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Because fluoxetine is tightly bound to plasma proteinsthe administration of fluoxetine to a patient taking another drug that is tightly bound to proteinfor examplewarfarindigitoxinmay cause a shift in plasma concentrations potentially resulting in an adverse effectsee CLINICAL PHARMACOLOGY

Patients should be monitored closely for changes in behaviorclinical worseningand suicidal tendenciesthis should be done during the initial 1-2 months of therapy and dosage adjustments.

In premarketing clinical trials for conditions other than PMDD2 patients are known to have developed a serious cutaneous systemic illnessIn neither patient was there an unequivocal diagnosisbut one was considered to have a leukocytoclastic vasculitisand the othera severe desquamating syndrome that was considered variously to be a vasculitis or erythema multiformeOther patients have had systemic syndromes suggestive of serum sickness.

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.

Patients should be monitored closely for changes in behaviorclinical worseningand suicidal tendenciesthis should be done during the initial 1-2 months of therapy and dosage adjustments.

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