Consumer medicine information

Prozac

Fluoxetine

BRAND INFORMATION

Brand name

Prozac

Active ingredient

Fluoxetine

Schedule

S4

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using Prozac.

PROZAC 20®

PROZAC 20®


 Consumer Medicine Information (CMI) summary

The full CMI on the next page has more details. If you are worried about taking this medicine, speak to your doctor or pharmacist.


 1. Why am I taking PROZAC?

PROZAC contains the active ingredient fluoxetine hydrochloride. PROZAC is used to treat depression, obsessive compulsive disorder (OCD) and premenstrual dysphoric disorder (PMDD).

For more information, see Section 1. Why am I taking PROZAC? in the full CMI.

 2. What should I know before I take PROZAC?

Do not use if you have ever had an allergic reaction to PROZAC or any of the ingredients listed at the end of the CMI.

Talk to your doctor if you have any other medical conditions, take any other medicines, or are pregnant or plan to become pregnant or are breastfeeding.

For more information, see Section 2. What should I know before I take PROZAC? in the full CMI.

 3. What if I am taking other medicines?

Some medicines may interfere with PROZAC and affect how it works.

A list of these medicines is in Section 3. What if I am taking other medicines? in the full CMI.

 4. How do I take PROZAC?
  • Your doctor will tell you how much PROZAC you need to take each day.

More instructions can be found in Section 4. How do I take PROZAC? in the full CMI.

 5. What should I know while taking PROZAC?

Things you should do
  • Remind any doctor, dentist or pharmacist you visit that you are taking PROZAC.
  • Tell your doctor immediately if you become pregnant while taking PROZAC.
  • Tell your doctor immediately if you have thoughts about harming or killing yourself
Things you should not do
  • Do not stop taking this medicine or lower the dosage without checking with your doctor.
  • Do not take the herbal remedy St. John's Wort while you are being treated with PROZAC.
  • Do not give PROZAC to anyone else, even if they have the same condition as you.
Driving or using machines
  • Do not drive or operate machinery until you know how PROZAC affects you.
  • PROZAC may cause impaired judgement, reduced coordination, or drowsiness in some people.
Drinking alcohol
  • Tell your doctor if you drink alcohol.
Looking after your medicine
  • Keep your capsules in the blister pack until it is time to take them.
  • Keep your capsules in a cool dry place where the temperature stays below 30°C.

For more information, see Section 5. What should I know while taking PROZAC? in the full CMI.

 6. Are there any side effects?

Common side effects include fatigue, weakness, diarrhoea, chills, headache, nausea, vomiting, weight loss, dry mouth, trouble sleeping, anxiety, abnormal thoughts/dreams, drowsiness, dizziness, sweating, twitches, rash, itch, sexual disturbances, frequent urination, changes in taste and changes in vision. Serious side effects may include: serious allergic reactions, muscle spasms, tremors, seizures, fast, irregular heartbeat, ECG changes, abnormal bleeding/bruising, sudden mood swings, confusion, loss of coordination, Stevens-Johnson syndrome, erythema multiforme and serotonin syndrome.

For more information, including what to do if you have any side effects, see Section 6. Are there any side effects? in the full CMI.


PROZAC 20®

Active ingredient: fluoxetine hydrochloride


 Consumer Medicine Information (CMI)

This leaflet provides important information about taking PROZAC. You should also speak to your doctor or pharmacist if you would like further information or if you have any concerns or questions about taking PROZAC.

Where to find information in this leaflet:

1. Why am I taking PROZAC?
2. What should I know before I take PROZAC?
3. What if I am taking other medicines?
4. How do I take PROZAC?
5. What should I know while taking PROZAC?
6. Are there any side effects?
7. Product details

1. Why am I taking PROZAC?

PROZAC contains the active ingredient fluoxetine hydrochloride. PROZAC belongs to a group of medicines called selective serotonin reuptake inhibitors (SSRIs). SSRIs are thought to work by their action on brain chemicals called amines which are involved in controlling mood.

PROZAC is used to treat:

  • depression
  • obsessive compulsive disorder (OCD)
  • premenstrual dysphoric disorder (PMDD).
2. What should I know before I take PROZAC?

