Fluoxetine (floo-OX-e-teen)

Treats depression, obsessive compulsive disorder (OCD), eating disorders, and panic disorders. Sarafem® treats premenstrual dysphoric disorder (PMDD), which is mood disorders and physical symptoms that occur 1 to 2 weeks before a woman's menstrual period. This medicine is a selective serotonin reuptake inhibitor (SSRI).

Brand Name(s):

Prozac, Prozac Weekly, Fluoxetine HCl, Sarafem, Fluoxetine Hydrochloride, Rapiflux

When This Medicine Should Not Be Used:

How to Use This Medicine:

Capsule, Delayed Release Capsule, Tablet, Liquid

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.Some people need to take this medicine every day, and some people need to take it only once a week. Make sure you understand your own schedule.
• You may need to take this medicine for up to 4 weeks before you start feeling better.
• Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
• You may take this medicine with or without food. Take your medicine at the same time each day.
• Swallow the delayed-release capsule whole. Do not crush, break, or chew it.
• This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.

If a dose is missed:

• For people who take this medicine every day (Prozac® or Sarafem®): If you miss a dose or forget to take your medicine, take it as soon as you can. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
• For people who take this medicine once a week (Prozac® Weekly): If you miss a dose or forget to take your medicine, take it as soon as you can. Then go back to your regular schedule the next week. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are using alprazolam (Xanax®), diazepam (Valium®), digoxin (Lanoxin®), flecainide (Tambocor®), linezolid (Zyvox®), St. John's wort, sumatriptan (Imitrex®), tramadol (Ultram®), tryptophan, vinblastine, medicine for seizures (such as carbamazepine, phenytoin, Dilantin®, or Tegretol®), or a blood thinner (such as warfarin or Coumadin®).
• Tell your doctor if you are using other medicines to treat depression (such as amitriptyline, desipramine, doxepin, imipramine, lithium, nortriptyline, pimozide, Orap®, Pamelor®, or Sinequan®), medicine to treat mental illness (such as clozapine, haloperidol, Clozaril®, or Haldol®), or a medicine called flecainide (Tambocor®) for heart rhythm problems.
• Make sure your doctor knows if you are also using any pain or arthritis medicines, sometimes called "NSAIDs" (such as aspirin, ibuprofen, naproxen, Advil®, Aleve®, Bextra®, Celebrex®, Ecotrin®, or Motrin®). Also tell your doctor if you have used an MAO inhibitor such as Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days.
• Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant, planning to become pregnant, or breastfeeding. Tell your doctor if you have seizures, diabetes, heart disease, liver disease, hyponatremia (low sodium in the blood), bleeding problems, manic disorder, or recent heart attack.
• For some children, teenagers, and young adults, this medicine can increase thoughts of suicide. Tell your doctor or your child's doctor right away if you or your child start to feel more depressed and have thoughts about hurting yourselves. Report any unusual thoughts or behaviors that trouble you or your child, especially if they are new or get worse quickly. Make sure the doctor knows if you or your child have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you or your child have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you, your child, or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
• If you develop a skin rash, even a mild one, stop taking this medicine and call your doctor right away.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Blistering, peeling, red skin rash.
• Change in how much or how often you urinate.
• Chest pain, pounding or uneven heartbeat.
• Confusion, weakness, and muscle twitching.
• Dry mouth, increased thirst, muscle cramps, nausea, or vomiting.
• Feelings of intense anxiety, agitation, or irritability.
• Fever, chills, body aches, or weakness.
• Painful, prolonged erection of your penis, or trouble having sex.
• Unusual bleeding, bruising, or weakness.
• Vomiting blood or something that looks like coffee grounds.

If you notice these less serious side effects, talk with your doctor:

• Changes in appetite with weight gain or loss.
• Decreased interest in sex.
• Dry mouth, sore throat, or yawning more than usual.
• Ear pain or ringing in your ears.
• Headache.
• Nausea, diarrhea, constipation, or upset stomach.
• Nervousness, shakiness, or sweating.
• Trouble sleeping.