Fluoxetine is used to treat depression, bulimia nervosa and obsessive-compulsive disorder. Find out how to take it safely and possible side effects. Fluoxetine is also called Fluox or Prozac.
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|June 2020: The funded brand of fluoxetine is changing|
|The funded brand of fluoxetine is changing from Arrow-Fluoxetine to Fluox. Fluox has previously been funded, so this might mean some people are returning to a brand they've used before. Arrow-Fluoxetine and Fluox are both generic brands of fluoxetine.
Read more about the fluoxetine brand change.
What is fluoxetine?
Fluoxetine is used to treat depression, obsessive-compulsive disorder or eating disorders. It belongs to a group of medicines called selective serotonin reuptake inhibitors (SSRIs). It is believed that SSRIs work by increasing the activity of certain chemicals working in our brains called neurotransmitters. These pass signals from one brain cell to another. Although we don’t know for certain, the neurotransmitters that are most likely to be involved in depression and some other conditions are thought to be serotonin and noradrenaline. Selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed antidepressants. SSRIs are called selective because they only affect serotonin.
- The dose of fluoxetine will be different for different people.
- Your doctor may start you on a low dose and if you need to, will increase your dose slowly after a few weeks. This allows your body to get used to the medicine and reduces side effects.
- Always take your fluoxetine exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much fluoxetine to take, how often to take it, and any special instructions.
How to take fluoxetine
- Timing: Fluoxetine is best taken in the morning. Take your dose at the same time each day. You can take fluoxetine with or without food but if you think it is upsetting your stomach, try taking it with food.
- Swallowing: If you are taking capsules, swallow with a glass of water. Do not open or chew. If you have problems swallowing capsules, let your doctor know as you could be prescribed dispersible tablets which are dissolved in water and then swallowed.
- Missed dose: If you forget to take your dose, take it if you remember soon after it is due, but if it nearly time for your next dose, just take it then. Do not take double the dose.
- Keep taking fluoxetine every day. It may take 4 to 6 weeks before you notice the full benefits. If you think fluoxetine is not working for you, do not stop taking it suddenly; speak to your doctor or nurse before stopping.
Precautions before starting fluoxetine
- Do you have any heart problems such as irregular heartbeat?
- Have you had problems with mania or psychosis?
- Do you have problems with your kidneys or liver?
- Do you have epilepsy?
- Do you have diabetes?
- Are you pregnant or breastfeeding?
- Do you have a bleeding disorder or stomach ulcer?
- Are you taking any other medicines, including medicines you can buy without a prescription, such as herbal and complementary medicines or pain relief medicines?
If so, it’s important that you tell your doctor or pharmacist before you start fluoxetine. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.
Precautions while taking fluoxetine
- Alcohol: avoid alcohol while you are taking fluoxetine, especially when you first start treatment. Drinking alcohol while taking SSRIs can cause drowsiness and affect concentration, putting you at risk of falls and other accidents. It can also cause agitation, aggression and forgetfulness. If you do drink alcohol, drink only small amounts and see how you feel. Do not stop taking your medication.
- Diabetes: if you have diabetes, you may need to check your blood glucose more often because fluoxetine can affect the levels of glucose in your blood.
What are the side effects of fluoxetine?
Like all medicines, fluoxetine can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.
The use of antidepressants has been linked with an increase in suicidal thoughts and behaviour. Children, teenagers, young adults and people with a history of suicidal behaviour are particularly at risk. This is most likely during the first few weeks of starting an antidepressant or if the dose is changed. It is important to look for signs of suicidal behaviour such as agitation or aggression and ask about suicidal thoughts, self-harm, worsening of low mood, If you notice any of these signs, contact your doctor immediately.
It is ok and important to ask about suicidal thoughts and this will not increase risk.
If you need urgent help or are concerned, phone:
- Lifeline 0800 543 354 (available 24/7), or
- Healthline 0800 611 116, who can give you the phone number for your local mental health crisis line.
Risk of bleeding
SSRIs can increase your risk of bleeding especially if taken with NSAIDs (non-steroidal anti-inflammatory drugs) such as diclofenac and ibuprofen. Check with your doctor or pharmacist before you take pain relief.
Sexual side effects
SSRIs in both men and women can cause reduced sexual drive, lack of libido and problems keeping an erection and reduce the intensity of orgasm. It’s important to talk to your healthcare provider if you get these effects, as they can be difficult to deal with and may not go away. Your healthcare provider may be able to suggest treatment or may reduce the dose of the SSRI or change to a different one. Read more about medicines and sexual problems.
Other side effects
|Side effects||What should I do?|
|Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product|
Fluoxetine interacts with many other medications (including pain relief medicines) and herbal supplements (such as St. John's Wort) so check with your doctor or pharmacist before starting fluoxetine or before starting any new medicines.
- Fluoxetine New Zealand Formulary
- Selective serotonin re-uptake inhibitors New Zealand Formulary
- The role of medicines in the management of depression in primary care BPAC, 2017
Additional resources for healthcare professionals
Discontinuation reactions NZ Formulary
Serotonin syndrome NZ Formulary
Agitation, restlessness and suicidal behaviour with fluoxetine, paroxetine and sertraline Medsafe, NZ, 2002
Update – qt prolongation with antidepressants Medsafe, NZ, 2013