Patient/caregiver was educated on contraindications for using Fluoxetine as follows:
- Fluoxetine carries significant risk for obstruction to the flow of aqueous humor, increasing the intraocular pressure, eye pain, headache, blurred vision with haloes around light, and compromised vision. So, fluoxetine use is contraindicated in individuals with history of glaucoma, especially the closed-angle glaucoma.
- Fluoxetine can interact with many antibacterial and antifungal antibiotics, antiarrhythmic medications, antidepressants, and antipsychotic medications, resulting in development or aggravation of underlying cardiac arrhythmias, leading to debility and sudden cardiac death. Avoid taking fluoxetine along with medications belonging to the above-mentioned groups, to prevent any dangerous arrhythmias from developing.
- Fluoxetine is mainly metabolized in the liver. If liver function is deficient, the metabolism of fluoxetine can be compromised. This can lead to increased blood levels of the medication and metabolites for longer periods of time, resulting in increased risk for side-effects and consequent toxicity. So, fluoxetine could be avoided in individuals with hepatic dysfunction and an alternative medication considered or used with caution, with periodical monitoring for liver functions and development of any toxic symptoms.
- Fluoxetine is mainly excreted by kidneys in the urine. Individuals with renal disease cannot excrete fluoxetine metabolites normally. The medication and metabolites can stay in blood circulation for longer time, resulting in increased risk for side-effects and consequent toxicity. So, fluoxetine could be avoided in individuals with renal dysfunction and an alternative medication considered or used with caution, with periodical monitoring for renal function and development of any toxic symptoms.
