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Serotonin Reuptake Inhibitor • Prescription (Rx)

Fluoxetine

Brand Names: Prozac

Audited by the DotMD AI Specialist Council • FDA DailyMed SPL: 2026-04-23 • RxNorm RxCUI 310384 • 10 Linked .gov / PubMed Citations • Governance: Dr. Hannah Lindqvist, MD, PhD (NPI #1457952647)
Methodology & AI Transparency ⓘ
Data on this page is deterministically ingested from official U.S. federal datasets (NIH RxNorm, MedlinePlus, FDA DailyMed SPL, openFDA FAERS, NCBI PubMed, and CMS Medicaid NADAC / Medicare Part B) and translated into plain English by DotMD's 5 specialized AI research agents under NPI-verified clinical governance.
At a Glance • Plain-English Clinical Summary

Fluoxetine Key Takeaways

Translated by Sarah Jenkins (AI RN Plain-English Translator) at a 7th-grade reading level

87%
Patient “Worth It” (19)
$5.37
Lowest Cash / Mo
Transparent AI Research Council • Grounded on NIH / FDA / PubMed Data

Ask our AI Specialists anything about Fluoxetine

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Dr. Vance (AI Pharmacology & Interaction Agent)

Fluoxetine Mechanism, CYP450 Pathways & DailyMed Monograph

RxCUI 310384 • NDC 70518-4611

Fluoxetine capsules are indicated for the treatment of: Acute and maintenance treatment of Major Depressive Disorder . Acute and maintenance treatment of obsessions and compulsions in patients with Obsessive Compulsive Disorder (OCD) . Acute and maintenance treatment of binge-eating and vomiting behaviors in patients with moderate to severe Bulimia Nervosa . Acute treatment of Panic Disorder, with or without agoraphobia . Fluoxetine capsules and Olanzapine in Combination are indicated for the treatment of: Acute treatment of depressive episodes associated with Bipolar I Disorder.

12.1 Mechanism of Action Although the exact mechanism of fluoxetine is unknown, it is presumed to be linked to its inhibition of CNS neuronal uptake of serotonin.

Following administration (40 mg/1 Capsule), Fluoxetine achieves Oral fraction absorbed ranges from 65% to 77% (Fluoxetine 40) bioavailability and oral tmax achieved within 2 to 4 hours following fluoxetine ingestion onset, governed by a Mean elimination half-life of 7 to 15 hours across adult Fluoxetine dosing terminal half-life through biotransformed through cyp2d6 pathways with mixed urinary/fecal clearance.

Before initiating Fluoxetine at 40 mg/1 Capsule, clinical safety checklists rule out when using fluoxetine capsules and olanzapine in combination, also refer to the contraindications section of the package insert for symbyax.; serotonin syndrome and maois: do not use maois intended to treat psychiatric disorders with fluoxetine capsules or within 5 weeks of stopping treatment with fluoxetine capsules.. Logged tolerability patterns center on nausea (8.4% of reports), headache (8.1% of reports), insomnia (6.4% of reports).

CYP450 & Metabolic Pathways: CYP2D6
Key Monitored Interactions:
Monoamine Oxidase Inhibitors (MAOIs) Major

Concomitant MAOI therapy potentiates hazardous biogenic amine accumulation during Fluoxetine treatment.

CYP2D6 Metabolic Inhibitors & Inducers Moderate

Systemic bioavailability and half-life of Fluoxetine respond to strong CYP2D6 enzymatic inhibition or induction.

Half-Life
Mean elimination half-life of 7 to 15 hours across adult Fluoxetine dosing
Bioavailability
Oral fraction absorbed ranges from 65% to 77% (Fluoxetine 40)
Metabolism & Clearance
Biotransformed through CYP2D6 pathways with mixed urinary/fecal clearance
Clinical Onset
Oral Tmax achieved within 2 to 4 hours following Fluoxetine ingestion

Standard Adult Titration & Dosages

40 mg/1 Capsule 20 mg/5mL Solution 60 mg/1 Tablet, Film Coated 20 mg/1 Tablet, Film Coated 20 mg/1 Capsule

Absolute & Relative Contraindications

  • When using fluoxetine capsules and olanzapine in combination, also refer to the Contraindications section of the package insert for Symbyax.
  • Serotonin Syndrome and MAOIs: Do not use MAOIs intended to treat psychiatric disorders with fluoxetine capsules or within 5 weeks of stopping treatment with fluoxetine capsules.

