General Overview of Fluoxetine
The medicine Fluoxetine is an antidepressant and belongs to the class of selective serotonin reuptake inhibitors. The medicine is available under the names Sarafem and Prozac in the market. This medicine is used for treating major psychotic disorders like depression, obsessive-compulsive disorder (OCD), panic disorder, bulimia, and premenstrual dysphoric disorder.
The drug is approved by the World Health Organization as an effective as well as the safe medicine. WHO has listed Fluoxetine as one of the Essential medicines for treating several psychotic disorders. Fluoxetine is available in solid and liquid form.
When Fluoxetine Show Results?
The results of Fluoxetine varies according to the severity of the condition as well as from person to person. In most of the cases, the drug shows improvement within 1-2 weeks of its use. In other cases, it takes 4-5 weeks for patients to fully recover from the disorder.
The drug shows improvements in the conditions only if taken daily in the prescribed manner (time and dosage). Initially, the doctor may start medication from a low dosage and then gradually increases it.
Directions for Usage of Drug
Patients who suffer from depression, bulimia, anxiety or any other psychotic disorder are advised to use Fluoxetine only when prescribed by their psychiatrist or physician. If your doctor has prescribed Fluoxetine then you must first share all your medical history with your doctor.
Always read the medication leaflet of the Fluoxetine before taking it, and if there is any confusion regarding its usage then ask your pharmacist. The direction for usage of Fluoxetine are listed below:
- The drug Fluoxetine must be taken orally with simple water.
- The standard dosage of Fluoxetine is one tablet daily in the morning. Do not take more than 2 tablets of Fluoxetine daily.
- If your doctor has prescribed Fluoxetine twice a day then make sure to take one at morning and one at noon.
- For premenstrual problems, you must take Fluoxetine either daily for one month or 2 weeks before your monthly period.
- Patients who use the liquid form of Fluoxetine must use a proper measuring spoon or device to take the dosage. It is highly prohibited to use the household spoon for taking out the prescribed dosage of Fluoxetine.
- Do not take extra or less dosage as prescribed by your doctor.
- Patients should not stop their medication without asking their doctor. They are required to take the medicine even when they feel well.
- If your doctor has prescribed you take Fluoxetine once a day, and you somehow forget to take it do not take twice dosage the next day. It will only worsen your condition.
It is very important to consult your doctor or pharmacist before using Fluoxetine as well as when you stop the medication. Also, patients who use Fluoxetine must list down other medications they are using before, during and after the usage of Fluoxetine drug.
It is essential because Fluoxetine is staying for many weeks in the body even after the patients stop taking it. And there is a risk of Fluoxetine remnants reacting/interacting with other medicines. The patients are advised to tell their doctor and pharmacist about the medications if they were using Fluoxetine at least 5 weeks ago.
The drugs which are likely to react or interact with Fluoxetine may include drugs which our liver enzymes remove from the body such as:
- Antiarrhythmics – Propafenone/flecainide
- Tricyclic Antidepressants – Desipramine/Imipramine
- Anti-platelet drugs - Clopidogrel
- NSAIDS – Ibuprofen
- Blood Thinners – Warfarin
There are serious consequences if the patients use MAO inhibitors during within the 5 weeks of the termination of treatment. MAO inhibitors include isocarboxazid, methylene blue, moclobemide, selegiline, safinamide etc.
Doctors advise stopping the use of MAO inhibitors at least 2 weeks before starting the course of Fluoxetine medicine and 5 weeks after the treatment. Moreover, the drug cannot be used with medications like aspirin as it can increase the risk of heart attack and bleeding if taken with Fluoxetine. The drug also increases the risk of Serotonin toxicity/ serotonin syndrome if taken with the serotonin increasing drugs.
Not only the medications but patients are also required to tell their doctor if they are also using other products marijuana, alcohol, antihistamines like cetirizine and diphenhydramine, drugs for sedation like alprazolam, diazepam, and zolpidem, narcotic pain relievers or muscle relaxants. Fluoxetine along with such products may cause serious allergies and cough problems. Patients are therefore advised to tell their conditions and products they are using to the doctors. If the conditions get worse or there are any signs of allergies rush to your doctor immediately.
