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Fluoxetine Coupon - Fluoxetine 20mg tablet

fluoxetine

Generic Sarafem
Used for Depression, Panic Disorder, Obsessive-Compulsive Disorder, PTSD, Eating Disorders
Used for Depression, Panic Disorder, Obsessive-Compulsive Disorder, PTSD, Eating Disorders

Fluoxetine (Sarafem) is an antidepressant used to treat premenstrual dysphoric disorder (PMDD). It's a selective serotonin reuptake inhibitor (SSRI) that contains the same active ingredient as fluoxetine (Prozac), which is used to treat other mental health conditions, including depression. Fluoxetine (Sarafem) is taken by mouth, either daily regularly or only for a couple of weeks during each menstrual cycle. Some common side effects include headache, weakness, and flu-like symptoms. Brand name Sarafem has been discontinued and fluoxetine (Sarafem) is only available as a lower-cost generic.

Reviewed by:
reviewer
Kristianne Hannemann, PharmD
reviewer
Allison Gourley, PharmD
Last reviewed on August 1, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Fluoxetine (Sarafem)?

What is Fluoxetine (Sarafem) used for?

How Fluoxetine (Sarafem) works

Fluoxetine (Sarafem) is part of an antidepressant class called selective serotonin reuptake inhibitors (SSRI), which blocks the absorption of a chemical called serotonin back into the brain. By balancing serotonin levels, fluoxetine (Sarafem) can help improve your mood.

Are you looking for information on fluoxetine (Prozac) instead?

Drug Facts

Common BrandsSarafem (brand name no longer available)
Drug ClassSSRI
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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What are the side effects of Fluoxetine (Sarafem)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Rhinitis (stuffy or runny nose) (16-23%)
  • Headache (13-15%)
  • Nausea (9-13%)
  • Weakness (8-12%)
  • Flu-like symptoms (3-12%)
  • Trouble falling or staying asleep (9-10%)
  • Throat pain/sore throat (6-10%)
  • Pain (3-9%)
  • Low sex drive (3-9%)
  • Accidental injury (1-8%)
  • Nervousness (3-7%)
  • Dizziness (2-7%)
  • Infection (up to 7%)
  • Abnormal thoughts (5-6%)
  • Diarrhea (2-6%)

Other Side Effects

  • Anxiety
  • Low appetite

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Suicidal thoughts and behavior
  • Serotonin syndrome: agitation, hallucinations (seeing or hearing things that aren't there), confusion, coma, fast heart rate, sudden changes in blood pressure, dizziness, sweating, blushing, high body temperature, diarrhea, vomiting, nausea, tremor, stiffness, muscle jerks, or seizures
  • Serious allergic reaction and rash: swelling of the face, eyes, or mouth; trouble breathing; fever; rash; hives; joint pain
  • Dangerously low sodium levels: headache, trouble focusing, difficulty remembering, feeling weak or unsteady, confusion, hallucinations, fainting, seizure, coma

Source: DailyMed

More on Fluoxetine (Sarafem) side effects

Women's Health: woman relaxing on sofa 1194601645

10 Sarafem Side Effects You Should Know About

Written by Nabila Ismail, PharmD

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Hives, itching, or skin rash

inability to sit still

restlessness

Less common

Chills or fever

joint or muscle pain

Rare

Anxiety

cold sweats

confusion

convulsions (seizures)

