Does Fluoxetine cause UTI? (+5 risk factors)
By
Dr Milena Locci de Oliveira (PhD)
Author bio
Dr Milena Locci de Oliveira is a Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP). She has experience in microbiology, analytical toxicology, and clinical pharmacokinetics. She writes and reviews content on these topics.
Dr Milena’s Highlights:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration in the areas of Pharmacometrics and Population Pharmacokinetics, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
“Science can be translated, and it is essential that everyone has access to quality information to make informed decisions” – Dr Milena Oliveira, PhD.
Professional Experience:
With a decade-long career as a researcher, Dr Milena has amassed extensive experience in conducting research projects in microbiology, analytical toxicology, and clinical pharmacokinetics.
Her expertise also extends to the preparation of technical and scientific reports, literature reviews, data analysis, and scientific communication, both oral and written.
Dr Milena has served as a Clinical Pharmacist, providing expert supervision and guidance to teams during the challenging times of the COVID-19 pandemic, particularly in the ICUs of two reference hospitals for patient hospitalization.
In her most recent role, Dr Milena worked on the implementation of the deliberatives of the São Paulo State Government Pharmaceutical Assistance Coordination. These decisions were aimed at ensuring medication access within the Unified Health System.
A widely multidisciplinary background enabled Dr Milena to become a professional capable of integrating scientific knowledge into private initiatives, education, and healthcare, delivering consistent services in patient safety and population health.
Professional Memberships & Affiliations:
Dr Milena Oliveira is a member of the Regional Council of Pharmacy of the State of São Paulo, Brazil.
Education:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
Relevant Published Work & Citations:
Oliveira ML de, Rocha A, Nardotto GHB, Pippa LF, Simões BP, Lanchote VL. Analysis of daunorubicin and its metabolite daunorubicinol in plasma and urine with application in the evaluation of total, renal and metabolic formation clearances in patients with acute myeloid leukemia. Journal of Pharmaceutical and Biomedical Analysis. Nov 2020. 191:113-124.
Abstracts. CPT: Pharmacometrics & Systems Pharmacology. 2020 Nov; 9 (S1).
Pippa LF, Oliveira ML de, Rocha A, de Andrade JM, Lanchote VL. Total, renal and hepatic clearances of doxorubicin and formation clearance of doxorubicinol in patients with breast cancer: Estimation of doxorubicin hepatic extraction ratio. Journal of Pharmaceutical and Biomedical Analysis. 2020 Jun 5; 185:113-231.
Godoy ALPC, De Jesus C, De Oliveira ML, Rocha A, Pereira MPM, Larangeira DF, Lanchote VL, Barrouin-Melo SM. Determination of Allopurinol and Oxypurinol in Dogs Plasma by High-Performance Liquid Chromatography with an Ultraviolet Detector: Application for Pharmacokinetic Studies. J Chromatogr Sep Tech. 2017; 8 (4).
Clímaco EC, Oliveira ML de, Pitondo-Silva A, Oliveira MG, Medeiros M, Lincopan N, et al. Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil. Infection, Genetics and Evolution. 2013 Oct;19:127–33.
Conference Papers:
Oliveira, M. L.; NARDOTTO, G. H. B.; PIPPA, L. F.; ROCHA, A.; SIMOES, B. P.; LANCHOTE, V. L. . Daunorubicin metabolism and urinary excretion in patients with acute myeloid leukemia. In: 84th Annual Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT) and the 20th Annual Meeting of the Association of the Clinical Pharmacology Germany (VKliPha), 2018, Göttingen. Naunyn-Schmiedeberg’s Arch Pharmacol, 2018. v. 391. p. S76-S76.
Oliveira, M. L.; NARDOTTO, G. H. B. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . The low contribution of urinary excretion in the elimination of daunorubicin and its metabolite daunorubicinol in patients with acute myeloid leukemia. In: 49th Brazilian Congress of Pharmacology and Experimental Therapeutics., 2017, Ribeirão Preto. Livro de Resumos, 2017. p. 64-64.
Oliveira, M. L.; PIPPA, L. F. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . Quantification of daunorubicin and its metabolite daunorubicinol in human plasma by LC-MS/MS. In: I International Meeting of Environmental Health and Toxicology (IMEHTOX), 2016, Ribeirão Preto. Livro de Resumos, 2016.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. . PFGE typing of Carbapenem-Resistant Acinetobacter baumannii isolated from different University Hospitals. In: V International Postgraduate and Research Symposium, 2012.
Clímaco, E.C. ; SILVA, A. P. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. Relação clonal entre linhagens de Acinetobacter baumannii produtoras de carbapenemases da família OXA em quatro hospitais no Brasil. In: XXI Latin American Congress of Microbiology, 2012, Santos. XXI Latin American Congress of Microbiology, 2012.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Darini A.L.C. . Dissemintion of OXA carbapenemases genes in carbapenem-resistant Acinetobacter baumannii in University Hospital of Juiz de Fora, MG. In: 8th CIFARP – International Congress of Pharmaceutical Sciences, 2011, Ribeirão Preto.
Clímaco, E.C. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Darini A.L.C. . Avaliação do sequenciamento parcial do gene rpoB e de seus flanqueadores para identificação de espécies de Acinetobacter na rotina laroratorial. In: 2° International Symposium on Clinical Microbiology, 2010, Florianópolis.
You can view some of Dr Milena’s work below and links to her professional profile.
