Patient/caregiver was educated on contraindications for using Fluoxetine as follows:
- Fluoxetine can interact with a number of other medications and can precipitate serious reactions. If you are being newly started on fluoxetine, discuss with your physician regarding all other medications you are currently taking and their safety with fluoxetine. Also, if you have been taking fluoxetine for long, discuss with your physician regarding your history of fluoxetine intake, when you are being started on any new medication.
- Do not take fluoxetine with alcohol or opioid pain medications, such as, hydrocodone and codeine, as these products can add to the dizziness and confusion caused by fluoxetine, and contribute to falls and accidents. A number of OTC cough medications and antihistamines, muscle relaxant medications, and antianxiety medications, can potentiate the confusion caused by fluoxetine and so, must be avoided taking along with fluoxetine.
- Fluoxetine use, especially along with a few other antidepressants, such as, imipramine, citalopram, and sertraline, can significantly increase the serotonin levels in the body and lead to development of serotonin syndrome. Caution must be exercised even when discontinuing on any of the above mentioned antidepressant medications with potential to increase serotonin levels and starting on fluoxetine, by observing a window period of atleast 2 weeks, before the transition to fluoxetine is made. Using fluoxetine with these medications closely can result in dangerously elevated serotonin in the blood, leading to development of serotonin syndrome, which can contribute to nausea, vomiting, diarrhea, rapid heart rate and dangerous arrhythmias, mania, agitation, and hallucinations.
