AdultPediatricGeriatricDosage Forms & Strengths capsule (Prozac, generic) 10mg 20mg 40mg capsule, delayed-release (generic) 90mg tablet (generic) 10mg 20mg 60mg oral solution 20mg/5mL (generic) Major Depressive Disorder Indicated for acute and maintenance treatment of major depressive disorder (MDD) Initial: 20 mg PO qDay May consider gradually increasing dose after several weeks by 20 mg/day; not to exceed 80 mg qDay Delayed-release capsule 90 mg PO qWeek Resistant Depression Indicated in combination with olanzapine for treatment of resistant depression (MMD in patients who do not respond to 2 separate trials of different antidepressants of adequate dose and duration in the current episode) Initial: 20 mg fluoxetine plus 5 mg olanzapine PO qHS Make dosage adjustments, if indicated, according to efficacy and tolerability within dose ranges of fluoxetine 20-50 mg and olanzapine 5-20 mg Depression Associated with Bipolar I Disorder Indicated in combination with olanzapine for treatment of acute depressive episodes associated with bipolar I disorder Initial: 20 mg fluoxetine plus 5 mg olanzapine PO qHS Make dosage adjustments, if indicated, according to efficacy and tolerability within dose ranges of fluoxetine 20-50 mg and olanzapine 5-12.5 mg Obsessive-Compulsive Disorder Indicated for acute and maintenance treatment of obsessions and compulsions in patients with obsessive compulsive disorder (OCD) Initial: 20 mg PO qDay May consider gradually increasing dose after several weeks by 20 mg/day (20-60 mg/day recommended range); not to exceed 80 mg qDay Delayed-release capsule 90 mg PO qWeek Bulimia Nervosa Indicted for acute and maintenance treatment of binge-eating and vomiting behaviors in patients with moderate to severe bulimia nervosa Initial or maintenance: May titrate dose to 60 mg PO qDay over several days Panic Disorder Indicated for acute treatment of panic disorder, with or without agoraphobia Initial: 10 mg PO qDay for first week, THEN 20 mg PO qDay May consider gradually increasing dose after several weeks; not to exceed 60 mg qDay; doses > 60 mg/day not evaluated Premenstrual Dysphoric Disorder Indicated for treatment of premenstrual dysphoric disorder Continuous administration: 20 mg PO qDay initially; may gradually increase dose; not to exceed 80 mg/day, OR Intermittent administration: 20 mg PO qDay starting 14 days before menstruation and through first full day of menses (repeat each cycle) Off-label Uses Fibromyalgia Generalized anxiety disorder Posttraumatic stress disorder Social anxiety disorder Dosage Modifications Renal impairment Mild, moderate, or severe: No dosage adjustment required Hemodialysis: Not significantly dialyzed Hepatic impairment Cirrhosis and chronic liver disease: Use lower doses (up to 50% reduction) or less frequent dosing Dosing Considerations Dose conversion Once weekly and immediate-release formulations Delayed release (once-weekly formulation): Immediate-release fluoxetine 20 mg/day = delayed-release fluoxetine 90 mg/week When converting from immediate-release fluoxetine daily dosing, initiate delayed-release fluoxetine (90 mg once weekly) 7 days after the 20 mg/day dose of immediate-release fluoxetine Patients must be stabilized on immediate-release fluoxetine 20 mg once daily before switching In combination with olanzapine Symbyax 3 mg olanzapine/25 mg fluoxetine = olanzapine 2.5 mg plus fluoxetine 20 mg Symbyax 6 mg olanzapine/25 mg fluoxetine = olanzapine 5 mg plus fluoxetine 20 mg Symbyax 12 mg olanzapine/25 mg fluoxetine = olanzapine 12.5 mg plus fluoxetine 20 mg Symbyax 6 mg olanzapine/50 mg fluoxetine = olanzapine 5 mg plus fluoxetine 10 mg Symbyax 12 mg olanzapine/50 mg fluoxetine = olanzapine 12.5 mg plus fluoxetine 50 mg Dosage Forms & Strengths capsule (Prozac, generic) 10mg 20mg 40mg tablet (generic) 10mg 20mg 60mg oral solution 20mg/5mL (generic) Major Depressive Disorder Indicated for acute and maintenance treatment of major depressive disorder (MDD) in children aged ≥8 years <8 years: Safety and efficacy not established ≥8 years 10-20 mg PO qDay, initially Start at 10 mg/day in lower weight children May gradually increase dose after 1 week; not to exceed 20 mg qDay Depression Associated with Bipolar I Disorder Indicated in combination with olanzapine for acute depressive episodes in bipolar I disorder in children and adolescents aged 10-17 years <10 years: Safety and efficacy not established 10-17 years Initial: 20 mg fluoxetine plus 2.5 mg olanzapine PO qHS Make dosage adjustments, if indicated, according to efficacy and tolerability within dose ranges of fluoxetine 20-50 mg and olanzapine 5-12.5 mg Obsessive-Compulsive Disorder Indicated for acute and maintenance treatment of obsessions and compulsions in patients with obsessive compulsive disorder (OCD) aged ≥7 years <7 years: Safety and efficacy not established ≥7 years 10 mg PO qDay, initially; may gradually increase dose after 2 weeks to 20 mg qDay; further increases may be considered after several weeks Adolescents and higher-weight children: Typical dosage range 20-60 mg qDay Lower-weight children: Typical dosage range 20-30 mg qDay Body Dysmorphic Disorder (Orphan) Treatment of body dysmorphic disorder in children and adolescents Orphan indication sponsor Hollander, Eric MD; The Mount Sinai School of Medicine, One Gustave L. Levy Place; New York, NY 10029-6574 Autism (Orphan) Orphan indication sponsor Neuropharm, Ltd; Felcham Park House, Lower Road, Leatherhead; UK Major Depressive Disorder Initial: 10 mg PO qDay May gradually increase dose by 10-20 mg after several weeks as tolerated Do not take at night unless sedation occurs Dosing Considerations Preferred drug of choice in elderly over tricyclic antidepressants because of fewer side effectsInteraction CheckerEnter a drug name and fluoxetineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (16)artemether/lumefantrineartemether/lumefantrine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.eliglustatfluoxetine increases levels of eliglustat by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated. If coadministered with strong or moderate CYP2D6 inhibitors, reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive and intermediate metabolizers; eliglustat is contraindiated if strong or moderate CYP2D6 inhibitors are given concomitantly with strong or moderate CYP3A inhibitors.fezolinetantfluoxetine will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitorsgoserelingoserelin increases toxicity of fluoxetine by QTc interval. Contraindicated. Increases risk of torsades de pointes.isocarboxazidisocarboxazid and fluoxetine both increase serotonin levels. Contraindicated.leuprolideleuprolide increases toxicity of fluoxetine by QTc interval. Contraindicated. Increases risk of torsades de pointes.linezolidlinezolid and fluoxetine both increase serotonin levels. Contraindicated. