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Precautions
Suicide: - The possibility of a suicide attempt is inherent in depression and may persist until significant remission occurs. Therefore, high risk patients should be closely supervised throughout ther
apy and consideration should be given to the possible need for hospitalization. In order to minimize the opportunity for overdosage, prescriptions for fluoxetine should be written for the smallest qua
ntity of drug consistent with good patient management.
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Special Wanring
Urogenital:
Frequent: Painful menstruation, sexual dysfunction, urinary tract infection, frequent micturition.
Infrequent: Abnormal ejaculation, impotence, menopause, amenorrhea, menorrh
agia, ovarian disorder, vaginitis, leukorrhea, fibrocystic breast, breast pain, cystitis, dysuria, urinary urgency, urinary incontinence.
Rare: Breast enlargement, galactorrhea, abortion, dy
spareunia, uterine spasm, vaginal hemorrhage, metrorrhagia, hematuria, albuminuria, polyuria, pyuria, epididymitis, orchitis, pyelonephritis, salpingitis, urethritis, kidney calculus, urethral pain, u
rolithiasis.
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Possible Side Effect
In children and adolescents, less common side effects may also include:
- Agitation, excessive menstrual bleeding, frequent urination, hyperactivity, mania or hypomania (inappropriate feelings of
elation and/or rapid thoughts), nosebleeds, personality changes, and thirst
A wide variety of other very rare reactions have been reported during Prozac therapy. If you develop any new or un
explained symptoms, tell your doctor without delay.
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Symptoms of overdose may include:
- unsteadiness
- confusion
- unresponsiveness
- nervousness
- tremor
- dizziness
- rapid, irregular, or pounding heartbeat
- seeing things or hearing voices tha
t do not exist (hallucinating)
- fever
- fainting
- coma
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Possible food and drug interactions
Venlafaxine (e.g., Effexor)¡XUsing these medicines with fluoxetine or within 5 weeks of stopping fluoxetine may increase the chance of developing a rare, but very serious, unwanted effect known as the
serotonin syndrome. This syndrome may cause confusion, diarrhea, fever, poor coordination, restlessness, shivering, sweating, talking or acting with excitement you cannot control, trembling or shaking
, or twitching. If you develop these symptoms contact your doctor as soon as possible. Taking tramadol with fluoxetine increases the chance of having convulsions (seizures). Also, taking tryptophan wi
th fluoxetine may result in increased agitation or restlessness and intestinal or stomach problems
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What special precautions should I follow?
Children¡XThis medicine has been tested in a limited number of children 7 to 18 years of age. These studies indicate that Prozac may help to treat depression and obsessive-compulsive disorder in child
en. However, unusual excitement, restlessness, irritability, and trouble in sleeping may be especially likely to occur in children, who seem to be more sensitive than adults to the effects of Prozac.
Prozac must be used with caution in children with depression. Studies have shown occurrences of children thinking about suicide or attempting suicide in clinical trials for this medicine. More study i
s needed to be sure Prozac is safe and effective in children.
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