Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Prozac should be used with extreme caution in CHILDREN younger than 7 years old; safety and effectiveness in these children have not been confirmed. Activated charcoal should be administered. Due to the large volume of distribution of this drug, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be of benefit. No specific antidotes for fluoxetine are known.
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. As might be predicted from its primary site of metabolism, liver impairment can affect the elimination of fluoxetine. Do not take an MAOI within 5 weeks of stopping PROZAC unless directed to do so by your physician.
US Major Depressive Disorder, OCD, Bulimia, and Panic Disorder clinical trials, plus non-US Panic Disorder clinical trials. PROZAC is primarily metabolized by CYP2D6. Concomitant treatment with CYP2D6 inhibitors can increase the concentration of PROZAC. Thinking abnormal is the COSTART term that captures concentration difficulties. Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose, change your dose, or take Prozac for longer than prescribed without checking with your doctor. Muller WE, Rolli M, Schafer C, Hafner U. Effects of hypericum extract LI 160 in biochemical models of antidepressant activity.
SARAFEM. can happen when SARAFEM is stopped. Second, the nursing mothers may have breastfed less often or engaged in other behaviors that affected the infants' weight gain. Third, the lower weight could be due to the mother's use of the drug while she was pregnant. "I think it's somewhat of a preliminary study. Peterson GN. Strategies for fluoxetine-MAOI combination therapy. Some PROZAC may pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby while taking PROZAC.
The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using fluoxetine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems heart failure, slow heartbeat, QT prolongation in the EKG family history of certain heart problems QT prolongation in the EKG, sudden cardiac death. Take this medication by mouth as directed by your doctor, usually once daily in the morning. If you are taking this medication twice a day, your doctor may direct you to take it in the morning and at noon. If all else fails and you can manage it, spend time in a sunnier climate. Bipolar Disorder, and depression. Safety of co-administration of doses above 18 mg olanzapine with 75 mg fluoxetine has not been evaluated in clinical studies. If you have diabetes, fluoxetine may affect your blood sugar levels. Monitor your blood sugar regularly and share the results with your doctor. Your doctor may need to adjust your medication, diet, and exercise when you start or stop fluoxetine. Paxil paroxetine hydrochloride US prescribing information. Apotex Technologies July, 2014. In addition, fluoxetine treatment was associated with a decrease in alkaline phosphatase levels. The safety of fluoxetine treatment for pediatric patients has not been systematically assessed for chronic treatment longer than several months in duration. In particular, there are no studies that directly evaluate the longer-term effects of fluoxetine on the growth, development and maturation of children and adolescent patients. Therefore, height and weight should be monitored periodically in pediatric patients receiving fluoxetine. Other brands of medicine that contain the same ingredient fluoxetine are available. These other brands may be used to treat premenstrual dysphoric disorder PMDD or to treat depression in patients with bipolar disorder. Do not take Prozac if you are taking any other medicine that contains fluoxetine. Discuss any questions or concerns with your doctor.
If you have any questions about Prozac, please talk with your doctor, pharmacist, or other health care provider. The tricyclic and and the selective serotonin reuptake inhibitor SSRI are often used to reduce the frequency of cataplexy, a condition in which a person experiences a sudden but temporary loss of muscle tone. SARAFEM and should counsel them in its appropriate use. Rowley M, Riutort K, Shapiro D, Casler J, Festic E, Freeman WD. Methylene blue-associated serotonin syndrome: a 'green' encephalopathy after parathyroidectomy. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. There are no clinical studies establishing the benefit of the combined use of ECT and fluoxetine. There have been rare reports of prolonged seizures in patients on fluoxetine receiving ECT treatment. Schedule naps during the day. This may not be a complete list of all interactions that may occur. Ask your health care provider if Prozac may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine. Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness; black, bloody, or tarry stools; chest pain; confusion; decreased concentration; decreased coordination; decreased sexual disease or ability; exaggerated reflexes; excessive sweating; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; hallucinations; joint or wrist aches or pain; memory problems; new or worsening mental, mood, or behavior changes eg, depression, anxiety, agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent or severe ringing in the ears; persistent, painful erection; persistent trouble sleeping; red, swollen, blistered, or peeling skin; seizures; severe or persistent dizziness or headache; severe or persistent nausea, vomiting, diarrhea, or stomach pain; significant weight loss; suicidal thoughts or attempts; tremor; trouble urinating; unusual bruising or bleeding; unusual weakness; vomit that looks like coffee grounds. Infants exposed to SSRIs in pregnancy may have an increased risk for persistent of the newborn PPHN. Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions.
Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. There has been a long-standing concern, however, that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment. Pooled analyses of short-term placebo-controlled trials of antidepressant drugs SSRIs and others showed that these drugs increase the risk of suicidal thinking and behavior suicidality in children, adolescents, and young adults ages 18-24 with Major Depressive Disorder MDD and other psychiatric disorders. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction with antidepressants compared to placebo in adults aged 65 and older. Tell your healthcare provider about all the medicines that you take, includingprescription and non-prescription medicines, vitamins, and herbal supplements. The development of new drugs and an understanding of how best to use them and the older drugs have significantly improved the quality of life of people with the disease. Effexor venlafaxine hydrochloride US prescribing information. Wyeth Pharmaceuticals December, 2012. US placebo-controlled clinical trials for bulimia. PROZAC may impair judgment, thinking, or motor skills. Its molecular weight is 345. Check to be sure a light box filters out harmful ultraviolet light.
First, I would like to say that it is crucial to find the right medicine for you by working with a doctor you trust. Prozac works for me, but may not work for you. Don't give up, and most importantly, don't wait to get help. Patients should be advised to inform their physician if they are taking, or plan to take, any prescription medication, including Symbyax, Sarafem, or over-the-counter drugs, including herbal supplements or alcohol. Patients should also be advised to inform their physicians if they plan to discontinue any medications they are taking while on PROZAC. Children and adolescents should have height and weight monitored during treatment. Cott JM. In vitro receptor binding and enzyme inhibition by Hypericum perforatum extract. Monitor cardiac rhythm and vital signs. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy.
This drug is used to treat a small subset of people with narcolepsy who have excessive daytime sleepiness and cataplexy that does not respond to the other medications. It is the only drug approved by the FDA for cataplexy. It has a history of abuse as a recreational drug; therefore, the FDA has classified it as a controlled substance. Anderson. He says that information is available on and . "Those are not detectable in the babies' serum even when the babies are nursing. When COMT is blocked, dopamine can be retained and used more effectively, reducing Parkinson's symptoms. COMT inhibitors like and can also increase the effectiveness of levodopa. Problems with blood sugar control. People who have and take PROZAC may have problems with low blood sugar while taking PROZAC. can happen when PROZAC is stopped. Your healthcare providermay need to change the dose of your diabetes medicines when you start or stop taking PROZAC. Parkinson's disease possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug. How should I take PROZAC?
Worldwide exposure to fluoxetine hydrochloride is estimated to be over 38 million patients circa 1999. Of the 1578 cases of overdose involving fluoxetine hydrochloride, alone or with other drugs, reported from this population, there were 195 deaths. Do not stop taking or change your medications unless you talk to your doctor first. Even if you feel good, continue to take your medications. Stopping your medications suddenly can make your condition worse. Fluoxetine can stay in your body for many weeks after your last dose and may interact with many other medications. Before using any medication, tell your doctor or pharmacist if you have taken fluoxetine in the previous 5 weeks. Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Can different inactive ingredients -- binders and fillers -- affect the drug's quality?
Who should not take PROZAC? Get emergency medical help if you have signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. The pupillary dilation that occurs following use of many antidepressant drugs including Prozac may trigger an angle closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy. PROZAC and some medicines may interact with each other, may not work as well, ormay cause serious side effects. The court said Lilly had used a type of invalid "double patenting" for Prozac, something the company disputes. PROZAC can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how PROZAC affects you. Do not drink alcohol while using PROZAC. Maintain a regular schedule. Many people have an improvement in their symptoms if they maintain a regular sleep schedule, usually seven to eight hours of sleep per night.
