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fluoxetine

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Brand names: Prozac, Sarafem

Selective Serotonin Reuptake Inhibitor (SSRI) Rx

Fluoxetine is a medicine that can help treat depression and other mental health conditions. It belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs).

Drug Pricing (NADAC)

Brand Price

$13.66/unit

Generic Price

$28.59/unit

Generic Available

Yes (33 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Fluoxetine can treat major depressive disorder in adults and children.

Common side effects

Abnormal dreams, Problems ejaculating, Loss of appetite

Key warnings

Antidepressants may increase the risk of suicidal thoughts and behaviors in children, teenagers, and young adults.

How It Works

Fluoxetine works by increasing the amount of serotonin in your brain. Serotonin is a chemical that helps regulate mood. By increasing serotonin, fluoxetine can help improve mood and reduce symptoms of depression, OCD, and other conditions.

How to Take It

Take fluoxetine exactly as your doctor tells you. For depression, the usual starting dose for adults is 20 mg each day, usually in the morning. Children may start with 10 to 20 mg per day. Your doctor may change your dose over time. You can take fluoxetine with or without food.

Pregnancy & Breastfeeding

Talk to your doctor if you are pregnant or plan to become pregnant. Fluoxetine should only be used during pregnancy if the benefit outweighs the risk to the baby. Breastfeeding is not recommended while taking fluoxetine.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store fluoxetine at room temperature, away from heat and moisture.

Side Effects (from patient reports)

Based on 29,645 FDA adverse event reports.

The medicine is not working
3,637
The medicine is interacting with another medicine
3,336
Harmful effect from different substances
3,316
Feeling sick to your stomach
3,233
Feeling tired
3,155
Death by suicide
2,904
Pain in the head
2,771
Using the medicine for a purpose it was not approved for
2,479
Feeling worried or nervous
2,441
Loose or watery stools
2,373

FDA Adverse Event Report Analysis

Detailed analysis of 64,119 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

64,119

Death-Related Reports

8,833

Hospitalization Reports

22,346

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 40,260 (69%)
Male 18,193 (31%)

Age Distribution

0–17 4,421
18–44 15,545
45–64 17,015
65–74 6,536
75+ 3,895

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DRUG INEFFECTIVE 3,638
2 DRUG INTERACTION 3,335
3 TOXICITY TO VARIOUS AGENTS 3,316
4 NAUSEA 3,233
5 FATIGUE 3,156
6 COMPLETED SUICIDE 2,904
7 HEADACHE 2,774
8 OFF LABEL USE 2,478
9 ANXIETY 2,444
10 DIARRHOEA 2,374
11 DIZZINESS 2,357
12 DEPRESSION 2,313
13 VOMITING 2,241
14 DYSPNOEA 2,177
15 PAIN 2,042

Reactions in Death Reports

COMPLETED SUICIDE 2,892
TOXICITY TO VARIOUS AGENTS 1,890
DEATH 1,513
CARDIAC ARREST 742
DRUG ABUSE 685
CARDIO-RESPIRATORY ARREST 675
RESPIRATORY ARREST 474
DRUG INTERACTION 368
POISONING 296
OVERDOSE 278

Reactions in Hospitalization Reports

DRUG INTERACTION 1,720
TOXICITY TO VARIOUS AGENTS 1,653
INTENTIONAL OVERDOSE 1,604
VOMITING 1,160
SUICIDE ATTEMPT 1,109
DRUG INEFFECTIVE 1,103
FALL 1,063
NAUSEA 1,046
DYSPNOEA 1,021
HYPOTENSION 1,001

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Antidepressants may increase the risk of suicidal thoughts and behaviors in children, teenagers, and young adults. Watch closely for worsening depression or suicidal thoughts. Tell your doctor right away if you notice any changes in mood or behavior. Fluoxetine is not approved for use in children younger than 7 years old.

Known Drug Interactions

major aspirin

NSAIDs, Aspirin, Warfarin): May potentiate the risk of bleeding ( 7.4 ) Drugs Tightly Bound to Plasma Proteins: May cause a shift in plasma concentrations ( 7.6 , 7.7 ) Olanzapine: When used in combination with fluoxetine, also refer to the Drug Interactions section of the package insert for Symbyax ( 7.7 ) Drugs that Prolong the QT Interval: Do not use fluoxetine with thioridazine or pimozide. 7.4 Drugs that Interfere with Hemostasis (e.g., NSAIDs, Aspirin, Warfarin) Serotonin release by platelets plays an important role in hemostasis. Epidemiological studies of the case-control and cohort...

Mechanism: Both drugs can interfere with how your blood cells clump together to stop bleeding, which increases your risk of bruising or bleeding.

What to do: Your doctor should monitor you closely for any signs of unusual bleeding or bruising while taking these together.

NSAIDs, Aspirin, Warfarin): May potentiate the risk of bleeding ( 7.4 ) Drugs Tightly Bound to Plasma Proteins: May cause a shift in plasma concentrations ( 7.6 , 7.7 ) Olanzapine: When used in combination with fluoxetine, also refer to the Drug Interactions section of the package insert for Symbyax ( 7.7 ) Drugs that Prolong the QT Interval: Do not use fluoxetine with thioridazine or pimozide. 7.4 Drugs that Interfere with Hemostasis (e.g., NSAIDs, Aspirin, Warfarin) Serotonin release by platelets plays an important role in hemostasis. Altered anticoagulant effects, including increased ble...

Mechanism: Fluoxetine can change how your blood thinner works and affect how your blood clots, making it more likely for you to bleed.

What to do: Your doctor will need to monitor your blood clotting levels very closely and may need to adjust your warfarin dose.

