Prozac

The active ingredient in Prozac is fluoxetine hydrochloride. It works primarily by increasing serotonin, a substance found in your brain. Serotonin helps to regulate your mood and emotions.

The immediate releases are taken orally, usually once or twice daily. The delayed-release capsule is used once a week, but it is only approved to treat depression.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Prozac. However, the following is a synopsis of the general guidelines for the use of Prozac:

• Do not crush, chew, break, or open a delayed-release Prozac Weekly capsule. Swallow the capsule whole.
• Inform your healthcare provider if you notice any sexual problems. Some issues like these can be resolved.
• Prozac can be taken with or without food, but it frequently causes nausea, particularly when starting the medication and changing doses; taking it with food may alleviate these side effects.
• Do not stop taking Prozac abruptly or you may have unpleasant withdrawal symptoms or worsening depression. Ask your doctor how to discontinue this medication properly.

The most common side effects of Prozac include:

• Nausea, weakness, drowsiness/yawning or headaches.
• Difficulty falling asleep or trouble sleeping.
• Diarrhea
• Loss of appetite and weight loss.
• Anxiety or nervousness.
• Dry mouth or throat pain.
• Low sex drive or sexual dysfunction.
• Abnormal dreams.
• Flu-like symptoms.

Some individuals may experience serious side effects while using Prozac. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Suicidal thoughts or behaviors, which is more common in young adults.
• Allergic reactions such as swelling of the mouth area or swelling of the face, hives or skin rashes, and difficulty breathing.
• Serotonin syndrome symptoms, including rapid heart rate, dizziness, perspiration, flushing, tremor (shakiness), muscle stiffness, muscle twitching or spasms, uncoordinated movement, anxiety, seizures, hallucinations, and coma.
• Abnormal heart rhythms (QT prolongation) with symptoms such as pounding chest, chest pain, or lightheadedness.
• Severe bleeding or bruising that doesn’t go away.
• Low blood sodium levels.
• New or worsening angle-closure glaucoma with symptoms like sudden eye pain or change in vision such as blurry vision, seeing halos around lights, or vision loss.

These are not all of the possible side effects of Prozac. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Prozac, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

• Allergies to fluoxetine or are currently on pimozide or thioridazine.
• If you have used an MAO inhibitor within the previous 14 days, do not use Prozac. A risky medication interaction may occur.
• Tell your healthcare provider about any additional antidepressants you're taking, including Celexa, Cymbalta, Desyrel, Effexor, Lexapro, Luvox, Oleptro, Paxil, Pexeva, Symbyax, Viibryd, or Zoloft.
• Tell your healthcare provider if you have ever had liver cirrhosis, diabetes, urinary problems, seizures, or epilepsy before using Prozac. Narrow-angle glaucoma, drug misuse or suicidal ideation, electroconvulsive treatment (ECT), or bipolar disorder (manic depression).
• Beware of young people having suicidal thoughts when first taking this medication. Make sure your healthcare provider checks your progress at regular visits and that your family is aware of this.

If you have any of the following conditions or if any of the following apply to you, please notify your healthcare professional since Prozac is not safe for you to use.

• Take or have taken a monoamine oxidase inhibitor (MAOI) such as linezolid or methylene blue in the previous 14 days.
• Take pimozide.
• Take thioridazine.

Prozac takes about 6 to 8 weeks to fully work and improve the moods and depression of most people. However, when Prozac initially begins to work, most people feel less anxious, restless, and exhausted. Your sleep, energy, and appetite may improve during the first month, and you may be able to focus better on daily duties.

When Prozac is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects.

• Prozac may induce a side effect known as QT prolongation (irregular heartbeat), which affects the heart. If you are taking certain other medications for asthma, high blood pressure, infections, depression, high blood pressure, mental illness, malaria, cancer, or HIV, your risk of QT prolongation may increase.
• If you take any opioid, sleeping pills, medication for anxiety or seizures, or a muscle relaxant, consult your healthcare provider as Prozac may exacerbate the effect of drowsiness.
• Consult your doctor before using a nonsteroidal anti-inflammatory medicine (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, or others. Taking an NSAID with Prozac may cause you to bruise or bleed readily.

Other interactions may include:

• Other antidepressants such as SNRIs or tricyclic antidepressants such as amitriptyline or nortriptyline. Also, buspirone, desipramine, lithium, and many others are medications used to treat anxiety, mood disorders, panic attacks, or mental illness.
• Tryptophan (also called L-tryptophan)
• St. John's Wort.
• Blood thinners like warfarin, Coumadin, and Jantoven.
• Adderall, Concerta, Ritalin, Vyvanse, Zenzedi, and others are medications used to treat ADHD or narcolepsy.
• Migraine headache medication, such as rizatriptan, sumatriptan, zolmitriptan, and others
• Fentanyl and tramadol are opioid pain medications.

This is not a full list of drug interactions and it is still important to speak to your healthcare provider to ensure safely taking Prozac.

Typically, your healthcare provider will start one off on a lower dose of Prozac and slowly begin to raise the dosage over a few weeks. If your overall daily dose is above 20mg, they may ask you to separate the dose and take it twice daily.

Immediate-release capsule:

• Major Depressive Disorder (MDD)
• Adults: The typical starting dose is 20 mg orally once a day in the morning. The highest suggested daily dose is 80 mg total.
• Children aged 8 years and up: The normal dose is 10 mg to 20 mg orally once daily.

• Obsessive-compulsive disorder (OCD)
• Adults: The typical starting dose is 20 mg orally once a day in the morning. The highest suggested daily dose is 80 mg total.
• Children aged 7 and up: The average initial dose varies from 10 mg to 20 mg orally once daily, depending on body weight. The normal maintenance dose varies from 20 to 60 mg per day.

• Bulimia Nervosa
• Adults: The normal maintenance dose is 60 mg taken orally once per day in the morning.

• Panic Disorder
• Adults: The typical starting dose is 10 mg taken orally once daily. The normal maintenance dose is 20 milligrams per day. The highest suggested daily intake is 60 mg.

• Depression due to bipolar 1 disorder
• Adults and children aged 10 years and up: The average daily dose is 20 mg to 50 mg by mouth, administered with olanzapine (Zyprexa).

• Treatment-resistant depression
• Adults: The normal dose varies from 20 mg to 50 mg orally daily, in conjunction with olanzapine (Zyprexa).

• Delayed-release capsule:
• Depression (7 years and older): The typical dose is 90 mg by mouth once weekly.

If you miss a dosage of this medication, take it right away. If it is almost time for your next dose, skip the missing dose and resume your normal dosing plan. Do not duplicate the doses.

Store Prozac at room temperature in a cool, dry area that is out of reach of children.

Eli Lilly and Company is the pharmaceutical company that produces Prozac.

There are several different generic versions of Prozac with the active ingredient fluoxetine.

If you need to stop taking Prozac, your healthcare provider will most likely recommend reducing the dose gradually. This tapering normally takes many weeks, about 6 to 8 weeks, and is done to help prevent Prozac withdrawal symptoms.

Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

You can use Prozac when pregnant. Some research suggests that Prozac (fluoxetine) may occasionally damage the development of a baby's heart. However, the danger is low, and most infants born to mothers who take fluoxetine have normal hearts.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.

Prozac can get into breast milk and induce adverse effects (such as fussiness and tiredness) in breastfed babies. Tell your psychiatrist if you're breastfeeding. They'll talk about the dangers and benefits of continuing fluoxetine (Prozac).