Prozac

Before taking this medicine

Do not take Prozac with pimozide or thioridazine because of the risk of serious heart rhythm problems. Thioridazine must not be taken within 5 weeks after stopping Prozac. Do not take Prozac with a monoamine oxidase inhibitor (MAOI) used to treat psychiatric disorders, or within 14 days after stopping one. These MAOIs must not be started until at least 5 weeks after stopping Prozac. Do not start Prozac while receiving linezolid or intravenous methylene blue. Conditions requiring caution or monitoring include: • Worsening symptoms or suicidal thoughts and behaviour, particularly in children, adolescents and young adults. • Bipolar disorder or signs of mania or hypomania. Screening for bipolar disorder is recommended before treatment. • A history of seizures or conditions that increase seizure risk. • Heart rhythm problems or risk factors for QT prolongation. • Untreated narrow drainage angles in the eyes, because angle-closure glaucoma may occur. • Cirrhosis or other circumstances that may increase fluoxetine exposure. Other medicines that affect serotonin increase the risk of serotonin syndrome, which can also occur with Prozac alone. If serotonin syndrome occurs, Prozac and other serotonergic medicines must be stopped and supportive treatment started. Aspirin, NSAIDs, warfarin and other medicines that affect blood clotting can increase bleeding risk when used with Prozac. Stop Prozac if a rash or allergic reaction appears. Low blood sodium has been reported; stopping treatment may be considered if symptoms develop. Significant weight loss, anxiety, insomnia and sexual dysfunction may also occur. Prozac may impair judgment, thinking and movement, so use caution when operating machinery. Use during pregnancy, particularly later in pregnancy, may increase the risk of persistent high blood pressure in the newborn’s lungs and problems such as breathing or feeding difficulties, unstable temperature, low muscle tone, tremor and irritability. Safety and effectiveness have not been established in children younger than 8 years with major depressive disorder or younger than 7 years with obsessive-compulsive disorder. For Prozac combined with olanzapine, they have not been established in children younger than 10 years with depressive episodes associated with bipolar I disorder. If Prozac is used with olanzapine, the additional contraindications, warnings and population-specific precautions in the Symbyax prescribing information also apply.