Medication Information:
Fluoxetine (generic) ~ Prozac, Prozac Weekly, Sarafem (brand) Classification: Selective serotonin reuptake inhibitor
Common Usage: Fluoxetine is indicated for the treatment of major
depressive disorder and obsessive-compulsive disorder. The efficacy and
safety of fluoxetine has not been established in children younger than eight
years of age in major depressive disorder, and in children younger than seven
years of age in obsessive-compulsive disorder. Fluoxetine is also
indicated for bulimia nervosa, premenstrual dysphoric disorder (PMDD) and panic
disorder with or without agoraphobia in adults. Important Side Effects:
The most common side effects associated with fluoxetine include headache,
nervousness, sleeplessness, drowsiness, anxiety, shakiness, dizziness, general
feeling of weakness or fatigue, nausea and upset stomach, diarrhea, decreased
appetite, constipation and decrease in sexual desire. Some side effects
may lessen in severity or even subside within a few weeks of therapy. When
dosages are increased, some side effects may correspondingly increase in
severity.
This is not a complete
list of all known or potential adverse effects. Notify your prescriber or
pharmacist of any symptoms that have started since you began taking this
medication, changing its dose or adding or changing other medication or diet.
Take care when performing any task (such as driving a car or operating
machinery) that requires your attention until you have experience with this drug
and are confident you can perform this task safely. Interactions with Other Medications: Fluoxetine may interact with
alcohol. Patients currently taking carbamazepine (Tegretol), lithium (Eskalith
and others), warfarin (Coumadin), phenytoin (Dilantin) and cimetidine (Tagamet)
may need to have the dosages of these drugs adjusted by their physician after
fluoxetine is added. Over-the-counter drugs such as decongestants and
antihistamines may increase the severity of certain side effects.
Dextromethorphan, which is found in many over-the-counter cold preparations, may
cause reactions such as hallucinations, fever and muscle stiffness (also known
as serotonin syndrome), and has the potential to become life threatening.
Pain relievers such as tramadol (Ultram), meperidine (Demerol) or codeine may
produce the same reaction when mixed with fluoxetine. Patients using
fluoxetine with other antidepressants or antipsychotic drugs must do so only
under the guidance of their physician. Fenfluramine (Pondimin) and
dexfenfluramine (Redux) should not be taken while taking fluoxetine.
This is not a complete
list of all known or potential drug interactions. To help prevent
problems, always make sure that your pharmacist and all prescribers know about
all medications you are taking, including over-the-counter drugs; dietary
supplements; folk or home remedies; or unusual foods, drinks or dietary habits. CommonDosages: For depression and obsessive-compulsive disorder.
In adults, the recommended starting dose of fluoxetine is 20 mg/day, taken in
the morning. The dose may be increased if there is no improvement after
several weeks, but a maximum dose of 80 mg/day should not be exceeded. As
with other antidepressants, it may take four weeks or longer to achieve the full
therapeutic effect. A lower or less frequent dose should be considered for
elderly patients, for patients with hepatic impairment and for patients with
other illnesses or who are taking other medications. If weekly dosing of
fluoxetine is to be initiated for extended treatment of depression, seven days
should be allowed to pass after the last daily dose.
The recommended starting
dose for children and adolescents with depression is 10 mg per day, increased
after one week to a target dose of approximately 20 mg per day. In lower
weight children, the starting and target dose may be 10 mg per day. The
dose may be increased after several weeks to a target dose of 20 mg per day in
patients who have not achieved an optimal response.
The recommended starting
dose for adolescents and higher weight children with obsessive-compulsive
disorder is 10 mg per day, increased after two weeks to a target dose of
approximately 20 mg per day. The dose may be increased after several
weeks, up to a maximum of 60 mg per day, in patients who have not
achieved an optimal response. In lower weight children, the recommended
starting dose is 10 mg per day. The dose may be increased after several
weeks to target dose of approximately 20 to 30 mg per day.
For bulimia nervosa.
In adults, the recommended dose of fluoxetine is 60 mg/day, administered in the
morning. For some patients, the dose should be gradually increased to 60
mg/day over several days. Doses over 60 mg/day have not been
systematically studied in patients with bulimia nervosa.
For PMDD. In
adults, the recommended dose of fluoxetine for treatment of PMDD is 20 mg/day.
Doses over 60 mg/day have not been systematically studied in patients with PMDD. Identification: Prozac is available in 10-mg, 20-mg and 40-mg capsules.
The 10-mg is green and is imprinted with "DISTA 3104" on the cap and "Prozac 10
mg" on the body. The 20-mg has a green cap and an off-white body and is
imprinted with "DISTA 3105" on the cap and "Prozac 20 mg" on the body. The
40-mg has a green cap, an organge body and is imprinted with "DISTA 3107" on the
cap and "Prozac 40 mg" on the body.
Prozac is also available
as a 10-mg tablet. The tablet is green, elliptical, scored on one side and
debossed with "Prozac 10" on the other.
Prozac is also available
in a mint-flavored oral solution (20 mg/mL).
Prozac Weekly is available
as a 90-mg capsule with a green cap and a clear body. "Lilly" is imprinted
on the cap and "3004" and "90 mg" are imprinted on the body.
Sarafem is available as
10-mg and 20-mg capsules. The 10-mg is lavender and is imprinted with "10
mg" on the body and "LILLY 3210" on the cap. The 20-mg has a pink body and
a lavender cap and is imprinted with "20-mg" on the body and "LILLY 3220" on the
cap. Storage: Store this medication at normal room temperature (59° F to 86°
F) in a tightly closed, child-, light- and moisture-resistant container. If you
have difficulty opening child-resistant containers, your pharmacist can provide
a container that is easier to open. Keep the medication out of direct
sunlight and avoid storing it in a warm or humid area - such as the bathroom or
kitchen - to prevent deterioration. To prevent accidental poisoning, keep
all medications out of the reach of children. Do not take an expired
medication. Do not transfer medication from one container to another.
Carefully discard discontinued medication where children cannot find it. Edited by Henrietta L.
Leonard, M.D. ASERVICE OF…. Psychopharmacology Update
Note: These guidelines are for general information only.For more specific information, consult your physician orpharmacist. | 
