Go Article Directory Pitcairn Islands: Symbyax

Generic Name: olanzapine and fluoxetine (Oral route)

floo-OX-e-teen hye-droe-KLOR-ide, oh-LAN-za-peen

Oral route(Capsule)

Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Not approved for use in pediatric patients. Elderly patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo. Although the causes of death in clinical trials were varied, most of the deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature. Observational studies suggest that antipsychotic drugs may increase mortality. It is unclear from these studies to what extent the mortality findings may be attributed to the antipsychotic drug as opposed to patient characteristics. Fluoxetine hydrochloride/olanzapine is not approved for the treatment of patients with dementia-related psychosis .

Commonly used brand name(s)

In the U.S.

Symbyax

Available Dosage Forms:

Capsule

Therapeutic Class: Antidepressant

Pharmacologic Class: Fluoxetine

Chemical Class: Thienobenzodiazepine

Uses For Symbyax

Olanzapine and fluoxetine combination is used to treat depression that is a part of bipolar disorder. This medicine should not be used to treat behavioral problems in older adult patients who have dementia.

Olanzapine and fluoxetine combination is also used to treat treatment resistant depression in patients who have been treated with other antidepressants that did not work well.

This medicine is available only with your doctor's prescription.

Before Using Symbyax

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of olanzapine and fluoxetine combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of olanzapine and fluoxetine combination in the elderly. However, elderly patients are more likely to have dementia or age-related liver, kidney, or heart problems, which may require caution or an adjustment of dosage in patients receiving olanzapine and fluoxetine combination.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil

Clorgyline

Furazolidone

Iproniazid

Isocarboxazid

Levomethadyl

Linezolid

Mesoridazine

Methylene Blue

Metoclopramide

Moclobemide

Nialamide

Pargyline

Phenelzine

Pimozide

Procarbazine

Selegiline

Terfenadine

Thioridazine

Toloxatone

Tranylcypromine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abciximab

Acecainide

Aceclofenac

Acemetacin

Acenocoumarol

Ajmaline

Alclofenac

Almotriptan

Amiodarone

Amisulpride

Amitriptyline

Amoxapine

Ancrod

Anisindione

Antithrombin III Human

Apazone

Aprindine

Ardeparin

Arsenic Trioxide

Aspirin

Astemizole

Azimilide

Benoxaprofen

Bivalirudin

Bretylium

Bromfenac

Bufexamac

Carprofen

Certoparin

Chloral Hydrate

Chloroquine

Chlorpromazine

Cilostazol

Citalopram

Clarithromycin

Clometacin

Clomipramine

Clonixin

Clopidogrel

Dalteparin

Danaparoid

Defibrotide

Dermatan Sulfate

Desipramine

Desirudin

Desvenlafaxine

Dexfenfluramine

Dexketoprofen

Dextromethorphan

Dibenzepin

Diclofenac

Dicumarol

Diflunisal

Dipyridamole

Dipyrone

Disopyramide

Dofetilide

Dolasetron

Doxepin

Droperidol

Droxicam

Duloxetine

Eletriptan

Enflurane

Enoxaparin

Eptifibatide

Erythromycin

Escitalopram

Etodolac

Etofenamate

Felbinac

Fenbufen

Fenfluramine

Fenoprofen

Fentiazac

Flecainide

Floctafenine

Fluconazole

Flufenamic Acid

Fluoxetine

Flurbiprofen

Fluvoxamine

Fondaparinux

Foscarnet

Frovatriptan

Gemifloxacin

Halofantrine

Haloperidol

Halothane

Heparin

Hydromorphone

Hydroquinidine

Ibuprofen

Ibutilide

Imipramine

Indomethacin

Indoprofen

Isoflurane

Isoxicam

Isradipine

Ketoprofen

Ketorolac

Lidoflazine

Lithium

Lorcainide

Lornoxicam

Magnesium Salicylate

Meclofenamate

Mefenamic Acid

Mefloquine

Meloxicam

Meperidine

Milnacipran

Mirtazapine

Nabumetone

Nadroparin

Naproxen

Naratriptan

Nepafenac

Niflumic Acid

Nimesulide

Nortriptyline

Octreotide

Oxaprozin

Oxyphenbutazone

Parnaparin

Paroxetine

Pentamidine

Pentosan Polysulfate Sodium

Phenindione

Phenprocoumon

Phenylbutazone

Pirazolac

Pirmenol

Piroxicam

Pirprofen

Prajmaline

Prasugrel

Probucol

Procainamide

Prochlorperazine

Propafenone

Propyphenazone

Proquazone

Quetiapine

Rasagiline

Reviparin

Rizatriptan

Salicylic Acid

Salsalate

Sematilide

Sertindole

Sertraline

Sibutramine

Sotalol

Spiramycin

St John's Wort

Sulfamethoxazole

Sulindac

Sultopride

Sumatriptan

Suprofen

Tamoxifen

Tapentadol

Tedisamil

Telithromycin

Tenidap

Tenoxicam

Tetrabenazine

Tiaprofenic Acid

Ticlopidine

Tinzaparin

Tirofiban

Tolmetin

Tramadol

Trazodone

Trifluoperazine

Trimethoprim

Trimipramine

Tryptophan

Vasopressin

Venlafaxine

Vilazodone

Warfarin

Ziprasidone

Zolmitriptan

Zomepirac

Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Alprazolam

Betel Nut

Bupropion

Buspirone

Carbamazepine

Ciprofloxacin

Clozapine

Cyclobenzaprine

Cyproheptadine

Delavirdine

Digoxin

Fluphenazine

Fluvoxamine

Fosphenytoin

Galantamine

Ginkgo

Haloperidol

Iloperidone

Lithium

Metoprolol

Nebivolol

Paroxetine

Pentazocine

Phenytoin

Risperidone

Ritonavir

Tetrabenazine

Valproic Acid

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Proper Use of Symbyax

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. .

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. Your doctor might ask you to sign some forms to show that you understand this information.

You may take this medicine with or without food.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (capsules):
- For treatment of depression that occurs with bipolar disorder or treatment resistant depression:
  - Adults—One capsule once a day in the evening. Your doctor may adjust your dose if needed.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Symbyax

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

For some children, teenagers, and young adults, this medicine can increase thoughts of suicide. Tell your doctor or your child's doctor right away if you or your child start to feel more depressed and have thoughts about hurting yourselves. Report any unusual thoughts or behaviors that trouble you or your child, especially if they are new or are getting worse quickly. Make sure the doctor knows if you or your child have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you or your child have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you, your child, or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.

Do not take this medicine within 2 weeks of taking a monoamine oxidase (MAO) inhibitor activity (e.g., isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]) and do not take an MAO inhibitor for at least 5 weeks after taking this medicine. If you do, you may develop extremely high blood pressure or seizures.

Do not take thioridazine (Mellaril®) while you are taking this medicine or less than 5 weeks after you have stopped taking this medicine. You should not use pimozide (Orap®) while you are taking this medicine. Using these medicines together can cause very serious heart problems.

Do not breastfeed while you are using this medicine.

This medicine may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or urination. Your doctor may give you insulin or other medicines that can lower the amount of sugar in your blood.

This medicine may increase your cholesterol and fats in the blood. If this condition occurs, your doctor may give you some medicines that can lower the amount of cholesterol and fats in the blood.

This medicine may increase your weight. Your doctor may need to check your weight regularly during treatment with this medicine.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

If you develop a skin rash, hives, or any allergic reaction to this medicine, stop taking the medicine and check with your doctor as soon as possible.