Warnings

Do not take PROZAC if:

  • you are allergic to fluoxetine hydrochloride, or any of the ingredients listed at the end of this leaflet. Always check the ingredients to make sure you can take this medicine.
  • you are taking another medicine for depression called a monoamine oxidase inhibitor (MAOI) or have been taking a MAOI within the last 14 days.
  • you are taking another medicine called pimozide to treat disturbances in thinking, feelings and behavior.

Check with your doctor if you:

  • have any other medical conditions, such as:
    - liver problems
    - heart conditions
    - raised eye pressure
    - kidney problems
    - seizures or fits
    - diabetes
    - bleeding disorders
    - any other mental condition
  • have allergies to any other medicines, foods, preservatives or dyes.
  • take any medicines for any other condition
  • drink alcohol.

During treatment, you may be at risk of developing certain side effects. It is important you understand these risks and how to monitor for them. See additional information under Section 6. Are there any side effects?

Pregnancy and breastfeeding

Check with your doctor if you are pregnant or intend to become pregnant. Your doctor will discuss the risks and benefits of taking PROZAC during pregnancy.. When taken during pregnancy, particularly in the last 3 months of pregnancy, medicines like PROZAC may affect your newborn baby and they may experience irritability, constant crying, feeding difficulties, vomiting, fluctuating temperature, seizures or fits, tremors, jitteriness, bluish appearance (cyanosis), breathing interruptions, low blood sugar, muscle stiffness, muscle weakness, or overresponsive reflexes, These symptoms are uncommon and may be due to the effect of PROZAC or the discontinuation of PROZAC.

When used during pregnancy, particularly in late pregnancy, medicines like PROZAC may increase the risk of a serious condition in babies called persistent pulmonary hypertension (PPHN) which may cause the baby to breathe faster and appear bluish. If this happens to your baby, you should contact your doctor and/or go straight to the Emergency Department at your nearest hospital.

If you take PROZAC near the end of your pregnancy, there may be an increased risk of heavy vaginal bleeding shortly after birth. Tell your doctor or midwife if you are taking PROZAC so that they can advise you.

Talk to your doctor if you are breastfeeding or intend to breastfeed. Breastfeeding while on PROZAC is not recommended.

Use in children

PROZAC is not recommended for use by children under the age of 18 years

3. What if I am taking other medicines?

Tell your doctor or pharmacist if you are taking any other medicines, including any medicines, vitamins or supplements that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some combinations of medicines may increase the risk of serious side effects and are potentially life threatening.

Some medicines may be affected by PROZAC or may affect how well it works. These include:

  • monoamine oxidase inhibitors (MAOIs), medicines used to treat some types of depression.
    You should stop taking MAOIs at least two weeks before starting PROZAC. If you do take PROZAC while you are taking a MAOI, you may experience elevated body temperature, muscle stiffness, involuntary muscle jerking, fluctuations of vital signs (blood pressure, heart rate, breathing rate) and mental state from extreme agitation progressing to confusion and coma (a condition called serotonin syndrome).
  • tamoxifen, a medicine used to treat breast cancer
  • lithium, a medicine used to treat mood swings and some types of depression
  • serotonin and noradrenaline reuptake inhibitors (SNRIs), SSRIs, tricyclic antidepressants and other medicines for depression, obsessive compulsive disorder or premenstrual dysphoric disorder (PMDD)
  • sleeping tablets or sedatives
  • medicines used to relieve anxiety
  • medicines used to treat certain mental and emotional conditions, also called antipsychotics
  • medicine used to treat disturbances in thoughts, feelings and behaviour, such as pimozide
  • medicines used to control seizures, such as phenytoin and carbamazepine
  • medicines used to prevent blood clots, such as warfarin
  • flecainide, a medicine used to treat some heart conditions
  • tryptophan
  • St John's Wort
  • medicines used to relieve pain, such as tramadol
  • triptan medicines used to treat migraine, such as sumatriptan.

Do not start taking other medicines for depression without checking with your doctor. Do this even if you have already stopped taking PROZAC.

Check with your doctor or pharmacist if you are not sure about what medicines, vitamins or supplements you are taking and if these affect PROZAC.

