Fluoxetine

The US label for fluoxetine capsules lists treatment of major depressive disorder, both acute and maintenance.

It also lists obsessive compulsive disorder, binge-eating and vomiting in moderate to severe bulimia nervosa, and panic disorder with or without agoraphobia.

With olanzapine, it is listed for depressive episodes in bipolar I disorder and for treatment resistant depression.

The label says fluoxetine alone is not indicated for bipolar depressive episodes or treatment resistant depression.

• Major depressive disorder
• Obsessive compulsive disorder
• Bulimia nervosa
• Panic disorder
• With olanzapine: bipolar I depressive episodes and treatment resistant depression

The label describes fluoxetine as a selective serotonin reuptake inhibitor.

It says the exact mechanism is unknown but is presumed to be linked to blocking the uptake of serotonin in the brain.

The dosing below is for the fluoxetine capsule label, which is an adult oral capsule label from the US.

For adults with depression, the US label says the starting dose is 20 mg a day in the morning. A rise may be considered after several weeks. The label sets a ceiling of 80 mg a day.

For obsessive compulsive disorder, the label gives 20 mg a day as the starting dose. For bulimia nervosa it gives 60 mg a day in the morning. For panic disorder it gives 10 mg a day as the starting dose.

The label says doses above 20 mg can be taken once in the morning or split between morning and noon.

It advises a lower or less frequent dose for people with liver impairment, older adults, and people with other illnesses or many medicines.

The label notes that fluoxetine stays in the body for a long time, so a change in dose may take weeks to show fully.

Indian pack labels may differ from the US label. Your prescriber's instruction always comes first. Do not change the dose or stop it yourself; ask your doctor or pharmacist.

Boxed warning: antidepressants raised suicidal thoughts and behaviour in children, teenagers and young adults in short studies. The label asks for close watching in all ages at the start of treatment.

The label says fluoxetine is not approved for children under 7 years.

It is contraindicated with MAO inhibitors, linezolid, intravenous methylene blue, pimozide and thioridazine.

Use cautiously with a history of seizures, bipolar disorder, bleeding problems, narrow-angle glaucoma or heart rhythm risks.

Pregnancy: late use of SSRIs may raise the risk of breathing problems and poor adaptation in the newborn. Discuss with your doctor before planning or continuing.

Older adults are more prone to low sodium. Fluoxetine may impair judgement and motor skills, so take care when driving.

• Children, teenagers and young adults: watch for suicidal thoughts
• Pregnancy and late pregnancy
• Older adults: low sodium risk
• Liver impairment: lower or less frequent dosing
• History of seizures, bleeding or glaucoma
• Driving and machinery

• MAO inhibitors, linezolid, methylene blue: do not combine
• Pimozide, thioridazine: do not combine
• Tricyclic antidepressants, haloperidol, clozapine, phenytoin, carbamazepine: levels may rise
• NSAIDs, aspirin, warfarin: more bleeding risk
• Other serotonergic or QT-prolonging medicines
• The label says never combine fluoxetine with MAO inhibitors used for psychiatric conditions, or start it within 14 days of stopping one.
• Wait 5 weeks after stopping fluoxetine before starting an MAOI.
• Pimozide and thioridazine must not be used with it because of heart rhythm and drug level risks.
• Fluoxetine strongly blocks the CYP2D6 enzyme, so levels of tricyclic antidepressants, some antipsychotics and some anticonvulsants may rise.
• NSAIDs, aspirin and warfarin may add to bleeding risk.
• Other serotonergic medicines raise the risk of serotonin syndrome.

No match in this label text. Ask your pharmacist about any medicine you take.

The label says to store the capsules at 20 to 25 degrees C, with short excursions to 15 to 30 degrees C allowed.

Overdose information: the label lists seizures, altered mental state, heart rhythm changes and serotonin syndrome. Contact a poison centre or emergency care at once.

Keep medicines out of reach of children.

In the Drugs Rules schedules we checked, Fluoxetine is listed under Schedule H (Schedule H, serial 204 (rules 65 and 97)). It is sold on prescription.

The National List of Essential Medicines 2022 lists Fluoxetine in these forms: Capsule 20 mg; Capsule 40 mg; Capsule 60 mg.

NPPA ceiling prices exist for some Fluoxetine formulations. The table in the price section shows each row we found.

The Jan Aushadhi (PMBJP) product list we checked has 3 entries that name Fluoxetine. Availability at a Kendra can change.

No entry found in the banned combination list we checked.

• Jan Aushadhi: Fluoxetine Hydrochloride Capsules IP 20mg, pack 10's (row p11:sno254)
• Jan Aushadhi: Fluoxetine 10 Mg Tablet, pack 10's (row p93:sno2020)
• Jan Aushadhi: Fluoxetine Capsules 60Mg, pack 10's (row p93:sno2021)

NPPA sets a ceiling price per unit for scheduled formulations. The table shows every Fluoxetine row we found.

A ceiling is the most a seller may charge per unit for that formulation. Actual prices are often lower. Check the pack and seller.

Some rows appear under more than one NPPA category or date. Ask the pharmacist which row applies to your pack.

Jan Aushadhi lists 3 products that name Fluoxetine. Compare the form, strength and pack size with your prescription before switching, and ask your doctor or pharmacist.

We do not show brand prices because they change often and we have not verified them.