What is this medication?
Selective Serotonin Reuptake Inhibitor; Antidepressant
Fluoxetine/Prozac is officially indicated for use in bipolar major depression, bulimia nervosa, major depressive disorder, obsessive-compulsive disorder, panic disorder, premenstrual dysphoric disorder, and treatment-resistant depression. It is also prescribed off-label for use in binge-eating disorder, body dysmorphic disorder, refractory fibromyalgia, post-traumatic stress disorder, generalized anxiety disorder, selective mutism, social anxiety disorder and premature ejaculation.
Premature ejaculation (PE) is also known as rapid or early ejaculation and is characterized by the following features:
- Ejaculation that always or nearly always occurs prior to or within approximately one minute of vaginal penetration.
- The inability to delay ejaculation on all or nearly all vaginal penetrations.
- Personal feelings of distress, frustration, anxiety, and/or the avoidance of sexual intimacy.
“ALERT: US Boxed Warning
Suicidality and antidepressant drugs:
Antidepressants increased the risk compared with placebo of suicidal thinking and behavior (suicidality) in short-term studies in children, adolescents, and young adults with major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of fluoxetine or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults older than 24 years; there was a reduction in risk with antidepressants compared with placebo in adults 65 years and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Appropriately monitor and closely observe patients of all ages who are started on antidepressant therapy for clinical worsening, suicidality, or unusual changes in behavior. Advise families and caregivers of the need for close observation and communication with the prescribing health care provider.
Fluoxetine is approved for use in children with MDD (aged 8 years and older) and obsessive-compulsive disorder (OCD; aged 7 years and older). Sarafem is not approved for use in children.”
How does this medication work?
Prozac/Fluoxetine selectively inhibits serotonin uptake. It exhibits only weak affinity for alpha, beta, histaminic, muscarinic and serotonin receptors as well as has weak anticholinergic effects.
How should I take this medication?
Premature ejaculation (off-label use)
Initial dose is 20mg daily, can increase the dose based on response and tolerability after 1 week (some experts suggest dose titration intervals of 3 to 4 weeks). Can increase to a maximum daily dose of 40mg once daily.
How to Take: Can be taken with or without food and taken regularly as prescribed.
You Need to Avoid Prozac/Fluoxetine: If you have hypersensitivity to Prozac/Fluoxetine or any of its components in the formulation; use of MAO inhibitors, linezolid, or intravenous methylene blue, pimozide or thioridazine.
Contact Your Doctor if You Ever Experience: Stop taking this medication and contact your doctor if you experience a rash (particularly in combination with facial swelling, breathing difficulties or flu-like symptoms); severe agitation, anxiety or excitation, major sleep disturbance or unusual change mood, muscle twitching or convulsions.
What should I watch for while using this medication?
Do not use in patients receiving monoamine oxidase inhibitors currently or within 2 weeks because of the risk of serotonin syndrome.
Use with caution in patients with liver disease.
Use with caution in patients with a history of seizures.
Has been rarely associated with platelet dysfunction, use cautiously in patients with underlying coagulation (platelet) defects.
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
Well tolerated, most side effects are transient and mild to moderate in nature. The most common side effects include:
Central nervous system: Insomnia (10% to 33%), headache (21%), drowsiness (5% to 17%), anxiety (6% to 15%), nervousness (8% to 14%), yawning (<11%)
Endocrine and metabolic: Decreased libido (4% to 11%)
Gastrointestinal: Nausea (12% to 29%), diarrhea (8% to 18%), anorexia (4% to 17%), xerostomia (9% to 12%)
Neuromuscular and skeletal: Weakness (9% to 21%), tremor (3% to 13%)
Respiratory: Pharyngitis (10% to 11%)
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