Linkedin: https://www.linkedin.com/in/dra-milena-locci-de-oliveira-28986042/?locale=en_US
ResearchGate: https://www.researchgate.net/profile/Milena-Oliveira-6
Escavador: https://www.escavador.com/sobre/5394254/milena-locci-de-oliveira
Lattes: https://buscatextual.cnpq.br/buscatextual/busca.do
Scopus: https://www.scopus.com/authid/detail.uri?authorId=57199779361
Scholar: https://scholar.google.com/citations?view_op=list_works&hl=pt-BR&user=1YUBDIQAAAAJ
In this article, we will discuss the possibility of Fluoxetine causing a UTI. We will further look into the risk factors that cause UTI by Fluoxetine. Furthermore, we will dig deep into the precautionary measures to avoid getting a UTI by Fluoxetine.
Does Fluoxetine cause UTI?
Fluoxetine does not cause urinary tract infections (UTIs). Fluoxetine may cause urinary retention which can result in bacterial overgrowth in the urinary tract resulting in UTIs.
Fluoxetine commonly causes insomnia, nausea, heartburn, drowsiness, bruising, and decreased libido. However, some individuals may experience UTIs due to urinary retention and other complications associated with prolonged use of Fluoxetine.
Although fluoxetine-associated UTIs are rarely reported, however, if you suspect this drug causing any urinary side effects, consult your doctor for further assistance.
UTIs are generally caused by a range of factors such as hygiene, sexual activity, underlying medical conditions, and other pathophysiologies. Some medications may also induce UTIs. These drug-induced UTIs are caused by certain drugs such as antibiotics, corticosteroids, chemotherapeutic, and immunotherapeutic agents.
What does research suggest?
Based on research studies, Fluoxetine has been reported to cause urinary difficulties and retention in a few patients. Fluoxetine is an SSRI that works by reuptake of serotonin in the brain which also plays a role in micturition (1).
A rare case of a 15-year-old girl was reported who was brought to the hospital with complaints of shortness of breath and dizziness. Her parents stated her history of sexual abuse and confirmed post-traumatic stress disorder (PTSD) for which she was prescribed 20mg/day of Fluoxetine (2).
Upon one-month follow-up examination, the patient reported urinary retention and difficulty in urinating since the start of Fluoxetine treatment. She complained of bladder pressure after urinating and worsening of these symptoms (2).
To avoid urinary retention, the patient was discontinued with Fluoxetine and started with Sertraline as a PTSD treatment. After initiating Sertraline treatment, no urinary side effects were observed in the patient (2).
Sertraline and Fluoxetine are both SSRIs but Sertraline has an alpha-adrenergic antagonist effect and an inhibitory effect on the dopamine transporter which Fluoxetine does not possess. Therefore, it can cause urinary retention, unlike Sertraline which can lead to UTIs as well in some cases (2).
What are the risk factors causing Fluoxetine-induced UTIs?
Following are some risk factors that may cause Fluoxetine induced UTis in some patients (3):
Concurrent medications and health condition
Use of other medications along with Fluoxetine may impact urinary health and cause UTIs. Medications such as immunosuppressants and corticosteroids may cause UTIs in some individuals.
Some underlying health conditions alter and weaken the immune system. Some medical conditions suppress the immune system making your body more prone to infections such as UTIs.
Hygiene and dehydration
Hygiene and hydration are important to avoid UTIs. SSRIs including Fluoxetine and Citalopram can cause dry mouth and dehydration which can lead to UTIs. Cleanliness and health maintenance are also crucial to avoiding UTIs.
Sexual activity
SSRIs can have an impact on sexual activities. Fluoxetine may also have potential effects on the sexual health and behaviour of individuals leading to UTIs.
How to manage and prevent Fluoxetine-induced UTIs?
If you suspect that taking Fluoxetine is affecting your urinary health, then you need to seek medical help. Your healthcare provider must assess your health condition and determine its actual cause and treatment.
However, if Fluoxetine is detected as the reason for developing UTIs, then your doctor must change your antidepressant drug based on your health condition.
Additionally, you can be prescribed an antibiotic to cure the UTIs. Always complete the full course of antibiotics to effectively treat and prevent recurrent UTIs.
Cranberry products and juices have been reported to be quite helpful in preventing UTIs. Additionally, you should maintain a healthy and hygienic lifestyle to avoid the recurrence of UTIs.
Furthermore, you should be extra cautious when urinating. Do not hold your urine for longer periods and maintain healthy urinary hygiene to avoid worsening of UTIs. Keep yourself hydrated too.
Conclusion
In the given article, we have discussed the effect of Fluoxetine on urinary side effects. We have successfully discussed the risk factors that may cause UTIs and other urinary difficulties in patients due to Fluoxetine.
Based on the study conducted for this article, I would suggest that Fluoxetine might not necessarily be associated with urinary difficulties but if it is s causing any problems, consult your doctor and shift to a safer antidepressant drug.
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References
1.-
Verhamme, K. M. C., Sturkenboom, M. C. J. M., Stricker, B. H. C., & Bosch, R. (2008). Drug-Induced Urinary Retention. Drug Safety, 31(5), 373–388. https://doi.org/10.2165/00002018-200831050-00002
2.-
Bulut ÖF, Karayağmurlu A, Kaya İ. Fluoxetine Related Urinary Retention in a 15-Year-Old Girl: a Case Report. Noro Psikiyatr Ars. 2022 Aug 16;59(3):246-247. doi: 10.29399/npa.27938. PMID: 36160069; PMCID: PMC9466638. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9466638/
3.-
Sohel AJ, Shutter MC, Molla M. Fluoxetine. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459223/
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