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fluoxetine and olanzapine

fluoxetine and olanzapine

Generic Name: fluoxetine and olanzapine (floo OX eh teen and oh LAN za peen)

Brand Name: Symbyax

OverviewSide EffectsDosageInteractionsFor ProfessionalsMore…

What is fluoxetine and olanzapine?

Fluoxetine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs).

Olanzapine is an antipsychotic medication. These drugs affect chemicals in the brain.

The combination of fluoxetine and olanzapine is used to treat depression caused by bipolar disorder (manic depression). Fluoxetine and olanzapine is also used to treat depression after at least 2 other medications have been tried without successful treatment of symptoms.

Fluoxetine and olanzapine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about fluoxetine and olanzapine?

This medication is not for use in psychotic conditions related to dementia. Olanzapine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions.

Do not use this medication together with pimozide (Orap) or thioridazine (Mellaril), or if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Video: Treatment for Depression Treatments for depression are getting better everyday and there are things you can start doing right away.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you become pregnant while taking fluoxetine and olanzapine, do not stop taking it without your doctor’s advice.

What should I discuss with my healthcare provider before taking fluoxetine and olanzapine?

This medication is not for use in psychotic conditions related to dementia. Olanzapine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions.

Do not use this medication together with pimozide (Orap) or thioridazine (Mellaril), or if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

You must wait at least 14 days after stopping an MAOI before you can take fluoxetine and olanzapine. After you stop taking fluoxetine and olanzapine, you must wait at least 5 weeks before you start taking thioridazine (Mellaril) or an MAOI.

To make sure you can safely take fluoxetine and olanzapine, tell your doctor if you have any of these other conditions:

  • liver disease;

  • heart disease, high or low blood pressure, or a history of heart attack or stroke;
  • diabetes, high cholesterol or triglycerides;
  • seizures or epilepsy;
  • narrow-angle glaucoma;
  • paralytic ileus (a stomach disorder);
  • breast cancer;
  • enlarged prostate; or
  • a history of drug abuse or suicidal thoughts.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Taking antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant while taking fluoxetine and olanzapine, do not stop taking it without your doctor’s advice.

FDA pregnancy category C. An SSRI antidepressant may cause serious lung problems in a newborn if you take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy.

Fluoxetine and olanzapine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are taking this medication.

Do not give this medication to anyone under 18 years old without medical advice.

How should I take fluoxetine and olanzapine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Fluoxetine and olanzapine can be taken with or without food. Try to take the medicine at the same time each day.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment.

Olanzapine can cause high blood sugar (hyperglycemia). If you are diabetic, check your blood sugar levels on a regular basis while you are taking olanzapine.

Store at room temperature away from moisture and heat.

See also: Fluoxetine and olanzapine dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include some of the serious side effects listed in this medication guide.

What should I avoid while taking fluoxetine and olanzapine?

Drinking alcohol can increase certain side effects of fluoxetine and olanzapine.

Fluoxetine and olanzapine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Fluoxetine and olanzapine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect such as:

  • sudden and severe headache, chest pain, numbness, and problems with vision, speech, or balance;

  • increased thirst, frequent urination, excessive hunger, or weakness;
  • agitation, hallucinations, fever, fast heart rate, overactive reflexes, vomiting, diarrhea, loss of coordination;
  • very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;
  • jerky muscle movements you cannot control, seizure (convulsions);
  • feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;
  • flu symptoms, easy bruising, sores in your mouth and throat; or
  • seizure (convulsions);
  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • dry mouth, increased appetite, weight gain;

  • feeling drowsy or tired;
  • blurred vision; or
  • swelling in your hands or feet.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: fluoxetine and olanzapine side effects (in more detail)

Fluoxetine and olanzapine Dosing Information

Usual Adult Dose for Bipolar Disorder:

For Depressive Episodes Associated with Bipolar I Disorder:

Initial dose: 25 mg-6 mg orally once a day in the evening.

While there is no body of evidence to answer the question of how long a patient treated with fluoxetine-olanzapine should remain on it, it is generally accepted that Bipolar I Disorder, including the depressive episodes associated with Bipolar I Disorder, is a chronic illness requiring chronic treatment. The physician should periodically reexamine the need for continued pharmacotherapy.

