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In a separate single-dose study, the prozac ECG of tablets dogs given high doses did not reveal prolongation of the prozac PR, QRS, or prozac QT intervals. Titrate slowly and usa prozac prozac pill prozac adjust dosage as needed in patients tablets who exhibit a combination of factors that prozac may slow metabolism. Prozac is used to treat: *Not approved for prozac use in children Talk to your tablets healthcare provider if prozac you tablets do not think that your prozac condition is getting betterwith prozac treatment. What prozac should I tell my healthcare provider before tablets taking tablets prozac? Do not take Mellaril within tablets 5 weeks of stopping prozac because this can cause serious heart rhythm problems or tablets suddendeath. Nsaids include aspirin, ibuprofen (Advil, Motrin naproxen (Aleve celecoxib (Celebrex tablets diclofenac, indomethacin, meloxicam, and prozac others. Advise families and caregivers of the prozac need for close observation and communication with prozac the prescriber see tablets warnings AND. Ifyou would like more prozac information, talk with your healthcare provider. Clinical studies of olanzapine and fluoxetine in combination did not include sufficient numbers of patients 65 years of age tablets to determine whether they respond differently from younger patients. Taking Prozac during pregnancy may cause serious lung problems or other complications in the baby. However, adverse effects on fertility were seen when juvenile rats were treated with fluoxetine see Use In Specific Populations. Caution is advisable in using prozac in patients with diseases or conditions that could affect metabolism or hemodynamic responses. Treatment resistant depression (Major Depressive Disorder in patients, who do not respond to 2 separate trials of different antidepressants of adequate dose tablets and duration in the current episode). 1 and FD C Yellow. Keep prozac bottle closed tightly. Table tablets 1: Approximate Dose Correspondence Between Symbyax1 and the Combination tablets of prozac and Olanzapine For tablets Symbyax (mg/day) Use in Combination Olanzapine (mg/day) prozac (mg/day) 3 mg olanzapine/25 mg fluoxetine.5 20 tablets 6 mg olanzapine/25 mg fluoxetine. Johns Wort Electroconvulsive therapy (ECT) have liver problems have kidney problems have heart problems have or had seizures or convulsions have bipolar disorder tablets or mania have low sodium levels in your blood have a history of a stroke. Panic Disorder Initial Treatment Initiate treatment with prozac 10 mg/day. Consequently, concentrations of S-norfluoxetine at steady state were lower. The size of the effect was related to baseline frequency, with greater reductions seen in patients with higher baseline frequencies. The S-fluoxetine enantiomer is eliminated more slowly and is the predominant enantiomer present in plasma at steady state. A specific caution involves patients who are taking or have recently taken fluoxetine and might ingest excessive quantities of a TCA. Limited evidence is available concerning the longer-term effects of fluoxetine on the development and maturation of children and adolescent patients. Other Contraindications The use of prozac is contraindicated with the following: Pimozide and thioridazine prolong the QT interval. Pregnancy Pregnancy Category C prozac should be tablets used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Fluoxetine doses above 60 mg/day tablets have not been systematically studied in patients with bulimia. The largest ingestion in pediatric patients was 3 grams which was nonlethal. The significance of this effect in humans is unknown. Skip the missed dose if it is almost time for your next scheduled dose. Height and weight tablets should be monitored periodically in pediatric patients receiving fluoxetine. A dose range of 20 tablets to 60 mg/day is recommended. After 2 weeks, increase the dose to 20 mg/day. Adjust dosage, if indicated, with the individual components according tablets to efficacy and tolerability. Prozac is primarily metabolized by CYP2D6 see contraindications, drug interactions, overdose, and clinical pharmacology. You must wait 5 weeks after stopping fluoxetine before you can take thioridazine or an maoi. However, because fluoxetine crosses the placenta and because of the possibility that fluoxetine may have adverse effects on the newborn, fluoxetine should be used during labor and delivery only if the potential benefit justifies the potential risk to the fetus. Avoid the concomitant use of drugs known to prolong the QT interval. Prozac Weekly capsules, a delayed-release formulation, contain enteric-coated prozac pellets of fluoxetine hydrochloride equivalent to 90 mg (291 mol) of fluoxetine. No reports involved the administration of methylene blue by other routes (such as oral tablets or local tissue injection) or at lower doses. 