Description: Selective Serotonin Reuptake Inhibitor; Antidepressant
“ALERT: US Boxed Warning
Suicidality and antidepressant drugs:
Antidepressants increased the risk compared with placebo of suicidal thinking and behavior (suicidality) in short-term studies in children, adolescents, and young adults with major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of fluoxetine or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults older than 24 years; there was a reduction in risk with antidepressants compared with placebo in adults 65 years and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Appropriately monitor and closely observe patients of all ages who are started on antidepressant therapy for clinical worsening, suicidality, or unusual changes in behaviour. Advise families and caregivers of the need for close observation and communication with the prescribing health care provider.
Fluoxetine is approved for use in children with MDD (aged 8 years and older) and obsessive-compulsive disorder (OCD; aged 7 years and older). Sarafem is not approved for use in children.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Prozac/Fluoxetine selectively inhibits serotonin uptake. It exhibits only weak affinity for alpha, beta, histaminic, muscarinic and serotonin receptors as well as has weak anticholinergic effects.
Indications For Use
Fluoxetine/Prozac is officially indicated for use in bipolar major depression, bulimia nervosa, major depressive disorder, obsessive-compulsive disorder, panic disorder, premenstrual dysphoric disorder, and treatment-resistant depression. It is also prescribed off-label for use in binge-eating disorder, body dysmorphic disorder, refractory fibromyalgia, post-traumatic stress disorder, generalized anxiety disorder, selective mutism, social anxiety disorder and premature ejaculation.
Premature ejaculation (PE) is also known as rapid or early ejaculation and is characterized by the following features:
Ejaculation always or nearly always occurs prior to or within approximately one minute of vaginal penetration.
The inability to delay ejaculation on all or nearly all vaginal penetrations.
Personal feelings of distress, frustration, anxiety, and/or the avoidance of sexual intimacy.
Do not use in patients receiving monoamine oxidase inhibitors currently or within 2 weeks because of the risk of serotonin syndrome.
Use caution in patients with liver disease.
Use caution in patients with a history of seizures.
Has been rarely associated with platelet dysfunction, use cautiously in patients with underlying coagulation (platelet) defects.
Premature ejaculation (off-label use)
The initial dose is 20mg daily, which can increase the dose based on response and tolerability after 1 week (some experts suggest dose titration intervals of 3 to 4 weeks). Can increase to a maximum daily dose of 40mg once daily.
Pharmacist Tips On Using
How to Take Prozac/Fluoxetine: Can be taken with or without food and taken regularly as prescribed.
How to Manage Common Side Effects of Prozac/Fluoxetine: The majority of side effects are mild and transient and disappear over time. However, if you develop a rash, hives or experience undesirable weight loss contact your doctor.
You Need to Avoid Prozac/Fluoxetine: If you have hypersensitivity to Prozac/Fluoxetine or any of its components in the formulation; use of MAO inhibitors, linezolid, or intravenous methylene blue, pimozide or thioridazine.
Contact Your Doctor if You Ever Experience: Stop taking this medication and contact your doctor if you experience a rash (particularly in combination with facial swelling, breathing difficulties or flu-like symptoms); severe agitation, anxiety or excitation, major sleep disturbance or unusual change in mood, muscle twitching or convulsions.
Well tolerated, most side effects are transient and mild to moderate in nature. The most common side effects include:
Central nervous system: Insomnia (10% to 33%), headache (21%), drowsiness (5% to 17%), anxiety (6% to 15%), nervousness (8% to 14%), yawning (<11%)
Endocrine and metabolic: Decreased libido (4% to 11%)
Gastrointestinal: Nausea (12% to 29%), diarrhea (8% to 18%), anorexia (4% to 17%), xerostomia (9% to 12%)
Neuromuscular and skeletal: Weakness (9% to 21%), tremor (3% to 13%)
Respiratory: Pharyngitis (10% to 11%)
Frequently Asked Questions
Do you take Prozac/Fluoxetine with food or on an empty stomach?
You can take Fluoxetine on an empty stomach or with food, however, if you experience nausea or an upset stomach you can take it with food.
Can you drink alcohol when you are on Fluoxetine/Prozac?
You should limit or completely avoid alcohol consumption when taking Prozac/Fluoxetine because it may increase psychomotor impairment.
What if you miss a dose?
If you miss taking a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses to make for a missed dose.
How quickly will you experience an improvement?
If you are taking this medication it may take up to 2 weeks before you notice any improvement.