Patient/caregiver was educated on precautions to be exercised while taking fluoxetine as follows:
- Fluoxetine can also induce frequency of urination or polyuria. Individuals, especially with history of poorly controlled diabetes with consequent increased urinary frequency and with history of frequent urinary tract infections, must be aware of this side-effect, as fluoxetine can exacerbate the discomfort of polyuria significantly, thus leading to low body fluid volume and dehydration. Observing compliance with proper hydration measures, compliance with daily fluid intake recommendations, timed voiding, and other hygienic practices can help reduce the discomfort of polyuria and prevent development of any UTIs, secondary to fluoxetine intake.
- Avoid using fluoxetine with other antidepressant medications that act along the same line as fluoxetine and increasing the serotonin levels in the body. Fluoxetine use along with antidepressants, such as, imipramine, phenelzine, citalopram, and sertraline, can significantly increase the serotonin levels in the body and lead to development of serotonin syndrome, thus resulting in nausea, vomiting, diarrhea, rapid heart rate and dangerous arrhythmias, mania, agitation, and hallucinations. 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, to prevent development of serotonin syndrome.
- Fluoxetine intake by diabetic individuals can result in poor blood sugar control and episodes of hypoglycemia. Diabetic individuals taking fluoxetine can present with episodes of confusion, extreme hunger, anxiety spells, fatigue, and loss of consciousness. Hypoglycemic episodes in diabetic individuals taking fluoxetine must be reported to the physician, for any appropriate consideration of dose change on anti-diabetic medications, to prevent development of any such hypoglycemic episodes.
