Fluoxetine important information

Fluoxetine is a prescription medication classified as a selective serotonin reuptake inhibitor (SSRI). It is commonly prescribed to treat depression, anxiety disorders, obsessive-compulsive disorder (OCD), panic disorder, and other mental health conditions. As with all prescription medications, fluoxetine may not be appropriate for everyone. For full prescribing information, view the drug label information.

Before using fluoxetine, what should I tell my doctor?

Before starting fluoxetine, tell your healthcare provider all relevant medical information, including but not limited to:

• • Bipolar disorder or a history of mania or hypomania
  • Liver disease
  • Heart rhythm problems or prolonged QT interval
  • Bleeding disorders or easy bruising
  • Low sodium levels (hyponatremia)
  • Glaucoma (especially narrow-angle glaucoma)
  • Seizure disorders or epilepsy
• • Prescription medications
  • Over-the-counter drugs
  • Vitamins and supplements
  • Herbal products (especially St. John’s wort)
  • Other antidepressants or psychiatric medications
• Any history of allergic reactions to fluoxetine or other SSRIs
• If you are pregnant, planning to become pregnant, or breastfeeding
• • Fluoxetine may carry risks during pregnancy or breastfeeding and should be discussed carefully with your provider.
• If you have thoughts of self-harm or suicide, or a history of suicidal behavior
• All medications you are currently taking or plan to take, including:
• If you consume alcohol or use recreational drugs, as these may interact with fluoxetine

What are some of the side effects of this drug?

Some side effects of fluoxetine are common and often mild, especially when starting treatment or adjusting doses. These may include:

• Diarrhea
• Dry mouth
• Sweating
• Decreased appetite or weight changes
• Nausea or upset stomach
• Anxiety, nervousness, or restlessness
• Sexual side effects (such as decreased libido or difficulty with arousal or orgasm)
• Trouble sleeping or insomnia
• Headache

Many of these effects improve over time. If any side effect becomes bothersome or does not go away, contact your healthcare provider.

What are side effects I should call my doctor about right away?

Contact your healthcare provider immediately or seek urgent medical care if you experience any of the following:

• Thoughts about suicide or self-harm
• Signs of serotonin syndrome, which may include:
• • High fever
  • Confusion
  • Rapid heart rate
  • Muscle stiffness or twitching
  • Heavy sweating
  • Diarrhea
• Severe allergic reactions, such as:
• • Swelling of the face, lips, tongue, or throat
  • Difficulty breathing
  • Rash or hives
• Seizures
• Abnormal bleeding or bruising
• Severe headache, vision changes, or eye pain
• New or worsening depression, anxiety, agitation, panic attacks, or irritability
• Fainting or irregular heartbeat

These symptoms may indicate serious or life-threatening reactions and require prompt evaluation.

Important safety information

• Antidepressants may increase the risk of suicidal thoughts or behaviors in children, adolescents, and young adults, especially during the first few months of treatment or when the dose is changed.
• Fluoxetine has a long half-life, meaning it stays in the body for several weeks after stopping. Side effects or drug interactions may persist even after discontinuation.
• Do not stop fluoxetine suddenly without medical guidance, as this may cause withdrawal-like symptoms or worsening of your condition.
• Avoid driving or operating heavy machinery until you know how fluoxetine affects you.
• Alcohol may worsen side effects and should be used cautiously or avoided.

Do not take fluoxetine if you

• Are allergic to fluoxetine or any of its ingredients
• Are currently taking, or have taken within the past 14 days:
• • Monoamine oxidase inhibitors (MAOIs)
  • Linezolid
  • Intravenous methylene blue
• Have been instructed by a healthcare professional not to take SSRIs
• Are taking medications that significantly increase the risk of dangerous heart rhythm problems, unless specifically approved by your healthcare provider

L-methylfolate important information

Before starting L-methylfolate, tell your healthcare provider all relevant medical information, including:

• All medical conditions you have or have had, especially:
• • Bipolar disorder, history of mania or hypomania
  • Seizure disorders
  • Pernicious anemia or known vitamin B12 deficiency (folate supplementation can improve anemia labs while underlying B12 deficiency may worsen neurologic injury if not treated)
  • Kidney disease (especially if you are on dialysis) or significant chronic illness
  • Any history of cancer, particularly if you have been told to avoid folate supplementation (follow oncology guidance)
• All medications and supplements you take, including:
• • Other folate-containing supplements or multivitamins
  • Medications that may interact with folate metabolism (your clinician will assess relevance), such as certain antiseizure medications
  • Any medications for mood disorders, including antidepressants and mood stabilizers
• Any allergies or prior adverse reactions to folate products or ingredients in the formulation
• Tell your provider if you have had suicidal thoughts, significant mood instability, or a history of manic symptoms.
• If you are pregnant, planning to become pregnant, or breastfeeding
• • Folate is often used in pregnancy, but dosing and indication should still be reviewed with your clinician, particularly for prescription-strength products.

What are some of the side effects of this drug?

Contact your healthcare provider right away or seek urgent care if you experience:

• Symptoms of a serious allergic reaction, such as:
• • Hives or widespread rash
  • Swelling of the face, lips, tongue, or throat
  • Trouble breathing
• New or worsening mood symptoms, such as:
• • Severe agitation, restlessness, or anxiety
  • Symptoms of mania/hypomania (e.g., unusually elevated or irritable mood, decreased need for sleep, racing thoughts, impulsive/risky behavior)
• Neurologic symptoms that could suggest untreated vitamin B12 deficiency, especially if you have risk factors:
• • New numbness/tingling in hands or feet
  • New balance problems or difficulty walking
  • New confusion or memory changes
 (These symptoms are not specific to L-methylfolate but warrant evaluation.)

Do not take L-methylfolate if you

• Are allergic to L-methylfolate or any ingredient in the formulation
• Have been instructed by a licensed healthcare professional to avoid folate supplementation
• Have a known or suspected untreated vitamin B12 deficiency and have been told to address B12 first (follow your clinician’s guidance)

Important Notice


 This information does not replace medical advice. Always follow the guidance of your licensed healthcare provider. If you believe you are experiencing a medical emergency, call 911 or your local emergency number immediately.