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fluoxetine contraindications

Adults with depression or obsessive-compulsive disorder are treated with fluoxetine. Learn about interactions, side effects, and indications.

Other names for this medication:
Prozac, Symbyax, Act Fluoxetine, Sarafem

Similar Products:
Daxid, Clomipramine, Tofranil, Endep, Duloxetine, Risperdal, Desyrel, Zyprexa, Olanzapine, Flunil, Celexa, Bupron


People with symptoms of depression, panic, anxiety, or obsessive-compulsive disorder benefit from fluoxetine because it prevents serotonin from being taken up by nerve cells (neurons). Fluoxetine is a prescription medicine used to treat major depressive disorder, bulimia nervosa (an eating disorder), obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder (PMDD). Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant. To treat manic depression brought on by bipolar disorder, fluoxetine is occasionally combined with another drug called olanzapine (Zyprexa). Read the Zyprexa medication guide and all patient instructions and warnings if you also take olanzapine (Zyprexa), as well as any other medications you may be taking. After at least two other medications have been tried and failed to successfully treat symptoms of depression, this combination is also used to treat the condition.


If clinical improvement is not seen after a few weeks, a dose increase may be thought about. -Acute episodes of Major Depressive Disorder (MDD) require several months or longer of sustained pharmacologic therapy. -Daily doses above 60 mg have not been thoroughly investigated in patients with this condition. -Daily doses above 60 mg have not been thoroughly investigated for the treatment of bulimia. -Doses above 20 mg per day may be administered in two divided doses, one in the morning and one at noon. -Doses above 60 mg per day have not been systematically investigated for the treatment of panic disorder. -A switch back to daily fluoxetine dosing using the immediate-release oral formulations should be taken into consideration if a satisfactory response with the once-weekly oral fluoxetine is not maintained. -There is very little experience with doses higher than 20 mg per day in children who are underweight, and none with doses higher than 60 mg per day. Comments: -Doses above 20 mg per day may be given in divided doses, in the morning and at noon. -Maintenance dose: 20 to 60 mg orally per day. -Maximum dose: 80 mg orally per day. It has been demonstrated that a daily dose of 20 mg is effective for up to 6 months of treatment. -The full effect could take at least four weeks of treatment to manifest. -The full impact might not be felt for at least 5 weeks after treatment. Prior to administering this medication to children and adolescents, it is important to weigh the potential risks against the clinical necessity. It's unclear if the dosage required to induce remission and/or sustain euthymia are equivalent. Comments: Doses above 20 mg per day may be divided into morning and noon doses. Complete instructions on Fluoxetine dosage Immediate-release oral formulations: -Initial dose: 10 mg orally once per day; increased after one week to 20 mg orally once per day; maintenance dose: 20 to 60 mg orally per day; maximum dose: 60 mg orally per day; Comments: -Doses above 20 mg per day may be given in divided doses, in the morning and at noon. For oral formulations with immediate release, the recommended starting dose is 20 mg taken once daily in the morning. If necessary clinical improvement is not seen after a few weeks, the dose may be increased. Immediate-release oral formulations: 60 mg taken orally once daily in the morning Comments: -Some patients may need to start at a lower dose and titrate up to the recommended dose over the course of several days. Adolescents and higher weight children: initial dose of 10 mg orally once daily, increased to 20 mg orally once daily after 2 weeks; maintenance dose of 20 to 60 mg orally per day; maximum dose of 60 mg orally per day; lower weight children: initial dose of 10 mg orally once daily, increased after several weeks if sufficient clinical improvement is not observed; maintenance dose of 20 to 30 mg orally once daily; maximum dose of 60 mg orally per day. Immediate-release oral formulations: 8 to 18 years: Initial dose: 10 to 20 mg orally once a day; the 10 mg daily dose may be increased after one week to 20 mg orally once a day Lower weight children: -Initial dose: 10 mg orally once a day, increased to 20 mg orally once a day after several weeks if sufficient clinical improvement is not observed -Maintenance dose: 10 to 20 mg orally once a day Comments: -The full effect may be delayed until after at least 4 weeks of treatment. Immediate-release oral formulations: Initial dose: -Continuous regimen: 20 mg orally once a day on every day of the menstrual cycle -Cyclic regimen: 20 mg orally once a day starting 14 days prior to the anticipated start of menstruation through to the first full day of menses, and repeated with each new cycle Maintenance dose: 20 to 60 mg per day for either the continuous or intermittent regimens Maximum dose: 80 mg orally per day Comments: -A daily dose of 60 mg has not been shown to be significantly more effective than 20 mg daily. Immediate-release oral formulations: Initial dose: 20 mg orally once daily in the morning; may be increased after a few weeks if sufficient clinical improvement is not seen Maintenance dose: 20 to 60 mg orally per day; maximum dose: 80 mg orally per day Delayed-release oral capsules: Initial dose: 90 mg orally once a week; started seven days after the last daily dose of immediate-release fluoxetine 20 mg formulations Use: Both acute and ongoing treatment for MDD Use: Acute and ongoing management of binge-eating and vomiting in mild to severe bulimia nervosa Obsessions and compulsions in OCD patients are treated both acutely and continuously with this medication. Use: The acute and ongoing management of obsessions and compulsions in OCD patients use: short-term management of panic disorder combined with or without agoraphobia Treatment of premenstrual dysphoric disorder (PMDD) Common Adult Bulimia Dose: Common Adult Depression Dose: Usual Adult Dose for Obsessive Compulsive Disorder: An adult's typical dose for panic disorder is: Usual Adult Dose for Premenstrual Dysphoric Disorder: Common pediatric dosage for depression: Obsessive-compulsive disorder dosage typically given to children:

