Fluoxetine brands and prices in Pakistan

About Fluoxetine

Fluoxetine is an antidepressant from the group called selective serotonin reuptake inhibitors (SSRIs). It is thought to work by raising the level of serotonin, a natural chemical messenger in the brain that helps with mood. It is a prescription medicine that comes as capsules, tablets (including tablets that dissolve in water) and a liquid. It usually takes a few weeks before people start to feel the benefit.

Who should not take it, or should take care

• Do not take it if you have ever had an allergic reaction or a serious side effect from fluoxetine or another SSRI antidepressant.
• Do not take it if you take, or have recently stopped, an MAOI antidepressant (such as phenelzine or tranylcypromine). A gap is needed when switching between these medicines in either direction; your doctor will plan it.
• Do not take it if you take metoprolol for heart failure, as the heartbeat may become too slow.
• Do not take it with pimozide or thioridazine.
• Tell your doctor if you have epilepsy or have had fits.
• Tell your doctor if you have ever had mania or bipolar disorder.
• Tell your doctor if you have diabetes, as your blood sugar and diabetes medicines may need checking.
• Tell your doctor if you have heart problems, a slow or uneven heartbeat, a heart rhythm problem called long QT (in you or your family), a recent heart attack, or high blood pressure.
• Tell your doctor if you have glaucoma (raised pressure in the eye).
• Tell your doctor if you have a bleeding disorder, especially bleeding in the gut, or bruise easily.
• Tell your doctor if you have liver or kidney problems, or low levels of sodium, potassium or magnesium in the blood. Older people and people taking water tablets are more likely to get low sodium.
• Tell your doctor if you are having electroconvulsive therapy (ECT).
• Sexual problems can happen, and the medicine leaflets say that in some people they have carried on after stopping. Talk to your doctor if this worries you.
• Pregnancy: NHS says it can be used in pregnancy if needed, after your doctor talks through the benefits and risks. The medicine leaflets mention a small rise in the chance of heart defects in the baby, a rare lung problem in newborns when taken late in pregnancy, short-lived symptoms in the newborn such as irritability or feeding problems, and heavier bleeding after birth. Do not stop it on your own; speak to your doctor quickly if you are pregnant or planning a pregnancy.
• Breastfeeding: fluoxetine passes into breast milk. NHS says it is sometimes used, but it is best to check, and your doctor may suggest a different antidepressant such as sertraline. The leaflets say to breastfeed only if clearly necessary. Get advice if you are worried about your baby.
• Children and young people: they have a higher risk of suicidal thoughts, hostility and aggression on this medicine and need close watching. Long-term effects on growth and development are not fully known.

Medicines and drinks that can interact

• MAOI antidepressants (such as phenelzine, isocarboxazid, tranylcypromine, moclobemide and selegiline), the antibiotic linezolid and methylene blue: risk of serotonin syndrome
• Metoprolol for heart failure: must not be taken together
• Pimozide and thioridazine
• Other medicines that raise serotonin, such as tramadol, triptans for migraine, lithium, tryptophan and buprenorphine
• St John's wort: do not use it with fluoxetine
• Blood thinners such as warfarin and apixaban, and painkillers such as aspirin, ibuprofen and naproxen, which raise the risk of bleeding
• Tamoxifen (a breast cancer medicine)
• Water tablets (diuretics) and some blood pressure medicines, which can add to the risk of low sodium
• Medicines that can affect the heart rhythm, including some heart rhythm medicines, antipsychotics, tricyclic antidepressants, antibiotics, antimalarials and antihistamines
• Phenytoin, carbamazepine, flecainide, risperidone and clozapine
• Insulin and other diabetes medicines
• Cyproheptadine, which may make fluoxetine work less well
• This is not a full list. Tell your doctor and pharmacist about every medicine, herbal remedy and supplement you take.

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it exactly as your doctor advises. You can take it with or without food.
• Swallow capsules and tablets whole with a glass of water. Dispersible tablets can be swallowed or stirred into water and drunk. For the liquid, use the syringe or spoon that comes with it.
• Keep taking it even if you do not feel better at first. It can take a few weeks to work.
• Do not stop taking it suddenly, even if you feel better. Stopping can cause withdrawal effects such as dizziness, pins and needles, sleep problems, restlessness, anxiety, feeling sick, shaking and headache. If you and your doctor decide to stop, the dose is lowered slowly.
• If you forget a dose, take it when you remember unless the next one is nearly due. Never take two doses to make up for a missed one.
• It is best not to drink alcohol, as it can make side effects such as drowsiness worse.
• Do not drive, ride a bike or use machines if you feel dizzy, sleepy or have blurred vision, or until you know how it affects you.
• If side effects bother you or do not go away, keep taking it and talk to your doctor or pharmacist, who can suggest ways to help.
• Keep your appointments so your doctor can check how you are doing. Tell any doctor, dentist or lab staff that you take fluoxetine.
• Store it out of the reach of children and return unused medicine to a pharmacy.

Common questions

How long does fluoxetine take to work?
It can take a few weeks before symptoms start to improve, and longer for the full effect. Keep taking it and tell your doctor how you are feeling. Some side effects are worst at the start and ease as your body gets used to it.

How long will I need to take it?
For depression, treatment often carries on for some time after you feel better. Your doctor may suggest stopping once you have been well for some time, and will lower the dose slowly.

Can I drink alcohol while taking fluoxetine?
It is best not to. Alcohol can make side effects such as drowsiness worse, and the medicine leaflets advise avoiding it. You can eat and drink normally otherwise.

Will fluoxetine affect my sex life?
It can. Lower sex drive and problems with erections, ejaculation or orgasm are common. In some people these problems have carried on after stopping. Talk to your doctor if this happens; do not just stop the medicine.

Is it safe to take fluoxetine with painkillers?
Take care. Taking it with aspirin or anti-inflammatory painkillers such as ibuprofen raises the risk of bleeding. Ask a pharmacist which painkiller is best for you.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.