Problems with blood sugar control. The significance of this effect in humans is unknown. Ciraulo DA, Shader RI. Fluoxetine drug-drug interactions: I. Antidepressants and antipsychotics. The effect of PROZAC on in humans is unknown. However, because fluoxetine crosses the placenta and because of the possibility that fluoxetine may have adverse effects on the newborn, fluoxetine should be used during labor and delivery only if the potential benefit justifies the potential risk to the fetus. If fluoxetine is added to the treatment regimen of a patient already receiving a drug metabolized by CYP2D6, the need for decreased dose of the original medication should be considered. In premarketing clinical trials, 2 patients are known to have developed a serious systemic illness. Jay C. Fournier, a graduate student at the University of Pennsylvania, Philadelphia, and lead author of the analysis, published in the Journal of the American Medical Association. Parkinson's drugs as the disease progresses. Early animal studies suggest Azilect may also slow progression of Parkinson's. Acute and maintenance treatment of treatment resistant depression in adults 18 to 85 years in 3 short-term, placebo-controlled trials and 1 randomized withdrawal study with an active control. Do not stop PROZAC without first talking to your healthcare provider. Keep this and all other drugs out of the reach of young children. Keep this medication tightly sealed in its original container. Store this medication at room temperature, away from excess heat or moisture. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor. Priligy dapoxetine hydrochloride Australian prescribing information. Ortho-McNeil Pharmaceutical March 19, 2013. There was no specific pattern of cardiovascular malformations.
Make dosage adjustments, if indicated, according to efficacy and tolerability. Safety of co-administration of doses above 12 mg of olanzapine with 50 mg of fluoxetine has not been evaluated in pediatric clinical studies. Periodically re-examine the need for continued pharmacotherapy. Your healthcare provider or pharmacist can tell you if it is safe to take PROZAC with your other medicines. Do not start or stop any medicine while taking PROZAC without talking to your healthcare provider first. John's Wort: possible toxicity? The analysis suggests that some depressed people do respond to placebo, he says, and that severely depressed people are most likely to benefit from antidepressants. Patients should be advised to call their doctor if they experience any increased or unusual bruising or bleeding while taking PROZAC. Over-the-counter drugs are available to treat some symptoms of PMS Cruzan says. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended. Pointes-type arrhythmias hypotension, mania, neuroleptic malignant syndrome-like reactions, pyrexia, stupor, and syncope. In patients of all ages who are started on antidepressant therapy, monitor closely for worsening and for emergence of suicidal thoughts and behaviors. You should not use fluoxetine if you are allergic to it, if you also take pimozide or thioridazine, or if you are being treated with methylene blue injection. Severe. These medicines may interact and cause very harmful effects and are usually not taken together.
Boyer EW, Shannon M. The serotonin syndrome. What are the side effects of fluoxetine? Again, hang in there, best wishes, and find a doctor who listens to you and is knowledgeable in their field. Anderson. "But we are dealing with averages. And there are some babies at the far end of spectrum where the effect could be great enough to be of concern. If you miss a dose of Prozac Weekly, take the missed dose as soon as you remember and take the next dose 7 days later. However, if it is almost time for the next regularly scheduled weekly dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose. What brand names are available for fluoxetine? You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment. Azilect rasagiline US prescribing information. Teva Neurosciences Inc. October, 2014. DSM-IV with or without agoraphobia. The most effective treatment for SAD is light therapy, sometimes combined with antidepressant drugs, psychotherapy talk therapy or both. Do not keep outdated drugs. Dispose of unused medications as instructed on the drug label or patient information sheet. You can also check with your pharmacist about proper disposal methods. Pimozide and thioridazine prolong the QT interval. PROZAC can increase the levels of pimozide and thioridazine through inhibition of CYP2D6. PROZAC can also prolong the QT interval. Talk to your healthcare provider if you do not think that your condition is getting betterwith PROZAC treatment. MedDRA dictionary term from integrated database of placebo controlled trials of 15870 patients, of which 9673 patients received fluoxetine. Parkinson's disease, but it may cause side effects including confusion and memory problems. Symmetrel increases the amount of dopamine available for use in the brain, therefore reducing symptoms of Parkinson's. There have been recent reports that Symmetrel may help reduce the involuntary movements dyskinesia associated with levodopa therapy.