4. How do I take PROZAC?

How much to take

  • The usual dose for PROZAC is one capsule taken once a day. Your doctor may increase or decrease your dose depending on your condition.
  • For premenstrual dysphoric disorder (PMDD), PROZAC may be prescribed to be taken every day or only during a certain part of the month. Your doctor will prescribe the dosing schedule that is right for you.
  • Follow the instructions provided and use PROZAC until your doctor tells you to stop.

When to take PROZAC

  • PROZAC should be taken as a single morning dose.
    If your doctor tells you to take PROZAC twice a day, take a dose in the morning and at noon. Take your medicine at about the same time each day.

How to take PROZAC

  • Swallow the capsules whole with a glass of water
  • It does not matter if you take this medicine before or after food.

How long to take PROZAC

  • Continue to take PROZAC for as long as your doctor recommends.
  • The length of treatment with PROZAC will depend on how quickly your symptoms improve.
  • Most medicines of this type take time to work so don't be discouraged if you do not feel better right away. While some symptoms will be relieved sooner than others, PROZAC commonly takes two to four weeks before improvement is really apparent.
  • If you do not start to feel better in about four weeks, check with your doctor.

If you forget to take PROZAC

PROZAC should be taken regularly at the same time each day.

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.

Otherwise, take it as soon as you remember, and then go back to taking your medicine as you would normally.

Do not take a double dose to make up for the dose you missed.

If you are not sure what to do, ask your doctor or pharmacist.

If you take too much PROZAC

If you think that you have taken too much PROZAC, you may need urgent medical attention. Symptoms of an overdose may include nausea (feeling sick), vomiting, seizures or fits, fast or slow heartbeat or change in heart rhythm, breathing difficulty, altered level of alertness from excitation to coma.

You should immediately:

  • phone the Poisons Information Centre
    (by calling 13 11 26), or
  • contact your doctor, or
  • go to the Emergency Department at your nearest hospital.

You should do this even if there are no signs of discomfort or poisoning.

5. What should I know while taking PROZAC?

Things you should do

Tell your doctor if you become pregnant or start breastfeeding while taking PROZAC. Your doctor will discuss the risks and benefits of taking PROZAC during pregnancy or breastfeeding.

Keep all of your doctor's appointments so that your progress can be checked.

The symptoms of depression or other psychiatric conditions may include thoughts of harming yourself or suicide. These symptoms may continue or get worse during the first one or two months of treatment until the full antidepressant effect of PROZAC becomes apparent. This is more likely to occur in young adults under 25 years of age.

If you or someone you know is demonstrating any of the following warning signs, call your doctor straight away or go to the Emergency Department at your nearest hospital:

  • worsening of your depression
  • thoughts or talk of death or suicide
  • thoughts or talk of self-harm or harm to others
  • any recent attempts at self-harm
  • increase in aggressive behaviour, irritability or any other unusual changes in behaviour or mood

All mentions of suicide or violence must be taken seriously.

Remind any doctor, dentist or pharmacist you visit that you are taking PROZAC. If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking PROZAC.

Things you should not do

  • Do not stop taking this medicine or lower the dosage without checking with your doctor. Suddenly stopping PROZAC may cause symptoms such as dizziness, sleep disturbance, headache, irritability, anxiety, agitation, nausea, confusion, weakness, and tingling or numbness in the hands or feet. Your doctor may want you to gradually reduce the amount of PROZAC you are taking before stopping completely
  • Do not take the herbal remedy St. John's Wort while you are being treated with PROZAC. If you are already taking the herbal remedy, stop taking St. John's Wort and mention it to your doctor at your next visit.
  • Do not give PROZAC to anyone else, even if they have the same condition as you.
  • Do not let yourself run out of PROZAC over the weekend or on holidays.
  • Do not take PROZAC to treat any other complaints unless your doctor tells you to.
  • Do not take PROZAC if the packaging is torn or shows signs of tampering or the capsules do not look quite right.

Driving or using machines

Do not drive or use any machines or tools until you know how PROZAC affects you.

PROZAC may cause impaired judgement, reduced coordination, or drowsiness in some people.

Drinking alcohol

Tell your doctor if you drink alcohol.

