulsants: Potential for elevated phenytoin and carbamazepine levels and clinical anticonvulsant toxicity.
• Serotonergic Drugs
• Drugs that Interfere with Hemostasis (e.g. NSAIDs, Aspirin, Warfarin): May potentiate the risk of bleeding.
• Drugs Tightly Bound to Plasma Proteins: May cause a shift in plasma concentrations.
• Olanzapine: When used in combination with fluoxetine, also refer to the Drug Interactions section of the package insert for Symbyax.
• Drugs that Prolong the QT Interval: Do not use fluoxetine with thioridazine or pimozide. Use with caution in combination with other drugs that prolong the QT interval.

Various FDA-approved generic manufacturers

Based on data from published observational studies, exposure to SSRIs, particularly in the month before delivery, has been associated with a less than 2-fold increase in the risk of postpartum hemorrhage.
There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antidepressants
during pregnancy. Healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or visiting online at MGH Center for women mental health. You should talk to your healthcare provider before taking this medication if you are pregnant.

• PROZAC