Generic Name: Fluoxetine Brand Name(s): Generics only. No brands available.

Know the basics

What is fluoxetine used for?

Fluoxetine is used to treat depression, panic attacks, obsessive compulsive disorder, a certain eating disorder (bulimia), and a severe form of premenstrual syndrome(premenstrual dysphoric disorder).

This fluoxetine may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. It may decrease fear, anxiety, unwanted thoughts, and the number of panic attacks. It may also reduce the urge to perform repeated tasks (compulsions such as hand-washing, counting, and checking) that interfere with daily living. Fluoxetine may lessen premenstrual symptoms such as irritability, increased appetite, and depression. It may decrease binging and purging behaviors in bulimia.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This drug is also used to treat a certain other eating disorder (anorexia nervosa), post traumatic stress disorder (PTSD), and certain nervous system/sleep disorders(cataplexy, narcolepsy). It may also be used to treat hot flashes that occur with menopause.

How should I take fluoxetine?

Take fluoxetine by mouth as directed by your doctor, usually once daily in the morning. If you are taking fluoxetine twice a day, your doctor may direct you to take it in the morning and at noon.

If you are taking fluoxetine for premenstrual problems, your doctor may direct you to take it every day of the month or just for the 2 weeks before your period through the first full day of your period. To help you remember, mark your calendar.

If you are using the liquid form of fluoxetine, measure the dose carefully using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start fluoxetine at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully. Take fluoxetine regularly to get the most benefit from it. To help you remember, take it at the same time each day.

It is important to continue taking fluoxetine as prescribed even if you feel well. Do not stop taking fluoxetine without first consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased.

You should see some improvement in 1 to 2 weeks. It may take 4 to 5 weeks before you feel the full benefit.

Tell your doctor if your condition does not improve or if it worsens.

How do I store fluoxetine?

Fluoxetine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store fluoxetine in the bathroom or the freezer. There may be different brands of fluoxetine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush fluoxetine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using fluoxetine?

Before taking fluoxetine:

  • Tell your doctor and pharmacist if you are allergic to fluoxetine or any other medications.
  • Tell your doctor if you are taking pimozide (orap),thioridazine or monoamine oxidase (mao) inhibitors such as isocarboxazid (marplan), phenelzine (nardil), selegiline (eldepryl, emsam, zelapar), and tranylcypromine (parnate), or if you have stopped taking a monoamine oxidase inhibitor within the past 2 weeks. Your doctor will probably tell you that you should not take fluoxetine. If you stop taking fluoxetine, you should wait at least 5 weeks before you begin to take thioridazine or a monoamine oxidase inhibitor.
  • Tell your doctor and pharmacist what other prescription and nonprescription medications and vitamins you are taking or plan to take. Be sure to mention any of the following: alprazolam (xanax); anticoagulants (‘blood thinners’) such as warfarin (coumadin); antidepressants (mood elevators) such as amitriptyline (elavil), amoxapine (asendin), clomipramine (anafranil), desipramine (norpramin), doxepin, imipramine (tofranil), nortriptyline (aventyl, pamelor), protriptyline (vivactil), and trimipramine (surmontil); aspirin and other nonsteroidal anti-inflammatory drugs (nsaids) such as ibuprofen (advil, motrin) and naproxen (aleve, naprosyn); clopidogrel (plavix),clopidogrel (plavix), diazepam (valium); digoxin (lanoxin); diuretics (‘water pills’); linezolid ; flecainide (tambocor); insulin or oral medications for diabetes; lithium (eskalith, lithobid); medications for anxiety and parkinson’s disease; methylene blue; medications for mental illness such as clozapine (clozaril) and haloperidol (haldol); medications for migraine headaches such as almotriptan (axert), eletriptan (relpax), frovatriptan (frova), naratriptan (amerge), rizatriptan (maxalt), sumatriptan (imitrex), and zolmitriptan (zomig); medications for seizures such as carbamazepine (tegretol) and phenytoin (dilantin); sedatives; sibutramine (meridia); sleeping pills; tramadol (ultram); tranquilizers; and vinblastine (velban). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • Tell your doctor what nutritional supplements and herbal products you are taking, especially products that contain st. John’s wort or tryptophan.
  • Tell your doctor if you are being treated with electroshock therapy (procedure in which small electric shocks are administered to the brain to treat certain mental illnesses), if you have recently had a heart attack and if you have or have ever had diabetes, seizures, or liver or heart disease.
  • Tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breast-feeding. If you become pregnant while taking fluoxetine, call your doctor. Fluoxetine may cause problems in newborns following delivery if it is taken during the last months of pregnancy.
  • Talk to your doctor about the risks and benefits of taking fluoxetine on a daily basis if you are 65 years of age or older. Older adults should not usually take fluoxetine on a daily basis because it is not as safe as other medications that can be used to treat the same conditions.
  • You should know that fluoxetine may make you drowsy. Do not drive a car or operate machinery until you know how fluoxetine affects you.
  • Remember that alcohol can add to the drowsiness caused by fluoxetine.
  • You should know that fluoxetine may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking fluoxetine. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.

