Brand
name: Prozac
Pronounced: PRO-zak
Generic name: Fluoxetine hydrochloride
Other brand names: Prozac Weekly, Sarafem
Why is Prozac prescribed?
Prozac is prescribed for the treatment of depression--that is, a continuing
depression that interferes with daily functioning. The symptoms of
major depression often include changes in appetite, sleep habits, and
mind/body coordination; decreased sex drive; increased fatigue; feelings
of guilt or worthlessness; difficulty concentrating; slowed thinking;
and suicidal thoughts.
Prozac is also prescribed to treat obsessive-compulsive disorder.
An obsession is a thought that won't go away; a compulsion is an action
done over and over to relieve anxiety. The drug is also used in the
treatment of bulimia (binge-eating followed by deliberate vomiting).
It has also been used to treat other eating disorders and obesity.
In addition, Prozac is used to treat panic disorder, including panic
associated with agoraphobia (a severe fear of being in crowds or public
places). People with panic disorder usually suffer from panic attacks--feelings
of intense fear that develop suddenly, often for no reason. Various
symptoms occur during the attacks, including a rapid or pounding heartbeat,
chest pain, sweating, trembling, and shortness of breath.
In children and adolescents, Prozac is used to treat major depression
and obsessive-compulsive disorder.
Prozac Weekly is approved for treating major depression.
Under the brand name Sarafem, the active ingredient in Prozac is also
prescribed for the treatment of premenstrual dysphoric disorder (PMDD),
formerly known as premenstrual syndrome (PMS). Symptoms of PMDD include
mood problems such as anxiety, depression, irritability or persistent
anger, mood swings, and tension. Physical problems that accompany PMDD
include bloating, breast tenderness, headache, and joint and muscle
pain. Symptoms typically begin 1 to 2 weeks before a woman's menstrual
period and are severe enough to interfere with day-to-day activities
and relationships.
Prozac belongs to the class of drugs called selective serotonin re-uptake
inhibitors (SSRIs). Serotonin is one of the chemical messengers believed
to govern moods. Ordinarily, it is quickly reabsorbed after its release
at the junctures between nerves. Re-uptake inhibitors such as Prozac
slow this process, thereby boosting the levels of serotonin available
in the brain.
Most important fact about Prozac without prescriptions.
Serious, sometimes fatal, reactions have been known to occur when
Prozac is used in combination with other antidepressant drugs known
as MAO inhibitors, including Nardil and Parnate; and when Prozac is
discontinued and an MAO inhibitor is started. Never take Prozac with
one of these drugs or within at least 14 days of discontinuing therapy
with one of them; and allow 5 weeks or more between stopping Prozac
and starting an MAO inhibitor. Be especially cautious if you have been
taking Prozac in high doses or for a long time.
In addition, Prozac should never be combined with thioridazine (Mellaril)
due to the risk of life-threatening drug interactions; and a minimum
of 5 weeks should be allowed between stopping Prozac and starting Mellaril.
If you are taking any prescription or nonprescription drugs, notify
your doctor before taking Prozac.
How should you take Prozac?
Prozac should be taken exactly as prescribed by your doctor.
Prozac usually is taken once or twice a day. To be effective, it should
be taken regularly. Make a habit of taking it at the same time you
do some other daily activity.
It may be 4 weeks before you feel any relief from your depression,
but the drug's effects should last about 9 months after a 3-month treatment
regimen. For obsessive-compulsive disorder, the full effect may take
5 weeks to appear.
If you miss a dose FLUNIL (Fluoxetine, Prozac)
Take the forgotten dose as soon as you remember. If several hours
have passed, skip the dose. Never try to "catch up" by doubling
the dose.
Storage FLUNIL (Fluoxetine, Prozac) instructions...
Store at room temperature.
Prozac side effects
Side effects cannot be anticipated. If any develop or change in intensity,
inform your doctor as soon as possible. Only your doctor can determine
if it is safe for you to continue taking Prozac.
