Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

• seizure (convulsions);

• tremors, shivering, muscle stiffness or twitching;

• a red, blistering, peeling skin rash;

• problems with balance or coordination; or

• agitation, confusion, sweating, fast heartbeat.

Less serious side effects may include:

• drowsiness, dizziness, weakness;

• runny nose, sore throat, headache, flu symptoms;

• nausea, diarrhea, changes in appetite;

• weight changes;

• decreased sex drive, impotence, or difficulty having an orgasm; or

• dry mouth, increased sweating.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect fluoxetine?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with fluoxetine may cause you to bruise or bleed easily.

Before taking fluoxetine, tell your doctor if you are using any of the following medicines:

• alprazolam (Xanax);

• clozapine (Clozaril, Fazaclo);

• digitoxin (Crystodigin);

• flecainide (Tambocor);

• haloperidol (Haldol);

• seizure medication such as phenytoin (Dilantin) or carbamazepine (Tegretol);

• tryptophan (also called L-tryptophan);

• vinblastine (Velban);

• a blood thinner such as warfarin (Coumadin);

• almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or

• any other antidepressants such as amitriptyline (Elavil), escitalopram (Lexapro), imipramine (Tofranil), sertraline (Zoloft), and others.

This list is not complete and there may be other drugs that can interact with fluoxetine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about fluoxetine.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.