Make sure your doctor knows about all the other medicines you are using. This medicine may cause serious conditions such as serotonin syndrome and neuroleptic malignant syndrome (NMS)-like reactions when taken with certain medicines such as linezolid [Zyvox®], lithium, tryptophan, St. John’s Wort, or some pain medicines (e.g., tramadol [Ultram®], sumatriptan [Imitrex®], zolmitriptan [Zomig®], or rizatriptan [Maxalt®]). Check with your doctor first before taking any other medicines.

Check with your doctor right away if you are having convulsions, difficulty with breathing, fast heartbeat, high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have any of the following symptoms while taking this medicine: lip smacking or puckering, puffing of cheeks, rapid or worm-like movements of tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

Make sure your doctor knows if you are also using aspirin, NSAIDS (e.g., ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, or Motrin®), or a blood thinner such as warfarin or Coumadin®. Olanzapine and fluoxetine combination may increase your risk of having bleeding problems especially when taken together with these medicines.

This medicine may make it more difficult for your body to cool itself down. Use care not to become overheated during exercise or hot weather since overheating may result in heat stroke.

This medicine may cause drowsiness, trouble in thinking, trouble in controlling movements, or trouble in seeing clearly. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to think or see well.

Do not suddenly stop taking this medicine. If you have been instructed to stop taking this medicine, ask your doctor how to slowly decrease the dose. This is to decrease the chance of having symptoms such as agitation, breathing problems, chest pain, confusion, diarrhea, dizziness or lightheadedness, fast heartbeat, headache, increased sweating, muscle pain, nausea, restlessness, runny nose, trouble with sleeping, trembling or shaking, unusual tiredness or weakness, vision changes, or vomiting.

Avoid drinking alcohol while you are using this medicine.

Symbyax Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Bloating or swelling of the face, arms, hands, lower legs, or feet

body aches or pain

confusion

congestion

cough

delusions

dementia

dryness or soreness of the throat

fever

hoarseness

rapid weight gain

runny nose

shakiness in the legs, arms, hands, or feet

tender, swollen glands in the neck

tingling of the hands or feet

trembling or shaking of the hands or feet

trouble with swallowing

unusual weight gain or loss

voice changes

Less common

Blurred vision

change in personality

change in vision

difficult or labored breathing

difficulty with sleeping

difficulty with speaking

dizziness

ear pain

headache

impaired vision

increase in body movements

loss of memory

nervousness

pounding in the ears

problems with memory

shortness of breath

slow, fast, pounding, or irregular heartbeat or pulse

tightness in the chest

wheezing

Rare

Inability to move the eyes

increased blinking or spasms of the eyelid

sticking out of the tongue

uncontrolled twisting movements of the neck, trunk, arms, or legs

unusual facial expressions

Incidence not known

Bloody or black, tarry stools

constipation

severe stomach pain

vomiting of blood or material that looks like coffee grounds

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Change in consciousness

changes in patterns and rhythms of speech

fainting

loss of consciousness

seizures

shakiness and unsteady walk

sleepiness

slurred speech

trouble with speaking

unsteadiness, trembling, or other problems with muscle control or coordination

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea

dry mouth

increased appetite

lack or loss of strength

weight gain

Less common

Change or problem with discharge of semen

decreased interest in sexual intercourse

difficulty with moving

inability to have or keep an erection

loss in sexual ability, desire, drive, or performance

muscle pain or stiffness

not able to have an orgasm

pain, swelling, or redness in the joints

tooth disorder

twitching

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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

See also: Symbyax side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Symbyax resources

Symbyax Side Effects (in more detail)
Symbyax Dosage
Symbyax Use in Pregnancy & Breastfeeding
Drug Images
Symbyax Drug Interactions
Symbyax Support Group
25 Reviews for Symbyax - Add your own review/rating

Symbyax Prescribing Information (FDA)

Symbyax MedFacts Consumer Leaflet (Wolters Kluwer)

Symbyax Consumer Overview

Compare Symbyax with other medications

Bipolar Disorder
Depression

Go Article Directory Pitcairn Islands

Tuesday, October 18, 2016

Symbyax