Although drinking alcohol is unlikely to affect your response to PROZAC, your doctor may suggest avoiding alcohol while you are being treated for depression.

Looking after your medicine

  • Keep your capsules in a cool dry place where the temperature stays below 30°C.
  • Keep your capsules in the blister pack until it is time to take them.

Follow the instructions in the carton on how to take care of your medicine properly.

Store it in a cool dry place away from moisture, heat or sunlight; for example, do not store it:

  • in the bathroom or near a sink, or
  • in the car or on window sills.

Keep it where young children cannot reach it.

Getting rid of any unwanted medicine

If you no longer need to take this medicine or it is out of date, take it to any pharmacy for safe disposal.

Do not take this medicine after the expiry date.

6. Are there any side effects?

All medicines can have side effects. If you do experience any side effects, most of them are minor and temporary. However, some side effects may need medical attention.

See the information below and, if you need to, ask your doctor or pharmacist if you have any further questions about side effects.

Less serious side effects

Less serious side effectsWhat to do
Gastrointestinal:
  • nausea, vomiting
  • upset stomach, diarrhoea
  • loss of appetite, weight loss, changes in taste, dry mouth
Nervous system:
  • drowsiness
  • flushing
  • nervousness, anxiety
  • dizziness
  • Abnormal thoughts
  • headache
Sleep related:
  • trouble sleeping, unusual dreams
Skin related:
  • itch
  • rash
  • sweating
Eye related:
  • changes in vision.
Muscle related:
  • twitches
General symptoms:
  • fatigue, weakness
  • yawning
  • allergic reactions
  • chills
  • sexual disturbances (decreased sexual drive, problems with orgasm, ejaculation or erection). In some cases, these symptoms have continued after stopping treatment
  • more frequent urination
Speak to your doctor if you have any of these less serious side effects and they worry you.

Serious side effects

Serious side effectsWhat to do
Serious allergic reaction:
  • Symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing, swelling of the face, lips, tongue or other parts of the body, or rash, itching or hives on the skin.
Nervous system:
  • muscle spasms
  • tremors
  • seizures or fits
  • loss of coordination
  • confusion
  • feeling confused, feeling restless, agitation, mood swings, sweating, shaking, diarrhoea, shivering, tremor, loss of coordination, overactive reflexes, hallucinations, sudden jerks in your muscles or a fast heart beat (these may be symptoms of a rare condition called serotonin syndrome)
  • sudden switches of mood to one of overactivity and uninhibited behaviour
Heart related:
  • fast, irregular heartbeat
  • ECG changes
General symptoms:
  • abnormal bleeding or bruising
  • a widespread rash with blisters and peeling skin, particularly around the mouth, nose, eyes and genitals (Stevens-Johnson syndrome)
  • severe skin rash, which may blister and looks like small targets (central dark spots surround by a paler area, with a dark ring around the edge) (erythema multiforme)
Call your doctor straight away, or go straight to the Emergency Department at your nearest hospital if you notice any of these serious side effects.

Tell your doctor or pharmacist if you notice anything else that may be making you feel unwell.

Other side effects not listed here may occur in some people.

Reporting side effects

After you have received medical advice for any side effects you experience, you can report side effects to the Therapeutic Goods Administration online at www.tga.gov.au/reporting-problems. By reporting side effects, you can help provide more information on the safety of this medicine.

Always make sure you speak to your doctor or pharmacist before you decide to stop taking any of your medicines.

7. Product details

This medicine is only available with a doctor's prescription.

What PROZAC contains

Active ingredient
(main ingredient)
fluoxetine hydrochloride
Other ingredients
(inactive ingredients)

pre-gelatinized maize starch

dimeticone 350

gelatin

iron oxide yellow

patent blue V

titanium dioxide

edible black ink.

Potential allergensContains sulfites

Do not take this medicine if you are allergic to any of these ingredients.

PROZAC capsules are gluten free.

What PROZAC looks like

PROZAC capsules are coloured green and off-white and are marked with "Lilly" and "3105" (Aust R 14653).

PROZAC capsules 20 mg are available in packs of 28.

