• Mood disorders

Fluoxetine Generic Name & Formulations

General Description

Fluoxetine (as HCl) 10mg, 20mg; tabs.

Pharmacological Class


How Supplied

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Fluoxetine Indications


Premenstrual dysphoric disorder.

Fluoxetine Dosage and Administration


Give daily throughout menstrual cycle or intermittently (start 14 days before expected menses onset through first full day of menses). Initially 20mg/day; max 80mg/day. Hepatic dysfunction: reduce dose.


Not established.

Fluoxetine Contraindications


During or within 14 days of MAOIs; do not start an MAOI during or within 5 weeks of fluoxetine. Concomitant pimozide, thioridazine, linezolid, IV methylene blue.

Fluoxetine Boxed Warnings

Boxed Warning

Suicidality and antidepressant drugs.

Fluoxetine Warnings/Precautions


Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. Monitor for serotonin syndrome or neuroleptic malignant syndrome-like symptoms; discontinue if occurs. Discontinue if unexplained allergic reaction (eg, rash) occurs. History of seizures. ECT. Screen for bipolar disorder; may activate mania/hypomania; monitor. Volume depletion. Conditions that affect metabolism or hemodynamic response. Cardiac disease. Hyponatremia (esp. elderly). Diabetes. Angle-closure glaucoma. Sexual dysfunction. Monitor for weight changes. Write ℞ for smallest practical amount. Reevaluate periodically. Avoid abrupt cessation. Labor & delivery. Pregnancy (Cat.C; avoid 3rd trimester; see full labeling for effects on neonate). Nursing mothers: not recommended.

Fluoxetine Pharmacokinetics

See Literature

Fluoxetine Interactions


See Contraindications. Do not start with concomitant linezolid or IV methylene blue; if treatment is necessary, discontinue fluoxetine before starting; monitor for serotonin syndrome for 5 weeks or until 24hrs after last dose of linezolid or IV methylene blue, whichever comes first. Do not start thioridazine within at least 5 weeks of discontinuing fluoxetine. Concomitant SSRIs, SNRIs, tryptophan: not recommended. Increased risk of serotonin syndrome with other serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). May potentiate protein-bound drugs (eg, warfarin, digoxin) and those metabolized by CYP2D6 (eg, tricyclics, vinblastine, flecainide). May potentiate carbamazepine, phenytoin. Monitor lithium, phenytoin, warfarin, tricyclics. Caution with benzodiazepines (eg, diazepam, alprazolam), antipsychotics (eg, clozapine, haloperidol), other CNS drugs, antiplatelets. Increased risk of bleeding with NSAIDs, aspirin, warfarin, and others that affect coagulation. Hyponatremia with diuretics.

Fluoxetine Adverse Reactions

Adverse Reactions

Headache, asthenia, pain, accidental injury, infection, flu syndrome, nausea, diarrhea, insomnia, dizziness, nervousness, abnormal thinking, decreased libido, rhinitis, pharyngitis; rash (may be serious).

Fluoxetine Clinical Trials

See Literature

Fluoxetine Note


Formerly known under the brand name Sarafem.

Fluoxetine Patient Counseling

See Literature