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Other Medicines
P450 isozyme (IID6): - Like other selective serotonin reuptake inhibitors, fluoxetine inhibits the specific hepatic cytochrome P450 isozyme (IID6) which is responsible for the metabolism of debrisoqui ne and sparteine. Although the clinical significance of this effect has not been established, inhibition of IID6 may lead to elevated plasma levels of co-administered drugs which are metabolized by th is isozyme. Drugs metabolized by cytochrome P450IID6 include the tricyclic antidepressants (e.g., nortriptyline, amitriptyline, imipramine, and desipramine), phenothiazine neuroleptics (e.g., perphena zine and thioridazine), and Type 1C antiarrhythmics (e.g., propafenone and flecainide).

What side effects can this medication cause?
Side effects from Prozac are common:

- upset stomach
- drowsiness
- weakness or tiredness
- excitement or anxiety
- insomnia
- nightmares
- dry mouth
- ski n more sensitive to sunlight than usual
- changes in appetite or weight

Tell your doctor if any of these symptoms are severe or do not go away:

- constipation
- difficult y urinating
- frequent urination
- blurred vision
- changes in sex drive or ability
- excessive sweating

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.

Prozac oral liquid comes with a specially marked dropper for measuring the dose. Ask your pharmacist to show you how to use the dropper. Dilute the liquid in 4 ounces (120 ml) of water, apple j uice, or Gatorade just before taking it.

Precautions
Seizures:
Fluoxetine should be used with caution in patients with a history of convulsive disorders. The incidence of seizures associated with fluoxetine during clinical trials did not appear to d iffer from that reported with other marketed antidepressants; however, patients with a history of convulsive disorders were excluded from these trials.

Concurrent administration with electro shock therapy should be avoided because of the absence of experience in this area. There have been rare reports of a prolonged seizure in patients on fluoxetine receiving ECT treatment.

Before Taking This Medicine
Pregnancy—One study of babies whose mothers had taken Prozac while they were pregnant found some problems in the babies, such as premature birth, jitteriness, and trouble in breathing or nursing. How ver, four other studies did not find any problems in babies or young children whose mothers had taken Prozac while they were pregnant. Tell your doctor if you are pregnant or if you may become pregnan t while you are taking this medicine.

Description
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.

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