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 5 weeks of monitoring, whichever comes first.lumefantrinelumefantrine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.mavacamtenfluoxetine will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. methylene bluemethylene blue and fluoxetine both increase serotonin levels. Contraindicated. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue fluoxetine immediately and monitor for CNS toxicity. Fluoxetine may be resumed 24 hours after last methylene blue dose or after 5 weeks of monitoring, whichever comes first.phenelzinephenelzine and fluoxetine both increase serotonin levels. Contraindicated.pimozidefluoxetine and pimozide both increase QTc interval. Contraindicated.fluoxetine increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation.procarbazineprocarbazine and fluoxetine both increase serotonin levels. Contraindicated. Combinations is contraindicated within 5 weeks of MAOI use.selegilineselegiline and fluoxetine both increase serotonin levels. Contraindicated. At least 5 weeks should elapse between discontinuation of fluoxetine and initiation of selegiline.thioridazinethioridazine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.thioridazine and fluoxetine both increase QTc interval. Contraindicated.fluoxetine increases levels of thioridazine by decreasing metabolism. Contraindicated. Risk of long QT syndrome.tranylcyprominetranylcypromine and fluoxetine both increase serotonin levels. Contraindicated.Serious - Use Alternative (132)adagrasibadagrasib, fluoxetine. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.alfentanilalfentanil, fluoxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.amiodaroneamiodarone and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.amisulprideamisulpride and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amitriptylinefluoxetine will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.fluoxetine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.amoxapinefluoxetine and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.anagrelideanagrelide and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.aripiprazolefluoxetine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.aripiprazole and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.arsenic trioxidearsenic trioxide and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.artemetherartemether and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.atomoxetineatomoxetine and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphinebuprenorphine and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalbuprenorphine buccal and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantbuprenorphine subdermal implant and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine transdermalbuprenorphine transdermal and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, long-acting injectionbuprenorphine, long-acting injection and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.bupropionfluoxetine increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.buspironefluoxetine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.carvedilolfluoxetine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.ceritinibceritinib and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.chlorpromazinefluoxetine will increase the level or effect of chlorpromazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.cimetidinefluoxetine will increase the level or effect of cimetidine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.citalopramcitalopram and fluoxetine both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions. ECG monitoring is recommended, along with drugs that may prolong the QT interval.clomipraminefluoxetine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.fluoxetine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.clopidogrelfluoxetine decreases effects of clopidogrel by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Clopidogrel efficacy may be reduced by drugs that inhibit CYP2C19. Inhibition of platelet aggregation by clopidogrel is entirely due to an active metabolite. Clopidogrel is metabolized to this active metabolite in part by CYP2C19. .cyclobenzaprinefluoxetine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.dacomitinibdacomitinib will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. desfluranedesflurane and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.desipraminefluoxetine will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.fluoxetine and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.desvenlafaxinefluoxetine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.dextromethorphanfluoxetine will increase the level or effect of dextromethorphan by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.fluoxetine and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.disopyramidedisopyramide and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.dolasetrondolasetron, fluoxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.dosulepinfluoxetine and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.doxepinfluoxetine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.fluoxetine and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.duloxetinefluoxetine will increase the level or effect of duloxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.duloxetine and fluoxetine both increase serotonin levels. Avoid or Use Alternate Drug.eliglustateliglustat and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.encorafenibencorafenib and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug. Encorafenib is associated with dose-dependent QTc interval prolongation. Avoid with drugs known to prolong QT interval.entrectinibfluoxetine and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.escitalopramfluoxetine will