Fluoxetine is generally well tolerated. The most common side effects for patients taking Fluoxetine are as follows:

-Akathisia
-Anxiety
-Asthenia
-Headache
-Flu syndrome
-Fever
-Vasodilation
-Nausea
-Diarrhea
-Dry mouth
-Dyspepsia
-Insomnia
-Nervousness
-Somnolence
-Dizziness
-Tremor
-Sweating
-Dilated pupils
-Heartburn
-Seizures
-Hives
-Rash

Anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, hypomania, and mania, have been reported in adult and pediatric patients being treated with Prozac for major depressive disorder as well as for other indications, both psychiatric and non-psychiatric. If these symptoms occur the medication should be reduced or cautiously withdrawn.

Since the introduction of fluoxetine, systemic events, possibly related to vasculitis and including lupus-like syndrome, have developed in patients with rash. Although these events are rare, they may be serious, involving the lung, kidney, or liver. Death has been reported to occur in association with these systemic events.

The simultaneous use of fluoxetine with triptans, tramadol or other serotonergic agents can result in a rare, but potentially life-threatening adverse drug reaction called Serotonin syndrome.

SSRIs such as fluoxetine have been associated with tardive dyskinesia and akathisia, among other extrapyramidal symptoms more commonly associated with antipsychotics.

Gay men's brains respond differently to fluoxetine, a selective serotonin reuptake inhibitor.

Reproductive and developmental toxicity

Other side effects may occur, including sexual dysfunction. Possible sexual side effects can include anorgasmia, reduced libido and impotence.

A U.S. NTP-CERHR expert panel concluded that the SSRI fluoxetine (Prozac) produces reproductive toxicity by causing reversible impaired sexual function and exhibits developmental toxicity characterized by an increased rate of poor neonatal adaptation.

Because fluoxetine is excreted in human milk, nursing while on fluoxetine is not recommended. The AAP classifies fluoxetine as a drug for which the effect on the nursing infant is unknown but may be of concern.

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