Is it safe to take fluoxetine during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using fluoxetine during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking fluoxetine. Fluoxetine is pregnancy risk category  C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Know the side effects

What are the side effects of fluoxetine?

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect such as:

  • Very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, overactive reflexes;
  • Nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination;
  • Headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops;
  • Severe skin reaction — fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include: cold symptoms such as stuffy nose, sneezing, sore throat; drowsiness, dizziness, feeling nervous; mild nausea, upset stomach, constipation; increased appetite, weight changes; sleep problems (insomnia); decreased sex drive, impotence, or difficulty having an orgasm; or dry mouth.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with fluoxetine?

Fluoxetine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval, especially: any other antidepressant; St. John’s Wort; tramadol; tryptophan (sometimes called L-tryptophan); a blood thinner–warfarin, Coumadin, Jantoven; medicine to treat mood disorders, thought disorders, or mental illness–amitriptyline, desipramine, lithium, nortriptyline, and many others; migraine headache medicine–rizatriptan, sumatriptan, zolmitriptan, and others; or narcotic pain medicine–fentanyl, tramadol.

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking fluoxetine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Does food or alcohol interact with fluoxetine?

Fluoxetine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with fluoxetine?

Fluoxetine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Bipolar disorder (mood disorder with mania and depression), or risk of;
  • Bleeding problems;
  • Diabetes;
  • Glaucoma (angle-closure type);
  • Hyponatremia (low sodium in the blood);
  • Mania, history of ;
  • Seizures, history of—Use with caution. May make these conditions worse;
  • Heart attack or stroke, recent or history of ;
  • Heart failure;
  • Heart rhythm problems (eg, QT prolongation), or history of;
  • Hypokalemia (low potassium in the blood);
  • Hypomagnesemia (low magnesium in the blood)—May cause side effects to become worse;
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body;

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using fluoxetine.

What is the dose of fluoxetine for an adult?

Usual Adult Dose for Bulimia:

  • Immediate-release oral formulations: Recommended dose: 60 mg orally once a day.

Usual Adult Dose for Depression:

Immediate-release oral formulations:

  • initial dose: 20 mg orally once a day, increased after several weeks if insufficient clinical improvement is observed.
  • maintenance dose: 20 to 60 mg orally per day.
  • maximum dose: 80 mg orally per day.

Delayed release oral capsules:

  • initial dose: 90 mg orally once a week, commenced 7 days after the last daily dose of immediate-release fluoxetine 20 mg formulations.

Usual Adult Dose for Obsessive Compulsive Disorder:

Immediate-release oral formulations:

  • initial dose: 20 mg orally once a day, increased after several weeks if insufficient clinical improvement is observed.
  • maintenance dose: 20 to 60 mg orally per day.
  • maximum dose: 80 mg orally per day.

Usual Adult Dose for Panic Disorder:

Immediate-release oral formulations:

  • initial dose: 10 mg orally once a day, increased after one week to 20 mg orally once a day.
  • maintenance dose: 20 to 60 mg orally per day.
  • maximum dose: 60 mg orally per day.

Usual Adult Dose for Premenstrual Dysphoric Disorder:

Immediate-release oral formulations:

  • initial dose: continuous regimen: 20 mg orally once a day on every day of the menstrual cycle. cyclic regimen: 20 mg orally once a day starting 14 days prior to the anticipated start of menstruation through to the first full day of menses, and repeated with each new cycle.
  • maintenance dose: 20 to 60 mg per day for either the continuous or intermittent regimens.
  • maximum dose: 80 mg orally per day.
  • duration: the 20 mg daily dosage has been shown to be effective for up to 6 months of treatment.

What is the dose of fluoxetine for a child?

Usual Pediatric Dose for Depression: Immediate-release oral formulations:

8 to 18 years: Initial dose: 10 to 20 mg orally once a day; the 10 mg daily dose may be increased after one week to 20 mg orally once a day;

Lower weight children:

  • initial dose: 10 mg orally once a day, increased to 20 mg orally once a day after several weeks if insufficient clinical improvement is observed;
  • maintenance dose: 10 to 20 mg orally once a day;

Usual Pediatric Dose for Obsessive Compulsive Disorder: 7 to 18 years: Immediate-release oral formulations:

Adolescents and higher weight children:

  • initial dose: 10 mg orally once a day, increased to 20 mg orally once a day after 2 weeks;
  • maintenance dose: 20 to 60 mg orally per day;
  • maximum dose: 60 mg orally per day;

Lower weight children:

  • initial dose: 10 mg orally once a day, increased after several weeks if insufficient clinical improvement is observed;
  • maintenance dose: 20 to 30 mg orally once a day;
  • maximum dose: 60 mg orally per day;

How is fluoxetine available?

Fluoxetine is available in the following dosage forms and strengths:

  • Casule, Oral: 10 mg, 20 mg, 40 mg.
  • Capsule Delayed Release, Oral: 90 mg.
  • Solution, Oral: 20 mg/5 mL (5 mL, 120 mL).
  • Tablet, Oral: 10 mg, 20 mg, 60 mg.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of fluoxetine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: January 4, 2017 | Last Modified: January 4, 2017