cool pale skin

diarrhea

difficulty with concentration

drowsiness

dryness of the mouth

excessive hunger

fast or irregular heartbeat

headache

increased sweating

increased thirst

lack of energy

mood or behavior changes

overactive reflexes

purple or red spots on the skin

racing heartbeat

shakiness or unsteady walk

shivering or shaking

talking, feeling, and acting with excitement and activity you cannot control

trouble with breathing

unusual or incomplete body or facial movements

unusual tiredness or weakness

Incidence not known

Abdominal or stomach pain

agitation

back or leg pains

bleeding gums

blindness

blistering, peeling, or loosening of the skin

bloating

blood in the urine or stools

bloody, black or tarry stools

blue-yellow color blindness

blurred vision

chest pain or discomfort

clay-colored stools

constipation

continuing vomiting

cough or dry cough

dark urine

decreased urine output

decreased vision

depression

difficulty with breathing

difficulty with swallowing

dizziness or lightheadedness

eye pain

fainting

fast, pounding, or irregular heartbeat or pulse

general body swelling

high fever

hives, itching, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

hostility

indigestion

irregular or slow heart rate

irritability

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

light-colored stools

loss of appetite

loss of bladder control

muscle twitching

nausea

nightmares

no blood pressure or pulse

noisy breathing

nosebleeds

pain in the ankles or knees

painful, red lumps under the skin, mostly on the legs

pains in the stomach, side, or abdomen, possibly radiating to the back

pinpoint red spots on the skin

rapid weight gain

red or irritated eyes

red skin lesions, often with a purple center

redness, tenderness, itching, burning, or peeling of the skin

severe muscle stiffness

severe sleepiness

slurred speech

sore throat

sores, ulcers, or white spots on the lips or in the mouth

stopping of heart

sudden shortness of breath or troubled breathing

sudden weakness in the arms or legs

sudden, severe chest pain

swelling of the face, ankles, or hands

swollen or painful glands

thoughts of killing oneself

tightness in the chest

tiredness

twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs

unconsciousness

unpleasant breath odor

unusual bleeding or bruising

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

unusually pale skin

use of extreme physical or emotional force

vomiting of blood

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Decreased appetite

Less common or rare

Abnormal dreams

breast enlargement or pain

change in sense of taste

changes in vision

feeling of warmth or heat

flushing or redness of the skin, especially on face and neck

frequent urination

hair loss

increased appetite

increased sensitivity of the skin to sunlight

menstrual pain

stomach cramps, gas, or pain

unusual secretion of milk, in females

weight loss

yawning

Incidence not known

Cracks in the skin

loss of heat from the body

painful or prolonged erections of the penis

scaly skin

swelling of the breasts or breast soreness in both females and males

unusual milk production

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Fluoxetine (Sarafem)

thumbs-up

Pros

Taken by mouth

Option to take it either continuously or only for a few weeks during each menstrual cycle

Available as a lower-cost generic

thumbs-down

Cons

Can cause sleeping problems

Can lower sex drive

Can interact with other medications and alcohol

pharmacist-tips

Pharmacist tips for Fluoxetine (Sarafem)

pharmacist

  • If your prescriber changes your dose of fluoxetine (Sarafem), it can take several weeks before you notice an improvement in your symptoms. Just because you don't notice a change right away, it doesn't mean this medication isn't working. Talk with your HCP if you have any questions.

    • Let your prescriber know if you notice unusual or sudden changes in your mood, behavior, or thoughts, when you're taking fluoxetine (Sarafem). Though not common, taking an antidepressant might raise the risk of suicidal thoughts or behaviors, especially in people ages 24 years and younger.

      • Fluoxetine (Sarafem) might cause insomnia. If you experience trouble sleeping, ask your HCP if you can take this medication in the morning. In general, fluoxetine (Sarafem) is usually taken once daily, around the same time every day.

        • Fluoxetine (Sarafem) can cause dizziness and affect your thinking and movement, so don't drive or do anything that needs a lot of focus or attention until you know how this medication affects you.

          • Fluoxetine (Sarafem) can interact with many medications, including over-the-counter medications and supplements. Let your prescriber know your full medication history before starting this medication.

            • Fluoxetine (Sarafem) can cause your eyes to dilate (widen) and worsen angle-closure glaucoma. Let your HCP know if you have glaucoma before starting this medication. Also, let your prescriber know if you experience symptoms such as blurry vision, headache, or eye pain.

              • If you have diabetes, taking fluoxetine (Sarafem) might cause changes to your blood sugar levels. Your healthcare team might ask you to check your blood sugar level regularly while you're taking this medication. Let your prescriber know if your blood sugar level isn't under control or dropping lower than expected because they might need to change the dose of your medications.