While the possibility exists that renally excreted metabolites of fluoxetine may accumulate to higher levels in patients with severe renal dysfunction, use of a lower or less frequent dose is not routinely necessary in renally impaired patients. Store Prozac at room temperature, between 59 and 86 degrees F 15 and 30 degrees C. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Prozac out of the reach of children and away from pets. SARAFEM, and other CNS acting drugs is required. Changes in the electrical activity of your heart QT prolongation and ventricular arrhythmia including Torsades de Pointes. This condition can be life threatening. Do not crush, chew, break, or open an extended-release capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time. Pediatric records were used to measure the babies' gain. Savella milnacipran hydrochloride US prescribing information. Forest Pharmaceuticals, Inc. October, 2013. PROZAC and other antidepressant medicines may increase suicidalthoughts or actions in some children, teenagers, or young adults within the first few months of treatment or when the dose is changed. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take see Drug Interactions section. Treatment with PROZAC and any concomitant serotonergic agents, should be discontinued immediately if the above events occur and supportive should be initiated. Tachycardia and an increase in blood pressure were observed. Consequently, the value of the ECG in predicting cardiac toxicity is unknown. Fournier tells WebMD. "We were interested in whether there was a clinically meaningful difference. The concentration in the mother's plasma was 295.
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PROZAC because this can cause serious heart rhythm problems or suddendeath. There was a decrease in bone mineralization and density at both doses, but the overall growth body weight gain or femur length was not affected. Fluoxetine is a selective serotonin reuptake inhibitors SSRI antidepressant. Fluoxetine affects chemicals in the brain that may be unbalanced in people with depression, panic, anxiety, or obsessive-compulsive symptoms. SAD, either alone or in conjunction with light therapy.
Fluoxetine is extensively metabolized in the liver to norfluoxetine and a number of other unidentified metabolites. The only identified active metabolite, norfluoxetine, is formed by demethylation of fluoxetine. In animal models, S-norfluoxetine is a potent and selective inhibitor of serotonin uptake and has activity essentially equivalent to R- or S-fluoxetine. R-norfluoxetine is significantly less potent than the parent drug in the inhibition of serotonin uptake. The primary route of elimination appears to be hepatic metabolism to inactive metabolites excreted by the kidney. The FDA approval was based in part upon the recommendation of an FDA expert advisory committee, which in November 1999 concluded that PMDD is a diagnosable condition and that the is an effective treatment, FDA spokeswoman Susan Cruzan tells WebMD.
Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Prozac should not be administered for at least 14 days after stopping and MAOIs should not be administered for at least 5 weeks after Prozac has been stopped. Use of Prozac during the third trimester of pregnancy may lead to adverse effects in the newborn. Tell your doctor if you become pregnant while taking Prozac. Prozac may cause heart defects or serious lung problems in a newborn if you take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant. Do not start or stop taking Prozac during pregnancy without your doctor's advice. Prozac passes into breast milk and may harm a nursing baby. Consult your doctor before breastfeeding. Some patients may experience withdrawal reactions such nausea, nervousness, and insomnia upon stopping Prozac.
NSAIDs such as ibuprofen, "blood thinners" such as warfarin. Stanford SC, Stanford BJ, Gillman PK. Risk of severe serotonin toxicity following co-administration of methylene blue and serotonin reuptake inhibitors: an update on a case report of post-operative delirium. Continuing to take Prozac while breastfeeding is not associated with any unusual behavior in children, but it is linked to reduced growth.