Fluoxetine (generic Prozac®)

Fluoxetine is the generic equivalent of Prozac®.

By law, a generic drug must be the same as its brand name counterpart in terms of active ingredient, dosage, safety, effectiveness, strength, stability, and quality. A generic may, however, differ in its inactive ingredients (i.e. flavoring, fillers, and preservatives).

Fluoxetine (Prozac®) can does come with serious warnings. These include:

• Increased risk of suicidal thoughts or actions *

• Serotonin syndrome—a rare, but potentially life-threatening condition that occurs when there’s too much serotonin in the brain

• Severe allergic reactions

• Abnormal bleeding

• Seizures or convulsions

• Manic episodes

• Changes in appetite or weight

• Low sodium levels in the blood

• Visual problems or glaucoma

• Irregular heartbeat—this can be life-threatening

If any of the above concern you, speak with your doctor or pharmacist about your perceived risk with Prozac and other treatment options that exist.

*A boxed warning is the most serious type of medication warning assigned by the FDA.

Fluoxetine is a selective serotonin re-uptake inhibitor, or SSRI. It works by blocking the brain’s quick absorption of serotonin, a “feed good” chemical in your brain. The end result? An increased level of serotonin in your brain, which is thought to improve mood.

Fluoxetine is FDA approved for the treatment of:

• Major depressive disorder (MDD) or depression

• Obsessive-compulsive disorder (OCD)

• Bulimia Nervosa, a type of eating disorder

• Panic disorder (PD), with or without agoraphobia

• Acute Depressive Episodes Associated with Bipolar Disorder Type I—in combination with olanzapine (Zyprexa®)

• Treatment Resistant Depression—in combination with olanzapine (Zyprexa®)

The most common side effects of fluoxetine include:

• Strange dreams

• Sexual dysfunction, including altered sex drive and delayed ejaculation

• Loss of appetite, diarrhea, nausea or vomiting

• Flu symptoms

• Feeling tired or fatigued, trouble sleeping

• Change in sleep habits

• Weight gain or weight loss

• Tremor or shaking

• Sweating

• Feeling anxious or nervous

• Hot flashes

• Dry mouth

Side effects may improve over time as your body adjusts to the medicine. This list doesn’t represent all possible side effects (or serious side effects) of fluoxetine. If you’re experiencing any ongoing, bothersome side effect(s), tell your healthcare provider right away.

If you’d like to learn more, speak with your doctor or pharmacist. The The Food and Drug Administration (FDA) also has a helpful medication guide for fluoxetine here.

Fluoxetine can interact with some medicines and supplements. It’s always recommended to give both your doctor and pharmacy an updated list of everything you’re taking, so drug interactions can be identified.

Some medicines and supplements fluoxetine can interact with include:

• Monoamine oxidase inhibitors (MAOIs): selegiline, phenelzine, linezolid, methylene blue, tranylcypromine, isocarboxazid

• Other SSRIs: sertraline (Zoloft®), citalopram, escitalopram, paroxetine

• SNRIs (serotonin and norepinephrine reuptake inhibitors): desvenlafaxine, venlafaxine, duloxetine, milnacipran

• Tricyclic antidepressants: amitriptyline, doxepin, imipramine, nortriptyline

• Sumatriptan

• Alcohol

• Amphetamines

• Benzodiazepines: diazepam, alprazolam

• Antipsychotics: haloperidol, clozapine, pimozide, and thioridazine

• Seizure medicines: carbamazepine, phenytoin

• St. John’s Wort

• Lithium

• Blood thinners or drugs that affect blood clotting: aspirin, ibuprofen, clopidogrel, heparin, warfarin

• Opioids: tramadol, hydromorphone, codeine

This list doesn’t represent all the drugs that may not be safe to take with fluoxetine. If you’re unsure whether a certain drug or supplement can be taken with fluoxetine, seek medical advice from a healthcare professional (your doctor or pharmacist). The FDA also has a helpful medication guide for fluoxetine here.

If you accidentally miss your dose of fluoxetine, take the dose as soon as you remember. If it’s almost time for your next dose (within 2 hours), skip the missed dose and take your next dose at the usual time. Don’t take two doses of fluoxetine at the same time.

Fluoxetine may be taken with or without food.

During pregnancy: While SSRIs are generally considered to be the safest class of medicines for depression or anxiety during pregnancy, risks may still exist.

While breastfeeding: Studies have found that small amounts of fluoxetine can enter breast milk and cause side effects.

It’s important to treat mental health-related conditions when pregnant or nursing, as untreated depression, anxiety, or other mental illness can harm both you and baby. Always let your provider know if you’re pregnant or breastfeeding, so you can discuss the risks and benefits of starting or continuing fluoxetine.

It’s recommended to avoid or limit the use of alcohol when taking fluoxetine. Drinking alcohol can intensify the side effects of fluoxetine, including drowsiness or dizziness, mental fogginess, reaction time, and sleepiness.