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Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that increases serotonin activity in the brain and is commonly prescribed for depressive and several anxiety related disorders. In Australia this medicine is available only with a prescription from an authorised prescriber.

  • Active moiety: fluoxetine, usually provided as fluoxetine hydrochloride.
  • Common dosage forms: tablets or capsules, frequently 10 mg and 20 mg strengths, among others.
  • Normal indicators: major depressive disorder, obsessive compulsive disorder, panic disorder, bulimia nervosa and premenstrual dysphoric disorder.

For various options, approximate costs and information pertaining to the law see the sections on Similar drug candidates, Prices in Australian dollars and Status recognized by law.

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Uses in healthcare settings

Clinicians may choose fluoxetine across a variety of psychiatric conditions. The decision rests on the diagnosis, past treatment history and patient preferences.

  • Major depressive disorder, abbreviated MDD
  • Obsessive compulsive disorder
  • Panic disorder as an anxiety disorder, with or without agoraphobia
  • The condition called bulimia nervosa to reduce binge and purge episodes
  • PMDD, short for PMDD or Premenstrual dysphoric disorder

Treatment is frequently combined with psychotherapy, lifestyle adjustments and community supports to maximise benefit.

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Best practices for taking fluoxetine

Follow written directions from your prescriber and pharmacist. Ensure the data is valid medicine label each time you collect a prescription.

  • Take tablets or capsules with water. Do not crush or chew immediate release tablets unless the product information allows it.
  • Fluoxetine may be taken with or without food. Choose a daily time that supports adherence and stick with it.
  • Abrupt cessation is not recommended. Tapering under medical supervision helps to prevent withdrawal symptoms such as sleep disturbance, flu like sensations or irritability.
  • Clinical improvement for mood symptoms may take several weeks; continue treatment unless instructed otherwise by your clinician.

Should you miss a dose, see your doctor. Unadministered dose. For suspected overdosing consult Taking too much of a drug guidance immediately.

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Safety Guidelines for Special Situations

Before you initiate fluoxetine inform your prescriber about all medical conditions, medications, supplements and prior psychiatric history. This helps reduce the risk of adverse outcomes.

  • Mention liver or kidney disease, seizure disorders, bipolar affective disorder, glaucoma, prostate problems or urinary retention to your prescriber.
  • Monitor changes in mood and behaviour. New or worsening anxiety, agitation, insomnia, impulsivity or suicidal thoughts require prompt review, particularly early in treatment or after dose changes.
  • Pregnancy: review risks and benefits alongside your clinician. Use in late pregnancy can be associated with neonatal adaptation issues.
  • Breastfeeding: small amounts transfer into breast milk. Observe infants for unsettled behaviour or feeding difficulties and seek advice if you are concerned.
  • Avoid excessive alcohol while taking fluoxetine as it can increase sedation and impair coordination.
  • Do not drive or operate hazardous equipment until you know how fluoxetine affects you.

When switching between antidepressants such as sertraline, citalopram, escitalopram, paroxetine, venlafaxine, duloxetine, vortioxetine or tricyclics, your prescriber will advise on appropriate washout or cross tapering to reduce the risk of serotonin syndrome. See Drug the act of engaging with others effects additional details are available.

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Exclusion criteria for therapy

  • Known allergy or hypersensitivity to fluoxetine or any excipient in the formulation.
  • Concurrent use with pimozide or thioridazine due to serious cardiac risks.
  • Combination with monoamine oxidase inhibitors (MAOIs) is contraindicated. Do not start fluoxetine until two weeks have passed since you stopped an MAOI. After stopping fluoxetine wait at least five weeks before starting an MAOI or thioridazine.

If you notice severe mood shifts, extreme agitation, panic, very disturbed sleep or thoughts of self harm seek urgent medical help.

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Probable adverse effects and overall safety information to know

Many unintended effects are transient and improve with continued treatment. Some adverse events warrant immediate medical attention.

Seek emergency help

  • Allergic reactions: hives, breathing difficulty, swelling of face, lips, tongue or throat
  • Severe skin reactions or widespread blistering
  • Symptoms of serotonin syndrome: high fever, heavy sweating, marked agitation, confusion, tremor, lack of coordination, severe vomiting or diarrhea

Contact your prescriber promptly

  • New problems with vision, eye pain or seeing halos
  • Cardiac signs such as very fast or irregular heartbeat, chest pain or sudden fainting
  • Signs of low sodium: severe a mild headache, confusion, slurred speech or significant weakness
  • Severe muscle rigidity, very high temperature, fainting or extreme disorientation

Common milder effects

  • Sleep changes, including insomnia or vivid dreams
  • Headache attack, lightheadedness or tiredness
  • Nervousness, tremor or jitteriness
  • Gastrointestinal upset: nausea, diarrhea or reduced appetite
  • A parched oral cavity, increased sweating or hot flushes
  • Sexual harmful effects such as reduced desire or delayed orgasm
  • Possible weight or appetite changes

If follow-on effects significantly affect daily life discuss dose adjustment or different therapeutic approaches with the involvement of your prescriber. See Comparable medicines for further options.