1These terms represent serious adverse events, but do not meet the definition for adverse drug reactions. Monitor cardiac rhythm and vital signs. The efficacy in geriatric patients has been established see Clinical Studies. Patients should be monitored for these symptoms when discontinuing tablets treatment with prozac. Mixed-drug ingestion or other methods of suicide complicated all 6 overdoses in children that resulted in fatalities. Serotonin syndrome symptoms may include mental status changes (e.g., agitation, hallucinations, delirium, and coma autonomic instability (e.g., tachycardia, labile blood pressure, dizziness, diaphoresis, flushing, hyperthermia tablets neuromuscular symptoms (e.g., tremor, rigidity, myoclonus, hyperreflexia, incoordination seizures, and/or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea). It is designated hydrochloride and has the empirical formula of C17H18F3nohcl. Cases of lithium toxicity and increased serotonergic effects have been reported. Periodically re-examine the need for continued pharmacotherapy. The statistically significantly superior effect of 60 mg versus placebo prozac was present as early as Week 1 and persisted throughout each study. In a placebo-controlled clinical trial, more patients taking prozac Weekly reported diarrhea buy prozac next day delivery than patients taking placebo (10 versus 3, respectively) or taking prozac 20 mg daily (10 versus 5, respectively). Nursing Mothers Patients should be advised to notify their physician if they intend to breast-feed an infant during therapy. A dangerous drug interaction could occur that may result in death. This antidepressant is in a class of drugs known as selective serotonin reuptake inhibitors, or ssris. Patients should be advised of the signs and symptoms associated with serotonin syndrome that may include mental status changes (e.g., agitation, hallucinations, delirium, and coma autonomic instability (e.g., tachycardia, labile blood pressure, dizziness, diaphoresis, flushing, hyperthermia neuromuscular changes (e.g., tremor, rigidity, myoclonus, hyperreflexia. Symbyax is dosed between 3 mg/25 mg (olanzapine/fluoxetine) per day and 12 mg/50 mg (olanzapine/fluoxetine) per day. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically more depressed, or have thoughts about suicide or hurting yourself. You should not use Prozac if you are allergic to fluoxetine, prozac if you also take pimozide or thioridazine, or if you are being treated with methylene blue injection. Precautions and, use In Specific Populations. For some patients it may be advisable to titrate up to this target dose over several days. Other important adverse reactions reported with fluoxetine overdose (single or multiple drugs) include coma, delirium, ECG abnormalities (such as nodal rhythm, QT interval prolongation and ventricular arrhythmias, including Torsades de Pointes-type arrhythmias hypotension, mania, neuroleptic malignant syndrome-like reactions, pyrexia, stupor, and syncope. Decreased need for sleep, before taking Prozac, tell your doctor if you have a history of seizures; bipolar disorder ; liver disease; heart problems, including heart rhythm problems; diabetes ; glaucoma tablets ; or thoughts of suicide or attempted suicide. Six patients died, 127 patients completely recovered, 1 patient experienced renal failure, and 22 patients had an unknown outcome. Caution is advised when using prozac in patients with diseases or conditions that could affect its metabolism see dosage AND prozac administration and clinical pharmacology. Abnormal Bleeding snris tablets and ssris, including fluoxetine, may increase the risk of bleeding reactions. In contrast, when the first 90 mg once-weekly dose and the last 20 mg once-daily dose were separated by 1 week, Cmax values were similar. When compared with normal metabolizers, the total prozac sum at steady state of the plasma concentrations of the 4 active enantiomers was not significantly greater among poor metabolizers. Similar ranges of fluoxetine and norfluoxetine plasma concentrations were observed in another study in 94 pediatric patients (ages 8 to 18) diagnosed with Major Depressive Disorder. The mean heart rate was reduced by approximately 3 beats/min. This combination is also used to treat tablets depression after at least 2 other medications have been tried without successful treatment of symptoms. Suicide prozac is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. Using any of these medications with Prozac may cause you to bruise or bleed easily. Snris tablets and ssris, including fluoxetine, have been associated with cases of clinically significant hyponatremia in elderly patients, who may be at greater risk for this adverse reaction see warnings AND precautions. Obsessive Compulsive Disorder Initial Treatment Adult Initiate prozac 20 mg/day, orally in the morning. In one of these studies, no dose-response relationship for effectiveness was demonstrated. The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness hypomania, and mania, have been reported in adult tablets and pediatric patients being treated with antidepressants for Major Depressive Disorder as well as for other indications, both psychiatric and nonpsychiatric. No adverse effects on the infant were reported. A dose range of 20 to 30 mg/day is recommended. The drug may be prescribed for behaviors such as tail chasing, constant licking, or other obsessive-compulsive behaviors. