Apo-Fluoxetine

Brand Names: Apo-Fluoxetine

Common Name: fluoxetine

What is this drug used for?

Fluoxetine belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). It is used for the treatment of depression and helps to elevate mood. Selective serotonin reuptake inhibitors work by increasing the amount of a neurotransmitter, called serotonin, that is available in certain parts of the brain. Although you may start feeling better within a few weeks of treatment, the full effects of the medication may not be evident until several weeks of treatment have passed. Fluoxetine is also used to reduce or eliminate the symptoms of obsessive-compulsive disorder (OCD) as well as to treat the eating disorder, bulimia nervosa.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Is there any reason not to take this drug?

Fluoxetine should not be taken by anyone who:

• is allergic to fluoxetine or any ingredients of the medication
• has taken a medication known as a MAO inhibitor within the past 14 days

What about possible side effects?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• anxiety or nervousness
• decreased appetite
• decreased sexual drive
• diarrhea
• dizziness or lightheadedness
• drowsiness
• dry mouth
• headache
• heartburn
• increased sweating
• nausea
• tiredness or weakness
• trembling or shaking
• trouble sleeping

Check with your doctor as soon as possible if any of the following side effects occur:

• inability to sit still, or restlessness
• skin rash, hives, or itching
• chills or fever
• joint or muscle pain
• breast enlargement or pain
• fast or irregular heartbeat
• purple or red spots on skin
• talking, feeling, and acting with excitement and activity you cannot control
• unusual secretion of milk (women)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• convulsions (seizures)
• symptoms of hypoglycemia (low blood sugar), including:
  • anxiety or nervousness
  • chills
  • cold sweats
  • confusion
  • cool pale skin
  • difficulty concentrating
  • drowsiness
  • excessive hunger
  • fast heartbeat
  • headache
  • shakiness or unsteady walk
  • unusual tiredness or weakness
• symptoms of hyponatremia (low blood sodium), including:
  • confusion
  • convulsions (seizures)
  • drowsiness
  • dryness of mouth
  • increased thirst
  • lack of energy
• symptoms of serotonin syndrome, including:
• diarrhea
• fever
• increased sweating
• mood or behaviour changes
• overactive reflexes
• racing heartbeat
• restlessness
• shivering or shaking
• trouble breathing
• unusual or incomplete body or facial movements

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

What if I am taking other drugs?

The following medications may affect the way fluoxetine works or increase the risk of side effects:

alcohol buspirone carbamazepine clarithromycin dextromethorphan levodopa lithium meperidine MAO inhibitors	nefazodone other SSRIs (e.g., paroxetine, fluvoxamine) sumatriptan St. John's wort tricyclic antidepressants tryptophan valproic acid divalproex

The following medications may be affected by fluoxetine or increase the risk of side effects:

• astemizole
• antipsychotics (e.g., haloperidol, risperidone, clozapine)
• benzodiazepines
• carbamazepine
• digoxin
• metoprolol
• nifedipine
• phenobarbital
• propranolol
• phenytoin
• tricyclic antidepressants (e.g., desipramine, imipramine)
• terfenadine
• verapamil
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Other information:

Be sure to inform your doctor of all your medical conditions before you begin taking a medication. Some conditions can affect how you should take this medication.

Allergy: Approximately 4% of people who take fluoxetine develop a rash or hives. Almost one-third of these people need to stop treatment because of the rash.

Diabetes: For people with diabetes, fluoxetine may alter blood glucose control. Low blood glucose has occurred during therapy with fluoxetine and high blood glucose has developed after treatment stops. As is true for many other types of medication when taken by people with diabetes, dosages of insulin or anti-diabetic tablets may need adjustment when therapy with fluoxetine starts or stops.

Drowsiness/reduced alertness: People taking fluoxetine are cautioned against driving a car or performing hazardous tasks until they determine that this medication does not affect them adversely.

Epilepsy: Fluoxetine should be used with caution by people with epilepsy.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, call your doctor as soon as possible.

Breast-feeding: Fluoxetine passes into breast milk. Women should stop breast-feeding while they are taking this medication.

Children: The safety and effectiveness of using this medication have not been established for children.

Special Instructions:

The recommended adult dose of fluoxetine ranges from 20 mg to 60 mg taken once daily in the morning, with or without food. The maximum recommended dose of fluoxetine is 80 mg daily. Once your symptoms have been brought under control, the lowest effective dose of fluoxetine as prescribed by your doctor should be used to keep the symptoms from coming back. Your doctor may advise you to keep taking fluoxetine for several months.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

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