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What side effects can this medication cause?
More common side effects may include:
- Abnormal dreams, abnormal ejaculation, abnormal vision, anxiety, diminished sex drive, dizziness, dry mouth, flu-like symptoms, flushing, gas, headache, im
potence, insomnia, itching, loss of appetite, nausea, nervousness, rash, sinusitis, sleepiness, sore throat, sweating, tremors, upset stomach, vomiting, weakness, yawning
Less common side eff
ects may include:
- Abnormal taste, agitation, bleeding problems, chills, confusion, ear pain, emotional instability, fever, frequent urination, high blood pressure, increased appetite, loss of m
emory, palpitations, ringing in the ears, sleep disorders, weight gain
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Other Medicines
Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil
], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil])¡XHigher blood levels of these medicines may occur, which increases the chance of having serious side e
fects. Your doctor may want to see you more often and may need to change the doses of your medicines. Also, taking amitriptyline, clomipramine, or imipramine with fluoxetine may increase the chance of
developing the serotonin syndrome
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How should this medicine be used?
Prozac comes as a capsule, tablet, and liquid to take by mouth. It is usually taken once or twice a day and may be taken with or without food. Follow the directions on your prescription label carefull
y, and ask your doctor or pharmacist to explain any part you do not understand. Take Prozac exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Prozac oral liquid comes with a specially marked dropper for measuring the dose. Ask your pharmacist to show you how to use the dropper. Dilute the liquid in 4 ounces (120 ml) of water, apple j
uice, or Gatorade just before taking it.
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Warning
Hyponatremia: - Several cases of hyponatremia (some with serum sodium lower than 110 mmol/L) have been reported. The hyponatremia appeared to be reversible when fluoxetine was discontinued. Although t
hese cases were complex with varying possible etiologies, some were possibly due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The majority of these occurrences have been in
older patients and in patients taking diuretics or who were otherwise volume depleted.
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Possible food and drug interactions
P450 isozyme (IID6): - Like other selective serotonin reuptake inhibitors, fluoxetine inhibits the specific hepatic cytochrome P450 isozyme (IID6) which is responsible for the metabolism of debrisoqui
ne and sparteine. Although the clinical significance of this effect has not been established, inhibition of IID6 may lead to elevated plasma levels of co-administered drugs which are metabolized by th
is isozyme. Drugs metabolized by cytochrome P450IID6 include the tricyclic antidepressants (e.g., nortriptyline, amitriptyline, imipramine, and desipramine), phenothiazine neuroleptics (e.g., perphena
zine and thioridazine), and Type 1C antiarrhythmics (e.g., propafenone and flecainide).
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Adverse Effects
Serious Adverse Reactions: - Suicidal thoughts and acts are far more common among depressed patients than in the general population. It is estimated that suicide is 22 to 36 times more prevalent in de
pressed persons than in the general population. A comprehensive meta-analysis of pooled data from 17 double blind clinical trials in patients with major depressive disorder compared fluoxetine (n=1765
) with a tricyclic antidepressant (n=731) or placebo (n=569), or both. The pooled incidence of emergence of substantial suicidal ideation was 1.2% for fluoxetine, 2.6% for placebo, and 3.6% for tricyc
lic antidepressants.
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