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Fluoxetine belongs to the selective serotonin reuptake inhibitor class, commonly abbreviated to SSRI. It increases serotonin availability in the brain and is used to treat several mood and anxiety related disorders. In Australia fluoxetine requires a prescription.
- Active moiety: fluoxetine, often provided as fluoxetine hydrochloride
- Common formulations locally: typically 10 mg and tablets with a 20 mg dose or capsules
- Primary portents: major depressive disorder, several anxiety disorders and some conditions in women's mental health
For quick links to other course options, price strategy guidance and also the framework of laws in Australia, see the sections on Similar pharmaceutical products, Prices denominated in AUD, and Status in law.
Applications for medical purposes
Clinicians prescribe fluoxetine for a range of psychiatric conditions. Whether it is appropriate will depend on your diagnosis, history and overall treatment plan.
- Major depressive disorder
- Obsessive compulsive disorder, abbreviated OCD
- Panic disorder as an anxiety disorder, including forms with agoraphobia.
- Bulimia nervosa, a binge-purge disorder, to help reduce bingeing and purging
- PMDD - Premenstrual dysphoric disorder, abbreviated PMDD
Medication is often combined with psychological therapies, lifestyle interventions and social support to maximise benefit.
Fluoxetine intake guidelines
Follow your prescriber along with the pharmacy directions exactly. Check labels each time you collect a script.
- Swallow tablets or capsules whole with water. Do not crush or chew modified release forms.
- You may take it with food or on an empty stomach; choose a regular time each day to help adherence.
- Abrupt cessation is not recommended. Stopping suddenly can produce withdrawal symptoms such as sleep disturbance, irritability or flu like sensations; ask your prescriber about tapering plans.
- Therapeutic effects for mood often need several weeks to develop; continue therapy unless advised otherwise.
When a dose is misseda thorough review the guidance on what to do next. The dose was missed. When there are urgent safety concerns, see the official directional guidance. ODing and Unanticipated effects.
Precautionary Measures and Special Scenarios
Before you begin the plan fluoxetine tell your doctor and pharmacist about all medical conditions, past histories and every medicine, supplement or herbal product you use. This reduces risk of interactions are not just about words, but meaning. and detrimental outcomes.
- Mention if you have liver or kidney disease, epilepsy or seizures, bipolar disorder, narrow angle glaucoma, urinary retention or prostate enlargement.
- Mental health monitoring is important: report new or worsening anxiety, agitation, insomnia, impulsivity or suicidal thoughts, especially early in treatment or after dose changes.
- Pregnancy: discuss potential adverse effects and benefits. Use in late pregnancy can be associated with neonatal adaptation issues.
- Breastfeeding: small quantities pass into breast milk; observe infants for feed or sleep changes and seek advice if concerned.
- Avoid heavy alcohol use while taking fluoxetine because it can worsen adverse reactions such as sedation or poor coordination.
- Please avoid driving or operating machinery until you know how the medication affects you.
If you are switching from or to another antidepressant such as sertraline, citalopram, escitalopram, paroxetine, venlafaxine, duloxetine, vortioxetine or a tricyclic, your prescriber will plan a safe washout or cross taper to reduce the risk of serotonin syndrome. See Alerts for pharmacologic interactive engagements span conversations, gestures, and feedback. between drugs.
Situations in which this treatment is not advised
- Known allergy to fluoxetine or any ingredient in the product.
- Concurrent use with pimozide or thioridazine because of potentially fatal heart rhythm effects.
- Concomitant use with monoamine oxidase inhibitors (MAOIs) is contraindicated. Allow at least 14 days after stopping an MAOI before starting fluoxetine. After stopping fluoxetine, wait at least five weeks before commencing an MAOI or thioridazine.
If you experience sudden severe mood changes, agitation, panic, intense insomnia or thoughts of harming yourself contact your prescriber or emergency services immediately.
Probable adverse effects
The majority of postmarketing effects are mild and fade as time passes. Some reactions can be serious and require urgent attention.
Seek emergency care
- Allergic signs: hives, trouble breathing, facial or throat swelling
- Severe skin reaction: high fever, sore throat, painful or blistering rash
- Serotonin syndrome: agitation, confusion, hallucinations, high temperature, profuse sweating, tremor, loss of coordination, vomiting or diarrhea
Call your doctor promptly
- New visual problems, eye pain or halos around lights
- Heart symptoms: very fast or irregular pulse, chest discomfort, sudden dizziness
- Signs of low sodium: severe headache, confusion, slurred speech, marked weakness or unsteadiness
- Severe muscle rigidity, very high fever, tremor, fainting or severe confusion
Common, usually less serious effects
- Changes in sleep pattern such as insomnia or vivid dreams
- Headache syndrome, lightheadedness or tiredness
- Feeling anxious, shaky or jittery
- Nausea, diarrhea, decreased appetite or abdominal discomfort
- Xerostomia, increased sweating, hot flushes
- Sexual effects including reduced libido or difficulty reaching climax
- Weight or appetite changes
If adverse sequelae are bothersome discuss dose adjustment or switching options in meeting with your clinician. See Similar pharmaceutical products for other possibilities.
