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Prozac is used to treat depression, bulimia (an eating disorder), obsessive compulsive disorders (OCD), and severe symptoms of premenstrual syndrome (premenstrual dysphoric disorder-PMDD). Prozac works by helping to restore the balance of certain natural chemicals in the brain.

Prozac Directions
Take Prozac by mouth usually once daily in the morning, with or without food; or as directed by your doctor. The dosage is based on your medical condition and response to therapy. Some medical conditions may require a different dosing schedule (e.g., twice daily in the morning and at noon ) as determined by your doctor. Take this medication exactly as prescribed. It is important to continue taking Prozac even if you feel well. Also, do not stop taking Prozac without consulting your doctor. It may take up to 4 weeks before the full benefit of Prozac takes effect.

Dosage
Since it may take up to 4 or 5 weeks to reach steady state plasma levels of Prozac, sufficient time should be allowed to elapse before Prozac dosage is gradually increased. Higher Prozac dosages are usually associated with an increased incidence of adverse reactions.

Depression:
Adults: The recommended initial dosage is Prozac 20 mg administered once daily in the morning. A gradual dose increase should be considered only after a trial period of several weeks if the expected clinical improvement does not occur.

Bulimia Nervosa:
Adult: The recommended dosage is 60 mg/day of Prozac, although studies show that lower Prozac doses may also be efficacious. Electrolyte levels should be assessed prior to initiation of treatment.

Obsessive-Compulsive Disorder:
A dose range of 20 mg/day to 60 mg/day of Prozac is recommended for the treatment of obsessive-compulsive disorder.

For any indication, the total Prozac dosage should not exceed a maximum of 80 mg/day since clinical experience with doses above 80 mg/day is very limited.

During maintenance therapy with Prozac, the Prozac dosage should be kept at the lowest effective level.

A lower or less frequent Prozac dosage should be used in patients with kidney and/or liver impairment and in those on multiple medications.

Geriatrics:
A lower or less frequent Prozac dosage is also recommended in the elderly.

Children:
The safety and effectiveness of Prozac in patients below the age of 18 years have not been established.

Prozac Drug Interactions
Certain medications taken with Prozac could result in serious, even fatal, drug interactions. Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine) within 2 weeks, and avoid taking thioridazine within 5 weeks, before or after treatment with Prozac. Consult your doctor or pharmacist for additional information. Prozac is not recommended for use with: weight loss medicine (e.g., sibutramine, phentermine), thioridazine, terfenadine, astemizole. Ask your doctor or pharmacist for more details. Tell your doctor of all prescription and nonprescription medication you may use, especially: other SSRI antidepressants (e.g., citalopram, sertraline), nefazodone, trazodone, venlafaxine, "triptan" migraine drugs (e.g., sumatriptan, zolmitriptan), tramadol, tricyclic antidepressants (e.g., amitriptyline, nortriptyline), flecainide, propafenone, haloperidol, clozapine, lithium, tryptophan, "blood thinners" (e.g., warfarin), anti-seizure drugs (e.g., carbamazepine, phenytoin/hydantoins), herbal/natural products (e.g., St John`s wort, ayahuasca). Tell your doctor if you take any drugs that cause drowsiness such as: medicine for sleep, tranquilizers, anti-anxiety drugs (e.g., alprazolam), narcotic pain relievers (e.g., codeine), muscle relaxants, psychiatric medicine (e.g., phenothiazines such as chlorpromazine), certain antihistamines (e.g., diphenhydramine). Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of these products. Report other drugs which affect the heart rhythm (QTc prolongation), such as: dofetilide, pimozide, sotalol, quinidine, procainamide, sparfloxacin, "water pills" (diuretics such as furosemide or hydrochlorothiazide). Ask your doctor or pharmacist for more details. Fluoxetine may affect the amount of glucose (sugar) in your blood. If you take any anti-diabetes medication (e.g., glipizide, glyburide, metformin), your dosage of these drugs may need to be adjusted when fluoxetine is started or discontinued. Consult your doctor. Do not start or stop any medicine without doctor or pharmacist approval.

Prozac Missed Dose
If you miss a dose of Prozac, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose of Prozac to catch up.