Apo-Fluoxetine Contraindications

APO-FLUOXETINE (fluoxetine hydrochloride) is contraindicated in patients with known hypersensitivity to the drug.
Monoamine Oxidase Inhibitors: There have been reports of serious, sometimes fatal, reactions (including hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs, and mental status changes that include extreme agitation progressing to delirium and coma) in patients receiving fluoxetine in combination with a monoamine oxidase inhibitor (MAOI), and in patients who have recently discontinued fluoxetine and then started on an MAOI. Some cases presented with features resembling neuroleptic malignant syndrome. Therefore, APO-FLUOXETINE should not be used in combination with an MAOI, or within 14 days of discontinuing therapy with an MAOI. Since fluoxetine and its major metabolite have very long elimination half-lives, at least 5 weeks should be allowed after stopping APO-FLUOXETINE before starting an MAOI. Limited reports suggest that orally administered cyproheptadine or intravenously administered dantrolene (Dantrium) may benefit patients experiencing such reactions.