Drafzin Special Precautions

Anxiety or marked sleeping difficulties at the start of therapy should be treated with tranquilizers or soporifics.
Because of its epileptogenic effect it should be used with caution in patients with epilepsy or a history of such disorders.
Fluoxetine should be discontinued in patients who develop a rash since systemic effects, possibly related to vasculitis, have occurred in such patients.
Depressed patients with suicidal tendencies should be carefully supervised during treatment. If fluoxetine is given for the depressive component of bipolar disorder, mania may be precipitated.
Treatment with fluoxetine may cause significant weight loss which may be undesirable especially in underweight depressed or bulimic patients.
In patients with severe hepatic or renal disorders metabolism or elimination of fluoxetine is prolonged therefore the dosage or the dosaging interval has to be adjusted.
Dosaging should be done carefully in patients taking drugs acting on the CNS. In patients with diabetes treatment with fluoxetine caused hypoglycaemia and after discontinuation of the antidepressant hyperglycaemia. Therefore dosage adjustment of insulin and/or the oral antidiabetic has to be considered in patients with diabetes.