Side effects of Fluoxetine
In the beginning, the drug may cause some side effects like nausea, dizziness, anxiety, sleep deprivation, drowsiness, sweating, and loss of appetite, tiredness or yawning. These side effects are normal but if any of the sign gets worse or you start feeling uncomfortable, immediately consult your doctor about your condition.
To avoid the side effects usually, the doctors prescribe a low dosage. And the amount of dosage is prescribed according to the condition of the patient and severity of the disorder. In most of the cases where patients use Fluoxetine, the benefits are higher and there are no or little signs of drug side effects.
Another Side effect of the drug Fluoxetine is the QT prolongation in which the heart rhythm is affected. The older adults are more likely to show the QT prolongation during the use of Fluoxetine medication. QT prolongation is a condition which can cause serious or fatal irregular, rapid heartbeats and other cardiac symptoms. In this situation, the patients also experience severe dizziness and fainting.
Patients suffering from other medical conditions like cardiac problems, family history of bipolar disorder, suicidal tendencies or other diseases (physical or psychological) has a higher risk of QT prolongation when using Fluoxetine.
When to See Doctor
There are certain signs which are the indication that either you need to change the dosage or stop taking the medicine. If you experience any serious side effects other than the usual initial signs immediately tell your doctor about your conditions. The side effects like severe/unusual mental discomfort, rapid mood swings/changes, feeling agitated, usual excitement or high energy levels.
If after the usage of Fluoxetine you have suicidal thoughts or unusual bleeding, bruising, muscle weakness, muscle spasms, tremors, sudden weight loss, changes in sexual ability or loss of interest in sex then you need to tell your doctor about it. if you experience any of these signs do not change your dosage or stop the medication without asking your doctor.
Fluoxetine rarely causes serious fatal side effects, in which case you might need immediate medical assistance. If during the treatment you have side effects like black/tarry/bloody stools, irregular, fast heartbeat, vomit-like coffee grounds, seizures, change in the color and amount of urine, faintness, blurred visions, swelling/redness of eyes, eye pain, and pupil widening get medical help.
In males, although very rare, Fluoxetine is believed to cause painful and prolonged erection which may last up to 4 and even more than 4 hours. It can also cause allergic reactions like rash, itching, swelling around the face, tongue or throat, dizziness or breathing problems. If the drug shows any of these side effects, you may need to stop the use of fluoxetine and avoid taking it.
Precautions You May Need
Patients who are prescribed to use the drug Fluoxetine are required to take some serious precautions to avoid any fatal side effects or consequences. These precautions are listed below:
- Patients having any type of allergies must tell about their condition to their doctor or pharmacist before using the medication. Because the ingredients used in Fluoxetine may cause serious allergies.
- Fluoxetine is believed to elevate the sugar level in blood and therefore patients with the diabetic condition are required to monitor their blood sugar regularly. They are also advised to talk about their diabetic condition in detail with their doctor. In additions, they must follow a strict diet and daily exercise & walk to reduce the effects of Fluoxetine on blood sugar.
- Fluoxetine can interact with alcohol and marijuana and can cause serious dizziness. Therefore patients who use fluoxetine should avoid any type of alcoholic beverages and marijuana products.
- The usage of Fluoxetine is prohibited during pregnancy unless otherwise prescribed by the doctor. The drug can harm the baby, and it can also show withdrawal symptoms in the babies which are rare. The withdrawal symptoms may include difficulty in feeding/breathing, muscle stiffness, constant crying or seizures.
- Breastfeeding mothers are should also not use this medicine. Because Fluoxetine passes in the breast milk and can cause serious harm to the infants.
- If you have any family history of the manic-depressive disorder or bipolar disorder, suicide attempts, diabetes, low blood sodium levels, liver problems, dehydration, seizures, intestinal ulcers, glaucoma etc. then consult your doctor before using the fluoxetine. It is advised not to use this medication if you have any of these medical problems.