* Side effects may include:
Abnormal dreams, abnormal ejaculation, abnormal vision, anxiety, diarrhea,
diminished sex drive, dizziness, dry mouth, flu-like symptoms, flushing,
gas, headache, impotence, insomnia, itching, loss of appetite, nausea, nervousness,
rash, sex-drive changes, sinusitis, sleepiness, sore throat, sweating, tremors,
upset stomach, vomiting, weakness, yawning
Why should Prozac not be prescribed?
If you are sensitive to or have ever had an allergic reaction to Prozac
or similar drugs such as Paxil and Zoloft, you should not take Prozac.
Make sure that your doctor is aware of any drug reactions that you
have experienced.
Do not take Prozac while using an MAO inhibitor (see "Most important
fact about Prozac"). You should also not use Prozac if you are
taking Mellaril (thioridazine). Likewise, do not start taking Mellaril
within 5 weeks of stopping Prozac.
Special warnings about Prozac
In clinical studies, antidepressants increased the risk of suicidal
thinking and behavior in children and adolescents with depression and
other psychiatric disorders. Anyone considering the use of Prozac or
any other antidepressant in a child or adolescent must balance this
risk with the clinical need. Prozac is approved for treating major
depression in children 8 years and older and for treating obsessive-compulsive
disorder in children 7 years and older.
Additionally, the progression of major depression is associated with
a worsening of symptoms and/or the emergence of suicidal thinking or
behavior in both adults and children, whether or not they are taking
antidepressants. 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.
Unless you are directed to do so by your doctor, do not take this
medication if you are recovering from a heart attack or if you have
liver disease or diabetes.
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.
While taking Prozac, you may feel dizzy or light-headed or actually
faint when getting up from a lying or sitting position. If getting
up slowly doesn't help or if this problem continues, notify your doctor.
If you develop a skin rash or hives while taking Prozac, discontinue
use of Prozac and notify your doctor immediately.
Prozac should be used with caution if you have a history of mania
or seizures. You should discuss all of your medical conditions with
your doctor before taking Prozac.
Prozac can occasionally cause decreased appetite and weight loss,
especially in depressed people who are already underweight and in those
with bulimia. If you notice changes in your weight or appetite, tell
your doctor.
Antidepressants such as Prozac could potentially cause stomach bleeding,
especially when combined with nonsteroidal anti-inflammatory drugs
(NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve),
and ketoprofen (Orudis KT). Consult your doctor before combining Prozac
with NSAIDs or blood-thinning medications.
There have been rare reports of prolonged seizures in people who received
electroconvulsive therapy (ECT) while taking Prozac. To date, there
are no clinical studies establishing the benefit of combined treatment
with Prozac and ECT.
Possible food and drug interactions when taking Prozac
Never take Prozac with MAO inhibitors or thioridazine (Mellaril) (see "Most
important fact about Prozac").
Do not drink alcohol while taking 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:
Alprazolam (Xanax)
Any other antidepressants
Carbamazepine (Tegretol)
Clozapine (Clozaril)
Diazepam (Valium)
Digitoxin (Crystodigin)
Drugs that impair brain function, such as sleep aids and narcotic painkillers
Flecainide (Tambocor)
Haloperidol (Haldol)
Lithium (Eskalith)
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen
(Advil, Motrin), naproxen (Aleve), and ketoprofen (Orudis KT)
Phenytoin (Dilantin)
Pimozide (Orap)
Sumatriptan (Imitrex)
Tryptophan
Vinblastine (Velban)
Warfarin (Coumadin)
Special information if you are pregnant or breastfeeding
The effects of Prozac during pregnancy have not been adequately studied.
If you are pregnant or plan to become pregnant, inform your doctor
immediately. This medication appears in breast milk, and breastfeeding
is not recommended while you are taking Prozac.
Recommended dosage for Prozac
DEPRESSION
Overdosage
Any medication taken in excess can have serious consequences. An overdose
of Prozac can be fatal. In addition, combining Prozac with certain
other drugs can cause symptoms of overdose. If you suspect an overdose,
seek medical attention immediately.
* Common symptoms of Prozac overdose include:
Nausea, rapid heartbeat, seizures, sleepiness, vomiting
