Prozac (fluoxetine hydrochloride) Drug / Medicine Information

fluoxetine hydrochloride

Consumer Medicine Information

What is in this leaflet

This leaflet answers some common questions about PROZAC. It does not contain all the available information. It does not take the place of talking with your doctor or pharmacist.

All medicines have risks and benefits.

Your doctor has weighed the risks of you taking PROZAC against the benefits they expect it will have for you.

If you have any concerns about taking this medicine, talk to your doctor or pharmacist.

Keep this leaflet with this medicine.

You may need to read it again.

What PROZAC is used for

PROZAC is used to treat:

depression

obsessive compulsive disorder (OCD)

premenstrual dysphoric disorder (PMDD)

Ask your doctor if you have any questions about why PROZAC has been prescribed for you.

Your doctor may have prescribed PROZAC for another reason.

PROZAC belongs to a group of medicines called selective serotonin reuptake inhibitors (SSRIs). SSRIs are thought to work by their action on brain chemicals called amines which are involved in controlling mood.

PROZAC is available only with a doctor's prescription.

PROZAC is not recommended for use in children and adolescents under 18 years of age.

Before you take PROZAC

When you must not take it

Do not take PROZAC if you are allergic to

any medicines containing fluoxetine

any of the ingredients listed at the end of this leaflet.

Some of the symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; rash, itching or hives on the skin.

Do not take PROZAC if you are taking another medicine for depression called a monoamine oxidase inhibitor (MAOI) or have been taking a MAOI within the last 14 days. Check with your doctor or pharmacist if you are unsure as to whether or not you are taking a MAOI.

If you do take PROZAC while you are taking a MAOI, you may experience shaking (tremor), shivering, muscle stiffness, fever, rapid pulse, rapid breathing or confusion.

Do not take PROZAC if you are taking another medicine called pimozide to treat disturbances in thinking, feelings and behaviour. Taking pimozide together with PROZAC may alter the rhythm of your heart.

Do not take PROZAC if the packaging is torn or shows signs of tampering or the capsules or tablets do not look quite right.

Do not take PROZAC if the expiry date on the pack has passed.

If it has expired or is damaged, return it to your pharmacist for disposal.

If you are not sure whether you should start taking PROZAC, talk to your doctor.

Before you start to take it

Tell your doctor if you have allergies to any other medicines, foods, preservatives or dyes.

Tell your doctor if you are pregnant or plan to become pregnant.

Your doctor will discuss the risks and benefits of taking PROZAC during pregnancy. If PROZAC is taken during pregnancy, you should be careful, particularly at the end of pregnancy. Transitory withdrawal symptoms have been reported rarely in the newborn after maternal use in the last 3 months of pregnancy.

Tell your doctor if you are breastfeeding or wish to breastfeed.

Tell your doctor if you have, or have had, any medical conditions, especially the following:

liver problems

kidney problems

fits

diabetes

a bleeding disorder or a tendency to bleed more than usual

Tell your doctor if you drink alcohol.

Although drinking alcohol is unlikely to affect your response to PROZAC, your doctor may suggest avoiding alcohol while you are being treated for depression.

If you have not told your doctor about any of the above, tell them before you start taking PROZAC.

Taking other medicines

Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from a pharmacy, supermarket or health food shop.

Some combinations of medicines may increase the risk of serious side effects and are potentially life threatening.

Some medicines may be affected by PROZAC, or may affect how well it works. These include:

monoamine oxidase inhibitors (MAOIs), medicines used to treat some types of depression.

You should stop taking MAOIs at least two weeks before starting PROZAC

lithium, a medicine used to treat mood swings and some types of depression

SNRIs, SSRIs and other medicines for depression, obsessive compulsive disorder or premenstrual dysphoric disorder (PMDD)

sleeping tablets or sedatives

medicines used to relieve anxiety

medicines used to treat certain mental and emotional conditions, also called antipsychotics

medicine used to treat disturbances in thinking, feelings and behaviour, such as pimozide

medicines used to control fits

medicines used to prevent blood clots, such as warfarin

flecainide, a medicine used to treat some heart conditions

tryptophan

St John's Wort

medicines used to relieve pain, such as tramadol

sumitriptan, a medicine used to treat migraine.

Your doctor can tell you what to do if you are taking any other medicines.

If you are not sure whether you are taking any of these medicines, check with your doctor or pharmacist.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking PROZAC.

Do not start taking other medicines for depression without checking with your doctor. Do this even if you have already stopped taking PROZAC.

Monoamine oxidase inhibitors (MAOIs), which are other medicines used for depression, may interfere with PROZAC. You should not start a MAOI for at least 5 weeks after stopping PROZAC.

How to take PROZAC

Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained in this leaflet.

If you do not understand the instructions on the box, ask your doctor or pharmacist for help.

How much to take

Your doctor will tell you how much PROZAC you need to take each day.

The usual dose for PROZAC is one capsule or one tablet taken once a day. Your doctor may increase or decrease your dose depending on your condition.

For premenstrual dysphoric disorder (PMDD), PROZAC may be prescribed to be taken every day or only during a certain part of the month. Your doctor will prescribe the dosing schedule that is right for you.