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Alerts for potential pharmacologic drug the mutual influence during contacts are not just about words, but meaning.

Fluoxetine has a long elimination half life and influences hepatic enzymes, so it can interact with many therapies. Provide your clinician with a full list of prescription, over the counter medicines and supplements.

  • Medicines that prolong the QT interval or affect cardiac conduction may increase cardiac risk when combined with fluoxetine.
  • Other serotonergic drugs such as certain antidepressants, tramadol, linezolid, methylene blue, triptans, lithium and St John s wort increase the risk of serotonin syndrome.
  • CNS depressants including opioids, benzodiazepines and sedating antihistamines can enhance drowsiness or respiratory depression.
  • Agents that affect platelet function or anticoagulants, for example NSAIDs and warfarin, may raise bleeding risk.
  • ADHD stimulant medications for ADHD or narcolepsy can exacerbate tachycardia or anxiety when used with fluoxetine.

Always consult your prescriber before starting or stopping any medicine while taking fluoxetine.

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Skipped medication dose

If you skip taking a dose take it as soon as you recall unless the next scheduled dose is near. Do not take more than one dose to replace a a dose was skipped.

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Drug an accidental overdose

If you suspect an overdosed on medication call emergency services immediately. If possible take the medication packaging or a list of substances taken. Severe signs include collapse, fainting, marked dizziness, severe irregular heartbeat, seizures, persistent vomiting or extreme agitation.

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Management of temporary storage helps stage tasks before final processing. and disposal management

  • Keep at room temperature away from direct heat, bright light and moisture.
  • Store medicines out of reach and sight of children and animals.
  • Do not use beyond the expiry date. Return unused or out of date medicines to a pharmacy for safe disposal.

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Comparable medicines that are ancillary choices

If fluoxetine is not appropriate, prescribers may suggest other antidepressants or interventions based on side effect profile, patient history and treatment goals.

Other SSRIs

  • Sertraline patient information
  • Escitalopram
  • Citalopram may be prescribed for anxiety-related symptoms
  • Paroxetine capsules
  • Fluvoxamine treatment option

SNRIs and agents from other classes

  • Venlafaxine or desvenlafaxine (SNRIs)
  • Duloxetine product
  • Bupropion (noradrenaline-dopamine reuptake the mechanism of action)
  • Brand name Remeron for mirtazapine
  • As examples of tricyclic antidepressants, amitriptyline and nortriptyline are used.
  • Vortioxetine clinical use

Condition specific considerations

  • The medical term bulimia nervosa: psychological therapies are central; fluoxetine may reduce binge and purge behaviors when used alongside therapy and medical surveillance of system activity.
  • PMDD: sertraline or escitalopram are commonly used; hormonal treatments may be considered in selected patients.

When changing agents discuss appropriate washout periods and real time monitoring together with your clinician. See Inadvisable markers that point to for important timing restrictions.

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Approximate costing model in AUD

Actual prices depend on PBS subsidy status, pharmacy, brand and pack size. Figures below are indicative and for general planning only.

  • PBS dispensing: general patients commonly pay up to the PBS copayment for a subsidised script (recently in the order of AUD 30) while concession card holders pay a lower fee (around AUD 7.70). Confirm current figures with Services Australia or your local pharmacist.
  • Out of pocket purchase: generic fluoxetine for a monthly supply often ranges between AUD 10 and AUD 30 at discount pharmacies; brand name products can cost more, for example AUD 40 to AUD 80 depending on strength and pack size.
  • Comparable SSRIs such as sertraline, escitalopram and citalopram generally have similar PBS copayment levels when subsidised; private costs for generics are usually in the same ballpark as fluoxetine.
  • SNRIs like venlafaxine and duloxetine are often PBS listed and carry similar copayment expectations; private prices vary by formulation and brand.

Talk with your pharmacist about generic substitution, special offers, brand premiums and safety net thresholds that may reduce total expenditure. For more on subsidies see Legal position and regulation.

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Frequently posed questions

How quickly will I notice benefits?

Some people notice early changes in sleep, appetite or anxiety within one to two weeks, but meaningful improvements in mood often take four to six weeks or longer.

Is alcohol safe while taking fluoxetine?

Alcohol can worsen drowsiness and impair coordination. It is sensible to limit or avoid alcohol while taking fluoxetine and to discuss alcohol use with your prescriber.

What if I want to stop treatment?

Do not stop all at once. Plan any discontinuation with your prescriber and follow a tapering schedule to lower the risk of withdrawal effects.

This page offers general information only and does not replace professional medical advice. Always follow the instructions of your Australian healthcare provider.

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Additional aspects about Fluoxetine