Patient/caregiver was educated on precautions to be exercised while taking fluoxetine as follows:
- Individuals with complaint of dehydration, secondary to history of diarrhea, vomiting, or poor fluid intake, can suffer electrolyte disturbances and be more prone to develop arrhythmias with fluoxetine. Also, fluoxetine carries the risk of increasing diarrhea, thus worsening the fluid deficit and dehydration. Electrolyte disturbances, such as, low potassium and magnesium levels, secondary to diuretic pill intake, can also act as a precipitating factor for cardiac arrhythmias with fluoxetine. Observing compliance with recommended supplement intake and/or hydration measures can help prevent development of arrhythmias in these individuals. Also, observe compliance with any periodical lab draws ordered for electrolyte levels and closely follow for development of signs and symptoms of cardiac arrhythmia, such as, episodes of chest pain, rapid heart rate, palpitations, dizziness, and shortness of breath. Report any such findings to your physician immediately, so that, an alternative plan of care could be considered.
- Fluoxetine can inhibit enzyme systems in the liver that are needed for the metabolism of dietary nutrients and various other medications. Inhibition of these enzymes systems can result in slowing of overall metabolism. Slowed metabolism of food and dietary nutrients with fluoxetine can result in symptoms of indigestion, such as, nausea and vomiting, abdominal pain, heartburn, and bloating. Slowed metabolism of medications can result in increased blood levels of these medications for longer periods of time, resulting in increased risk for side-effects and consequent toxicity due to these medications. Discuss with your physician regarding your list of medications, both current and any new, and the possibility of slowed metabolism of any of them secondary to fluoxetine intake, with consequent increased risk for side-effects and toxicity. Report to your physician regarding any worsening symptoms of indigestion, for any appropriate relief measures to be considered.
