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Symbyax (olanzapine/fluoxetine)

Last updated on: Jan 24, 2007

What is Symbyax?

Symbyax contains two medicines, olanzapine and fluoxetine. Olanzapine is in a class of medications called atypical antipsychotics. Antipsychotic medicines are used to treat symptoms of schizophrenia that may include hearing voices, seeing things, or sensing things that are not there, mistaken beliefs or unusual suspiciousness. Fluoxetine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It is used to treat depression, obsessive-compulsive disorder, bulimia, and panic disorder.
Symbyax is used to treat adults who have depression with bipolar disorder. Bipolar disorder is a mental illness that causes extreme mood swings.

Who Should Not Take Symbyax?

Never take Symbyax if you are taking another drug used to treat depression, called a Monoamine Oxidase Inhibitor (MAOI), or if you have stopped taking an MAOI in the last 14 days. Taking Symbyax close in time to an MAOI can result in serious, sometimes fatal, reactions, including:

High body temperature
Coma
Seizures (convulsions)

Do not take a MAOI within 5 weeks of stopping Symbyax. MAOI drugs include Nardil (phenelzine sulfate), Parnate (tranylcypromine sulfate), Marplan (isocarboxazid), and other brands.

Never take Symbyax if you are taking Mellaril (thioridazine), used to treat schizophrenia. Also, do not take Mellaril within 5 weeks of stopping Symbyax. Taking Symbyax close in time to Mellaril can result in serious heart beat problems.

What are The Risks?

The following are the major potential risks and side effects of Symbyax therapy. However, this list is not complete.

Symbyax can cause serious problems such as:

A life-threatening nervous system problem called neuroleptic malignant syndrome (NMS). NMS can cause a high fever, stiff muscles, sweating, a fast or irregular heart beat, change in blood pressure, and confusion. NMS can affect your kidneys. NMS is a medical emergency. Call your healthcare professional right away if you experience these symptoms.
A movement problem called tardive dyskinesia (TD). Call your healthcare professional right away if you get muscle movements that cannot be stopped.
High blood sugar and diabetes. Patients with diabetes or who have a highechance for diabetes should have their blood sugar checked often.
Strokes have happened in older patients treated for mental illness from dementia. Symbyax is not approved for this use. See FDA Alert.
Bleeding problems. Symbyax may cause bleeding problems, especially if taken with aspirin, NSAIDs (nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen), or other drugs that affect bleeding.
Sexual problems. You may have problems with impotence (erectile dysfunction), abnormal ejaculation, difficulty reaching orgasm, or decreased libido (sexual desire).
Mania. You may become hyperactive, excitable or elated.
Low salt levels in the blood. Weakness, confusion, or trouble thinking can be caused by low salt levels in the blood.
Other serious side effects may include low blood pressure seen as dizziness, and possibly fainting; increased heart beat; seizures; liver problems; increased body temperature; and difficulty swallowing.
The most common side effects include sleepiness, dry mouth, dizziness, restlessness, diarrhea, weight gain, increased appetite, and tremor.

What Should I Tell My Healthcare Professional?

Before you start taking Symbyax, tell your healthcare professional if you:

have or had heart problems
have or had seizures.
have or had diabetes or increased blood sugar
have or had liver disease
are trying to become pregnant, are already pregnant, or are breast-feeding.
are taking fluoxetine, Prozac, Prozac Weekly, Sarafem, olanzapine, Zyprexa, or Zyprexa Zydis. These medicines each contain an ingredient that is also found in Symbyax.
drink alcohol

Are There Any Interactions With Drugs or Foods?

Because certain other medications can interact with Symbyax, review all medications that you are taking with your healthcare professional, including those that you take without a prescription.
Your healthcare professional may have to adjust your dose or watch you more closely if you take the following medications:

blood pressure medicines
levodopa and other medicines called dopamine agonists
omeprazole
rifampin
carbamazepine
fluvoxamine
clozapine
haloperidol
phenytoin
lithium
pimozide
sumatriptan
warfarin

Avoid drinking alcohol while taking Symbyax.

Is There Anything Else I Need to Know?

Dizziness, and sometimes fainting, caused by a drop in blood pressure may happen with Symbyax, especially when you first start taking this medicine or when the dose is increased.
Symbyax may impair judgment, thinking, or motor skills. You should be careful in operating machinery, including automobiles, until you know how Symbyax affects you.
It is important to avoid overheating and dehydration while taking Symbyax. Symbyax may make it harder to lower your body temperature.

This information is provided by the U.S. Food & Drug Administration.
For more information about this drug, click here.