Fluoxetine Hydrochloride, Olanzapine (oh-LAN-za-peen)

Treats depression that is a part of bipolar disorder. This medicine contains a selective serotonin reuptake inhibitor (SSRI) antidepressant.

Brand Name(s):

Symbyax

When This Medicine Should Not Be Used:

How to Use This Medicine:

Capsule

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• 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.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are using digitoxin, linezolid (Zyvox®), omeprazole (Prilosec®), rifampin (Rifadin®), St. John's wort, sumatriptan (Imitrex®), tramadol (Ultram®), tryptophan, or vinblastine. Tell your doctor if you are using a blood thinner (such as warfarin or Coumadin®), other medicine for mental illness (such as clozapine, fluvoxamine, haloperidol, lithium, tryptophan, Clozaril®, Haldol®, or Luvox®), medicine for Parkinson's disease (such as levodopa, Sinemet®, or Stalevo®), phenothiazine medicine (such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, or Trilafon®), or medicine for heart rhythm problems (such as flecainide, propafenone, Rythmol®, or Tambocor®).
• Make sure your doctor knows if you are also using a pain or arthritis medicine (such as aspirin, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Feldene®, Daypro®, Motrin®, Orudis®, Relafen®, or Voltaren®), medicine for seizures (such as carbamazepine, phenytoin, Dilantin®, or Tegretol®), medicine to treat depression (such as amitriptyline, desipramine, imipramine, nortriptyline, Aventyl®, Elavil®, Norpramin®, Pamelor®, or Tofranil®), medicine for anxiety (such as alprazolam, diazepam, Librium®, Valium®, or Xanax®), or blood pressure medicine (such as atenolol, hydrochlorothiazide [HCTZ], lisinopril, metoprolol, Cozaar®, Diovan®, Lotrel®, Norvasc®, Prinivil®, Toprol®, or Zestril®).
• Do not drink alcohol while you are using this medicine.
• Tell your doctor if you are also using any other medicine that contains olanzapine or fluoxetine. Some other brand names are Zyprexa®, Zyprexa Zydis®, Prozac®, Prozac Weekly?, or Sarafem®.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant, or if you have diabetes or a family history of diabetes. Tell your doctor if you have forgetfulness or confusion related to aging (such as Alzheimer's disease or other kind of dementia). Make sure your doctor knows if you have seizures, bleeding problems, liver disease, prostate problems, narrow-angle glaucoma, trouble swallowing, or a history of neuroleptic malignant syndrome (NMS), breast cancer, or severe constipation. Your doctor needs to know if you have any kind of heart or circulation problems, including heart disease, low blood pressure, high blood pressure, heart failure, heart rhythm problems, or a history of heart attack or stroke.
• Do not breastfeed while you are using this medicine.
• 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.
• This medicine may raise or lower your blood sugar, or it may cover up symptoms of very low blood sugar (hypoglycemia).
• Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.
• 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.
• If you develop new hives or a skin rash, even a mild one, stop using this medicine and call your doctor right away.
• You might get overheated while using this medicine. Drink plenty of water during hot weather, while exercising, or while using a hot tub or sauna. If your body gets too hot, you might feel dizzy, weak, tired, or confused. You might have an upset stomach or vomit. Call your doctor if drinking cool water and moving away from the heat does not cool you down.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert. You may also feel lightheaded when getting up suddenly from a lying or sitting position, so stand up slowly.
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
• If your symptoms do not improve or if they get worse, call your doctor.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Change in how much or how often you urinate.
• Changes in behavior, or thoughts of hurting yourself or others.
• Ear pain or discharge.
• Fast, slow, uneven, or pounding heartbeat.
• Feeling very thirsty, hungry, or weak.
• Fever, unusual sweating, or feeling too hot.
• Lightheadedness or fainting.
• Muscle stiffness, spasms, twitching, or other muscle movements you cannot control (especially in your face or mouth).
• Seizures or tremors.
• Sudden or severe headache, problems with vision, speech, or walking.
• Swelling in your hands, ankles, or feet.
• