Categories: Medicine A-Z

Fluoxetine – A-Z Medicine


What is Fluoxetine used for?

Fluoxetine is a oral medication that is available in tablets, capsules, and liquids. This drug is one type of antidepressant drug, i.e. selective serotonin reuptake inhibitors (SSRI). This drug works by increasing the amount of serotonin in the brain in order to help maintain mental balance.

This drug can be used to treat depression, panic attacks, obsessive compulsive disorder (obsessive-compulsive disorder), certain eating disorders (bulimia), and severe conditions in premenstrual syndrome (premenstrual dysphoric disorder).

Not only that, this medicine can improve your mood, sleep, appetite, and your energy level. In addition, fluoxetine can also help increase your enthusiasm and passion for life. This drug can reduce fear, anxiety, unwanted thoughts, and panic attacks.

Fluoxetine can also reduce PMS symptoms such as irritability, increased appetite, and depression. This drug can reduce food picking behavior in bulimia conditions.

If you want to buy this medicine, you must include a doctor's prescription. So, you can not get it freely at the pharmacy.

How to use fluoxetine?

Here are some things you should know when using fluoxetine, including how to use it.

  • Take this medication as directed by your doctor, usually once a day in the morning. If you use this medicine twice a day, your doctor may recommend you use it in the morning and in the afternoon.
  • If you use fluoxetine for premenstrual problems, your doctor may direct you to use it every day when you menstruate every month or only for two weeks before your period begins. To help you remember, mark your calendar.
  • If you use this medicine in liquid form, carefully measure the dose using a special measuring device / spoon. Don't use household spoons because you might not get the right dose.
  • The dosage is based on your medical condition and response to treatment. To reduce the risk of side effects, your doctor may direct you to start using this drug at low doses and gradually increase the dose. Follow the doctor's instructions carefully.
  • Use this medicine regularly to get the maximum benefit. To help you remember, use it at the same time every day.
  • It is important to continue taking this medicine as prescribed even if you feel better. Do not stop taking this medicine without consulting your doctor.
  • You will see several changes over the period of one to two weeks. However, it takes 4-5 weeks before you feel the overall benefits.
  • Tell your doctor if your condition does not improve or it gets worse.
  • Follow the rules given by your doctor or pharmacist before starting treatment. If you have questions, consult your doctor or pharmacist.

How is fluoxetine stored?

The procedure for storing fluoexetine is as follows:

  • This drug is best stored at room temperature, away from direct light and damp places.
  • Do not store in the bathroom and do not freeze in the freezer.
  • Other brands of this drug may have different storage rules.
  • Observe the storage instructions on the product packaging or ask your pharmacist. Keep all medicines out of the reach of children and pets.

Meanwhile, below are the proper procedures for getting rid of fluoxetine:

  • Do not flush medicine in the toilet or in the sewer unless instructed. Discard this product when it has expired or if it is no longer needed.
  • Do not mix this medicine with other household waste.

Consult the pharmacist or an officer from your local waste disposal agency about how to safely dispose of your product.


The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dose of fluoxetine for adults?

Adult dose for bulimia

Immediate release oral formulations

  • Recommended dosage: 60 mg orally once a day.

Adult dose for depression

Immediate release oral formulations

  • Initial dose: 20 mg orally once a day, but can be increased after a few weeks if no significant changes occur.
  • Treatment dose: 20-60 mg orally per day.
  • Maximum dose: 80 mg orally per day.

Delayed release of oral capsules

  • Initial dose: 90 mg orally once a week, starting seven days after the dose of the previous 20 mg dose of fluoxetine.

Adult dose for obsessive compulsive disorder

Immediate release oral formulations

  • Initial dose: 20 mg orally once a day, increasing after a few weeks if no clinical improvement is seen.
  • Maintenance dose: 20-60 mg orally per day
  • Maximum dose: 80 mg orally per day

Adult dose for panic disorder

Immediate release oral formulations

  • Initial dose: 10 mg orally once a day, increasing after one week to 20 mg orally once a day
  • Maintenance dose: 20-60 mg orally per day
  • Maximum dose: 60 mg orally per day

Adult dose for premenstrual dysphoric disorder

Immediate release oral formulations

  • Initial dose: 20 mg orally once a day on each day of the menstrual cycle or once a day starting 14 days before the start of menstruation until the first day of menstruation, and repeated every new cycle.
  • Maintenance dose: 20-60 mg per day for both continuous and intermittent use.
  • Maximum dose: 80 mg orally per day
  • Duration: 20 mg daily dose has been proven effective for up to 6 months of treatment

What is the dose of fluoxetine for children?

