It is important that your doctor check your progress at regular visits, to allow dosage adjustments and help reduce any side effects.

If you develop a skin rash or hives, stop taking fluoxetine and check with your doctor as soon as possible.

Fluoxetine may cause some people to be agitated, irritable or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these unwanted effects, tell your doctor right away.

Do not suddenly stop taking your fluoxetine. If you have been instructed to stop taking fluoxetine, ask you healthcare professional how to slowly decrease the dose. This is to decrease the chance of having symptoms such as agitation, breathing problems, chest pain, confusion, diarrhea, dizziness or light-headedness, fast heartbeat, headache, increased sweating, muscle pain, nausea, restlessness, runny nose, trouble in sleeping, trembling or shaking, unusual tiredness or weakness, vision changes, or vomiting.

Do not take fluoxetine within 2 weeks of taking a 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]) and do not take an MAO inhibitor for at least 5 weeks after taking fluoxetine. If you do, you may develop extremely high blood pressure or convulsions.

Do not take thioridazine (e.g., Mellaril) while you are taking fluoxetine or less than 5 weeks after you have stopped taking fluoxetine. Using these medicines together can cause very serious heart problems.

Avoid drinking alcohol while you are taking fluoxetine.

For diabetic patients:

• FLUOXETINE may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

FLUOXETINE may cause some people to become drowsy or less able to think clearly, or to have poor muscle control. Make sure you know how you react to fluoxetine before you drive, use machines, or do anything else that could be dangerous if you are not alert and well able to control your movements.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• More common
  • Decreased sexual drive or ability;  inability to sit still;  restlessness;  skin rash, hives, or itching 
  
  

• Less common
  • Chills or fever;  joint or muscle pain  
  
  

• Rare
  • Breast enlargement or pain;  convulsions (seizures);  fast or irregular heartbeat;  purple or red spots on skin;  symptoms of hypoglycemia (low blood sugar), including anxiety or nervousness, chills, cold sweats, confusion, cool pale skin, difficulty in concentration, drowsiness, excessive hunger, fast heartbeat, headache, shakiness or unsteady walk, or unusual tiredness or weakness;  symptoms of hyponatremia (low blood sodium), including confusion, convulsions (seizures), drowsiness, dryness of mouth, increased thirst, lack of energy;  symptoms of serotonin syndrome, including diarrhea, fever, increased sweating, mood or behavior changes, overactive reflexes, racing heartbeat, restlessness, shivering or shaking;  talking, feeling, and acting with excitement and activity you cannot control;  trouble in breathing;  unusual or incomplete body or facial movements;  unusual secretion of milk, in females 
  
  

• Incidence not known
  • Abdominal or stomach pain;  agitation ;  back or leg pains;  bleeding gums;  blindness;  blistering, peeling, loosening of skin;  bloating;  blood in urine or stools;  bloody, black, or tarry stools;  blue-yellow color blindness;  blurred vision;  changes in behavior ;  chest pain or discomfort;  clay-colored stools;  coma;  constipation;  continuing vomiting;  cough/dry cough;  dark urine;  decreased urine output;  decreased vision;  depression;  difficulty breathing;  difficulty swallowing;  dizziness or lightheadedness;  eye pain;  fainting;  fainting, fast, pounding, or irregular heartbeat or pulse;  fatigue;  general body swelling;  high fever;  high or low blood pressure;  hives or welts;  hives, itching, puffiness or swelling of the eyelids or around the eyes, face, lips or tongue;  hostility;  increased hunger;  indigestion;  irregular or slow heart rate;  irritability ;  itching;  joint or muscle pain;  large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs;  lethargy;  light-colored stools;  loss of appetite;  loss of bladder control;  muscle twitching;  nausea;  nightmares;  no blood pressure or pulse ;  noisy breathing;  nosebleeds ;  pain in ankles or knees;  painful, red lumps under the skin, mostly on the legs;  pains in stomach, side, or abdomen, possibly radiating to the back;  palpitations;  pinpoint red spots on skin;  pounding heartbeat;  rapid weight gain;  red or irritated eyes;  red skin lesions, often with a purple center;  redness, tenderness, itching, burning, or peeling of skin;  severe muscle stiffness;  shortness of breath;  skin rash;  slurred speech;  sore throat;  sores, ulcers, or white spots on lips or in mouth;  stopping of heart;  stupor;  sudden, severe chest pain;  sudden shortness of breath or troubled breathing;  sudden weakness in arms or legs;  swelling of face, ankles, or hands;  swollen or painful glands ;  thoughts of killing oneself;  tightness in chest;  tiredness;  twitching, twisting, uncontrolled repetitive movements of tongue, lips, face, arms, or legs;  unconsciousness;  unpleasant breath odor;  unusual bleeding or bruising ;  unusually pale skin;  use of extreme physical or emotional force;  vomiting of blood;  wheezing;  yellow eyes or skin 
  
  

• Symptoms of overdose--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 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• More common
  • Anxiety or nervousness;  decreased appetite ;  diarrhea;  drowsiness;  headache;  increased sweating;  nausea;  tiredness or weakness;  trembling or shaking;  trouble in sleeping  
  
  

• Less common or rare
  • Abnormal dreams;  change in sense of taste;  changes in vision;  chest pain;  constipation;  dizziness or light-headedness;  dryness of mouth;  feeling of warmth or heat;  flushing or redness of skin, especially on face and neck;  frequent urination;  hair loss;  increased appetite;  increased sensitivity of skin to sunlight;  menstrual pain;  stomach cramps, gas, or pain;  vomiting;  weight loss;  yawning 
  
  

• Incidence not known
  • Cracks in the skin;  loss of heat from the body;  painful or prolonged erections of penis ;  red, swollen skin;  scaly skin 
  
  

After you stop taking fluoxetine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this period of time, check with your doctor if you notice any of the following side effects:

• Anxiety;  dizziness;  feeling that body or surroundings are turning;  general feeling of discomfort or illness;  headache;  nausea;  sweating;  unusual tiredness or weakness 

• Incidence not known
  • Cracks in skin;  loss of heat from the body;  painful or prolonged erection of the penis ;  red, swollen skin;  scaly skin;  swelling of the breasts or breast soreness in both females and males;  unusual milk production  
  
  

After you stop using fluoxetine, it may still produce some side effects that need attention. During this period of time, chek with your doctor immediately if you notice the following side effect:

• Actions that are out of control;  agitation ;  anxiety;  burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feeling;  crying;  depersonalization ;  euphoria;  feeling of distress ;  feeling that body or surroundings are turning;  general feeling of discomfort or illness;  headache;  irritability;  mental depression;  mood or mental changes;  nervousness;  nausea;  paranoia;  quick to react or overreact emotionally ;  rapidly changing moods;  sleeplessness;  sweating;  talking, feeling, and acting with excitement;  trouble sleeping;  unable to sleep;  unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness ;  unusual tiredness or weakness;  vaginal bleeding 

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, fluoxetine is used in certain patients with the following medical conditions:

• Premature ejaculation