Fluoxetine and olanzapine

Fluoxetine is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). Olanzapine is a medication used to treat mental health conditions, known as an antipsychotic.

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

Fluoxetine and olanzapine is sometimes prescribed when other medications have not worked.

Fluoxetine and olanzapine may also be used for other reasons that are not mentioned in this medication guide.

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.

Store at room temperature away from moisture and heat.

You should not use fluoxetine and olanzapine if you also take pimozide or thioridazine, or if you take other medicines that have fluoxetine or olanzapine in a non-combination form.

Do not use fluoxetine and olanzapine if you have taken 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.

Fluoxetine and olanzapine is not approved for use by anyone younger than 10 years old.

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

You should not use this medicine if you also take pimozide or thioridazine, or if you take other forms of fluoxetine or olanzapine (such as Prozac, Rapiflux, Sarafem, Selfemra, or Zyprexa).

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.

Fluoxetine and olanzapine may increase the risk of death in older adults with dementia-related psychosis and is not approved for this use.

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.

Fluoxetine and olanzapine is not approved for use by anyone younger than 10 years old.

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

Seek medical treatment if you experience 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).

High doses or long-term use of fluoxetine and olanzapine can lead to a serious movement disorder that may not be reversible, especially in women and older adults. Tell your doctor immediately if you have uncontrollable muscle movements of your lips, tongue, eyes, face, arms, or legs.

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.

Fluoxetine and olanzapine may cause serious side effects. Call your doctor right away if you have:

• unusual bleeding or bruising;
• vision changes;
• fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (feeling 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.

Seek medical attention immediately if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects of fluoxetine and olanzapine 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 can report side effects to FDA at 1-800-FDA-1088.

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.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

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

• Avoid driving or operating machinery until you know how fluoxetine and olanzapine will affect you.

• Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Dizziness or severe drowsiness can cause falls, fractures, or other injuries.

Fluoxetine and olanzapine can lead to a serious heart problem. Your risk may increase if you are also taking certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.

Taking fluoxetine and olanzapine with other medications that make you drowsy or slow your breathing can make these effects worse. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, cold or allergy medicine, or medicine for anxiety or seizures.

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 lead to easy bruising or bleeding.

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