Children's dosage for depression

For ages 8-18 years:

  • Initial dose: 10 to 20 mg orally once a day; 10 mg daily dose can be increased after one week to 20 mg orally once a day.
  • Initial dose: 10 mg orally once a day, increasing to 20 mg orally once a day after several weeks if no clinical improvement is seen.
  • Maintenance dose: 10-20 mg orally once a day.

Children's doses for obsessive compulsive disorder

For ages 7 to 18 years:

  • Teenagers and children with a higher weight:
    • Initial dose: 10 mg orally once a day, increasing to 20 mg orally once a day after 2 weeks
    • Maintenance dose: 20-60 mg orally per day
    • Maximum dose: 60 mg on a daily basis
  • Lower weight children:
    • Initial dose: 10 mg orally once a day, increasing after a few weeks if no clinical improvement is seen
    • Maintenance dose: 20-30 mg orally once a day
    • Maximum dose: 60 mg orally per day.

At what dose is fluoxetine available?

  • Capsules, Oral: 10 mg, 20 mg, 40 mg
  • Delayed capsules, Oral: 90 mg
  • Solution, Oral: 20 mg / 5 mL (5 mL, 120 mL)
  • Tablets, Oral: 10 mg, 20 mg, 60 mg

Side effects

What side effects can be experienced due to fluoxetine?

The use of fluoxetine is the same as the use of other drugs, because it can also cause symptoms of side effects. These symptoms include health conditions, ranging from mild to quite serious.

Get emergency medical help if you have signs of this allergic reaction: nausea, vomiting, sweating, itching, difficulty breathing, swelling of the face, lips, tongue, or throat, or feel like you are about to faint.

Report any new symptoms or symptoms getting worse to your doctor, such as changes in mood or behavior, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, hyperactive (mental or physical), more depressed, or have thoughts about suicide or self-harm.

Serious side effects that might occur if you use fluoxetine are:

  • very rigid muscles, high fever, sweating, fast or uneven heartbeat, tremors, overactive reflexes
  • nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination
  • headache, difficulty concentrating, memory problems, weakness, confusion, hallucinations, fainting, convulsions, shortness of breath or unable to breathe
  • severe skin reactions – fever, sore throat, swelling on the face or tongue, burning sensation in your eyes, skin ache, followed by a red or purple skin rash that spreads (especially on the face or upper body) and causes blisters and peeling.

If you experience any of the above side effects, tell your doctor immediately and get medical treatment. Meanwhile, side effects that are not so serious from using fluoxetine are:

  • flu symptoms such as nasal congestion, sneezing, sore throat
  • sleepy, dizzy, feeling nervous
  • mild nausea, stomach ache, constipation
  • increased appetite, change in body weight
  • sleep problems (insomnia)
  • decreased sex drive, impotence, or difficulty having an orgasm
  • dry mouth.

The side effects above are classified as mild and will disappear by itself, over time. However, if these side effects do not go away, contact your doctor immediately.

Not everyone experiences the following side effects. There may be some side effects not mentioned above. If you have concerns about certain side effects that might occur when you use fluoxetine, it is mandatory for you to consult your doctor or pharmacist.

Prevention & Warnings

What should be known before using fluoxetine?

Before using fluoxetine, there are a few things you should know about, including:

  • Telling your doctor that you are allergic to fluoxetine is a must.
  • tell your doctor if you are taking pimozide (Orap), thioridazine or monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you are already stopped using monoamine oxidase inhibitors in the past two weeks. If you stop using fluoxetine, you must wait at least 5 weeks before you start to use thioridazine or monoamine oxidase inhibitors.
  • tell your doctor and pharmacist about prescription drugs and non-prescription drugs, vitamins, nutritional supplements, and herbal products that you use or will use.
  • tell your doctor about nutritional supplements and herbal products that you use, especially products that contain St. John's wort or tryptophan.
  • tell your doctor if you are being treated with electroshock therapy (a procedure where a small electric shock is given to the brain to treat certain mental illnesses), if you have recently had a heart attack and if you have or have had diabetes, seizures, or liver disease or heart disease.
  • tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or breastfeeding. If you become pregnant while using fluoxetine, contact your doctor. Fluoxetine can cause problems in newborns after delivery if used during the last months of pregnancy.
  • Talk to your doctor about the risks and benefits of using fluoxetine every day if you are 65 years or older.
  • This medicine can cause drowsiness. Don't do activities that require high concentration when under the influence of fluoxetine.

