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Switching A Patient To Or From a Monoamine Oxidase InhibitorMAOIIntended To Treat Psychiatric Disorders.

Serotonin release by platelets plays an important role in hemostasisEpidemiological studies of the case-control and cohort design that have demonstrated an association between use of psychotropic drugs that interfere with serotonin reuptake and the occurrence of upper gastrointestinal bleeding have also shown that concurrent use of an NSAID or aspirin may potentiate this risk of bleedingAltered anticoagulant effectsincluding increased bleedinghave been reported when SNRIs or SSRIs are coadministered with warfarinPatients receiving warfarin therapy should be carefully monitored when fluoxetine is initiated or discontinuedsee WARNINGS AND PRECAUTIONS

It is important to continue taking this medication as prescribed even if you feel wellDo not stop taking this medication without first consulting your doctorSome conditions may become worse when the drug is abruptly stoppedYour dose may need to be gradually decreased.

Patientstheir familiesand their caregivers should be encouraged to be alert to the emergence of anxietyagitationpanic attacksinsomniairritabilityhostilityaggressivenessimpulsivityakathisiapsychomotor restlessnesshypomaniamaniaother unusual changes in behaviorworsening of depressionand suicidal ideationespecially early during antidepressant treatment and when the dose is adjusted up or downFamilies and caregivers of patients should be advised to look for the emergence of such symptoms on a day-to-day basissince changes may be abruptSuch symptoms should be reported to the patient’s prescriber or health professionalespecially if they are severeabrupt in onsetor were not part of the patient’s presenting symptomsSymptoms such as these may be associated with an increased risk for suicidal thinking and behavior and indicate a need for very close monitoring and possibly changes in the medicationsee BOXED WARNING and WARNINGS AND PRECAUTIONS

The liquid form of this medication contains alcoholCaution is advised if you have diabetesalcohol dependenceor liver diseaseSome medicationssuch as metronidazoledisulfiramcan cause a serious reaction when combined with alcoholAsk your doctor or pharmacist about using this product safely.

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