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Neonates exposed to fluoxetine and other SSRIs or serotonin and norepinephrine reuptake inhibitorsSNRIslate in the third trimester have developed complications requiring prolonged hospitalizationrespiratory supportand tube feedingSuch complications can arise immediately upon deliveryReported clinical findings have included respiratory distresscyanosisapneaseizurestemperature instabilityfeeding difficultyvomitinghypoglycemiahypotoniahypertoniahyperreflexiatremorjitterinessirritabilityand constant cryingThese features are consistent with either a direct toxic effect of SSRIs and SNRIs orpossiblya drug discontinuation syndromeIt should be noted thatin some casesthe clinical picture is consistent with serotonin syndromesee WARNINGS AND PRECAUTIONS
Serotonin release by platelets plays an important role in hemostasisEpidemiological studies of the case-control and cohort design that have demonstrated an association between use of psychotropic drugs that interfere with serotonin reuptake and the occurrence of upper gastrointestinal bleeding have also shown that concurrent use of an NSAID or aspirin may potentiate this risk of bleedingAltered anticoagulant effectsincluding increased bleedinghave been reported when SNRIs or SSRIs are coadministered with warfarinPatients receiving warfarin therapy should be carefully monitored when fluoxetine is initiated or discontinuedsee WARNINGS AND PRECAUTIONS
A very serious allergic reaction to this drug is rareHoweverget medical help right away if you notice any symptoms of a serious allergic reactionincludingrashitching/swellingespecially of the face/tongue/throatsevere dizzinesstrouble breathing.
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