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Drugs reference index «Rapiflux»

Rapiflux

Generic Name: fluoxetine (Oral route)

floo-OX-e-teen

Oral routeCapsuleCapsule, Delayed ReleaseSolution

Suicidality and Antidepressant Drugs - Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of fluoxetine hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Fluoxetine hydrochloride is approved for use in pediatric patients with MDD and obsessive compulsive disorder (OCD) .

Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. PROZAC(R) is approved for use in pediatric patients with MDD and obsessive compulsive disorder (OCD) .

Oral routeTablet

Suicidality and Antidepressant Drugs - Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of fluoxetine hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Patients who are started on antidepressant therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. SARAFEM(R) is not approved for use in pediatric patients.

Pooled analyses of short-term (4 to 16 weeks) placebo-contolled trials of 9 antidepressant drugs (SSRIs and others) in children and adolescents with major depressive disorder (MDD), obsessive compulsive disorder (OCD), or other psychiatric disorders (a total of 24 trials involving over 4400 patients) have revealed a greater risk of adverse events representing suicidal thinking or behavior (suicidality) during the first few months of treatment in those receiving antidepressants. The average risk of such events in patients receiving antidepressants was 4%, twice the placebo risk of 2%. No suicides occurred in these trials .

Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. SARAFEM(R) is not approved for use in pediatric patients .

Commonly used brand name(s):

In the U.S.

  • Prozac
  • Prozac Weekly
  • Rapiflux
  • Sarafem
  • Selfemra

In Canada

  • Phl-Fluoxetine

Available Dosage Forms:

  • Capsule
  • Capsule, Delayed Release
  • Tablet
  • Syrup
  • Solution

Therapeutic Class: Antidepressant

Pharmacologic Class: Serotonin Reuptake Inhibitor

Uses For Rapiflux

Fluoxetine is used to treat mental depression. It is also used to treat obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder (PMDD), and panic disorder.

Fluoxetine is used with olanzapine to treat depression that is a part of bipolar disorder. It is also used to treat treatment resistant depression in patients who have been treated with other antidepressants that did not work well. This medicine may also be used for other conditions as determined by your doctor.

Fluoxetine belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). These medicines are thought to work by increasing the activity of a chemical called serotonin in the brain.

This medicine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, fluoxetine is used in certain patients with the following medical conditions:

  • Premature ejaculation.

Before Using Rapiflux

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of fluoxetine in children with depression. However, safety and efficacy have not been established in children below 8 years of age.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of fluoxetine in children with obsessive-compulsive disorder. However, safety and efficacy have not been established in children below 7 years of age.

Appropriate studies have not been performed on the relationship of age to the effects of fluoxetine in children with bulimia nervosa and panic disorder. Safety and efficacy have not been established.

Appropriate studies have not been performed on the relationship of age to the effects of olanzapine and fluoxetine combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of fluoxetine in the elderly. However, elderly patients may be more sensitive to the effects of this medicine than younger adults and are more likely to have liver problems, which may require caution and an adjustment in the dose for patients receiving fluoxetine.

