From the Guidelines
It is not recommended to crush or dissolve Prozac (fluoxetine) capsules.
Reasons to Avoid Crushing or Dissolving
- Prozac capsules are designed to release the medication slowly over time, and crushing or dissolving them can cause the entire dose to be released at once, potentially leading to increased side effects or toxicity 1.
- As most oral medications are absorbed within the proximal jejunum, altering the dosage form can affect absorption rates, and sustained- and delayed-release medications should be avoided in certain conditions, implying that similar caution should be applied to Prozac capsules 1.
- Controlled release formulations, like some morphine tablets, should not be crushed or used for alternative administration routes, suggesting a similar precaution for Prozac capsules to maintain their intended release mechanism 2.
Alternative Administration Options
- If you have difficulty swallowing the capsules, consult your doctor or pharmacist for alternative administration options, such as opening the capsule and mixing the contents with a small amount of food like applesauce, but only under their guidance.
- Monitoring medication levels in the blood may be necessary when altering the administration method to ensure the patient is receiving the appropriate dose 1.
From the FDA Drug Label
The Pulvule, oral solution, and Prozac Weekly capsule dosage forms of fluoxetine are bioequivalent. Prozac Weekly capsules, a delayed–release formulation, contain enteric–coated pellets that resist dissolution until reaching a segment of the gastrointestinal tract where the pH exceeds 5. 5.
The FDA drug label does not answer the question.
From the Research
Crushing or Dissolving Prozac (Fluoxetine) Capsules
- There is no direct evidence in the provided studies that specifically addresses the crushability or dissolvability of Prozac (fluoxetine) capsules.
- However, the studies suggest that crushing or opening capsules can have serious consequences, such as altering the drug's absorption, leading to overdose or underdosing, and potentially exposing the person handling the medication to harmful drug particles 3, 4, 5.
- A study on the crushability analysis of immediate-release oral tablets and capsules found that many drugs should not be crushed due to stability and pharmacokinetics concerns, and that alternative dosage forms should be considered when possible 4.
- Another study developed a checklist of evaluation criteria to assess the crushability of immediate-release products and found that some products may be suitable for crushing based on conditional recommendations, while others should not be crushed due to special formulations or high-risk properties 6.
- It is recommended to consult the FDA-approved product label or contact the manufacturer for specific guidance on the handling of Prozac (fluoxetine) capsules, as the provided studies do not provide direct evidence on this topic 4, 6.