Prozac Weekly

Prozac Weekly is a prescription medicine used to treat depression, obsessive compulsive disorder (OCD), bulimia, and panic disorder. Prozac Weekly belongs to a group of drugs called selective serotonin reuptake inhibitor (SSRI). It works by changing the levels of certain chemicals in the brain that affect your mood.

Prozac Weekly is a prescription medicine used to treat the following conditions:

• Depression (known medically as major depressive disorder (MDD) or clinical depression)
• Obsessive compulsive disorder (OCD) 
• Bulimia nervosa 
• Panic disorder 
• Depression associated with bipolar disorder, taken with olanzapine (Symbyax) 
• Treatment-resistant depression (depression that has not gotten better with at least 2 other treatments) (Symbyax) 

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Eli Lilly and Company

Prozac Weekly may cause serious side effects. See "Drug Precautions" section.

Common possible side effects in people who take Prozac Weekly include: 

• unusual dreams 
• sexual problems 
• loss of appetite, diarrhea, indigestion, nausea or vomiting, weakness, or dry mouth 
• flu symptoms 
• feeling tired or fatigued 
• change in sleep habits
• yawning 
• sinus infection or sore throat 
• tremor or shaking 
• sweating 
• feeling anxious or nervous 
• hot flashes 
• rash 

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• Triptans used to treat migraine headache 
• Medicines used to treat mood, anxiety, psychotic or thought disorders, including tricyclics, lithium, SSRIs, SNRIs, MAOI’s (including linezolid, an antibiotic), or antipsychotics 
• Tramadol 
• Over-the-counter supplements such as tryptophan or St. John’s Wort 

If you take Prozac Weekly, you should not take any other medicines that contain Prozac Weekly including: 

• Symbyax 
• Sarafem 
• Selfemra
• Prozac

This is not a complete list of Prozac Weekly drug interactions. Ask your doctor or pharmacist for more information.

Prozac Weekly and some medicines may interact with each other, may not work as well, or may cause serious side effects. Your healthcare provider or pharmacist can tell you if it is safe to take Prozac Weekly with your other medicines. Do not start or stop any medicine while taking Prozac Weekly without talking to your healthcare provider first.

Prozac Weekly and other antidepressant medicines may cause serious side effects, including:

1. Suicidal thoughts or actions:

• Prozac Weekly and other antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment or when the dose is changed.
• Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions.
• Watch for these changes and call your healthcare provider right away if you notice:
  • New or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe.
  • Pay particular attention to such changes when Prozac Weekly is started or when the dose is changed.

Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.

Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency, especially if they are new, worse, or worry you:

• attempts to commit suicide
• acting on dangerous impulses
• acting aggressive or violent
• thoughts about suicide or dying
• new or worse depression
• new or worse anxiety or panic attacks
• feeling agitated, restless, angry or irritable
• trouble sleeping
• an increase in activity or talking more than what is normal for you
• other unusual changes in behavior or mood

Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency. Prozac Weekly may be associated with these serious side effects:

2. Serotonin Syndrome or Neuroleptic Malignant Syndrome-like reactions. This condition can be life-threatening and may include:

• agitation, hallucinations, coma or other changes in mental status
• coordination problems or muscle twitching (overactive reflexes)
• racing heartbeat
• high or low blood pressure
• sweating or fever
• nausea, vomiting, or diarrhea
• muscle rigidity

3. Severe allergic reactions:

• trouble breathing
• swelling of the face, tongue, eyes or mouth
• rash, itchy welts (hives) or blisters, alone or with fever or joint pain

4. Abnormal bleeding: Prozac Weekly and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin, Jantoven), a non-steroidal anti-inflammatory drug (NSAIDs, like ibuprofen or naproxen), or aspirin.

