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Warning
Hyponatremia: - Several cases of hyponatremia (some with serum sodium lower than 110 mmol/L) have been reported. The hyponatremia appeared to be reversible when fluoxetine was discontinued. Although t hese cases were complex with varying possible etiologies, some were possibly due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The majority of these occurrences have been in older patients and in patients taking diuretics or who were otherwise volume depleted.


Other Medicines
Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])¡X Do ot take fluoxetine while you are taking or within 2 weeks of taking an MAO inhibitor. If you do, you may develop confusion, agitation, restlessness, stomach or intestinal problems, sudden high body te mperature, extremely high blood pressure, and severe convulsions. At least 14 days should be allowed between stopping treatment with an MAO inhibitor and starting treatment with fluoxetine.


How should you take this medication?
Prozac should be taken exactly as prescribed by your doctor.

Prozac usually is taken once or twice a day. To be effective, it should be taken regularly. Make a habit of taking it at the same time you do some other daily activity.

It may be 4 weeks before you feel any relief from your depression, but the drug's effects should last about 9 months after a 3-month treatment regimen . For obsessive-compulsive disorder, the full effect may take 5 weeks to appear.

Why is this drug prescribed?
Prozac is used to treat mental depression. It is also used to treat obsessive-compulsive disorder, bulimia nervosa, and premenstrual dysphoric disorder.

Prozac also may be used for other cond itions as determined by your doctor.

Prozac belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). These medicines are thought to work by increasing the act ivity of a chemical called serotonin in the brain.

What side effects can this medication cause?
If you experience any of the following symptoms, call your doctor immediately:

- jaw, neck, and back muscle spasms
- slow or difficult speech
- shuffling walk
- persistent, fi ne tremor or inability to sit still
- fever, chills, sore throat, or flu-like symptoms
- difficulty breathing or swallowing
- severe skin rash or hives
- yellowing of the skin or e yes
- irregular heartbeat

Adverse Effects
Urogenital:
Frequent: Painful menstruation, sexual dysfunction, urinary tract infection, frequent micturition.

Infrequent: Abnormal ejaculation, impotence, menopause, amenorrhea, menorrh agia, ovarian disorder, vaginitis, leukorrhea, fibrocystic breast, breast pain, cystitis, dysuria, urinary urgency, urinary incontinence.

Rare: Breast enlargement, galactorrhea, abortion, dy spareunia, uterine spasm, vaginal hemorrhage, metrorrhagia, hematuria, albuminuria, polyuria, pyuria, epididymitis, orchitis, pyelonephritis, salpingitis, urethritis, kidney calculus, urethral pain, u rolithiasis.


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