Pregnancy

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Bepridil
  • Clorgyline
  • Dihydroergotamine
  • Ergoloid Mesylates
  • Ergonovine
  • Ergotamine
  • Furazolidone
  • Iproniazid
  • Isocarboxazid
  • Levomethadyl
  • Linezolid
  • Mesoridazine
  • Methylergonovine
  • Methysergide
  • Metoclopramide
  • Moclobemide
  • Nialamide
  • Pargyline
  • Phenelzine
  • Pimozide
  • Procarbazine
  • Selegiline
  • Terfenadine
  • Thioridazine
  • Toloxatone
  • Tranylcypromine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abciximab
  • Acecainide
  • Acenocoumarol
  • Ajmaline
  • Almotriptan
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Amoxapine
  • Ancrod
  • Anisindione
  • Antithrombin III Human
  • Aprindine
  • Ardeparin
  • Arsenic Trioxide
  • Aspirin
  • Astemizole
  • Azimilide
  • Bivalirudin
  • Bretylium
  • Certoparin
  • Chloral Hydrate
  • Chloroquine
  • Chlorpromazine
  • Cilostazol
  • Clarithromycin
  • Clopidogrel
  • Dalteparin
  • Danaparoid
  • Defibrotide
  • Dermatan Sulfate
  • Desipramine
  • Desirudin
  • Desvenlafaxine
  • Dexfenfluramine
  • Dextromethorphan
  • Dibenzepin
  • Dicumarol
  • Dipyridamole
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Doxepin
  • Droperidol
  • Duloxetine
  • Eletriptan
  • Enflurane
  • Enoxaparin
  • Eptifibatide
  • Erythromycin
  • Fenfluramine
  • Flecainide
  • Fluconazole
  • Fondaparinux
  • Foscarnet
  • Frovatriptan
  • Gemifloxacin
  • Halofantrine
  • Haloperidol
  • Halothane
  • Heparin
  • Hydroquinidine
  • Ibutilide
  • Imipramine
  • Isoflurane
  • Isradipine
  • Lidoflazine
  • Lorcainide
  • Mefloquine
  • Meperidine
  • Milnacipran
  • Mirtazapine
  • Nadroparin
  • Naratriptan
  • Nortriptyline
  • Octreotide
  • Parnaparin
  • Pentamidine
  • Pentosan Polysulfate Sodium
  • Phenindione
  • Phenprocoumon
  • Pirmenol
  • Prajmaline
  • Prasugrel
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Propafenone
  • Quetiapine
  • Rasagiline
  • Reviparin
  • Rizatriptan
  • Sematilide
  • Sertindole
  • Sibutramine
  • Sotalol
  • Spiramycin
  • St John's Wort
  • Sulfamethoxazole
  • Sultopride
  • Sumatriptan
  • Tapentadol
  • Tedisamil
  • Telithromycin
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Tramadol
  • Trazodone
  • Trifluoperazine
  • Trimethoprim
  • Trimipramine
  • Tryptophan
  • Vasopressin
  • Venlafaxine
  • Warfarin
  • Ziprasidone
  • Zolmitriptan
  • Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aceclofenac
  • Acemetacin
  • Alclofenac
  • Alprazolam
  • Benoxaprofen
  • Bromfenac
  • Bufexamac
  • Bupropion
  • Buspirone
  • Carbamazepine
  • Carprofen
  • Celecoxib
  • Clonixin
  • Clozapine
  • Cyclobenzaprine
  • Cyproheptadine
  • Delavirdine
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Digoxin
  • Dipyrone
  • Droxicam
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenbufen
  • Fenoprofen
  • Fentiazac
  • Floctafenine
  • Flufenamic Acid
  • Fluphenazine
  • Flurbiprofen
  • Fosphenytoin
  • Galantamine
  • Ginkgo
  • Ibuprofen
  • Iloperidone
  • Indomethacin
  • Indoprofen
  • Isoxicam
  • Ketoprofen
  • Ketorolac
  • Lithium
  • Lornoxicam
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Metoprolol
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Nebivolol
  • Niflumic Acid
  • Nimesulide
  • Oxaprozin
  • Parecoxib
  • Paroxetine
  • Pentazocine
  • Phenylbutazone
  • Phenytoin
  • Pirazolac
  • Piroxicam
  • Pirprofen
  • Propyphenazone
  • Proquazone
  • Risperidone
  • Ritonavir
  • Rofecoxib
  • Sulindac
  • Suprofen
  • Tenidap
  • Tenoxicam
  • Tetrabenazine
  • Tiaprofenic Acid
  • Tolmetin
  • Valdecoxib
  • Zomepirac

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bipolar disorder (mood disorder with alternating episodes of mania and depression), or risk of or
  • Bleeding problems or
  • Hyponatremia (low sodium in the blood) or
  • Seizures, history of—Use with caution. May make these conditions worse.
  • Diabetes or
  • Hypogglycemia (low blood sugar)—This medicine may lower your blood sugar levels. The amount of insulin or oral antidiabetic medicine that you need to take may change.
  • Diseases affecting metabolism or diseases involving blood circulation—Caution should be used in patients with these medical problems.
  • Drug abuse, history of—Potential for increased dependence on this medicine.
  • Electroconvulsive therapy (ECT)—Use with caution. May cause prolonged seizures in patients receiving ECT treatment with fluoxetine.
  • Heart disease (unstable) or
  • Myocardial infarction (heart attack), recent history of—The effects of fluoxetine in patients with these conditions are not known.
  • Kidney disease or
  • Liver disease—Use with caution. Higher blood levels of fluoxetine may occur, increasing the chance of side effects.
  • Mania or hypomania, history of—Use of fluoxetine may activate these conditions.
  • Weight loss—Fluoxetine may cause weight loss. This weight loss is usually small, but if a large weight loss occurs, it may be harmful in some patients especially in depressed or bulimic patients.

Proper Use of fluoxetine

This section provides information on the proper use of a number of products that contain fluoxetine. It may not be specific to Rapiflux. Please read with care.

Take this medicine only as directed by your doctor, to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Talk with your doctor if you have any questions.

If this medicine upsets your stomach, it may be taken with food.