How to take it

Swallow the capsules whole with a glass of water.

If you cannot swallow the tablets, disperse them in water.

Swirl the tablet in half a glass of water until it falls apart, then drink it immediately.

When to take it

PROZAC is usually taken as a single morning dose.

If your doctor tells you to take PROZAC twice a day, take a dose in the morning and at noon.

Take your medicine at about the same time each day.

Taking it at the same time each day will help you remember when to take it.

It does not matter if you take this medicine before or after food.

How long to take it

Continue taking PROZAC for as long as your doctor recommends.

The length of treatment with PROZAC will depend on how quickly your symptoms improve.

Most medicines of this type take time to work so don't be discouraged if you do not feel better right away. While some symptoms will be relieved sooner than others, PROZAC commonly takes two to four weeks before improvement is really apparent.

If you do not start to feel better in about four weeks, check with your doctor.

If you forget to take it

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.

Otherwise, take it as soon as you remember, and then go back to taking your medicine as you would normally.

Do not take a double dose to make up for the dose that you missed.

If you are not sure what to do, ask your doctor or pharmacist.

If you have trouble remembering to take your medicine, ask your pharmacist for some hints.

If you take too much (overdose)

Immediately telephone your doctor or Poisons Information Centre (13 11 26) for advice or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else may have taken too much PROZAC. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.

If you have taken too much PROZAC, you may feel sick in the stomach, vomit, feel restless, agitated or excited.

While you are taking PROZAC

Things you must do

If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking PROZAC.

Tell all doctors, dentists and pharmacists who are treating you that you are taking PROZAC.

Tell your doctor if you become pregnant while taking PROZAC.

Your doctor will discuss the risks and benefits of taking PROZAC during pregnancy. If PROZAC is used during pregnancy, you should be careful, particularly at the end of pregnancy. Transitory withdrawal symptoms have been reported rarely in the newborn after maternal use in the last 3 months of pregnancy.

Keep all of your doctor's appointments so that your progress can be checked.

The symptoms of depression or other psychiatric conditions may include thoughts of harming yourself or suicide. These symptoms may continue or get worse during the first one or two months of treatment until the full antidepressant effect of PROZAC becomes apparent. This is more likely to occur in young adults under 25 years of age.

If you or someone you know is demonstrating any of the following warning signs, contact your doctor or a mental health professional right away or go to the nearest hospital for treatment:

worsening of your depression

thoughts or talk of death or suicide

thoughts or talk of self-harm or harm to others

any recent attempts at self-harm

increase in aggressive behaviour, irritability or any other unusual changes in behaviour or mood

All mentions of suicide or violence must be taken seriously.

Things to be careful of

If you experience drowsiness, do not drive, operate machinery or do anything else that could be dangerous.

Things you must NOT do

Do not stop taking your medicine or lower the dosage without checking with your doctor.

Suddenly stopping PROZAC may cause symptoms such as dizziness, anxiety, headache, feeling sick, or tingling or numbness of the hands or feet. Your doctor may want you to gradually reduce the amount of PROZAC you are taking before stopping completely.

Do not take the herbal remedy St. John's Wort while you are being treated with PROZAC. If you are already taking the herbal remedy, stop taking St. John's Wort and mention it to your doctor at your next visit.

Do not drive or operate machinery until you know how PROZAC affects you.

PROZAC may cause drowsiness in some people.

Do not give PROZAC to anyone else, even if they have the same condition as you.

Do not let yourself run out of PROZAC over the weekend or on holidays.

Do not use PROZAC to treat any other complaints unless your doctor tells you to.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking PROZAC.

PROZAC may have unwanted side effects in some people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

Side effects vary from patient to patient and often lessen with continued use.

Do not be alarmed by the following lists of side effects. You may not experience any of them.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor or pharmacist if you notice any of the following and they worry you:

nausea, vomiting

upset stomach, diarrhoea

loss of appetite, weight loss, changes in taste, dry mouth

trouble sleeping, unusual dreams

nervousness, anxiety

drowsiness, weakness

dizziness

excessive sweating, flushing, chills

lesions of skin and mucous membrane

fever and joint aches

sexual problems

more frequent urination

changes in vision.

If any of the following happen, tell your doctor immediately or go to Accident and Emergency at your nearest hospital:

itching, skin rash or hives

shortness of breath, wheezing or trouble breathing

swelling of the face, lips, tongue or other parts of the body

muscle spasms

tremors

twitches

convulsions or fits

fast, irregular heart beat

abnormal bleeding or bruising

sudden switches of mood to one of overactivity and uninhibited behaviour.

sudden fever

hallucinations

loss of coordination

confusion

overactive reflexes

The above list includes very serious side effects. You may need urgent medical attention or hospitalisation.

Children and Adolescents

Headaches are very common side effects.

Weight loss and decreased height gain have been observed in association with the use of PROZAC in children and adolescent patients. This is similar to other medicines that belong to the group of medicines called selective serotonin reuptake inhibitors (SSRIs).

Tell your doctor or pharmacist if you notice anything that is making you feel unwell.

Other side effects not listed above may also occur in some people.