Olanzapine/fluoxetine (By mouth)

Introduction

Fluoxetine Hydrochloride (floo-OX-e-teen hye-droe-KLOR-ide), Olanzapine (oh-LAN-za-peen)

Treats depression, including the depression that is part of bipolar disorder. This medicine contains an antipsychotic and a selective serotonin reuptake inhibitor (SSRI) antidepressant.

Brand Name(s)

Symbyax

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

Do not use this medicine if you have had an allergic reaction to olanzapine (Zyprexa®) or fluoxetine (Prozac®, Sarafem®). Do not use this medicine within 14 days of using an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, Parnate®, methylene blue, or linezolid (Zyvox®). Do not use thioridazine (Mellaril®) or an MAOI for at least 5 weeks after you stop taking this medicine. Do not use this medicine with pimozide (Orap®).

How to Use This Medicine

Capsule

  • Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
  • It is best to take this medicine in the evening.
  • This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.

If a dose is missed:

  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are using buspirone (Buspar®), digitoxin, fentanyl (Sublimaze®), lithium (Eskalith®, Lithobid®), omeprazole (Prilosec®), rifampin (Rifadin®, Rimactane®), St John's wort, tryptophan supplements, or vinblastine (Velban®). Tell your doctor if you are using medicine to treat migraine headaches (such as rizatriptan, sumatriptan, tramadol, zolmitriptan, Frova®, Maxalt®, Relpax®, Zomig®), other medicine for mental illness (such as clozapine, fluvoxamine, haloperidol, Clozaril®, Haldol®, Luvox®), medicine for Parkinson disease (such as levodopa, Sinemet®, Stalevo®), a phenothiazine medicine (such as prochlorperazine, promethazine, Phenergan®), or medicine for heart rhythm problems (such as flecainide, propafenone, Rythmol®, Tambocor®).
  • Make sure your doctor knows if you are also using a blood thinner (such as warfarin, Coumadin®, Jantoven®), an NSAID pain or arthritis medicine (such as aspirin, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®), medicine for seizures (such as carbamazepine, phenytoin, Dilantin®, Tegretol®), other medicine to treat depression (such as amitriptyline, nortriptyline, desipramine, fluoxetine, mirtazapine, paroxetine, Celexa®, Elavil®, Lexapro®, Norpramin®, Paxil®, Zoloft®), medicine for anxiety (such as alprazolam, diazepam, Librium®, Valium®, Xanax®), or blood pressure medicine (such as atenolol, hydrochlorothiazide, lisinopril, metoprolol, Cozaar®, Diovan®, Lotrel®, Norvasc®, Prinivil®, Toprol®, Zestril®).
  • Do not drink alcohol while you are using this medicine.
  • Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant, or if you have liver disease, bleeding problems, high cholesterol, glaucoma, low sodium in the blood, prostate problems, or a history of breast cancer, mania, seizures, or severe constipation. Your doctor needs to know if you have heart disease or circulation problems, including heart failure, heart rhythm problems, low blood pressure, or a history of heart attack or stroke.
  • Do not breastfeed while you are using this medicine.
  • For some children, teenagers, and young adults, this medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed and have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you, especially if they are new or are getting worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.
  • This medicine may cause a serious condition called serotonin syndrome, when taken with certain medicines. Call your doctor right away if you have a fever, confusion, mental changes, restlessness, fast heartbeat, muscle spasms, trouble walking, nausea, vomiting, or diarrhea.
  • Check with your doctor right away if you have fever, sweating, unusual confusion, uneven heartbeat, or changes in blood pressure. These could be symptoms of neuroleptic malignant syndrome (NMS).
  • Check with your doctor right away if you have jerky muscle movements that you cannot control. These movements may happen in your face, tongue, jaw, or other muscles. These are symptoms of tardive dyskinesia. This problem may not go away after you stop using the medicine.
  • This medicine is not approved for use in older people who have dementia, because it can increase the risk of death. This risk has not been shown for the approved uses of this medicine.
  • This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
  • This medicine may make it more difficult for your body to cool down. Be careful to not become overheated during exercise or hot weather, because you could have heat stroke.
  • This medicine could raise your blood sugar levels, even if you do not have diabetes. If you do have diabetes or pre-diabetes, make sure your doctor knows.
  • This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you are dizzy.
  • Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
  • Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Anxiety, restlessness, fever, sweating, muscle spasms, nausea, vomiting, diarrhea, seeing or hearing things that are not there
  • Blurred vision, eye pain
  • Change in how much or how often you urinate
  • Confusion, weakness, and muscle twitching
  • Feeling too hot, unusual sweating, pounding heartbeat
  • Feeling very thirsty or hungry
  • Fever, sweating, confusion, uneven heartbeat, muscle stiffness
  • Jerky muscle movement you cannot control (often in your face, tongue, or jaw)
  • Lightheadedness, dizziness, or fainting
  • Seizures or tremors
  • Trouble sleeping, unusual dreams
  • Unusual behavior, thoughts of hurting yourself or others
  • Unusual bleeding or bruising

If you notice these less serious side effects, talk with your doctor:

  • Dry mouth
  • Sexual problems
  • Sleepiness or unusual drowsiness
  • Swelling in your hands, ankles, or feet
  • Weight gain

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last Reviewed on 06/12/2013

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This page was last updated: September 18, 2013

         
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