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Indications

• Fluoxetine is used to treat depression, panic attacks, obsessive-compulsive disorder (OCD), bulimia, and premenstrual dysphoric disorder (PMDD).
• It can improve mood, sleep, appetite, and energy levels.
• Fluoxetine may reduce fear, anxiety, unwanted thoughts, and the frequency of panic attacks.
• It helps decrease compulsive behaviors like handwashing, counting, and checking.
• The medication may alleviate premenstrual symptoms such as irritability, increased appetite, and depression.
• In bulimia, fluoxetine may reduce binging and purging behaviors.

Dosage and administration

• Read the Medication Guide provided by your pharmacist before using fluoxetine and each time you refill.
• Take fluoxetine orally as directed by your doctor, usually once daily in the morning, or as prescribed for twice daily dosing.
• If using fluoxetine for premenstrual problems, take it daily or as directed by your doctor, marking your calendar to help remember.
• If using the liquid form, measure the dose carefully with a special device, not a household spoon.
• Dosage is based on your medical condition; start with a low dose and increase gradually as directed by your doctor.
• Take the medication regularly at the same time each day for maximum benefit.
• Continue taking fluoxetine even if you feel well; do not stop without consulting your doctor to avoid worsening conditions.
• Improvement may be seen in 1 to 2 weeks, with full benefit possibly taking 4 to 5 weeks.
• Inform your doctor if your condition does not improve or worsens.

Side effects

• Common side effects of fluoxetine may include nausea, drowsiness, dizziness, anxiety, trouble sleeping, loss of appetite, tiredness, sweating, and yawning.
• Inform your doctor if these side effects persist or worsen.
• Serious side effects may include unusual or severe mental/mood changes, easy bleeding/bruising, muscle weakness/spasm, tremors, decreased interest in sex, changes in sexual ability, and unusual weight loss.
• Seek immediate medical attention for very serious side effects such as black stools, vomit resembling coffee grounds, seizures, signs of kidney problems, eye pain/swelling/redness, widened pupils, and vision changes.
• If you have diabetes, monitor blood sugar regularly, as fluoxetine may affect levels, requiring adjustments to medication, diet, and exercise.
• Fluoxetine may increase serotonin levels, leading to serotonin syndrome/toxicity. Seek immediate medical help for symptoms like fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, muscle twitching, unexplained fever, and unusual agitation/restlessness.
• Rarely, males may experience a painful or prolonged erection lasting 4 or more hours; seek immediate medical attention to avoid permanent problems.
• A serious allergic reaction to fluoxetine is rare but may include symptoms like rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, and trouble breathing.
• This list is not exhaustive; contact your doctor or pharmacist for any other observed side effects.

Precautions

• Inform your doctor or pharmacist about any allergies to fluoxetine or other substances, as inactive ingredients may cause allergic reactions.
• Discuss your medical history with your doctor or pharmacist, particularly if you have a personal or family history of bipolar disorder, suicide attempts, liver problems, diabetes, low sodium levels, severe dehydration, seizures, peptic ulcer disease, or glaucoma.
• This medication may cause dizziness or drowsiness; avoid alcohol or marijuana, as they can enhance these effects. Do not engage in activities requiring alertness until it’s safe.
• The liquid form of fluoxetine contains alcohol; caution is advised for those with diabetes, alcohol dependence, or liver disease. Ask about potential interactions with other medications.
• Inform your doctor or dentist about all products you use before surgery, including prescription drugs, nonprescription drugs, and herbal products.
• Children may be more sensitive to side effects, especially weight loss. Monitor weight and height in children taking this drug.
• Older adults may be more sensitive, particularly to bleeding and loss of coordination, increasing the risk of falling. Low sodium levels are also a concern, especially with diuretic use.
• During pregnancy, use fluoxetine only, when necessary, as it may harm the unborn baby. Babies born to mothers using fluoxetine late in pregnancy may experience withdrawal symptoms; notify the doctor if you observe feeding/breathing difficulties, seizures, muscle stiffness, or constant crying.
• Do not stop taking the medication without consulting your doctor, especially if planning pregnancy. Discuss the benefits and risks of using fluoxetine during pregnancy.
• Fluoxetine passes into breast milk and may have adverse effects on a nursing infant; consult your doctor before breastfeeding.

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