Missed dose

Do not take extra medicine to make up the missed dose. Taking two doses at once is not advised. If, however, the time for the subsequent regularly scheduled weekly dose is approaching, skip the missed dose and proceed with the next as prescribed. Take the missed Prozac Weekly dose as soon as you remember, then take the next dose seven days later. If it is almost time for your next dose, skip the missed dose and take the medication as soon as you can.


Call emergency services at 911 right away if the victim has fallen, experienced a seizure, is having trouble breathing, or cannot be roused. Call the poison control hotline at 1-800-222-1222 in the event of an overdose. You can find information online at Overdose symptoms may include the following: unsteadiness, confusion, unresponsiveness, nervousness, uncontrollable shaking of a part of the body, dizziness, rapid, irregular, or pounding heartbeat, seeing things or hearing voices that are not there (hallucinating), fever, fainting, seizures, and coma (loss of consciousness for a while).


However, you shouldn't dispose of this medication in the toilet. A medicine take-back program is the preferable method for getting rid of your medication. All medications should be kept out of the sight and reach of children, as many of the containers (such as weekly pill containers and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for small children to open. Keep this medication tightly closed in its original container away from the reach of children. If you do not have access to a take-back program, you can find more information at the FDA's Safe Disposal of Medicines website ( Keep it at room temperature and out of the bathroom and away from light, excessive heat, and moisture. For information on take-back programs in your neighborhood, speak with your pharmacist or get in touch with the waste/recycling department of your city. Always lock safety caps and immediately put the medication in a safe place, one that is up and away and out of their sight and reach. Unused medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.

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Side effects

Fluoxetine could have negative effects.


For more information, consult your doctor or pharmacist. Fluoxetine and some medications may interact, cause some to work less effectively, or have serious side effects. Do not start or stop any medicine while taking fluoxetine without talking to your healthcare provider first. Especially tell your doctor if you take: Triptans used to treat migraine headache Medicines used to treat mood, anxiety, psychotic or thought disorders, including tricyclics, lithium, SSRIs, SNRIs, MAOI’s (including linezolid, an antibiotic), or antipsychotics Tramadol Over-the-counter supplements such as tryptophan or St. John’s Wort If you take fluoxetine, you should not take any other medicines that contain fluoxetine including: Symbyax Sarafem Prozac Weekly This is not a complete list of fluoxetine drug interactions. Inform your doctor about all of the medications you take, including vitamins, herbal supplements, prescription and non-prescription drugs. You can find out if it's okay to take fluoxetine with other medications from your doctor or pharmacist.


Abnormal bleeding: fluoxetine and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin, Jantoven), a non-steroidal anti-inflammatory drug (NSAIDs, like ibuprofen or naproxen), or aspirin. 5. Take Mellaril (thioridazine), a monoamine oxidase inhibitor (MAOI), and ask your pharmacist for a complete list of the medication's ingredients. If you experience any of the following symptoms, call your healthcare provider right away, or dial 911 in an emergency, especially if they are new, worse, or worry you: attempts at suicide acting on dangerous impulses acting aggressive or violent thoughts about suicide or dying experiencing new or worse depression experiencing new or worse anxiety or panic attacks having difficulty falling asleep experiencing an increase in activity or talking more than is typical for you. modifications to appetite or weight. Children and adolescents should have height and weight monitored during treatment. 8. Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. Avoid drinking alcohol while taking fluoxetine. If you have stopped taking an MAOI within the last two weeks, don't start taking fluoxetine. The antipsychotic medication pimozide (Orap), which can cause serious heart problems, should not be taken within 5 weeks of stopping fluoxetine. The risk may be higher for elderly people. The following serious side effects could be brought on by fluoxetine and other antidepressants: 1. These harmful side effects of fluoxetine may occur: 2. Get medical help right away if you have any of these symptoms: high fever uncontrolled muscle spasms stiff muscles rapid changes in heart rate or blood pressure confusion loss of consciousness (pass out) Fluoxetine can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms. Low levels of sodium (salt) in the blood. Manic episodes include extreme increases in energy and sleep problems, racing thoughts, reckless behavior, excessive happiness or irritability, and faster or more frequent talking. Other precautions: Do not take an MAOI within 5 weeks of stopping fluoxetine. When starting fluoxetine or changing the dose, pay close attention to any changes like this. Fluoxetine users who take it just before or just after an MAOI may experience severe or even fatal side effects. Seizures or convulsions 6. reactions resembling neuroleptic malignant syndrome or serotonin syndrome Extreme allergic reactions include difficulty breathing, swelling of the face, tongue, eyes, or mouth, rash, itchy welts (hives), or blisters, either alone or in conjunction with fever or joint pain. Stop taking fluoxetine if you experience any of these serious side effects: anxiety, irritability, high or low mood, restlessness, changes in sleep patterns, headache, sweating, nausea, dizziness, electric shock-like sensations, shaking, or confusion. Do not take fluoxetine if you are allergic to any ingredient in fluoxetine capsules or solution (liquid). Suicidal thoughts or behaviors: During the first few months of treatment or when the dose is changed, some children, teenagers, or young adults may experience an increase in suicidal thoughts or behaviors while taking fluoxetine and other antidepressant medications. Symptoms may include: headache weakness or feeling unsteady confusion, problems concentrating or thinking or memory problems Do not stop fluoxetine without first talking to your healthcare provider. Agitation, hallucinations, coma or other mental status changes, coordination issues or muscle twitching (overactive reflexes), racing heartbeat, high or low blood pressure, sweating or fever, nausea, vomiting, or diarrhea, and muscle rigidity are all possible symptoms of this potentially fatal condition. Keep an eye out for any of the following changes, and contact your healthcare provider right away if you notice any of them: Significant or new changes in mood, behavior, thoughts, or feelings. Before you understand how fluoxetine affects you, avoid driving, operating machinery, and engaging in other risky activities.

