Prozac

Generic Name: fluoxetine (floo OX e teen)
Brand names: Prozac, Prozac Weekly, Rapiflux, Sarafem, Selfemra, Prozac Pulvules

What is Prozac?

Prozac (fluoxetine) is a selective serotonin reuptake inhibitors (SSRI) antidepressant. Prozac affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms.

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

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

Prozac may also be used for purposes not listed in this medication guide.

Important information about Prozac

Do not take Prozac together with pimozide (Orap), thioridazine (Mellaril), or an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate). A dangerous drug interaction could occur, leading to serious side effects.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment with Prozac.

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. Prozac may cause serious lung problems in a newborn if you take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you become pregnant while taking Prozac, do not stop taking the medication without first talking to your doctor.

Before taking Prozac

Do not use Prozac if you are using any of the following drugs:

• pimozide (Orap);

• thioridazine (Mellaril); or

• an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate).

Serious and sometimes fatal reactions can occur when these medicines are taken with Prozac. You must wait at least 14 days after stopping an MAO inhibitor before you can take Prozac. You must wait 5 weeks after stopping Prozac before you can take thioridazine (Mellaril) or an MAOI.

To make sure you can safely take Prozac, tell your doctor if you have any of these other conditions:

• cirrhosis of the liver;
• kidney disease;

• diabetes;

• glaucoma;

• seizures or epilepsy;

• bipolar disorder (manic depression); or

• a history of drug abuse or suicidal thoughts.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment with Prozac, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. Prozac may cause serious lung problems in a newborn if you take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you become pregnant while taking Prozac, do not stop taking the medication without first talking to your doctor. Fluoxetine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give Prozac to anyone younger than 18 years old without a doctor's advice.

See also: Prozac information from Drugs.com pregnancy and breastfeeding warnings (in more detail)

How should I take Prozac?

Take Prozac exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose of Prozac to make sure you get the best results.

Do not crush, chew, break, or open an extended-release Prozac capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

Measure liquid medicine with a special dose measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose measuring device, ask your pharmacist for one.

It may take 4 weeks or longer before you start feeling better. Do not stop using Prozac without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.

To treat premenstrual dysphoric disorder, the usual dose of Prozac is once daily while you are having your period, or 14 days before you expect your period to start. Follow your doctor's instructions.

Store Prozac at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

If you miss a dose of Prozac Weekly, take the missed dose as soon as you remember and take the next dose 7 days later. However, if it is almost time for the next regularly scheduled weekly dose, skip the missed dose and take the next one as directed.Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose may cause nausea, vomiting, fever, sleepiness, rapid or uneven heartbeat, confusion, fainting, seizures, or coma.

What should I avoid while taking Prozac?

Drinking alcohol can increase certain side effects of Prozac. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

See also: Prozac information from Drugs.com and alcohol (in more detail)

Prozac side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Prozac: 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 any of these serious side effects while taking Prozac:

• severe blistering, peeling, and red skin rash;

• 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; or

• headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.

Less serious Prozac 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.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Prozac information from Drugs.com side effects (in more detail)

What other drugs will affect Prozac?

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others. Using an NSAID with Prozac may cause you to bruise or bleed easily.

Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety). They can add to sleepiness caused by Prozac.

Tell your doctor about all other medications you are using, especially:

• alprazolam (Xanax);

• clopidogrel (Plavix);

• clozapine (Clozaril, Fazaclo);

• flecainide (Tambocor);

• haloperidol (Haldol);

• seizure medication such as phenytoin (Dilantin) or carbamazepine (Tegretol);

• tryptophan (also called L-tryptophan);

• vinblastine (Velban);

• a blood thinner such as warfarin (Coumadin, Jantoven);

• almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex, Treximet), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or

• any other antidepressants such as amitriptyline (Elavil, Vanatrip, Limbitrol), escitalopram (Lexapro), imipramine (Tofranil), sertraline (Zoloft), and others.

This list is not complete and other drugs may interact with Prozac. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Prozac.