fluoxetine and olanzapine

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

Do not use fluoxetine and olanzapine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Fluoxetine and olanzapine is not approved for use in older adults with dementia-related psychosis.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

What is fluoxetine and olanzapine?

Fluoxetine is selective serotonin reuptake inhibitors (SSRI) antidepressant. Olanzapine is an antipsychotic medication.

Fluoxetine and olanzapine is a combination medicine used to treat depression caused by bipolar disorder (manic depression).

Fluoxetine and olanzapine is sometimes given after other medications have failed.

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?

Do not use this medicine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, and tranylcypromine. Do not take an MAO inhibitor within 5 weeks after you stop taking fluoxetine and olanzapine.

Tell your doctor if you have ever had:

• Alzheimer's disease:
• liver disease;
• narrow-angle glaucoma;
• heart problems;
• high or low blood pressure;
• low white blood cell (WBC) counts;
• a seizure;
• bleeding problems;
• breast cancer;
• a stroke, including "mini-stroke" or "TIA";
• diabetes, high cholesterol or triglycerides;
• bowel obstruction, or severe constipation;
• electroconvulsive therapy (ECT);
• an enlarged prostate; or
• trouble swallowing.

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with fluoxetine and olanzapine and cause a serious condition called serotonin syndrome.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Ask your doctor about taking this medicine if you are pregnant. Taking an SSRI antidepressant during late pregnancy may cause serious medical complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine without your doctor's advice.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of fluoxetine and olanzapine on the baby.

It may be harder for you to get pregnant while you are using this medicine.

If you are breastfeeding, tell your doctor if you notice fussiness, drowsiness, feeding problems, weight loss, or unusual muscle movements in the nursing baby.

How should I take fluoxetine and olanzapine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You should not stop using fluoxetine and olanzapine suddenly. Follow your doctor's instructions about tapering your dose.

Take the medicine at the same time each day, with or without food.

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.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

What should I avoid while taking fluoxetine and olanzapine?

What are the possible side effects of fluoxetine and olanzapine?

Seek medical treatment if you have symptoms of a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, flu-like symptoms, unusual bruising, or jaundice (yellowing of your skin or eyes).

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.

• unusual bleeding or bruising;
• vision changes;
• fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out);
• dehydration symptoms --feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;
• severe nervous system reaction --very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;
• high blood sugar --increased thirst, increased urination, hunger, fruity breath odor, confusion, upset stomach;
• low sodium level --headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady; or
• low white blood cell counts --fever, chills, mouth sores, skin sores, sore throat, cough, trouble breathing.

Common side effects may include:

• drowsiness, blurred vision, dry mouth;
• increased appetite, weight gain;
• trouble concentrating, feeling tired;
• swelling in your hands or feet;
• tremor; or
• abnormal liver function or cholesterol tests.

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 other drugs will affect fluoxetine and olanzapine?

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with fluoxetine and olanzapine may cause you to bruise or bleed easily.

Many drugs can affect fluoxetine and olanzapine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Your pharmacist can provide more information about fluoxetine and olanzapine.