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How should this medicine be used?
Prozac comes as a capsule, tablet, and liquid to take by mouth. It is usually taken once or twice a day and may be taken with or without food. Follow the directions on your prescription label carefull y, and ask your doctor or pharmacist to explain any part you do not understand. Take Prozac exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Continue to take Prozac even if you feel well. Do not stop taking Prozac without talking to your doctor, especially if you have taken large doses for a long time. Your doctor probably will want to decrease your dose gradually. This drug must be taken regularly for a few weeks before its full effect is felt.

Special Wanring
Adverse Events Leading to Discontinuation of Treatment: - Fifteen percent of approximately 4000 patients who received fluoxetine in North American clinical trials discontinued treatment due to an adve rse event. The more common events causing discontinuation included: Psychiatric, primarily nervousness, anxiety, and insomnia; digestive, primarily nausea; nervous system, primarily dizziness, astheni a and headaches; skin, primarily rash and pruritus. In obsessive compulsive disorder studies, 12.1% of fluoxetine treated patients discontinued treatment early because of adverse events. Anxiety, and rash, at incidences of less than 2%, were the most frequently reported events.

Why is this medication prescribed?
Prozac is a member of the family of drugs called "selective serotonin re-uptake inhibitors." Serotonin is one of the chemical messengers believed to govern moods. Ordinarily, it is quickly reabsorbed after its release at the junctures between nerves. Re-uptake inhibitors such as Prozac slow this process, thereby boosting the levels of serotonin available in the brain.

Drug Interactions
General Anesthetics: - Since little is known about the interaction between fluoxetine and general anesthetics, fluoxetine should be discontinued for as long as clinically possible prior to elective su rgery.

Symptoms of overdose may include:

- unsteadiness
- confusion
- unresponsiveness
- nervousness
- tremor
- dizziness
- rapid, irregular, or pounding heartbeat
- seeing things or hearing voices tha t do not exist (hallucinating)
- fever
- fainting
- coma

Warning
Hyponatremia: - Several cases of hyponatremia (some with serum sodium lower than 110 mmol/L) have been reported. The hyponatremia appeared to be reversible when fluoxetine was discontinued. Although t hese cases were complex with varying possible etiologies, some were possibly due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The majority of these occurrences have been in older patients and in patients taking diuretics or who were otherwise volume depleted.