Fluoxetine is one of the cheapest prescriptions in American pharmacies, and it is also one where the gap between the best and worst price you can pay is enormous in percentage terms even though it is small in dollars. CMS recorded 7,481,805 generic fluoxetine prescriptions in Medicare Part D alone during 2024, at an average of $10.92 per fill.
Every figure on this page was pulled on September 4, 2026 from CMS acquisition and spending data, Walmart’s published program document, Cost Plus Drugs, HealthWarehouse and drugs.com. This page covers what fluoxetine costs and where to fill it. It does not cover whether fluoxetine is right for you, which is a conversation for a prescriber. Prozac is FDA-approved for major depressive disorder, obsessive compulsive disorder, bulimia nervosa and panic disorder.
What Does Fluoxetine Cost Without Insurance?
The first column is CMS’s National Average Drug Acquisition Cost file, effective August 19, 2026 and published in the September 2, 2026 release, which is what retail pharmacies pay to buy the drug. The second column is the lowest published cash price found, read September 4, 2026. The third is an ordinary retail cash price for the same quantity.
| Form and quantity | Pharmacy acquisition cost (NADAC) | Best published cash price | Retail cash price |
|---|---|---|---|
| Fluoxetine 10 mg capsule, 30 | $0.03625 each ($1.09 for 30) | $5.38 at Cost Plus Drugs | $6.46 to $9.93 |
| Fluoxetine 20 mg capsule, 30 | $0.02885 each ($0.87 for 30) | $5.45 at Cost Plus Drugs | $6.70 to $9.79 |
| Fluoxetine 40 mg capsule, 30 | $0.04990 each ($1.50 for 30) | $5.76 at Cost Plus Drugs | $7.63 to $12.42 |
| Fluoxetine 10 mg tablet, 30 | $0.07135 each ($2.14 for 30) | $6.21 at Cost Plus Drugs | not published at 30 |
| Fluoxetine 20 mg tablet, 30 | $0.09253 each ($2.78 for 30) | $6.24 at Cost Plus Drugs | not published at 30 |
| Fluoxetine 60 mg tablet, 30 | $0.18699 each ($5.61 for 30) | $7.59 at Cost Plus Drugs | $28.59 |
| Fluoxetine 20 mg capsule, 90 | $2.60 for 90 | $24 on Walmart’s program | $9.00 to $13.77 |
| Fluoxetine 20 mg/5 mL solution, 120 mL | $0.19620 per mL ($23.54) | quantity basis not published | $32.31 to $43.49 |
| Fluoxetine DR 90 mg, 4 capsules (one month of weekly dosing) | $30.72767 each ($122.91 for 4) | $113.68 at Cost Plus Drugs | $117.57 |
| Prozac 20 mg capsule, 30 (brand) | $13.98077 each, September 2025 vintage | none published | $435.45 |
Two things jump out. First, the drug itself is nearly free: a pharmacy buys a month of 20 mg capsules for 87 cents. Everything above that is dispensing overhead, which is why Cost Plus Drugs’ flat $5.00 pharmacy labor fee sets a floor that no amount of shopping gets you under.
Second, brand Prozac sits in a different universe. Its NADAC row has not refreshed since September 2025 while every generic row is current to August 2026, which is itself a signal of how little brand Prozac moves. CMS’s Medicare Part D file for 2024 recorded 11,749 Prozac prescriptions against 7.48 million generic ones.
What Drives the Price
Capsule versus tablet. Fluoxetine is sold as both, and they are not priced alike. The 20 mg capsule is $0.02885 in NADAC while the 20 mg tablet is $0.09253, over three times as much for the same dose. The capsules are also the form Walmart’s program covers.
Strength. The three common capsule strengths (10, 20 and 40 mg) are all within a penny or two of each other at acquisition. The 60 mg tablet is roughly six times the 20 mg capsule, and drugs.com prices thirty of them at $28.59 against under $10 for the capsules.
Where you fill it. This is the biggest lever. Mail-order cash pharmacies, big-box generic programs and ordinary chain counters can differ by two or three times on a drug that costs the pharmacy less than a dollar a month. HealthWarehouse, for example, publishes $9.30 for thirty 20 mg capsules, $13.50 for ninety and $21.60 for 180, which is competitive at 30 but not the cheapest option at 90.