                • Don't suddenly stop taking fluoxetine (Sarafem) without first speaking with your prescriber, especially if you've been taking it regularly for a long time. Doing so can cause withdrawal symptoms such as headache, dizziness, nausea, and vomiting. Your prescriber can help you stop fluoxetine (Sarafem) safely by lowering your dose slowly over time.

                  faqs

                  Frequently asked questions about Fluoxetine (Sarafem)

                  Is fluoxetine (Sarafem) a controlled substance?
                  No, fluoxetine (Sarafem) isn't considered a controlled substance because it isn't known to have a risk of addiction or dependence.
                  How long does it take for fluoxetine (Sarafem) to work?
                  How long it takes for fluoxetine (Sarafem) to work can vary from person to person. In general, you might need to continue treatment through a few menstrual cycles (periods) before your PMDD symptoms get better. But a small study found that some people felt their PMDD symptoms improving within a week of starting fluoxetine (Sarafem). Talk with your obstetrician-gynecologist (OB-GYN) or healthcare professional (HCP) if you have concerns about how long it might take for fluoxetine (Sarafem) to work.
                  Does fluoxetine (Sarafem) cause drowsiness?
                  People who take fluoxetine (Sarafem) typically don't report drowsiness as a side effect. But tiredness and low energy can be a symptom of PMDD. In fact, taking fluoxetine (Sarafem) might improve low energy levels that's linked to PMDD. But if you feel more sleepy after starting fluoxetine (Sarafem), talk with your healthcare team. They can work with you to figure out what might be causing your symptoms.
                  Can you drink on fluoxetine (Sarafem)?
                  It's best to avoid drinking alcohol when you're taking fluoxetine (Sarafem). This is because drinking alcohol can worsen some of the side effects of fluoxetine (Sarafem), including nausea, headaches, and lower sex drive. In addition, drinking alcohol might worsen some PMDD symptoms, including depression.
                  What painkillers can I take with fluoxetine (Sarafem)?
                  Ask your HCP what pain medications you can take with fluoxetine (Sarafem). You might be able to take certain over-the-counter painkillers, like acetaminophen (Tylenol), with fluoxetine (Sarafem) because they don't have any known interactions. But acetaminophen (Tylenol) isn't a safe choice for certain people, such as those with liver problems. Your HCP might ask you to avoid taking fluoxetine (Sarafem) with non-steroidal anti-inflammatory drug (NSAID), like ibuprofen (Advil). There's a chance that taking an NSAID with an SSRI, like fluoxetine (Sarafem), can raise the risk of bleeding.
                  Is fluoxetine (Sarafem) an MAOI?
                  No, fluoxetine (Sarafem) isn't a monoamine oxidase inhibitor (MAOI), it's a selective serotonin reuptake inhibitor (SSRI). It's important that you don't take fluoxetine (Sarafem) within 2 weeks of taking an MAOI because it can lead to a serious condition called serotonin syndrome. Some examples of MAOIs include selegiline, phenelzine, and isocarboxazid. If your HCP prescribes an MAOI for you, it's important that you don't start the new MAOI medication until 5 weeks have passed since your last fluoxetine (Sarafem) dose.
                  Can I stop taking fluoxetine (Sarafem) when I no longer need it?
                  Talk to your prescriber if you want to stop taking fluoxetine (Sarafem). If you've been taking this medication daily regularly, stopping suddenly can lead to withdrawal symptoms such as feeling irritated, dizziness, and anxiety. In order to avoid these side effects, your prescriber can help you stop fluoxetine (Sarafem) safely by lowering your dose slowly over time.
                  Is fluoxetine (Sarafem) the same as fluoxetine (Prozac)?
                  Both fluoxetine (Sarafem) and fluoxetine (Prozac) have the same ingredient called fluoxetine. The main difference between them is what conditions they're FDA-approved to treat. Fluoxetine (Sarafem) is only approved for premenstrual dysphoric disorder (PMDD). Fluoxetine (Prozac) is used to treat other mood-related conditions, such as depression, obsessive-compulsive disorder (OCD), and bulimia nervosa. Another difference is dosing. When you're taking fluoxetine (Sarafem) for PMDD, your HCP might give you the option of taking it only for a couple weeks leading up to you period during each menstrual cycle. But fluoxetine (Prozac) is typically taken daily regularly for mood-related conditions. Talk with your HCP if you have more questions about fluoxetine (Sarafem) and fluoxetine (Prozac).
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                  What are the risks and warnings for Fluoxetine (Sarafem)?

