Prozac

Generic name: Fluoxetine hydrochloride

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, and bulimia. In children and adolescents, Prozac is used to treat major depression and obsessive-compulsive disorder. Prozac Weekly is approved for treating major depression.

What is the most important information I should know about Prozac?

Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment.

Individuals being treated with Prozac and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly—especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior—and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.

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.

Who should not take Prozac?

Do not take Prozac while using a medication known as a monoamine oxidase inhibitor (MAOI). You should also not use Prozac if you are taking thioridazine. You should not start thioridazine within 5 weeks of stopping Prozac. You should 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 medication you are taking before beginning treatment with Prozac. Also, talk to your doctor about your complete medical history, especially if you have liver disease, kidney disease, diabetes, seizures or epilepsy, bipolar disorder (manic depression) or a history of drug abuse or suicidal thoughts.

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.

Depression

Adults: It may take 4 weeks before the full antidepressant effect of Prozac is seen.

The recommended starting dose is 20 milligrams (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 to 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.

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 milligrams of medication.

Children 8 years and older: 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.

Obsessive-Compulsive Disorder

Adults: It may take 5 weeks before the full effects of Prozac are seen.

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 to 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 and older: 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 to 30 mg a day.

Bulimia

Adults: The recommended dose is 60 mg day taken in the morning. The doctor may start you at a lower dose and gradually increase it over a period of several days.

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.

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.

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 MAO inhibitors or thioridazine.

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, abnormal vision, anxiety, chest pain, chills, confusion, diarrhea, diminished sex drive, dizziness, dry mouth, flu-like symptoms, flushing, gas, headache, hives, impotence, impaired thinking, insomnia, itching, loss of appetite, nausea, nervousness, rash, seizures, sex-drive changes, sinusitis, sleepiness, sore throat, sweating, tremors, upset stomach, vomiting, weakness, yawning

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 it as soon as possible. If you don't remember until the next day, skip the dose you missed and go back to your regular schedule. Do not take a double dose.

How should I store Prozac?

Store at room temperature.