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Precautions

Do NOT use Fluoxetine if:

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• you take or took a monoamine oxidase inhibitor (MAOI) (eg, phenelzine), selegiline, or St. John's wort within the past 14 days

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• you take a fenfluramine derivative (eg, dexfenfluramine), an H₁ antagonist (eg, astemizole, terfenadine), nefazodone, pimozide, a serotonin-norepinephrine reuptake inhibitor (SNRI) (eg, venlafaxine), another SSRI (eg, paroxetine), sibutramine, thioridazine, or tryptophan.

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Contact your doctor or health care provider without delay if all of these apply to you.

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Some health conditions may communicate with Fluoxetine. Tell your medical professional or pharmacist in case you have any medical ailments, in particular when any of the following apply to you:

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Some medicines may interact with Fluoxetine. Tell your doctor if you take some other medicines, especially any with the following:

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• Anorexiants (eg, phentermine), fenfluramine derivatives (eg, dexfenfluramine), linezolid, MAOIs (eg, phenelzine), metoclopramide, nefazodone, selegiline, serotonin 5-HT₁ receptor agonists (eg, sumatriptan), sibutramine, SNRIs (eg, venlafaxine), St. John's wort, trazodone, or tryptophan because severe unwanted side effects, say for example a reaction which could include fever, rigid muscles, hypertension changes, mental changes, confusion, irritability, agitation, delirium, or coma, may occur

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• Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the chance of bleeding, including stomach bleeding, could be increased

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• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels could possibly be increased

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• Tramadol as the risk of seizures could possibly be increased

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• Cyclobenzaprine or H₁ antagonists (eg, astemizole, terfenadine) because severe heart problems, including irregular heartbeat, may occur

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• Cyproheptadine as it may decrease Fluoxetine's effectiveness

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• Aripiprazole, benzodiazepines (eg, alprazolam), beta-blockers (eg, propranolol), carbamazepine, clozapine, dextromethorphan, digoxin, flecainide, haloperidol, hydantoins (eg, phenytoin), lithium, norepinephrine reuptake inhibitors (eg, atomoxetine), phenothiazines (eg, chlorpromazine, thioridazine), pimozide, propafenone, risperidone, tricyclic antidepressants (eg, amitriptyline), or vinblastine since the chance of their unwanted side effects could possibly be increased by Fluoxetine.

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This is probably not a total list of all interactions which could occur. Ask your doctor if Fluoxetine may communicate with other medicines which you take. Check along with your doctor before you begin, stop, or affect the dose associated with a medicine.

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Important safety information:

• Fluoxetine could cause drowsiness or dizziness. These effects may be worse if you go with alcohol or certain medicines. Take Fluoxetine with caution. Do not drive or perform other possible unsafe tasks unless you understand how you reply to it.

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• Check using your doctor before you consume alcohol or use medicines that might cause drowsiness (eg, sleep aids, muscle relaxers) while you consider Fluoxetine; it might enhance their effects. Ask your friendly phamacist in case you have queries about which medicines could cause drowsiness.

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• Several weeks may pass before your symptoms improve. Do NOT take greater than the recommended dose, improve your dose, or take Fluoxetine for over prescribed without checking using your doctor.

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• Children and teenagers having Fluoxetine could possibly be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who've had suicidal thoughts or actions inside past. The risk can be greater in patients who may have had bipolar (manic-depressive) illness, or if their family members also have it. Watch patients having Fluoxetine closely. Contact a doctor immediately if new, worsened, or sudden symptoms for example depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact your physician immediately if any indications of suicidal thoughts or actions occur.

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• Diabetes patients - Fluoxetine may affect your blood glucose. Check blood glucose levels closely. Ask your physician when you customize the dose of your respective diabetes medicine.

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• Serotonin syndrome is often a possibly fatal syndrome that may be a result of Fluoxetine. Your risk could possibly be greater for Fluoxetine with certain other medicines (eg, MAOIs, SSRIs, "triptans"). Symptoms can sometimes include agitation; coma; confusion; sweating in excess; fast or irregular heartbeat; fever; hallucinations; nausea, vomiting, or diarrhea; tremor. Contact your physician at the same time for those who have any of these symptoms.

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• Neuroleptic malignant syndrome (NMS) is really a possibly fatal syndrome that may be brought on by Fluoxetine. Symptoms can sometimes include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your physician simultaneously for those who have some of these symptoms.

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• If your doctor notifys you to halt taking Fluoxetine, you simply must await many weeks prior to starting to take certain other medicines (eg, MAOIs, nefazodone, thioridazine). Ask your medical professional ought to start to take your medicines after you might have stopped taking Fluoxetine.

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• Fluoxetine may rarely result in a prolonged, painful erection. This could happen even when you're not having sexual intercourse. If this is not treated immediately, it could possibly cause permanent sexual difficulties such as impotence. Contact your medical professional right away should this happen.

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• Fluoxetine contains some of the same ingredients as Prozac, medicine utilized to treat depression as well as other mental problems, and Symbyax, medicine employed to treat depression in patients with bipolar disorder. Do not take Fluoxetine if you are also taking Prozac or Symbyax. Discuss any questions or concerns with your doctor.

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• Use Fluoxetine with caution within the elderly; they could be more understanding of its effects, especially low blood sodium levels.

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• Caution is advised when utilizing Fluoxetine in children; they might be more sensitive to its effects, especially increased probability of suicidal thoughts or actions.

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• Fluoxetine ought to be combined with extreme care in youngsters; safety and effectiveness in children have not been confirmed.

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• Fluoxetine may cause weight changes. Children and teenagers might need regular weight and growth checks when they take Fluoxetine.

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