Usual Adult Dose for Depression:

For Treatment Resistant Depression:

Initial dose: 25 mg-6 mg orally once a day in the evening.

While food has no appreciable effect on the absorption of olanzapine and fluoxetine given individually, the effect of food on the absorption of fluoxetine-olanzapine has not been studied. Dosage adjustments, if indicated, can be made according to efficacy and tolerability. Antidepressant efficacy has been demonstrated with fluoxetine-olanzapine in a dose range of 25 to 50 mg for fluoxetine and 6 to 18 mg for olanzapine. The safety of doses above 75 mg per 18 mg has not been evaluated in clinical studies.

While there is no body of evidence to answer the question of how long a patient treated with fluoxetine-olanzapine should remain on it, it is generally accepted that treatment resistant depression (major depressive disorder in adult patients who do not respond to 2 separate trials of different antidepressants of adequate dose and duration in the current episode) is a chronic illness requiring chronic treatment. The physician should periodically reexamine the need for continued pharmacotherapy.

Usual Geriatric Dose for Bipolar Disorder:

For Depressive Episodes Associated with Bipolar I Disorder:

Initial dose: 25 mg-3 mg to 25 mg-6 mg orally once a day in the evening.

While there is no body of evidence to answer the question of how long a patient treated with fluoxetine-olanzapine should remain on it, it is generally accepted that Bipolar I Disorder, including the depressive episodes associated with Bipolar I Disorder, is a chronic illness requiring chronic treatment. The physician should periodically reexamine the need for continued pharmacotherapy.

Usual Geriatric Dose for Depression:

For Treatment Resistant Depression:

Initial dose: 25 mg-3 mg to 25 mg-6 mg orally once a day in the evening.

While food has no appreciable effect on the absorption of olanzapine and fluoxetine given individually, the effect of food on the absorption of fluoxetine-olanzapine has not been studied. Dosage adjustments, if indicated, can be made according to efficacy and tolerability. Antidepressant efficacy has been demonstrated with fluoxetine-olanzapine in a dose range of 25 to 50 mg for fluoxetine and 6 to 18 mg for olanzapine. The safety of doses above 75 mg per 18 mg has not been evaluated in clinical studies.

While there is no body of evidence to answer the question of how long a patient treated with fluoxetine-olanzapine should remain on it, it is generally accepted that treatment resistant depression (major depressive disorder in adult patients who do not respond to 2 separate trials of different antidepressants of adequate dose and duration in the current episode) is a chronic illness requiring chronic treatment. The physician should periodically reexamine the need for continued pharmacotherapy.

What other drugs will affect fluoxetine and olanzapine?

Ask your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with fluoxetine and olanzapine may cause you to bruise or bleed easily.

Before using fluoxetine and olanzapine, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety). They can add to sleepiness caused by fluoxetine and olanzapine.

Tell your doctor about all other medicines you use, especially:

  • vinblastine (Velban);

  • heart rhythm or blood pressure medication;
  • tryptophan (sometimes called L-tryptophan);
  • lithium, clozapine (Clozaril, Fazaclo), haloperidol (Haldol);
  • phenytoin (Dilantin), carbamazepine (Carbatrol, Tegretol);
  • a blood thinner such as warfarin (Coumadin, Jantoven);
  • theophylline (Elixophyllin, Theo-24, Theochron, Uniphyl, and others);
  • medicine to treat Parkinson’s disease, such as bromocriptine (Parlodel), pergolide (Permax), pramipexole (Mirapex), ropinorole (Requip), or cabergoline (Cabaser);
  • almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex, Treximet), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
  • any other antidepressants, especially another form of fluoxetine or olanzapine such as Prozac, Prozac Weekly, Sarafem, or Zyprexa.

This list is not complete and other drugs may interact with fluoxetine and olanzapine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

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More fluoxetine and olanzapine resources

  • Side Effects
  • Recommended Dosage
  • Pregnancy Warnings
  • Drug Images
  • Drug Interactions
  • Support Group
  • 28 Reviews - Add your own review/rating

Compare fluoxetine and olanzapine with other medications

  • Bipolar Disorder
  • Depression

Where can I get more information?

  • Your pharmacist can provide more information about fluoxetine and olanzapine.

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