Indications for PROZAC WEEKLY:
Maintenance phase of depression.
90mg once weekly. Start 7 days after last dose of fluoxetine 20mg (when switching from daily dosing).
Concomitant MAOIs during or within at least 5 weeks of discontinuing fluoxetine. Within 14 days of discontinuing an MAOI. Concomitant linezolid or IV methylene blue. Concomitant pimozide, thioridazine (may cause QTc prolongation).
Suicidal thoughts and behaviors.
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. Monitor for serotonin syndrome or neuroleptic malignant syndrome-like signs/symptoms; discontinue if occurs. Discontinue if unexplained allergic reaction occurs. Renal or hepatic dysfunction. History of seizures or mania/hypomania. ECT (prolonged seizures). Congenital or history of long QT syndrome and other conditions (eg, hypokalemia, hypomagnesemia, recent MI, uncompensated heart failure, bradyarrhythmias, other significant arrhythmias); monitor ECG periodically. Reevaluate periodically in long-term use. Avoid abrupt cessation. Monitor weight. Conditions that affect metabolism or hemodynamic responses. Volume depletion. Angle-closure glaucoma. Diabetes. Write ℞ for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C; avoid 3rd trimester or consider lower dose; see full labeling for effects on neonate). Nursing mothers: not recommended.
See Contraindications. Do not start with concomitant linezolid or IV methylene blue; if treatment is necessary, discontinue fluoxetine before starting; monitor for serotonin syndrome for 5 weeks or until 24 hours after last dose of linezolid or IV methylene blue, whichever comes first. Do not start thioridazine within at least 5 weeks of discontinuing fluoxetine. Caution with concomitant triptans, tricyclics, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, St. John's wort, linezolid, IV methylene blue; may cause serotonin syndrome. Avoid concomitant drugs known to prolong the QT interval (eg, ziprasidone, iloperidone, chlorpromazine, erythromycin, gatifloxacin, Class IA & III antiarrhythmics, pentamidine, methadone, and others. May potentiate protein-bound drugs (eg, warfarin, digoxin) and those metabolized by CYP2D6 (eg, tricyclics, vinblastine, flecainide). May potentiate carbamazepine, phenytoin. Monitor lithium, phenytoin, warfarin, tricyclics. Caution with benzodiazepines (eg, diazepam, alprazolam), antipsychotics (eg, clozapine, haloperidol), other CNS drugs. Increased risk of bleeding with NSAIDs, aspirin, warfarin, others that affect coagulation. Hyponatremia with diuretics.
CNS stimulation (eg, anxiety, nervousness, insomnia, abnormal dreams), sexual dysfunction, anorexia, asthenia, diarrhea, dry mouth, dyspepsia, flu syndrome, respiratory symptoms, rash (may be serious), somnolence, sweating, tremor, vasodilatation, yawn; mania/hypomania, weight loss, motor impairment, serum sickness, hypo- or hyperglycemia, urticaria, pruritus; hyponatremia (consider discontinuing if occurs). Children: thirst, hyperkinesia, agitation, personality disorder, epistaxis, urinary frequency, menorrhagia.
Caps 10mg—100; 20mg—30, 100, 2000; 40mg—30; Tabs 60mg—30; Liq—contact supplier; Weekly—4