What does fluoxetine do to your mood?

This medication may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. It may decrease fear, anxiety, unwanted thoughts, and the number of panic attacks.

Is fluoxetine the same as Xanax?

Xanax (alprazolam) and Prozac (fluoxetine) are used to treat anxiety and panic disorders. Prozac is used off-label for anxiety. Prozac is primarily used to treat depression, bulimia, obsessive-compulsive disorder (OCD), and premenstrual dysphoric disorder (PMDD). Xanax and Prozac belong to different drug classes.

What does fluoxetine do to your mood?

Fluoxetine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.

Which is better fluoxetine or fluvoxamine for OCD?

Prozac (fluoxetine) is good for treating depression and anxiety. It's more energizing than other antidepressants, so it may not be the best choice for people who have trouble sleeping. Luvox CR (fluvoxamine) is a first choice for treating obsessive-compulsive disorder.

Is fluoxetine good for IBS?

Conclusions: Fluoxetine is an effective and well-tolerated short-term treatment for pain and constipation-predominant irritable bowel syndrome.

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calistia Mar 13, 2010, 8:05:12 PM

It is a selective inhibitor of serotonin reuptake and has little effect on other neurotransmitters. It is often prescribed for bipolar disorder along with the antipsychotic olanzapine. Fluoxetine is a widely prescribed antidepressant due to its efficacy and safety profile. Moderate to high quality evidence suggests greater improvement in depression with combined olanzapine and fluoxetine when compared to placebo, olanzapine or lamotrigine alone. What is the evidence for fluoxetine as treatment for bipolar disorder?

Ghayoor Abbas May 27, 2014, 2:15:50 AM

When dosing is stopped, active drug substance will persist in the body for weeks. Dosage adjustments should be made carefully on an individual patient basis, to maintain the patient at the lowest effective dose. Doses above 80 mg/day have not been systematically evaluated.

v0dkuh Oct 4, 2018, 4:29:46 PM

Let your doctor know if you ever had any kind of kidney diseases. Ø Do not take Fluoxetine if you are taking pimozide (Orap). Ø Take Fluoxetine exactly as prescribed by the doctor.

hummingbirdofwar Apr 11, 2014, 4:42:00 PM

Take this medication regularly to get the most benefit from it. This medication may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. Do not use a household spoon because you may not get the correct dose. You should see some improvement in 1 to 2 weeks.

nyarlat Jul 18, 2018, 9:52:01 AM

(21/1430) Would you accept only one or the other approaches? Absolute risk – up to 30 % of exposed neonates Symptoms may arise immediately after birth and resolve within 2 weeks Most reports have involved Fluoxetine (Prozac) and Paroxetine (Paxil) • 10 Antidepressants in Pregnancy 2.Neonatal Behavioral Syndrome Jitteriness/tremor Irritability/constant crying Mild respiratory distress/tachypnea Hypoglycemia Poor tone Weak cry Desaturation on feeding Temperature instability • 11 SSRI/SNRI Discontinuation Syndrome in Adults F.I.N.I.S.H. Presentation on theme: "Antidepressant Classes 1.Selective Serotonin Reuptake Inhibitor (SSRI) Sertraline (Zoloft) Fluoxetine (Prozac) Paroxetine (Paxil) Citalopram (Celexa) Escitalopram.

superbon Jun 14, 2020, 9:05:08 AM

In addition, fluoxetine is used to treat trichotillomania if cognitive behaviour therapy is unsuccessful. Fluoxetine Capsules • Product Information: Fluoxetine is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. Fluoxetine is approved in the US for the treatment of major depression (including pediatric depression), obsessive-compulsive disorder (in both adult and paediatric populations), bulimia nervosa, panic disorder and premenstrual dysphoric disorder.

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