Medication the study maps how the interaction between participantss evolve over time. and safety
Fluoxetine has a long elimination half life and interacts with many medicines. Always give a complete list of current medicines, including over the counter and herbal supplements.
- Medications that prolong the QT interval or affect heart rhythm can interact and increase cardiac risk.
- Other serotonergic drugs such as certain antidepressants, tramadol, linezolid, methylene blue injection, triptans, lithium and St Johns wort herb increase serotonin syndrome risk.
- CNS depressants like opioids, benzodiazepines, sedating antihistamines and some sleep agents may increase drowsiness and sedation.
- Drugs that affect bleeding such as NSAIDs or anticoagulants may raise the risk of bruising or bleeding.
- Stimulant-based medications for ADHD or narcolepsy can increase heart rate or anxiety when combined with fluoxetine.
Always consult your prescriber before starting or stopping any medicine while on fluoxetine.
Dose not administered
In case a dose is missed, take it as soon as you remember, except when the next dose is close. Do not take two doses at the same moment to catch up on a i did not take a dose.
An an opioid overdose
Suspect an having an overdose? Call emergency services straight away. Please bring the packaging the medication came in, if possible. Symptoms of significant having an overdose may include fainting, severe dizziness, very fast or irregular heartbeat, seizures, severe vomiting or agitation.
Storage device and safeguarding
- Keep at room temperature away from direct heat and moisture.
- Place this item in a safe location where children and animals cannot reach or see it.
- Do not use after the expiry date printed on the container. Return unused medicines to a pharmacy for disposal.
Alternative and comparable medicines
If fluoxetine is not suitable or does not work well, prescribers may recommend an another option depending on side effect profile and clinical need.
Other SSRIs commonly considered
- The antidepressant sertraline
- The antidepressant escitalopram
- Citalopram is an approved antidepressant medication
- The antidepressant paroxetine
- Fluvoxamine pharmaceutical
SNRIs and different classes
- Venlafaxine or desvenlafaxine (SNRIs)
- Duloxetine prescription
- Bupropion (norepinephrine-dopamine the structure that supports it)
- Mirtazapine dosage form
- Amitriptyline and nortriptyline are typical tricyclic antidepressants.
- Vortioxetine dose forms
Notes by condition
- Bulimia nervosa, a binge-purge eating disorder: psychological therapy is primary; fluoxetine has evidence for reducing binge/purge behaviours alongside nutritional care.
- PMDD: sertraline and escitalopram are frequently used additional choices; some patients may benefit from hormonal treatment in combination under specialist advice.
When switching between agents discuss required washout intervals and continuous oversight in conjunction with your prescriber. See Medical clinical circumstances that negate use for important timing rules.
AUD prices (approximate)
Costs depend on whether the medicine is dispensed under the Pharmaceutical Benefits Scheme (PBS), the pharmacy you use, brand choice and pack size. The figures below are indicative.
- PBS co payment: general patients usually pay up to the PBS co payment cap per subsidised script (approximately AUD 30 in recent years) and concession card holders pay a lower fixed amount (around AUD 7.70). Eligibility and exact caps should be checked with Services Australia and local drugstore chains.
- Private purchase (without PBS): generic fluoxetine for a one month supply commonly costs between AUD 10 and AUD 30 at discount outlets; brand name products may cost more, for example branded fluoxetine formulations can be AUD 40 to AUD 80 depending on supplier and pack size.
- Comparable SSRIs on the PBS such as sertraline, escitalopram and citalopram usually attract similar co payment rates when subsidised; private prices for generics are often comparable.
- SNRIs such as venlafaxine or duloxetine are also PBS listed in many formulations and generally align with similar co payment expectations; private prices vary by strength and brand.
Ask your pharmacist about generic substitutions, brand premiums, discount offers and safety net thresholds that may reduce out of pocket expenses.
The status of lawful authorization and regulatory framework in Australia
- Scheduling: fluoxetine is classified as Schedule 4 (S4) in Australia, meaning it is prescription only.
- Supply rules: it must be dispensed by an Australian pharmacy against a valid prescription. Sharing or supplying your prescription medicine to others is unlawful.
- Advertising: direct consumer advertising of prescription medicines is strictly regulated and broadly restricted.
- Personal importation: under the TGA Personal Import Scheme limited quantities (commonly up to a three month supply) may be imported for personal use if you hold a valid prescription and meet scheme conditions.
- Travel advice: carry medicines in original packaging with the pharmacy label and keep a copy of the prescription when travelling. Check entry requirements at your destination.
- Off label use: prescribers may lawfully use medicines off label when clinically justified with informed consent.
If you need specific legal or regulatory advice contact your pharmacist, prescriber or consult official TGA and state health resources.
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Quick responses
How quickly does fluoxetine act?
Some people notice symptom improvement within 1 to 2 weeks. Meaningful mood improvement typically takes 4 to 6 weeks or more.
Is drinking alcohol permitted here?
Tipple can amplify incidental effects such as drowsiness and impaired coordination. It is recommended to limit or avoid alcohol while taking fluoxetine.
What happens if I need to stop treatment?
Do not end things abruptly. Work with your prescriber to arrange a gradual reduction to minimise withdrawal symptoms.
This page offers general information only and does not replace personalised medical advice. Always follow the recommendations of your Australian healthcare professional.
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