NSAIDs, Aspirin, Warfarin): May potentiate the risk of bleeding ( 7.4 ) Drugs Tightly Bound to Plasma Proteins: May cause a shift in plasma concentrations ( 7.6 , 7.7 ) Olanzapine: When used in combination with fluoxetine, also refer to the Drug Interactions section of the package insert for Symbyax ( 7.7 ) Drugs that Prolong the QT Interval: Do not use fluoxetine with thioridazine or pimozide. Olanzapine — Fluoxetine (60 mg single dose or 60 mg daily dose for 8 days) causes a small (mean 16%) increase in the maximum concentration of olanzapine and a small (mean 16%) decrease in olanzapine ...

Mechanism: Fluoxetine can cause a small change in the amount of olanzapine that stays in your blood. This happens because fluoxetine interferes with how your body breaks down the other medication.

What to do: Your doctor may need to adjust your doses or monitor you more closely when these drugs are used together.

NSAIDs, Aspirin, Warfarin): May potentiate the risk of bleeding ( 7.4 ) Drugs Tightly Bound to Plasma Proteins: May cause a shift in plasma concentrations ( 7.6 , 7.7 ) Olanzapine: When used in combination with fluoxetine, also refer to the Drug Interactions section of the package insert for Symbyax ( 7.7 ) Drugs that Prolong the QT Interval: Do not use fluoxetine with thioridazine or pimozide. 7.7 Potential for Fluoxetine to affect Other Drugs Pimozide — Concomitant use in patients taking pimozide is contraindicated. Pimozide can prolong the QT interval.

Mechanism: Taking these two drugs together can cause dangerous changes to the electrical rhythm of your heart. This is known as QT prolongation and can be very serious.

What to do: Do not take these two medications together because the risk to your heart is too high.

NSAIDs, Aspirin, Warfarin): May potentiate the risk of bleeding ( 7.4 ) Drugs Tightly Bound to Plasma Proteins: May cause a shift in plasma concentrations ( 7.6 , 7.7 ) Olanzapine: When used in combination with fluoxetine, also refer to the Drug Interactions section of the package insert for Symbyax ( 7.7 ) Drugs that Prolong the QT Interval: Do not use fluoxetine with thioridazine or pimozide. Thioridazine — Thioridazine should not be administered with fluoxetine or within a minimum of 5 weeks after fluoxetine has been discontinued, because of the risk of QT Prolongation [see Contraindicat...

Mechanism: These drugs can cause serious heart rhythm problems when used at the same time. Because fluoxetine stays in your system for a long time, the danger remains even after you stop taking it.

What to do: Do not take these drugs together, and wait at least five weeks after stopping fluoxetine before starting thioridazine.

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Common Questions

Can I stop taking fluoxetine suddenly?
No, do not stop taking fluoxetine without talking to your doctor. Stopping suddenly can cause withdrawal symptoms.
How long does it take for fluoxetine to work?
It may take 4 weeks or longer to feel the full effects of fluoxetine.
Can I drink alcohol while taking fluoxetine?
It is best to avoid alcohol while taking fluoxetine, as it can worsen side effects.
Does fluoxetine cause weight gain?
Fluoxetine can cause weight loss or weight gain in some people.
Can fluoxetine affect my sleep?
Yes, fluoxetine can cause insomnia or sleepiness.
Can I take other medicines with fluoxetine?
Talk to your doctor before taking any other medicines with fluoxetine, as some can cause serious interactions.
What should I do if I have side effects?
Tell your doctor if you have any side effects that bother you or do not go away.
Can fluoxetine cause anxiety?
Yes, fluoxetine can cause anxiety in some people.
Is it safe to drive while taking fluoxetine?
Fluoxetine can cause sleepiness or dizziness, so be careful when driving or operating machinery.
What if fluoxetine doesn't seem to be working?
Talk to your doctor if you don't feel any better after taking fluoxetine for several weeks.
What are the common side effects of fluoxetine?
The most commonly reported side effects of fluoxetine include Abnormal dreams, Problems ejaculating, Loss of appetite, Feeling anxious, Feeling weak. Based on 29,645 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does fluoxetine interact with other medications?
Yes, fluoxetine has 68 known drug interactions. Notable interactions include aspirin, warfarin, olanzapine. Always inform your doctor about all medications you are taking.
What drug class is fluoxetine?
fluoxetine belongs to the Selective Serotonin Reuptake Inhibitor (SSRI) drug class. It requires a prescription (Rx). Fluoxetine can treat major depressive disorder in adults and children.
Is fluoxetine safe during pregnancy?
Talk to your doctor if you are pregnant or plan to become pregnant. Fluoxetine should only be used during pregnancy if the benefit outweighs the risk to the baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has fluoxetine been recalled?
There is 1 recall associated with fluoxetine products. CGMP Deviations: Presence of N-Nitroso Fluoxetine exceeding interim acceptable intake limit. Check the recalls section below for full details and affected products.

Active Recalls

Class II May 27, 2025

CGMP Deviations: Presence of N-Nitroso Fluoxetine exceeding interim acceptable intake limit.

Torrent Pharma Inc.

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What the FDA Data Shows for fluoxetine

The FDA label for fluoxetine (sold under brand names such as Prozac, Sarafem) classifies it as a prescription-only medication in the Selective Serotonin Reuptake Inhibitor (SSRI) class. Fluoxetine can treat major depressive disorder in adults and children. Official labeling lists 22 commonly reported side effects, including Abnormal dreams, Problems ejaculating, Loss of appetite.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 29,645 voluntary reports. The database also lists 68 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $28.59 versus $13.66 for the brand.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 1 recall record on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: February 1, 2019

All federal data sources used on this page