If you are taking fluoxetine for depression, it may take 4 weeks or longer before you begin to feel better. Also, you may need to keep taking this medicine for 6 months or longer to stop the depression from returning. If you are taking fluoxetine for obsessive-compulsive disorder, it may take 5 weeks or longer before you begin to get better. Your doctor should check your progress at regular visits during this time.

If you are taking fluoxetine for bulimia nervosa, you may begin to get better after 1 week. However, it may take 4 weeks or longer before you get better.

If you are using the oral liquid form of fluoxetine, shake the bottle well before measuring each dose. Use a small measuring cup or a measuring spoon to measure each dose. The teaspoons and tablespoons that are used for serving and eating food do not measure exact amounts.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (delayed-release capsules, pulvules, or solution):
    • For depression:
      • Adults—At first, 20 milligrams (mg) once a day, taken as a single dose in the morning. Your doctor may increase your dose as needed. However, the dose is usually not more than 80 mg a day. Once your depression is under control, your doctor may wish to change you to a weekly dose. In this case, you will usually take a 90-mg capsule as a single dose one day per week.
      • Children above 8 years of age—At first, 10 to 20 mg a day, taken as a single dose in the morning. Your doctor may increase your dose as needed.
      • Children below 8 years of age—Use and dose must be determined by your doctor.
    • For depression that occurs with bipolar disorder or treatment resistant depression:
      • Adults—At first, one capsule of 20 mg fluoxetine and 5 mg oral olanzapine once a day in the evening. Your doctor may increase your dose as needed. However, the dose is usually not more than 18 mg of oral olanzapine and 75 mg of fluoxetine.
      • Children—Use and dose must be determined by your doctor.
    • For bulimia nervosa:
      • Adults—60 milligrams (mg) once a day, taken as a single dose in the morning. Your doctor may start with a lower dose and increase it gradually. The dose is usually not more than 80 mg a day.
      • Children—Use and dose must be determined by your doctor.
    • For obsessive-compulsive disorder:
      • Adults—At first, usually 20 milligrams (mg) a day, taken as a single dose in the morning. Your doctor may increase your dose as needed. However, the dose is usually not more than 80 mg a day.
      • Children above 7 years of age—At first, 10 mg a day, taken as a single dose in the morning. Your doctor may increase your dose as needed. However, the dose is usually not more than 60 mg a day.
      • Children below 7 years of age—Use and dose must be determined by your doctor.
    • For panic disorder:
      • Adults—At first, 10 milligrams (mg) once a day, taken as a single dose in the morning or evening for one week. Your doctor may increase your dose as needed. However, the dose is usually not more than 60 mg per day.
      • Children—Use and dose must be determined by your doctor.
    • For premenstrual dysphoric disorder:
      • Adults—At first, usually 20 milligrams (mg) once a day, taken as a single dose in the morning. Your doctor may have you take 20 mg every day of your menstrual cycle or for only 14 days out of your cycle. Your doctor will determine the use and dose that is right for you. Your doctor may increase your dose as needed. However, the dose is usually not more than 80 mg a day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Rapiflux

It is important that your doctor check your progress at regular visits, to allow changes in your dose and help reduce any side effects.

If you develop a skin rash or hives, stop taking fluoxetine and check with your doctor as soon as possible.

Fluoxetine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these unwanted effects, tell your doctor or your child's doctor right away.

Do not stop suddenly taking this medicine without checking first with your doctor. If you have been instructed to stop taking fluoxetine, ask your doctor how to slowly decrease the dose. This is to decrease the chance of having symptoms such as agitation, breathing problems, chest pain, confusion, diarrhea, dizziness or lightheadedness, a fast heartbeat, headache, increased sweating, muscle pain, nausea, restlessness, runny nose, trouble with sleeping, trembling or shaking, unusual tiredness or weakness, vision changes, or vomiting.

Do not take fluoxetine within 2 weeks of taking an monoamine oxidase (MAO) inhibitor (e.g., isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]). Do not take an MAO inhibitor for at least 5 weeks after taking fluoxetine. If you do, you may develop extremely high blood pressure or seizures.

Do not take thioridazine (Mellaril®) while you are taking fluoxetine or less than 5 weeks after you have stopped taking fluoxetine. You should not use pimozide (Orap®) while you are taking this medicine. Using these medicines together can cause very serious heart problems.

You should not take other medicines that also contain fluoxetine. This includes Symbyax®, Sarafem®, or Prozac Weekly®. Using these medicines together may increase your chance for more serious side effects.

Make sure your doctor knows about all the other medicines you are using. Fluoxetine may cause serious conditions such as serotonin syndrome and neuroleptic malignant syndrome (NMS)-like reactions when taken with certain medicines such as linezolid [Zyvox®], lithium, tryptophan, St. John's Wort, or some pain medicines (e.g., tramadol [Ultram®], sumatriptan [Imitrex®], zolmitriptan [Zomig®], or rizatriptan [Maxalt®]). Check with your doctor first before taking any other medicines.

