Jeffrey Panko NP Psychiatry · Patient education
Fluoxetine
Prozac / Sarafem / Generic oral formulations
A guide for adults taking fluoxetine.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Daily capsules, tablets, and liquid are available; some delayed-release regimens are weekly. PMDD treatment may use a prescribed cycle-based schedule. Do not interchange these schedules.
What it is used for
Fluoxetine treats depression, OCD, panic disorder, and bulimia. Certain formulations are used for premenstrual dysphoric disorder. A separate combination with olanzapine has additional indications and its own risks.
How it works
It inhibits serotonin reuptake. Fluoxetine and its active metabolite remain in the body for weeks, so dose changes and interactions can have delayed or lasting effects.
What to expect over time
Sleep, energy, or appetite may change before mood improves. Benefit usually builds over several weeks; some conditions need a longer trial at a useful dose.
Track the symptoms you are treating and how you manage daily activities. Keep follow-up appointments. Schedule an earlier appointment if your mood gets worse.
Taking your medication
- Follow your exact daily, weekly, or cycle-based prescription.
- Take with or without food and measure liquid accurately.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
- Consult with your provider before stopping, switching, or adding another antidepressant.
When to get help
Emergency symptoms. Get emergency care for a seizure, severe allergic reaction, or sudden eye pain with vision changes. Fever with agitation, diarrhea, and stiff or twitching muscles may be serotonin syndrome and needs urgent assessment.
Prompt medical advice. Contact your provider right away for marked agitation, new hallucinations, or unusually high energy with very little need for sleep.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Nausea, diarrhea, or stomach discomfort
- Headache, sweating, or a mild tremor
- Sleep changes or early restlessness
- Changes in sexual desire, arousal, or orgasm
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Antidepressants can increase suicidal thoughts in people under 25. Watch for changes in mood or behavior at any age, especially when starting treatment or changing a dose.
Tell your provider about emotional numbness, unusual agitation, or a reduced need for sleep with increased energy. These changes may call for a treatment adjustment.
Report unusual bruising or bleeding, severe headache, confusion, or marked weakness. SSRIs can increase bleeding risk and sometimes lower blood sodium.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss any history of mania or bipolar disorder, seizures, heart disease, glaucoma, and kidney or liver problems.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Do not combine with an MAOI. Generally allow at least 14 days after stopping an MAOI before fluoxetine, and at least five weeks after stopping fluoxetine before an MAOI. Some situations need longer.
Pimozide and thioridazine are contraindicated. Fluoxetine inhibits CYP2D6 and can affect many medicines long after the last dose.
Other serotonergic medicines increase serotonin-syndrome risk. NSAIDs, aspirin, and anticoagulants can add bleeding risk.
Everyday tips
A regular dose time and refill reminder can help prevent missed doses.
Bring a few specific observations to appointments: sleep, motivation, anxiety, and activities that have become easier or harder.
Your questions answered
Can I stop when I feel better?
Consult with your provider. Continuing treatment after improvement can reduce the chance that symptoms return. Most antidepressants should be reduced gradually to limit withdrawal symptoms.
What if I have sexual side effects?
Changes in desire, arousal, or orgasm are worth discussing. Your provider can review the dose or treatment options; do not stop or skip doses on your own.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.