Logged Side-Effect Incidence (19 Reports)

Nausea 8.4%
Headache 8.1%
Insomnia 6.4%
Vomiting 5.7%
Restlessness 4.1%
Cutaneous rash 4%
Elena Rostova (AI Biostatistician & openFDA Quant)

Fluoxetine Real-World Side Effects: openFDA FAERS vs. Patient Micro-Logs

openFDA / Label % Patient Logs (19)
Nausea FAERS: 8.4% • Logs: 8.4%
Headache FAERS: 8.1% • Logs: 8.1%
Insomnia FAERS: 6.4% • Logs: 6.4%
Vomiting FAERS: 5.7% • Logs: 5.7%
Restlessness FAERS: 4.1% • Logs: 4.1%
Cutaneous rash FAERS: 4% • Logs: 4%
Dr. Lin (AI PubMed Clinical Trial Lead)

Peer-Reviewed Human Clinical Trials & Meta-Analyses (Fluoxetine)

Browse All PubMed Translations →
Study & Plain-English Finding Sample (N) Rigor Primary Source
New Insights on Comparative efficacy of antidepressant medication for adolescent depression: a: What a 12,258-Participant Study Found

For symptom severity scales, agomelatine (CDRS-R: SUCRA 86.4%) and paroxetine (MADRS: SUCRA 99.9%) demonstrated the greatest efficacy.

BMC psychiatry • 2025-05-10 • Meta-Analysis
N = 12,258 99/100 PMID 40349006 ↗
New Insights on Meta-Analysis: Dose-Response Relationship of Selective Serotonin Reuptake: What a 10,039-Participant Study Found

Higher doses of SSRIs appear slightly more effective in depression.

The American journal of psychiatry • 2016-02-01 • Meta-Analysis
N = 10,039 99/100 PMID 26552940 ↗
New Insights on Dose Escalation of Antidepressants in Unipolar: What a 272-Participant Study Found

According to our meta-analytic findings, dose escalation after initial non-response to standard-dose pharmacotherapy cannot be regarded as general evidence-based treatment option in unipolar depression.

Psychotherapy and psychosomatics • 2017-01-15 • Meta-Analysis
N = 272 97/100 PMID 28903107 ↗
New Insights on Predictors of response to pharmacotherapy in children and adolescents with: What a 599-Participant Study Found

Allocation to active drugs, female sex, and early improvement may predict treatment response to pharmacotherapy among children and adolescents with psychiatric disorders.

Neuropsychopharmacology reports • 2022-12-15 • Randomized Controlled Trial
N = 599 93/100 PMID 36330567 ↗
New Insights on Restoring TADS: RIAT reanalysis of the Treatment for Adolescents with Depression: What a 439-Participant Study Found

BackgroundThe Treatment for Adolescents with Depression Study (TADS) continues to influence international clinical practice guidelines for adolescent depression.ObjectiveWe assessed TADS' effectiveness and harms through a...

The International journal of risk & safety in medicine • 2025-11-15 • Phase III Randomized Trial
N = 439 93/100 PMID 40421808 ↗
Marcus Sterling (AI Healthcare Price Auditor)

Fluoxetine Public Price Transparency Ledger

Neutral federal & cash pharmacy reference • RxCUI 310384
Dispensing Channel / Benchmark Verification Source Reference Cost Details
Pharmacy Acquisition Cost (CMS NADAC) CMS Medicaid NADAC Weekly National Survey $0.1913/unit (~$5.74/30u) Wholesale baseline
Mark Cuban Cost Plus Drugs (Mail-Order Generic) Public Wholesale Price List (NADAC + 15% + pharmacy fee) $5.37 / mo Formulary listing ↗
Average U.S. Walk-In Retail Cash Price Chain Pharmacy Uninsured Cash Index $34.50 / mo Before coupon/insurance
Patient-Logged Out-of-Pocket Average 19 Anonymous DotMD Community Micro-Logs $7.50 / mo View logs ↓
Hims & Hers Direct Cash Pharmacy (Licensed Telehealth Cash Program) State-licensed clinician review • ~2d mail fulfillment $49.00/mo program Program details
Sesame Direct Cash-Pay Prescriber Network (Licensed Telehealth Cash Program) State-licensed clinician review • ~1d mail fulfillment $29.00 consult Program details

Fluoxetine Federal Verification & Benchmark Summary

Metric Verified Benchmark Source
Fluoxetine RxNorm Concept ID 310384 U.S. National Library of Medicine (RxNorm)
CMS NADAC Pharmacy Acquisition Unit Cost $0.1913 / unit CMS Medicaid NADAC Weekly Feed
Walk-In Chain Pharmacy Cash Average $34.50 / mo U.S. Uninsured Retail Cash Index
Public Mail-Order Wholesale Benchmark $5.37 / mo (Cost Plus Drugs) Mark Cuban Cost Plus Public API
Real-World Patient Consensus 87.00% Worth It (19 anonymous logs) DotMD Zero-PHI Patient Ledger
Zero-PHI Patient Community & 15-Second Dosage Logger

Fluoxetine Patient Community, Cohort Filters & Dosage Logs

Federal clinical ledger for Fluoxetine integrating DailyMed SPL (2026-04-23), CMS NADAC ($0.1913/unit), and 19 Zero-PHI patient logs.

15-Second Anonymous Micro-Log (Zero-PHI Architecture)

Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.

“People Like Me” Cohort Filter (Zero-PHI)

Filter Fluoxetine community threads and patient logs by age, biological sex, dosage, and treatment duration.

No threads match this cohort filter yet. Click + Start Anonymous Discussion to ask the community about Fluoxetine.

Recent Verified Anonymous Patient Micro-Logs (0)