Prozac
Generic Name: Fluoxetine
What is Prozac?
Prozac belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). It is used in adults for the treatment of major depressive disorder, panic disorder, obsessive-compulsive disorder, bulimia (eating disorder), treatment-resistant depression, and depression associated with bipolar disorder. In children and adolescents, Prozac is used to treat major depression and obsessive-compulsive disorder.What is the most important information I should know about Prozac?
Antidepressants can increase the risk of suicidal thinking and behavior in children, adolescents, and young adults. Patients of all ages who are started on antidepressants or are taking a new dose should be watched closely for clinical worsening, suicidality, or unusual behavior. Patients and their families should contact the doctor immediately if new symptoms develop or seem to get worse. Signs to watch for include anxiety, hostility, sleeplessness, restlessness, impulsive or dangerous behavior, and thoughts about suicide or dying.If you get a rash or hives while taking Prozac, call your doctor right away because this can be a sign of a serious medical condition.
Prozac may cause the development of potentially life-threatening reactions known as serotonin syndrome (a potentially life-threatening drug reaction that causes the body to have too much serotonin, a chemical produced by the nerve cells) or neuroleptic malignant syndrome (NMS, a life threatening brain disorder) when taken alone or in combination with other drugs. Symptoms may include mental status changes, increase in heart rate and temperature, incoordination, overactive reflexes, muscle rigidity, nausea, vomiting, or diarrhea. Contact your doctor immediately if you experience any of these signs or symptoms.
Prozac should not be taken in combination with monoamine oxidase inhibitors (MAOIs), a class of drugs used to treat depression, psychiatric or emotional conditions, or Parkinson's disease, or within 14 days before or 5 weeks after treatment with Prozac. In some cases a serious, possibly fatal, reaction may occur.
Who should not take Prozac?
Do not take Prozac while using MAOIs. You should also not use Prozac if you are taking thioridazine; do not start thioridazine therapy within 5 weeks of stopping Prozac. Do not take Prozac if you are taking pimozide.If you are allergic to or have ever had an allergic reaction to Prozac or similar drugs, you should not take Prozac. Make sure that your doctor is aware of any drug reactions that you have experienced.
What should I tell my doctor before I take the first dose of Prozac?
Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Prozac. Also, talk to your doctor about your complete medical history, especially if you have liver problems, seizure or bleeding disorders, or a history of suicide or mania.What is the usual dosage?
The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.Bulimia
Adults: The recommended dose is 60 milligrams (mg) a day taken in the morning. The doctor may start you at a lower dose and gradually increase it over a period of several days.
Depression
Adults: The recommended starting dose is 20 mg a day, usually taken in the morning. If needed, the doctor may gradually increase the dose up to a maximum of 80 mg a day. The usual daily dose ranges from 20-60 mg. Daily doses above 20 mg should be taken in the morning or in two smaller doses taken in the morning and at noon.
It may take 4 weeks before the full antidepressant effect of Prozac is seen.
Prozac Weekly: You need to wait at least 7 days after stopping your daily dose of Prozac before switching to the once-weekly formulation. One Prozac Weekly capsule contains 90 mg of medication.
Children ≥8 years: The usual starting dose is 10 or 20 mg a day. Children starting at 10 mg will have their dose increased to 20 mg a day after 1 week. Underweight children may need to remain at the 10-mg dose.
Depression (Treatment-Resistant)
Adults: The recommended starting dose is 20 mg given in combination with 5 mg of olanzapine. If needed, doses may be increased to 5-20 mg of olanzapine and 20-50 mg of Prozac.
Depressive Episodes Associated with Bipolar I Disorder
Adults: The recommended starting dose is 20 mg given in combination with 5 mg of olanzapine. If needed, doses may be increased to 5-12.5 mg of olanzapine and 20-50 mg of Prozac.
Obsessive-Compulsive Disorder
Adults: The recommended starting dose is 20 mg a day, usually taken in the morning. If needed, the doctor may gradually increase the dose up to a maximum of 80 mg a day. The usual daily dose ranges from 20-60 mg. Daily doses above 20 mg should be taken in the morning or in two smaller doses taken in the morning and at noon.
Children ≥7 years: The recommended starting dose is 10 mg a day. After 2 weeks, the doctor will increase the dose to 20 mg. If needed, the doctor may further increase the dose up to a maximum of 60 mg a day. The recommended dosage range for underweight children is 10-30 mg a day.
It may take 5 weeks before the full effects of Prozac are seen.
Panic Disorder
Adults: The recommended starting dose is 10 mg a day. After 1 week, the doctor will increase the dose to 20 mg. If no improvement is seen after several weeks, the doctor may increase the dose to a maximum of 60 mg a day.
How should I take Prozac?
Prozac should be taken exactly as prescribed by your doctor. Do not stop taking Prozac suddenly without first talking to your doctor.Prozac usually is taken once or twice a day, at the same time each day. To be effective, it should be taken regularly. Prozac can be taken with or without food.
What should I avoid while taking Prozac?
Prozac may cause you to become drowsy or less alert and may affect your judgment. Therefore, driving or operating dangerous machinery or participating in any hazardous activity that requires full mental alertness is not recommended until you know how Prozac affects you.Do not drink alcohol while taking Prozac.
What are possible food and drug interactions associated with Prozac?
If Prozac is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Prozac with the following: alcohol, alprazolam, other antidepressants, antipsychotics, carbamazepine, clozapine, desipramine, diazepam, digitoxin, drugs that affect the central nervous system, flecainide, haloperidol, imipramine, linezolid, lithium, narcotic painkillers, nonsteroidal anti-inflammatory drugs (such as aspirin, ibuprofen, naproxen, and ketoprofen), phenytoin, pimozide, propafenone, sleep aids, St. John's wort, sumatriptan, terfenadine, tryptophan, tramadol, vinblastine, and warfarin.Never take Prozac with MAOIs, thioridazine, or pimozide.
What are the possible side effects of Prozac?
Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.Side effects may include: abnormal dreams, abnormal ejaculation, loss of appetite, anxiety, weakness, diarrhea, dry mouth, indigestion, flulike symptoms, impotence, insomnia, diminished sex drive, nausea, sore throat, rash, watery nasal discharges, sleepiness, sweating, tremor, hot flashes
Can I receive Prozac if I am pregnant or breastfeeding?
Tell your doctor immediately if you are pregnant, or plan to become pregnant. Prozac given late in the third trimester of pregnancy was associated with complications. If you are receiving Prozac during pregnancy, speak to your doctor about switching to other treatment options or lowering the dose.This medication appears in breast milk, and breastfeeding is not recommended while you are taking Prozac.
What should I do if I miss a dose of Prozac?
Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular dosing schedule. Do not take two doses at once.How should I store Prozac?
Store at room temperature.
