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Fluoxetine for depression, obsessive compulsive disorder and bulimia nervosa
Fluoxetine for depression, obsessive compulsive disorder and bulimia nervosa
This leaflet is about fluoxetine. It can be used to treat various conditions, including depression, obsessive compulsive disorder and bulimia nervosa.
This leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
This leaflet is also availble in Polish: Fluoksetyna na depresję, zaburzenia obsesyjno-kompulsywne i bulimię nerwową
Do not stop giving this medicine suddenly, as your child may get withdrawal symptoms.
Name of drug
Common brands: Prozac®, Prozep®, Olena®, Oxactin®
Why is it important for my child to take this medicine?
Fluoxetine is a type of drug called a selective serotonin reuptake inhibitor, which is commonly referred to as an SSRI. It increases the activity of a chemical called serotonin in the brain. It will help to reduce the symptoms of obsessive compulsive disorder (OCD) or bulimia nervosa, particularly when used with therapy. It also helps to reduce the symptoms of depression, and improve mood and behaviour. It takes some time for this medicine to work.
It is important that you continue to give it regularly, even if you think it isn’t helping.
What is fluoxetine available as?
- Capsules: 20 mg, 60 mg (may contain lactose or gelatin)
- Dispersible tablets: 20 mg (may contain sorbitol)
- Liquid medicine: 20 mg in 5 mL (contains sucrose and a small amount of alcohol)
When should I give fluoxetine?
Fluoxetine is usually given once each day. This is usually in the morning.
Give the medicine at about the same time each day so that this becomes part of your child’s daily routine, which will help you to remember.
How much should I give?
Your doctor will work out the amount of fluoxetine (the dose) that is right for your child. The dose will be shown on the medicine label.
Usually your child will started on a low dose of fluoxetine. Your doctor may increase this dose later, if they think this is necessary.
It is important that you follow your doctor’s instructions about how much to give.
How should I give fluoxetine?
Capsules should be swallowed with a glass of water, milk or juice. Your child should not chew the capsule.
Dispersible (Olena) tablets can be swallowed whole with a glass of water or fruit juice. Your child should not chew the tablet. You can disperse the tablet in water. Your doctor or pharmacist will tell you how much liquid to use, and how much to give your child. Make sure your child drinks it all straight away. Do not crush the tablet.
Liquid medicine: Measure out the right amount using a medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.
When should the medicine start working?
It usually takes about 2 weeks for fluoxetine to start working but may take longer. Continue to give the medicine to your child during this time. Your doctor will decide whether it is helping once your child has been taking it for a few weeks.
What if my child is sick (vomits)?
- If your child is sick less than 30 minutes after having a dose of fluoxetine, give them the same dose again.
- If your child is sick more than 30 minutes after having a dose of fluoxetine, you do not need to give them another dose. Wait until the next normal dose.
What if I forget to give it?
Give the missed dose as soon as you remember during the day. If you do not remember by bedtime, miss out the forgotten dose and give the next dose as usual in the morning.
Never give a double dose of fluoxetine.
What if I give too much?
If you think you may have given your child too much fluoxetine, contact your doctor or local NHS services (111 in England and Scotland; 0845 4647 in Wales). Have the medicine packet with you if you telephone for advice.
Are there any possible side-effects?
We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).
Side-effects that you must do something about
If your child seems confused or agitated and has a fever (temperature above 38°C), muscle stiffness and a rapid heartbeat, take them to hospital or call an ambulance straight away. They may have a rare but serious reaction called serotonin syndrome.
If your child gets swelling of the eyes, face or lips, a rash, redness, itchiness, blistering or peeling of the skin, or has difficulty breathing, take them to your doctor or hospital straight away. They may be allergic to fluoxetine.
Very rarely, fluoxetine can cause seizures (convulsions or fits). If your child has a seizure, telephone for an ambulance. Do not restrain your child, but try to make sure that they cannot hurt themselves (e.g. put a cushion under their head and move them away from furniture).
If your child has trouble focusing, seems confused, unsteady or disorientated, or has hallucinations (seeing things that are not there), contact your doctor straight away.
If your child feels very low or suicidal, tense, nervous, worried or on edge, please contact your doctor.
Other side-effects you need to know about
Your child may have the following side-effects when they first start taking fluoxetine. These usually wear off after a few days as your child’s body gets used to the medicine. If they continue to be a problem after a week, contact your doctor.
- Your child may get indigestion, stomach ache, feel sick or be sick (vomit). Giving each dose with some food may help.
- Your child may get diarrhoea or constipation (difficulty doing a poo). They may have difficulty passing urine (doing a wee).
- They may have a headache.
- They may have difficulty sleeping or have nightmares, or they may feel more sleepy and tired than normal.
- Fluoxetine can affect the ability to do skilled tasks such as driving, riding a bicycle or playing sports. Your child should take care when doing tasks that require co-ordination until they get used to the medicine.
- They may feel more or less hungry than usual – tell your doctor if your child appears to have gained or lost a lot of weight.
- They may have difficulty swallowing. Try giving your child soft food to eat.
- They may have a dry mouth, or a metallic or bitter taste in the mouth – eating citrus fruits (oranges), taking sips of water or sucking on sugar-free boiled (hard) sweets may help.
- They may produce a milky substance from the nipples. This is nothing to worry about. Contact your doctor if this happens.
- Your child’s skin will be more sensitive to sunlight. Keep them out of strong sun. When outdoors, they should wear a long-sleeved top, trousers and a hat and should use a high-factor sun screen (at least SPF 30).They should not go on a tanning bed.
Can other medicines be given at the same time as fluoxetine?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Fluoxetine should not be taken with some common drugs that you get on prescription. It is important to tell your doctor and pharmacist about any other medicines your child is taking before starting fluoxetine.
- Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.
Is there anything else I need to know about this medicine?
Do not stop giving fluoxetine suddenly, as your child may get withdrawal effects (dizziness, feeling sick, pins and needles, headache and anxiety).
- If you or your child wants to stop fluoxetine, discuss this with your doctor. They may want to reduce the dose slowly.
- Do not change the dose you give your child without discussing this with your doctor.
Your child should not eat grapefruit or drink grapefruit juice as this may increase the amount of fluoxetine in the body, which could be harmful.
- If your daughter becomes pregnant whilst taking this medicine, or thinks she may be pregnant, she should see her doctor as soon as possible. She should continue to take the fluoxetine until she has seen the doctor.
- Only give fluoxetine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
If you think someone else may have taken the medicine by accident, contact your doctor for advice.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
- Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
Where should I keep this medicine?
- Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
- Make sure that children cannot see or reach the medicine.
- Keep the medicine in the container it came in.
Who to contact for more information
Your child’s doctor or pharmacist or nurse will be able to give you more information about fluoxetine and about other medicines used to treat your child’s condition.
You can also get useful information from:
NHS 111: 111
NHS 24: 111
- Wales/Galw Lechyd Cymru)
NHS Direct: 0845 4647
- Northern Ireland
NI Direct: www.nidirect.gov.uk
0845 766 0163
0808 802 5544
08457 90 90 90
- Anorexia and Bulima Care
03000 11 12 13
Version 2, November 2014. © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: November 2017.
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.