Prozac (Fluoxetine)

Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It treats mental health conditions like depression, obsessive-compulsive disorder, panic disorder, and bulimia nervosa. Fluoxetine works by increasing serotonin in the brain, a chemical that helps control mood and behavior. The medication may also be combined with olanzapine to treat bipolar depression and depression that has not improved after trying at least two other medicines.

Directions

Take Prozac as directed by your healthcare provider. Fluoxetine is typically taken by mouth once daily in the morning. The usual starting dose ranges from 10 mg to 20 mg once daily for adults with depression, though this may vary based on the specific condition being treated. For depression, the recommended dose is usually 20 mg per day, but some patients may start at 10 mg daily for the first week before increasing.

Prozac can be taken with or without food. If a dose is missed, take it as soon as you remember unless it's close to the next scheduled dose. Don't take two doses at the same time to make up for a missed one. The medication may take several weeks to show maximum benefits, so it's important to take it even if you don't feel immediate improvement.

Ingredients

The active ingredient in Prozac is fluoxetine.

Cautions

• Before using this medication, you may want to consult a healthcare provider about the following:
  • Any existing health conditions
  • Any allergies
  • A list of all medications currently being taken
• Some children, teens, and young adults may have worsening depression or new suicidal thoughts, especially during the first few months of treatment or after dose changes.
• Adults over age 25 generally do not have an increased risk of suicidal thoughts, and adults 65 and older may have a lower risk compared with not taking an antidepressant.
• New or unusual changes in mood or behavior can occur, including anxiety, agitation, restlessness, insomnia, irritability, or impulsive behavior.
• Prozac can cause a rare but serious condition called serotonin syndrome, especially when taken with other medicines that affect serotonin. Get medical help right away if symptoms like confusion, fever, fast heart rate, muscle stiffness, or severe nausea occur.
• Allergic reactions such as rash, hives, swelling, or breathing problems have been reported. Stop the medication and seek medical care if these symptoms appear.
• Prozac may trigger mania or hypomania in people with bipolar disorder, even if it has not been previously diagnosed. Screening for bipolar disorder is important before starting treatment.
• Seizures have been reported rarely, especially in people with a history of seizures. Use caution if you have seizure risk factors.
• Appetite changes and weight loss can occur, particularly in underweight individuals. Weight should be monitored during treatment.
• Prozac may increase the risk of bleeding, especially if taken with aspirin, NSAIDs, warfarin, or other blood-thinning medicines. Tell your provider if you notice unusual bruising or bleeding.
• Eye pressure problems, including angle-closure glaucoma, can occur in people with narrow eye angles. Seek urgent care if you develop sudden eye pain or vision changes.
• Low sodium levels in the blood have been reported, especially in older adults or people taking diuretics. Symptoms may include headache, confusion, weakness, or unsteadiness.
• Anxiety, nervousness, and trouble sleeping are fairly common, particularly early in treatment. These symptoms often improve over time but should be reported if severe.
• Heart rhythm problems, including QT prolongation, have been reported in rare cases. Prozac should be used with caution in people with heart conditions or those taking certain other medications.
• Prozac can affect blood sugar levels in people with diabetes, sometimes requiring medication changes. Monitor blood sugar closely when starting or stopping treatment.
• The medication can affect judgment, thinking, or coordination, especially when first starting. Avoid driving or operating machinery until you know how it affects you.
• Prozac stays in the body for several weeks after stopping, which can affect medication changes or interactions. Always tell providers you are taking or recently stopped Prozac.
• Stopping Prozac suddenly can cause symptoms like dizziness, irritability, mood changes, sleep problems, or or “electric shock” sensations. Tapering slowly is usually recommended.
• Sexual side effects such as low libido, delayed orgasm, or erectile problems may occur. These symptoms should be discussed with a healthcare provider.

Contraindications

Avoid taking or using this medication if any of the following apply:

• Current use of monoamine oxidase inhibitors (MAOIs) or use within the past 14 days
• Treatment with thioridazine or current use of pimozide
• Known allergy to fluoxetine or any ingredients in the medication

Side Effects

Common side effects of Prozac include:

• Nausea
• Diarrhea
• Dry mouth
• Headache
• Trouble sleeping (insomnia)
• Anxiety or nervousness
• Feeling tired or weak
• Decreased appetite or weight changes
• Sweating or tremor

These side effects are usually mild and often improve as your body adjusts to the medication. Some people may also experience sleepiness, dizziness, or sexual side effects such as decreased libido or difficulty with orgasm.

More serious side effects can occur, including suicidal thoughts or behaviors (especially in children, teens, and young adults), serotonin syndrome, seizures, abnormal bleeding, low sodium levels, and heart rhythm changes. Seek medical attention for severe mood changes, confusion, fever, irregular heartbeat, vision changes, or signs of an allergic reaction.