Make sure your doctor knows if you are also using aspirin, NSAIDS (e.g., ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, or Motrin®), or a blood thinner (e.g., warfarin [Coumadin®]). Fluoxetine may increase your risk of having bleeding problems especially when taken together with these medicines.

Avoid drinking alcohol while you are taking fluoxetine.

Do not breastfeed while you are using this medicine.

For diabetic patients:

  • This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

This medicine may cause some people to become drowsy or less able to think clearly, or to have poor muscle control. Make sure you know how you react to fluoxetine before you drive, use machines, or do anything else that could be dangerous if you are not alert and well able to control your movements.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Rapiflux Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Inability to sit still
  • restlessness
  • skin rash, hives, or itching
Less common
  • Chills or fever
  • joint or muscle pain
Rare
  • Anxiety or nervousness
  • cold sweats
  • confusion
  • convulsions (seizures)
  • cool pale skin
  • diarrhea
  • difficulty with concentration
  • drowsiness
  • dryness of the mouth
  • excessive hunger
  • fast or irregular heartbeat
  • headache
  • increased sweating
  • increased thirst
  • lack of energy
  • mood or behavior changes
  • overactive reflexes
  • purple or red spots on the skin
  • racing heartbeat
  • shakiness or unsteady walk
  • shivering or shaking
  • talking, feeling, and acting with excitement and activity you cannot control
  • trouble with breathing
  • unusual or incomplete body or facial movements
  • unusual tiredness or weakness
Incidence not known
  • Abdominal or stomach pain
  • agitation
  • back or leg pains
  • bleeding gums
  • blindness
  • blistering, peeling, or loosening of the skin
  • bloating
  • blood in the urine or stools
  • bloody, black, or tarry stools
  • blue-yellow color blindness
  • blurred vision
  • chest pain or discomfort
  • clay-colored stools
  • constipation
  • continuing vomiting
  • cough or dry cough
  • dark urine
  • decreased urine output
  • decreased vision
  • depression
  • difficulty with breathing
  • difficulty with swallowing
  • dizziness or lightheadedness
  • eye pain
  • fainting
  • fast, pounding, or irregular heartbeat or pulse
  • general body swelling
  • high fever
  • high or low blood pressure
  • hives, itching, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • hostility
  • indigestion
  • irregular or slow heart rate
  • irritability
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • loss of appetite
  • loss of bladder control
  • muscle twitching
  • nausea
  • nightmares
  • no blood pressure or pulse
  • noisy breathing
  • nosebleeds
  • pain in the ankles or knees
  • painful, red lumps under the skin, mostly on the legs
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pinpoint red spots on the skin
  • rapid weight gain
  • red or irritated eyes
  • red skin lesions, often with a purple center
  • redness, tenderness, itching, burning, or peeling of the skin
  • severe muscle stiffness
  • severe sleepiness
  • shortness of breath
  • skin rash
  • slurred speech
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stopping of heart
  • sudden shortness of breath or troubled breathing
  • sudden weakness in the arms or legs
  • sudden, severe chest pain
  • swelling of the face, ankles, or hands
  • swollen or painful glands
  • thoughts of killing oneself
  • tightness in the chest
  • tiredness
  • twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
  • unconsciousness
  • unpleasant breath odor
  • unusual bleeding or bruising
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  • unusually pale skin
  • use of extreme physical or emotional force
  • vomiting of blood
  • wheezing
  • yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Decreased appetite
  • decreased sexual drive or ability
Less common or rare
  • Abnormal dreams
  • breast enlargement or pain
  • change in sense of taste
  • changes in vision
  • feeling of warmth or heat
  • flushing or redness of the skin, especially on face and neck
  • frequent urination
  • hair loss
  • increased appetite
  • increased sensitivity of the skin to sunlight
  • menstrual pain
  • stomach cramps, gas, or pain
  • unusual secretion of milk, in females
  • weight loss
  • yawning
Incidence not known
  • Cracks in the skin
  • loss of heat from the body
  • painful or prolonged erections of the penis
  • scaly skin
  • swelling of the breasts or breast soreness in both females and males
  • unusual milk production

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

  • Actions that are out of control
  • burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feeling
  • crying
  • depersonalization
  • dizziness
  • euphoria
  • feeling of distress
  • feeling that body or surroundings are turning
  • general feeling of discomfort or illness
  • paranoia
  • quick to react or overreact emotionally
  • rapidly changing moods
  • sleeplessness
  • sweating
  • unable to sleep
  • vaginal bleeding

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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