Who distributes PROZAC

Eli Lilly Australia Pty Ltd
Level 9, 60 Margaret Street
Sydney NSW 2000

Eli Lilly and Company (NZ) Limited
PO Box 109 197, Newmarket
Auckland
Telephone (09) 523 9300

This leaflet was prepared in September 2023.

vA7

Published by MIMS November 2023

BRAND INFORMATION

Brand name

Prozac

Active ingredient

Fluoxetine

Schedule

S4

 

1 Name of Medicine

Fluoxetine hydrochloride.

2 Qualitative and Quantitative Composition

Capsules. Fluoxetine 20 mg fluoxetine (present as the hydrochloride).
Excipients with known effect: Sulfites.
Oral liquid (not available in Australia). Fluoxetine 20 mg/5 mL (present as the hydrochloride).
Excipients with known effect: Sugars and benzoate.
For the full list of excipients, see Section 6.1 List of Excipients.

3 Pharmaceutical Form

Capsules. A size 3 capsule with an opaque green cap and an opaque yellow body. Imprinted with "Lilly 3105".
Oral liquid (not available in Australia). A clear, colourless solution, mint odour.

4 Clinical Particulars

4.9 Overdose

Symptoms. Cases of overdose of fluoxetine alone usually have an uncomplicated course and resolve without residual effects. Symptoms of overdose have included nausea, vomiting, seizures, cardiovascular dysfunction ranging from asymptomatic arrhythmias (including nodal rhythm and ventricular arrhythmias) or ECG changes indicative of QTc prolongation to cardiac arrest (including very rare cases of torsades de pointes), pulmonary dysfunction and signs of altered CNS status ranging from excitation to coma. During a 13 year period, there were 34 fatal reports of overdose where fluoxetine was the only reported ingestant although many of the case reports were incomplete.
Management of overdose. Establish and maintain an airway; ensure adequate oxygenation and ventilation. Activated charcoal, which may be used with sorbitol, should be considered in treating overdose. Activated charcoal may reduce absorption of the medicine if given within one or two hours after ingestion. In patients who are not fully conscious or have impaired gag reflex, consideration should be given to administering activated charcoal via a nasogastric tube, once the airway is protected.
Cardiac and vital signs monitoring is recommended, along with general symptomatic and supportive measures. Based on experience in animals, which may not be relevant to humans, fluoxetine induced seizures which fail to remit spontaneously may respond to diazepam.
There are no specific antidotes for fluoxetine hydrochloride.
Due to the large volume of distribution of fluoxetine hydrochloride, forced diuresis, dialysis, haemoperfusion, and exchange transfusion are unlikely to be of benefit.
In managing overdosage, consider the possibility of multiple drug involvement. For information on the management of overdose, contact the Poisons Information Centre on 13 11 26 (Australia).

5 Pharmacological Properties

5.3 Preclinical Safety Data

Genotoxicity. Fluoxetine and norfluoxetine have been shown to have no genotoxic effects based on the following assays: bacterial mutation assay, DNA repair assay in cultured rat hepatocytes, and in vivo sister chromatid exchange assay in Chinese hamster bone marrow cells.
Carcinogenicity. There is no evidence of carcinogenicity with fluoxetine hydrochloride from animal studies. The dietary administration of fluoxetine to rats for two years at dose levels of 8-11 mg/kg/day produced no evidence of carcinogenicity.

6 Pharmaceutical Particulars

6.7 Physicochemical Properties

Chemical structure. Fluoxetine hydrochloride is an antidepressant for oral administration. It is designated (±)-N-methyl-3-phenyl-3-[(α,α,α-trifluoro-p-tolyl)-oxy]-propylamine hydrochloride, and has the empirical formula of C17H18F3NO.HCl. Its molecular weight is 345.79.
Fluoxetine hydrochloride is a white to off-white crystalline solid with a solubility of 14 mg/mL in water.
The structural formula is as follows:
https://stagingapi.mims.com/au/public/v2/images/fullchemgif/CSFLUHYD.gif CAS number. The CAS number for fluoxetine hydrochloride is 59333-67-4.

7 Medicine Schedule (Poisons Standard)

S4 - Prescription only Medicine.

Summary Table of Changes

https://stagingapi.mims.com/au/public/v2/images/fulltablegif/PROZACST.gif