                  Fluoxetine (Sarafem) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                  risk-warning

                  Suicidal thoughts and behavior

                  • Risk factors: People age 24 and younger | Mood problems

                    Studies suggest that taking antidepressants might raise the risk of suicidal thoughts and behavior. The risk seems to be higher for people ages 24 years and younger who already have depression or other mood problems.

                    Please let your family members or caregivers know of these risks so they can pay attention to any changes in your mood or behavior. Let your healthcare professional (HCP) know if your mood gets worse or if you have thoughts of wanting to hurt yourself because you might need to switch to another medication.

                    risk-warning

                    Serotonin syndrome

                    • Risk factors: Taking medications that raise serotonin levels | Taking medications that prevent the breakdown of serotonin

                      Fluoxetine (Sarafem) can cause a life-threatening condition called serotonin syndrome, where high levels of a chemical called serotonin builds up in your body. The risk is higher when you take other medications that also raise serotonin levels, such as triptans, tricyclic antidepressants, lithium (Lithobid), or St. John's wort. Avoid taking fluoxetine (Sarafem) within 2 weeks of taking an MAO inhibitor, such as phenelzine (Nardil) or tranylcypromine (Parnate). Get emergency medical help if you experience symptoms like agitation, confusion, dizziness, or shakiness.

                      risk-warning

                      Serious allergic reactions and rash

                      Fluoxetine (Sarafem) can cause serious, and sometimes life-threatening, allergic reactions and rashes. These side effects can go away once you stop taking fluoxetine (Sarafem) and get medical care. Let your HCP know right away if you experience any symptoms, such as rashes or hives, or if you also get other symptoms along with it, such as fever, joint pain, swelling, carpal tunnel syndrome, trouble breathing, or swelling.

                      risk-warning

                      Not for use alone in bipolar disorder

                      • Risk factors: Bipolar disorder

                        Sometimes, depression can be a sign of bipolar disorder. Although extremely rare, it's possible that taking an antidepressant alone can trigger a manic episode (great excitement, euphoria, delusions, and overactivity) in people who have bipolar disorder. Let your HCP know before starting fluoxetine (Sarafem) if you or someone in your family has bipolar disorder, and report any unusual changes in behavior.

                        risk-warning

                        Changes in appetite and weight

                        • Risk factors: Taking higher doses of fluoxetine (Sarafem)

                          Fluoxetine (Sarafem) can affect your appetite and cause both weight loss and weight gain. Let your HCP know if fluoxetine (Sarafem) is affecting your appetite and weight, and they can help you adjust your dose or change to a different medication.

                          risk-warning

                          Risk of bleeding

                          • Risk factors: Taking other medications that can cause bleeding

                            Fluoxetine (Sarafem) might raise the risk of bleeding, which can be life-threatening. Let your HCP know if you're taking other medications that might also cause bleeds, such as aspirin (Aspir-Low), NSAIDs, warfarin, or other blood thinners. See your HCP right away if you fall or hit your head so they can check for bleeding inside your body. Get medical help if you experience symptoms, such as dark stool, vomiting blood, bruises that don't go away, or nose bleeds that are hard to stop.

                            risk-warning

                            Glaucoma

                            • Risk factors: History of angle-closure glaucoma

                              Fluoxetine (Sarafem) can lead to or worsen angle-closure glaucoma. You might need to see your optometrist regularly and get eye exams to check your eyes and make sure your vision isn't worsening. Contact your optometrist or psychiatrist if you notice changes in your vision after starting fluoxetine (Sarafem).