5. Seizures or convulsions

6. Manic episodes:

• greatly increased energy
• severe trouble sleeping
• racing thoughts
• reckless behavior
• unusually grand ideas
• excessive happiness or irritability
• talking more or faster than usual

7. Changes in appetite or weight. Children and adolescents should have height and weight monitored during treatment.

8. Low salt (sodium) levels in the blood. Elderly people may be at greater risk for this. Symptoms may include:

• headache
• weakness or feeling unsteady
• confusion, problems concentrating or thinking or memory problems

Do not stop Prozac Weekly without first talking to your healthcare provider. Stopping Prozac Weekly too quickly may cause serious symptoms including:

• anxiety, irritability, high or low mood, feeling restless or changes in sleep habits
• headache, sweating, nausea, dizziness
• electric shock-like sensations, shaking, confusion

Do not take Prozac Weekly if you: 

• are allergic to any ingredient of Prozac Weekly. Ask your pharmacist for a complete list of ingredients.
• take a Monoamine Oxidase Inhibitor (MAOI). 
• take Mellaril (thioridazine). Do not take Mellaril within 5 weeks of stopping Prozac Weekly because this can cause serious heart rhythm problems or sudden death. 
• take the antipsychotic medicine pimozide (Orap) because this can cause serious heart problems.

Other precautions:

• Do not take an MAOI within 5 weeks of stopping Prozac Weekly. 
• Do not start Prozac Weekly if you stopped taking an MAOI in the last 2 weeks. People who take Prozac Weekly close in time to an MAOI may have serious or even lifethreatening side effects. Get medical help right away if you have any of these symptoms:
  • high fever 
  • uncontrolled muscle spasms 
  • stiff muscles 
  • rapid changes in heart rate or blood pressure 4 
  • confusion 
  • loss of consciousness (pass out) 

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Prozac Weekly there are no specific foods that you must exclude from your diet when receiving Prozac Weekly.

Before starting Prozac Weekly, tell your healthcare provider if you: 

• Are taking certain drugs or treatments such as:
  • Triptans used to treat migraine headache 
  • Medicines used to treat mood, anxiety, psychotic or thought disorders, including tricyclics, lithium, SSRIs, SNRIs, MAOI’s (including linezolid, an antibiotic), or antipsychotics 
  • Tramadol 
  • Over-the-counter supplements such as tryptophan or St. John’s Wort 
  • Electroconvulsive therapy (ECT) 
• have liver problems 
• have kidney problems 
• have heart problems 
• have or had seizures or convulsions 
• have bipolar disorder or mania 
• have low sodium levels in your blood 
• have a history of a stroke 
• have high blood pressure 
• have or had bleeding problems 
• are pregnant breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Prozac Weekly falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans, though. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed. 

Prozac Weekly has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from Prozac Weekly, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

• Take Prozac Weekly exactly as prescribed. Your doctor may need to change (adjust) the dose of Prozac Weekly until it is right for you.
• If you miss a dose of Prozac Weekly, take the missed dose as soon as you remember.
• To prevent serious side effects, do not stop taking Prozac Weekly suddenly. If you need to stop taking Prozac Weekly, your doctor can tell you how to safely stop taking it.
• Prozac Weekly can be taken with or without food.
• Prozac Weekly is usually taken once weekly.
• If you do not think you are getting better or have any concerns about your condition while taking Prozac Weekly, call your doctor.

Take Prozac Weekly exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The recommended dose of Prozac Weekly is 90 mg once a week.

If you take too much Prozac Weekly call your local Poison Control Center or seek emergency medical attention right away.

• Store at room temperature between 59°F and 86°F (15°C to 30°C). 
• Keep away from light. 
• Keep bottle closed tightly. 
• Keep and all medicines out of the reach of children.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

• Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short–term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older.
• In patients of all ages who are started on antidepressant therapy, monitor closely for worsening and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber.
• PROZAC is not approved for use in children less than 7 years of age.

When using PROZAC and olanzapine in combination, also refer to Boxed Warning section of the package insert for Symbyax.