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Prozac oral

5HT-1D Agonists/SSRIs; SNRIs

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Both of these medicines may increase the level of serotonin in your body.

What might happen:

High serotonin levels may cause changes in body temperature, blood pressure and behavior, leading to a medical condition called Serotonin Syndrome. Serotonin Syndrome may be life threatening.

What you should do about this interaction:

Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together.If you experience muscle twitching, tremors, shivering and stiffness, fever, heavy sweating, heart palpitation, restlessness, confusion, agitation, trouble with coordination, or severe diarrhea contact your doctor right away.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.US Food and Drug Administration Center for Drug Evaluations and Research - FDA Public Health Advisory. Combined Use of 5-Hydroxytryptamine Receptor Agonists (Triptans), Selective Serotonin Reuptake Inhibitors (SSRIs) or Selective Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs) May Result in Life-threatening Serotonin Syndrome. available at: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPati entsandProviders/DrugSafetyInformationforHeathcareProfessionals/PublicHeal thAdvisories/ucm124349.htm July 19, 2006.
2.Imitrex Injection (sumatriptan) US prescribing information. GlaxoSmithKline October 2, 2012.
3.Imitrex Injection/Tablets/Nasal Spray (sumatriptan) Canadian product monograph. GlaxoSmithKline, Inc. May 07, 2004.
4.Imitrex Tablets (sumatriptan) US prescribing information. GlaxoSmithKline March, 2012.
5.Imitrex Nasal Spray (sumatriptan) US prescribing information. GlaxoSmithKline March, 2012.
6.Amerge (naratriptan) US prescribing information. GlaxoSmithKline October, 2013.
7.Maxalt (rizatriptan) US prescribing information. Merck & Co., Inc. December, 2011.
8.Zomig (zolmitriptan) US prescribing information. AstraZeneca Pharmaceuticals LP September, 2012.
9.Zoloft (sertraline) US prescribing information. Pfizer Inc. December, 2012.
10.Effexor (venlafaxine hydrochloride) US prescribing information. Wyeth Pharmaceuticals December, 2012.
11.Cymbalta (duloxetine hydrochloride) US prescribing information. Eli Lilly and Company October, 2012.
12.Prozac (fluoxetine hydrochloride) US prescribing information. Eli Lilly and Company January, 2013.
13.Symbyax (olanzapine and fluoxetine hydrochloride) US prescribing information. Eli Lilly and Company January, 2013.
14.Mathew NT, Tietjen GE, Lucker C. Serotonin syndrome complicating migraine pharmacotherapy. Cephalalgia 1996 Aug;16(5):323-7.
15.Joffe RT, Sokolov ST. Co-administration of fluoxetine and sumatriptan: the Canadian experience. Acta Psychiatr Scand 1997 Jun;95(6):551-2.
16.Szabo CP. Fluoxetine and sumatriptan: possibly a counterproductive combination. J Clin Psychiatry 1995 Jan;56(1):37-8.
17.Blier P, Bergeron R. The safety of concomitant use of sumatriptan and antidepressant treatments. J Clin Psychopharmacol 1995 Apr;15(2):106-9.
18.Leung M, Ong M. Lack of an interaction between sumatriptan and selective serotonin reuptake inhibitors. Headache 1995 Sep;35(8):488-9.
19.Wing YK, Clifford EM, Sheehan BD, Campling GM, Hockney RA, Cowen PJ. Paroxetine treatment and the prolactin response to sumatriptan. Psychopharmacology (Berl) 1996 Apr;124(4):377-9.
20.Smith DA, Cleary EW, Watkins S, Huffman CS, Polvino WJ. Zolmitriptan (311C90) does not interact with fluoxetine in healthy volunteers. Int J Clin Pharmacol Ther 1998 Jun;36(6):301-5.
21.Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005 Mar 17; 352(11):1112-20.
22.Evans RW, Tepper SJ, Shapiro RE, Sun-Edelstein C, Tietjen GE. The FDA alert on serotonin syndrome with use of triptans combined with selective serotonin reuptake inhibitors or selective serotonin-norepinephrine reuptake inhibitors: American Headache Society position paper. Headache 2010 Jun;50(6):1089-99.
23.Evans RW. The FDA alert on serotonin syndrome with combined use of SSRIs or SNRIs and Triptans: an analysis of the 29 case reports. MedGenMed 2007;9(3):48.
24.Savella (milnacipran hydrochloride) US prescribing information. Forest Pharmaceuticals, Inc. October, 2013.

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