Life on the pill

Fluoxetine
Systematic (IUPAC) name
(RS)-N-methyl-3-phenyl-3-[4- (trifluoromethyl)phenoxy]propan-1-amine
Identifiers
CAS number
54910-89-3
ATC code
N06AB03
PubChem
3386
DrugBank
APRD00530
ChemSpider
56589
Chemical data
Formula
C17H18F3NO
Mol. mass
309.3 g/mol (345.8 for •HCl)
Pharmacokinetic data
Bioavailability
72%peak at 6-8 hours
Protein binding
94.5%
Metabolism
Hepatic
Half life
1-3 days (acute); 4-6 days (chronic); Active metabolite Norfluoxetine 4-16 days (acute and chronic)
Excretion
Kidneys 80%, intestines 15%
Therapeutic considerations


Fluoxetine pills
Fluoxetine (trade name Prozac) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. Fluoxetine is approved for the treatment of major depression (including pediatric depression), obsessive-compulsive disorder (in both adult and pediatric populations), bulimia nervosa, anorexia nervosa, panic disorder and premenstrual dysphoric disorder.[1] Despite the availability of newer agents, it remains extremely popular. Over 22.2 million prescriptions for generic formulations of fluoxetine were filled in the United States in 2007, making it the third most prescribed antidepressant.[2]

How does Prozac work? What will it do for me?

Fluoxetine belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). It is used for the treatment of depression and helps to elevate mood. Selective serotonin reuptake inhibitors work by increasing the amount of a neurotransmitter, called serotonin, that is available in certain parts of the brain. Although you may start feeling better within a few weeks of treatment, the full effects of the medication may not be evident until several weeks of treatment have passed. Fluoxetine is also used to reduce or eliminate the symptoms of obsessive-compulsive disorder (OCD) as well as to treat the eating disorder, bulimia nervosa.
Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use Prozac?

The recommended adult dose of fluoxetine ranges from 20 mg to 60 mg taken once daily in the morning, with or without food. The maximum recommended dose of fluoxetine is 80 mg daily. Once your symptoms have been brought under control, the lowest effective dose of fluoxetine as prescribed by your doctor should be used to keep the symptoms from coming back. Your doctor may advise you to keep taking fluoxetine for several months.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What form(s) does Prozac come in?

Capsules
10 mgEach green capsule, printed with Dista 3104 and PROZAC 10 mg, contains fluoxetine HCl equivalent to fluoxetine 10 mg (32.3 µmoles). Nonmedicinal ingredients: silicone and starch; capsule shell: benzyl alcohol, butylparaben, carboxymethylcellulose sodium, edetate calcium disodium, FD&C Blue No. 1, gelatin, iron oxide yellow, methylparaben, propylparaben, sodium lauryl sulfate, sodium propionate and titanium dioxide.
20 mgEach green and yellow capsule, printed with Dista 3105 and PROZAC 20 mg, contains fluoxetine HCl equivalent to fluoxetine 20 mg (64.7 µmoles). Nonmedicinal ingredients: silicone and starch; capsule shell: benzyl alcohol, butylparaben, carboxymethylcellulose sodium, edetate calcium disodium, FD&C Blue No. 1, gelatin, iron oxide yellow, methylparaben, propylparaben, sodium lauryl sulfate, sodium propionate and titanium dioxide.
Oral Solution
5 mL of clear, colourless syrup solution, with an odour of mint, contains fluoxetine HCl equivalent to fluoxetine 20 mg (64.7 µmoles). Nonmedicinal ingredients: benzoic acid, glycerin, mint flavour, purified water and sucrose. Energy: 50.3 kJ (12.0 kcal)/5 mL.Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.

Who should NOT take Prozac?

Fluoxetine should not be taken by anyone who:
is allergic to fluoxetine or any ingredients of the medication
has taken a medication known as a MAO inhibitor within the past 14 days

What side effects are possible with Prozac?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
anxiety or nervousness
decreased appetite
decreased sexual drive
diarrhea
dizziness or lightheadedness
drowsiness
dry mouth
headache
heartburn
increased sweating
nausea
tiredness or weakness
trembling or shaking
trouble sleeping

Check with your doctor as soon as possible if any of the following side effects occur:
inability to sit still, or restlessness
skin rash, hives, or itching
chills or fever
joint or muscle pain
breast enlargement or pain
fast or irregular heartbeat
purple or red spots on skin
talking, feeling, and acting with excitement and activity you cannot control
unusual secretion of milk (women)
Stop taking the medication and seek immediate medical attention if any of the following occur:
convulsions (seizures)
symptoms of hypoglycemia (low blood sugar), including:
anxiety or nervousness
chills
cold sweats
confusion
cool pale skin
difficulty concentrating
drowsiness
excessive hunger
fast heartbeat
headache
shakiness or unsteady walk
unusual tiredness or weakness
symptoms of hyponatremia (low blood sodium), including:
confusion
convulsions (seizures)
drowsiness
dryness of mouth
increased thirst
lack of energy
symptoms of serotonin syndrome, including:
diarrhea
fever
increased sweating
mood or behaviour changes
overactive reflexes
racing heartbeat
restlessness
shivering or shaking
trouble breathing
unusual or incomplete body or facial movements

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for Prozac?

Be sure to inform your doctor of all your medical conditions before you begin taking a medication. Some conditions can affect how you should take this medication.

Allergy: Approximately 4% of people who take fluoxetine develop a rash or hives. Almost one-third of these people need to stop treatment because of the rash.
Diabetes: For people with diabetes, fluoxetine may alter blood glucose control. Low blood glucose has occurred during therapy with fluoxetine and high blood glucose has developed after treatment stops. As is true for many other types of medication when taken by people with diabetes, dosages of insulin or anti-diabetic tablets may need adjustment when therapy with fluoxetine starts or stops.
Drowsiness/reduced alertness: People taking fluoxetine are cautioned against driving a car or performing hazardous tasks until they determine that this medication does not affect them adversely.
Epilepsy: Fluoxetine should be used with caution by people with epilepsy.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, call your doctor as soon as possible.
Breast-feeding: Fluoxetine passes into breast milk. Women should stop breast-feeding while they are taking this medication.
Children: The safety and effectiveness of using this medication have not been established for children.

What other drugs could interact with Prozac?

The following medications may affect the way fluoxetine works or increase the risk of side effects:

alcohol
buspirone
carbamazepine
clarithromycin
dextromethorphan
levodopa
lithium
meperidine
MAO inhibitors
nefazodone
other SSRIs (e.g., paroxetine, fluvoxamine)
sumatriptan
St. John's wort
tricyclic antidepressants
tryptophan
valproic acid
divalproex
The following medications may be affected by fluoxetine or increase the risk of side effects:
astemizole
antipsychotics (e.g., haloperidol, risperidone, clozapine)
benzodiazepines
carbamazepine
digoxin
metoprolol
nifedipine
phenobarbital
propranolol
phenytoin
tricyclic antidepressants (e.g., desipramine, imipramine)
terfenadine
verapamil
warfarin
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Now that you know more about the pill this is what it has done for me. When I first started taking this medication I was VERY VERY sick. All I wanted to do is lie in bed and die. I kept feeling like I was going to throw up. I couldn't dicipher if I was hungry or needed to empty what little contents there were in my belly. I felt weak all the time and clamy. I didn't want to do anything or talk to anyone. I did however force myself it's not like I can really ignore the child....

But am starting to feel better physically and mentally, I am taking the prozac for anxiety. And although it didn't have an immediate positive effect it has been helping. I am on the lowest dose possible and my anxiety is getting alot better. I am better overall when it comes to dealing with stressful events. Things that should not be stressful was stressful for me and although I have fought my doctor about taking medications for the past 2 years, I am glad she has convinced me. So here's hoping that I have continued success with this as I venture back to work next week.