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction with antidepressants compared to placebo in adults aged 65 and older. A reaction was considered treatment-emergent if it occurred for the first time or worsened while receiving therapy following baseline evaluation. Digestive System Infrequent: dysphagia, gastritis, gastroenteritis, melena, stomach ulcer ; Rare: bloody diarrhea, duodenal ulcer, esophageal ulcer, gastrointestinal hemorrhage, hematemesis, hepatitis, peptic ulcer, stomach ulcer hemorrhage. Potential For Other Drugs To Affect prozac Drugs Tightly Bound To Plasma Proteins Because fluoxetine is tightly bound to plasma proteins, adverse effects may result from displacement of protein-bound fluoxetine by other tightly-bound drugs see clinical pharmacology. These differences can be almost entirely explained tablets by differences in weight. There have been spontaneous reports in women taking fluoxetine of orgasmic dysfunction, including anorgasmia. Epidemiological studies of the case-control and cohort design that have demonstrated prozac an association between use of psychotropic drugs that interfere with serotonin reuptake and the occurrence of upper gastrointestinal bleeding have also shown that concurrent tablets use. Ask your doctor how to safely stop using this medicine. Other users have reported weight loss while using Prozac; more research is needed to determine how Prozac and other ssris may contribute to weight changes. Patients should also be advised to inform their physicians if they plan to discontinue any medications they are taking while on prozac. Do not start or stop taking this medicine during pregnancy without your doctor's advice. Peak concentrations from once-weekly doses of prozac Weekly capsules of fluoxetine are in the range of the average concentration for 20 mg once-daily dosing. Seizures In US placebo-controlled clinical trials for Major Depressive Disorder, prozac convulsions (or reactions described as possibly having been seizures) were reported.1 of patients treated with prozac and.2 of patients treated with placebo. Patients should be advised to avoid driving a car or operating hazardous machinery until they are reasonably certain that their performance is not affected see warnings AND precautions. Acute and maintenance treatment of binge-eating and vomiting behaviors in adult prozac patients with moderate to severe Bulimia Nervosa in 3 short-term and 1 long-term, placebo-controlled trials see Bulimia Nervosa. The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Hemic And Lymphatic System Infrequent: ecchymosis ; Rare: petechia, purpura. Marketed by: Lilly USA, LLC, Indianapolis, IN 46285, USA. Table 3: Most Common Treatment-Emergent Adverse Reactions: Incidence in Major Depressive Disorder, OCD, Bulimia, and Panic Disorder Placebo-Controlled Clinical Trials1,2 Percentage prozac generic name of Patients Reporting Event Major Depressive Disorder OCD Bulimia Panic Disorder Body System/ Adverse Reaction prozac (N1728) Placebo (N975). Multiple doses of prozac have been administered to 10,782 patients with various diagnoses in US clinical trials. Drugs Tightly Bound To Plasma Proteins Because fluoxetine is tightly bound to plasma proteins, the administration of fluoxetine to a patient taking another drug that is tightly bound to protein (e.g., Coumadin, digitoxin) may cause a shift in plasma concentrations. Antipsychotics Some clinical data suggests a possible pharmacodynamic and/or pharmacokinetic interaction between ssris and antipsychotics. Coadministration of alprazolam and fluoxetine has resulted in increased alprazolam plasma concentrations and in further psychomotor performance decrement due to increased alprazolam levels. The full therapeutic effect may be delayed until 5 weeks of treatment or longer. Use In Specific Populations Pregnancy Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy. Subgroup analyses on the cdrs-R total score did not suggest any differential responsiveness on the basis of age or gender. What should I avoid while taking prozac? The use of prozac within 14 days of stopping an maoi intended to treat psychiatric disorders is also contraindicated see dosage AND administration and warnings AND precautions. Other Reactions Following is a list of treatment-emergent adverse reactions reported by patients treated with fluoxetine in clinical trials. These fluoxetine toxicities in juvenile rats have not been observed in adult animals. There may be circumstances when it is necessary to initiate treatment with an maoi such as linezolid or intravenous methylene blue in a patient taking prozac. Altered anticoagulant effects, including increased bleeding, have been reported when snris or ssris are coadministered with warfarin. Additionally, in vitro studies have shown ketoconazole, a potent inhibitor of CYP3A4 activity, to be at least 100 times more potent than fluoxetine or norfluoxetine as an inhibitor of the metabolism of several substrates for this enzyme, including astemizole, cisapride, and midazolam. Follow all directions on your prescription label. Due to the large volume of distribution of this drug, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be of benefit. Whether these systemic reactions and rash have a common underlying cause or are due to different etiologies or pathogenic processes is not known. For more information about prozac call 1-800-Lilly- Rx ( ). 1, and the 40 mg Pulvules also contains FD C Blue. No gender-associated difference in fluoxetine pharmacokinetics was observed.

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