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Special Wanring
Gastrointestinal:
Frequent: Nausea, disturbances of appetite, diarrhea.

Infrequent: Vomiting, stomatitis, dysphagia, eructation, esophagitis, gastritis, gingivitis, glossitis, melena, th irst, abnormal liver function tests.

Rare: Bloody diarrhea, hematemesis, gastrointestinal hemorrhage, duodenal ulcer, stomach ulcer, mouth ulceration, hyperchlorhydria, colitis, enteritis, c holecystitis, cholelithiasis, hepatitis, hepatomegaly, liver tenderness, jaundice, increased salivation, salivary gland enlargement, tongue discoloration, fecal incontinence, pancreatitis.

What is this Drug
Under the brand name Sarafem, the active ingredient in Prozac is also prescribed for the treatment of premenstrual dysphoric disorder (PMDD), formerly known as premenstrual syndrome (PMS). Symptoms of PMDD include mood problems such as anxiety, depression, irritability or persistent anger, mood swings, and tension. Physical problems that accompany PMDD include bloating, breast tenderness, headache , and joint and muscle pain. Symptoms typically begin 1 to 2 weeks before a woman's menstrual period and are severe enough to interfere with day-to-day activities and relationships.


Symptoms of overdose may include:
May be more severe than side effects that may occur from regular doses, or several symptoms may occur together
- Agitation and restlessness; convulsions (seizures); drowsiness; fast heartbeat; nausea and vomiting; talking, feeling, and acting with excitement and activity you cannot control; trembling or shaking

Possible food and drug interactions
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.


Precautions
Geriatrics: - Elderly patients should initially receive fluoxetine in low dosage with slow progressive increases only if required and tolerated. Patients who have concomitant systemic illnesses or who are receiving other drugs concomitantly should be under careful observation at all dosage levels.


Possible food and drug interactions
Combining Prozac with MAO inhibitors or Mellaril (thioridazine) is dangerous.

Do not drink alcohol while taking this medication.

It is especially important to check with your docto r before combining Prozac with the following:

- Alprazolam (Xanax)
- Carbamazepine (Tegretol)
- Clozapine (Clozaril)
- Diazepam (Valium)
- Digitoxin (Crystodigin)
- Drugs that impair brain function, such as sleep aids and narcotic painkillers
- Flecainide (Tambocor)
- Haloperidol (Haldol)
- Lithium (Eskalith)
- Other antidepressants (Elavil) < br> - Phenytoin (Dilantin)
- Pimozide (Orap)
- Tryptophan
- Vinblastine (Velban)
- Warfarin (Coumadin)



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