Fill size. Because the dispensing fee is flat, larger fills are always cheaper per capsule. Walmart’s program charges $9 for a 30-day supply and $24 for 90 days, so the 90-day option is about 11 percent cheaper per month. Drugs.com’s per-unit column drops from about $0.22 at 30 capsules to about $0.10 at 90.
Delayed-release and liquid forms. The 90 mg weekly delayed-release capsule and the 20 mg/5 mL oral solution both cost multiples of the plain capsule. Four weekly capsules run $113.68 to $122.91 for the month, which is more than 20 times the daily capsule.
Cash Price vs. Insurance
For fluoxetine, cash is often the better deal even when you have coverage. A published cash price of $5.45 to $9.00 for a month undercuts plenty of generic copays, and if you are inside a high-deductible plan you would otherwise be paying the pharmacy’s full negotiated rate against the deductible anyway.
The exception runs the other way. Because these figures are already so low, the practical difference between the best and worst option is a few dollars a month, so the effort is only worth it if you are also managing other prescriptions or a broader antidepressant budget. Where cash really wins is on brand Prozac, where no cash channel is cheaper than a covered fill would be, and the answer is almost always to ask whether the generic works instead.
One structural note: a cash-price fill generally does not count toward your deductible or out-of-pocket maximum. On a $6 prescription that hardly matters. On an expensive one it can. Discount-card prices sit in the same bucket, and our comparison of GoodRx versus SingleCare explains how those programs work and what they cost you in exchange.
How to Pay Less
1. Price the mail-order cash pharmacies first. Cost Plus Drugs publishes an itemized price on every product page and charges a flat $5.00 pharmacy labor fee per fill plus $5.00 standard shipping. At $5.45 for thirty 20 mg capsules it was the lowest published price found on September 4, 2026. Because the fee is flat, a 90-day fill spreads it further. It is mail order, so it fits a stable ongoing prescription rather than a same-day start.
2. Use Walmart’s program list, but know which tier you are in. Reading the program document itself, fluoxetine 10 mg tablets and 20 and 40 mg capsules sit in the $9 for 30 days and $24 for 90 days tier, alongside citalopram, sertraline, mirtazapine and trazodone. They are not in the $4 and $10 tier, despite what a lot of secondhand summaries say. Nine dollars with no coupon and no membership is still one of the simplest cheap options in retail pharmacy.
3. Ask for the capsule and the 90-day quantity. Both are pure price decisions with no clinical downside to raising them. Switching from the 20 mg tablet to the 20 mg capsule cuts the acquisition cost by two thirds, and moving from 30 to 90 capsules cuts the per-capsule retail price roughly in half. Your prescriber decides what is appropriate, but nothing stops you from asking.
4. Run the price through a comparison before you fill. Even at these dollar amounts the spread between the cheapest and priciest published option is roughly two to one. Our fair price tool shows the range for common prescriptions so you know whether a quoted number is normal.
5. If the prescriber visit is the real cost, deal with that separately. For a drug this cheap, the appointment is almost always the bigger line item. Federally qualified health centers and community clinics charge on a sliding scale based on income, and many will write and manage a maintenance prescription. Our guide to free clinics and sliding-scale care explains how to find one and what to bring.
6. Skip the brand unless there is a specific reason. Brand Prozac at $435.45 for thirty capsules is 65 times the generic. Whether the brand is medically necessary in your case is your prescriber’s call, but the price difference is worth naming out loud before the prescription is written.
The Bottom Line
Generic fluoxetine is a solved problem for cash payers. A month costs between about $5.45 and $12 nearly everywhere that publishes a price, the pharmacy paid under a dollar for it, and the cheapest and most expensive published options are separated by a few dollars rather than a few hundred.
The two places money actually leaks are the brand, which costs 65 times the generic, and the less common forms, where a weekly delayed-release capsule or an oral solution can cost 10 to 20 times what daily capsules do. If you are pricing a different molecule in the same category, our guides to bupropion and sertraline run the same numbers.