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 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 fluoxetine and olanzapine if you are using any of the following drugs:
-
pimozide (Orap);
-
thioridazine (Mellaril); or
-
an MAO inhibitor such as isocarboxazid (Marplan),
tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl,
Emsam).
Serious and sometimes fatal reactions can occur when these medicines
are taken with fluoxetine and olanzapine. You must wait at least 14 days after stopping an MAO
inhibitor before you can take fluoxetine and olanzapine. You must wait 5 weeks after stopping
fluoxetine and olanzapine before you can take thioridazine (Mellaril) or an MAO inhibitor.
If you have any of these other conditions, you may need a dose adjustment or special tests to
safely take this medication:
-
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;
-
glaucoma;
-
paralytic ileus (a stomach disorder);
-
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.
FDA pregnancy category C. 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 are
planning a pregnancy, or if you become pregnant while taking fluoxetine and olanzapine, do not stop
taking the medication without first talking to your doctor.
Fluoxetine and olanzapine can pass into breast milk and may harm a nursing baby. Do not
use this medication without telling your doctor if you are breast-feeding a baby.
Do not give fluoxetine and olanzapine to anyone younger than 18 years old without the
advice of a doctor.
How should I take fluoxetine and olanzapine?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger
amounts, or take it for longer than recommended by your doctor. 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 of using this medicine before your symptoms improve. For best
results, keep using the medication as directed. Talk with 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 fluoxetine and olanzapine at room temperature away from moisture and heat.
What happens if I miss a dose of fluoxetine and olanzapine?
Take the missed dose as soon as you remember. However, if it is almost time for the next
regularly scheduled dose, skip the missed dose and take the next one as directed.
Do not
take extra medicine to make up the missed dose.
Where can I get more information about fluoxetine and olanzapine?
Your pharmacist has information about fluoxetine and olanzapine written for health professionals that you may read.
What are the possible side effects of fluoxetine and olanzapine?
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.
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.
Call your doctor at once if you have any of these serious side effects:
-
sudden and severe headache, blurred vision, confusion, chest pain,
numbness, and problems with vision, speech, or balance;
-
increased thirst, frequent urination, excessive hunger, or
weakness;
-
fever, stiff muscles, confusion, sweating, fast or uneven
heartbeats, trouble breathing;
-
jerky muscle movements you cannot control;
-
seizure (convulsions);
-
feeling like you might pass out;
-
easy bruising or bleeding; or
-
nausea, stomach pain, low fever, loss of appetite, dark
urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
-
trouble swallowing, runny nose, sore throat;
-
weight gain, swelling in your hands of feet;
-
drowsiness, trouble concentrating, sleep problems
(insomnia);
-
dry mouth, diarrhea, changes in appetite; or
-
decreased sex drive, impotence, or difficulty having an
orgasm.
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.
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 take fluoxetine and olanzapine together with pimozide (Orap), thioridazine
(Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), rasagiline
(Azilect), phenelzine (Nardil), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
You may have thoughts about suicide when you first start taking an antidepressant, especially if
you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the
first 12 weeks of treatment.
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.
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.
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 are planning a pregnancy, or
if you become pregnant while taking fluoxetine and olanzapine, do not stop taking the medication
without first talking to your doctor.
What should I avoid while taking fluoxetine and olanzapine?
Drink plenty of fluids, especially in hot weather and during exercise. It is easier to become
dangerously overheated and dehydrated while you are taking fluoxetine and olanzapine.
Avoid drinking alcohol, which can increase some of the side effects of fluoxetine and
olanzapine.
Fluoxetine and olanzapine can cause side effects that may impair your thinking or reactions.
Be careful if you drive or do anything that requires you to be awake and alert.
What other drugs will affect fluoxetine and olanzapine?
Talk to 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.
The following drugs can interact with fluoxetine and olanzapine. Tell your doctor if you are
using any of these:
-
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);
-
another form of fluoxetine or olanzapine such as Prozac,
Prozac Weekly, Sarafem, or Zyprexa;
-
theophylline (Theo-Dur, TheoBid, Uniphyl, Slo-Bid,
Elixophyllin, 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), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
-
any other antidepressants.
This list is not complete and there may be other drugs that can interact with
fluoxetine and olanzapine. Tell your doctor about all the prescription and over-the-counter medications
you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do
not start using a new medication without telling your doctor.
What happens if I have an overdose of fluoxetine and olanzapine?
