Prozac

By Medically reviewed by hellodoktor

Generic Name: Prozac Brand Name(s): Prozac.

Uses

What is Prozac® (fluoxetine) used for?

Prozac® is a selective serotonin reuptake inhibitors (SSRI) antidepressant. Fluoxetine affects chemicals in the brain that may be unbalanced in people with depression, panic, anxiety, or obsessive-compulsive symptoms.

Prozac® is used to treat major depressive disorder, bulimia nervosa (an eating disorder), obsessive-compulsive disorder, and panic disorder.

Prozac® is sometimes used together with another medication called olanzapine (Zyprexa) to treat manic depression caused by bipolar disorder. This combination is also used to treat depression after at least 2 other medications have been tried without successful treatment of symptoms.

How should I take Prozac® (fluoxetine)?

Take Prozac® exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Do not crush, chew, break, or open a delayed-release Prozac® Weekly capsule. Swallow the capsule whole.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using Prozac® suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

How do I store Prozac® (fluoxetine)?

Prozac® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Prozac® in the bathroom or the freezer. There may be different brands of Prozac® 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 Prozac® 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.

Precautions & warnings

What should I know before using Prozac® (fluoxetine)?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of Prozac® or other medications.
  • You have any other illnesses, disorders, or medical conditions.
  • You take pimozide or thioridazine, or if you are being treated with methylene blue injection.

Do not use Prozac if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

You must wait at least 14 days after stopping an MAO inhibitor before you can take Prozac®. You must wait 5 weeks after stopping fluoxetine before you can take thioridazine or an MAOI.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms.

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.

Taking Prozac® during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine during pregnancy without your doctor’s advice.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using Prozac® during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Prozac®. Prozac® 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

Side effects

What side effects can occur from Prozac® (fluoxetine)?

Common side effects may include:

  • Sleep problems (insomnia)
  • Strange dreams
  • Headache
  • Dizziness
  • Vision changes
  • Tremors or shaking
  • Feeling anxious or nervous
  • Pain
  • Weakness
  • Yawning
  • Tired feeling
  • Upset stomach
  • Loss of appetite
  • Nausea
  • Vomiting
  • Diarrhea
  • Dry mouth
  • Sweating
  • Hot flashes
  • Changes in weight or appetite
  • Stuffy nose
  • Sinus pain
  • Sore throat
  • Flu symptoms
  • Decreased sex drive, impotence, or difficulty having an orgasm

Call your doctor at once if you have:

  • Blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights
  • High levels of serotonin in the body–agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting
  • Low levels of sodium in the body–headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady
  • Severe nervous system reaction–very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out
  • 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

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

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.

Interactions

What drugs may interact with Prozac® (fluoxetine)?

Prozac® 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.

Products that may interact with this drug are:

  • Any other antidepressant
  • John’s Wort
  • Tryptophan (sometimes called L-tryptophan)
  • A blood thinner – warfarin, Coumadin, Jantoven
  • Medicine to treat anxiety, mood disorders, thought disorders, or mental illness – amitriptyline, buspirone, desipramine, lithium, nortriptyline, and many others
  • Medicine to treat ADHD or narcolepsy – Adderall, Concerta, Ritalin, Vyvanse, Zenzedi, and others
  • Migraine headache medicine – rizatriptan, sumatriptan, zolmitriptan, and others
  • Narcotic pain medicine – fentanyl, tramadol.

Does food or alcohol interact with Prozac® (fluoxetine)?

Prozac® 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 Prozac® (fluoxetine)?

Prozac® 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.

Health conditions that may interact with this drug are:

  • Cirrhosis of the liver
  • Kidney disease
  • Diabetes
  • Narrow-angle glaucoma
  • Seizures or epilepsy
  • Bipolar disorder (manic depression)
  • A history of drug abuse or suicidal thoughts
  • You are being treated with electroconvulsive therapy (ECT)

Dosage

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

What is the dose of Prozac® (fluoxetine) for an adult?

Major Depressive Disorder

Initiate dose is 20 mg/day orally in the morning. Consider a dose increase after several weeks if insufficient clinical improvement is observed.

Administer doses above 20 mg/day once daily in the morning or twice daily (i.e., morning and noon).

The maximum fluoxetine dose should not exceed 80 mg/day.

Obsessive Compulsive Disorder

Initiate dose is 20 mg/day, orally in the morning. Consider a dose increase after several weeks if insufficient clinical improvement is observed.

The full therapeutic effect may be delayed until 5 weeks of treatment or longer.

Administer doses above 20 mg/day once daily in the morning or twice daily (i.e., morning and noon).

A dose range of 20 to 60 mg/day is recommended; however, doses of up to 80 mg/day have been well tolerated in open studies of OCD.

The maximum fluoxetine dose should not exceed 80 mg/day.

Bulimia Nervosa

Administer dose is 60 mg/day in the morning.

For some patients it may be advisable to titrate up to this target dose over several days.

Fluoxetine doses above 60 mg/day have not been systematically studied in patients with bulimia.

In the controlled clinical trials of fluoxetine supporting its effectiveness in the treatment of Bulimia Nervosa, patients were administered fixed daily fluoxetine doses of 20 or 60 mg, or placebo.

Only the 60 mg dose was statistically significantly superior to placebo in reducing the frequency of binge-eating and vomiting.

Panic Disorder

Initiate dose is 10 mg/day.

After one week, increase the dose to 20 mg/day. Consider a dose increase after several weeks if no clinical improvement is observed.

Fluoxetine doses above 60 mg/day have not been systematically evaluated in patients with Panic Disorder.

In the controlled clinical trials of fluoxetine supporting its effectiveness in the treatment of Panic Disorder, patients were administered fluoxetine doses in the range of 10 to 60 mg/day.

The most frequently administered dose in the 2 flexible-dose clinical trials was 20 mg/day.

What is the dose of Prozac® (fluoxetine) for a child?

 Major Depressive Disorder

Initiate dose is 10 or 20 mg/day.

After 1 week at 10 mg/day, increase the dose to 20 mg/day. However, due to higher plasma levels in lower weight children, the starting and target dose in this group may be 10 mg/day.

Consider a dose increase to 20 mg/day after several weeks if insufficient clinical improvement is observed.

In the short-term (8 to 9 week) controlled clinical trials of fluoxetine supporting its effectiveness in the treatment of Major Depressive Disorder, patients were administered fluoxetine doses of 10 to 20 mg/day.

Obsessive Compulsive Disorder

In adolescents and higher weight children, initiate treatment with a dose of 10 mg/day. After 2 weeks, increase the dose to 20 mg/day.

Consider additional dose increases after several more weeks if insufficient clinical improvement is observed.

A dose range of 20 to 60 mg/day is recommended.

How is Prozac® (fluoxetine) available?

Prozac® is available in the following dosage forms and strengths:

  • Capsule: Fluoxetine hydrochloride 10mg

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 Prozac®, 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.

Sources

Review Date: July 7, 2017 | Last Modified: September 13, 2019

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