                              risk-warning

                              Low sodium levels

                              • Risk factors: Older adults | Taking water pills | Low body fluids

                                Fluoxetine (Sarafem) can cause very low sodium levels in your blood. This is usually the result of a condition called syndrome of inappropriate antidiuretic hormone secretion (SIADH), where the body has trouble getting rid of water. The risk is higher if you're older than 65 years old, taking diuretics (water pills), or don't have enough body fluids. This problem usually goes away when you stop taking fluoxetine (Sarafem), but it can be life-threatening if left untreated. Let your prescriber know if you get symptoms of headache, difficulty concentrating, memory problems, confusion, weakness, or unsteadiness.

                                risk-warning

                                Anxiety and difficulty sleeping

                                Fluoxetine (Sarafem) can cause anxiety, nervousness, and insomnia (difficulty sleeping) in some people. Let your prescriber know if this is a problem for you, and they can let you know your options.

                                risk-warning

                                Sexual problems

                                Fluoxetine (Sarafem) can lower sex drives. In females, this medication can delay orgasms or cause them not to have an orgasm at all. Let your prescriber know if this is a problem for you while taking fluoxetine (Sarafem).

                                dosage

                                Fluoxetine (Sarafem) dosage forms

                                The average cost for 30 tablets of 20mg of Fluoxetine (Sarafem) is $10.20 with a free GoodRx coupon. This is 86.49% off the average retail price of $75.52.
                                tablet
                                Tablet
                                DosageQuantityPrice as low asPrice per unit
                                10mg30 tablets$9.00$0.30
                                20mg30 tablets$10.20$0.34
                                60mg30 tablets$12.60$0.42

                                Typical dosing for Fluoxetine (Sarafem)

                                Depending on your symptoms, your obstetrician-gynecologists (OB-GYN) or healthcare professional (HCP) will prescribe fluoxetine (Sarafem) for you to take in one of two ways:

                                • Daily dosing: The typical dose is to take 20 mg by mouth once daily.

                                • Dosing based on menstrual cycle: The typical dose is to take 20 mg by mouth once daily, starting 2 weeks before your period through the first full day of your period.

                                Your dose might differ if you have liver problems or other health conditions.

                                interactions

                                Interactions between Fluoxetine (Sarafem) and other drugs

                                Fluoxetine (Sarafem) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Fluoxetine (Sarafem). Please note that only the generic name of each medication is listed below.

                                Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                                Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                                Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                                drug-cost

                                How much does Fluoxetine (Sarafem) cost?

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                                contraindications-icon

                                Fluoxetine (Sarafem) contraindications

                                Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Fluoxetine (Sarafem) will not be safe for you to take.

                                • Taking monoamine oxidase inhibitors (MAOIs) with fluoxetine (Sarafem) or within 5 weeks of stopping fluoxetine (Sarafem)

                                • Taking fluoxetine (Sarafem) within 14 days of stopping an MAOI

                                • Taking pimozide with fluoxetine (Sarafem)

                                • Taking thioridazine with fluoxetine (Sarafem)

                                alternatives

                                What are alternatives to Fluoxetine (Sarafem)?

                                There are a number of medications that your doctor can prescribe in place of Fluoxetine (Sarafem). Compare a few possible alternatives below.
                                Fluoxetine (Sarafem)
                                Used for:
                                $9.00 Lowest GoodRx priceView Prices
                                Sertraline (Zoloft)
                                Used for:
                                $9.60 Lowest GoodRx priceView Prices
                                latest news

                                What is the latest news about Fluoxetine (Sarafem)?

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                                References

                                Best studies we found

                                MedlinePlus. (2023). Syndrome of inappropriate antidiuretic hormone secretion.

                                National Institute of Mental Health. (2024). Bipolar disorder.

                                Pidgeon, T. S., et al. (2022). Carpal tunnel syndrome. OrthoInfo.

                                View All References (3)

                                Steinberg, E. M., et al. (2012). Rapid response to fluoxetine in women with premenstrual dysphoric disorder. Depression and Anxiety.

                                Torrent Pharmaceuticals Limited. (2024). Fluoxetine tablet [package insert]. DailyMed.

                                U.S. Food and Drug Administration. (2018). Suicidality in children and adolescents being treated with antidepressant medications.

                                GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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