Is fluoxetine safe for pregnant and breastfeeding women?

There is no adequate research on the risks of using this drug in pregnant or nursing women. Always consult your doctor to consider the potential benefits and risks before using this medicine. This drug is included in the category C pregnancy risk according to the US Food and Drugs Administration (FDA) in America or the equivalent of the Food and Drug Supervisory Agency (BPOM) in Indonesia. The following are references to pregnancy risk categories according to the FDA:

  • A = No risk,
  • B = No risk in some studies,
  • C = Maybe risky,
  • D = There is positive evidence of risk,
  • X = Contraindications,
  • N = Unknown

There are no adequate studies in women to determine the risk to infants when using this drug during breastfeeding. Consider the potential benefits and risks before using this drug while breastfeeding.


What other medicines might interact with fluoxetine?

Drug interactions can change the performance of your medication or increase the risk of serious side effects. Not all possible drug interactions are listed in this article. Keep a list of all the products you use (including prescription / nonprescription medicines and herbal products) and consult your doctor or pharmacist. Do not start, stop or change the dose of any drug without the doctor's approval.

The use of this drug with other drugs that make you sleepy can worsen this effect. Ask your doctor before using fluoxetine with sleeping pills, narcotic pain medications, muscle relaxants, or medications for anxiety, depression, or seizures.

Many drugs can interact with fluoxetine. Not all interactions may be listed here. Tell your doctor about all the medicines you started using and stopped using during treatment. The following are medicines that can interact with fluoxetine, including:

  • alprazolam (Xanax)
  • anticoagulants (‘blood thinners’) such as warfarin (Coumadin)
  • antidepressants (elevator mood) such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin, imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivil) and doipepine
  • aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
  • clopidogrel (Plavix), clopidogrel (Plavix), diazepam (Valium)
  • digoxin (Lanoxin)
  • diuretic (‘water pill’)
  • Linezolid
  • flecainide (Tambocor)
  • insulin or oral medication for diabetes
  • lithium (Eskalith, Lithobid)
  • cure for anxiety and Parkinson's disease
  • methylene blue
  • drugs for mental illnesses such as clozapine (Clozaril) and haloperidol (Haldol)
  • medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), Naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig)
  • medications for seizures such as carbamazepine (Tegretol) and phenytoin (Dilantin); sedative
  • sibutramine (Meridia)
  • sleeping pills
  • tramadol (Ultram)
  • Sedative
  • vinblastine (Velban)
  • St. John wort
  • tramadol
  • tryptophan (sometimes called L-tryptophan)
  • medication to treat mood disorders, thinking disorders, or mental illness – amitriptyline, desipramine, lithium, nortriptyline, and many others
  • migraine drugs – rizatriptan, sumatriptan, zolmitriptan
  • narcotic pain medication – fentanyl, tramadol.

Can food or alcohol interact with fluoxetine?

Certain medicines should not be used when eating or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions can interact with Fluoxetine?

Other health problems in your body can affect the use of this drug. Tell your doctor if you have other health problems. Here are health problems that can interact with fluoxetine:

  • bipolar disorder (mood disorders with mania and depression)
  • bleeding problem
  • diabetes
  • glaucoma (closed angle type)
  • hyponatremia (low sodium in the blood)
  • mania, including its history
  • heart attack or stroke, new or historical
  • heart failure
  • heart rhythm problems (for example, QT extension), or history
  • hypokalemia (low potassium in the blood)
  • hypomagnesemia (low magnesium in the blood)
  • liver disease


What should I do in an emergency or overdose?

In cases of emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

Symptoms of an overdose that may occur when using fluoxetine are:

  • confusion
  • not responsive
  • nervous
  • shaking uncontrollably on a part of the body
  • dizzy
  • rapid, irregular pounding heartbeats.
  • seeing things or hearing voices that don't exist (hallucinating)
  • fever
  • passed out
  • coma (loss of consciousness for a certain period of time)

What should I do if I miss a dose?

If you forget one dose of this medicine, take it as soon as possible. But when it is nearing the next dose, skip the missed dose and return to the usual dosage schedule. Do not double the dose.

Hello Health Group does not provide medical advice, diagnosis, or treatment.

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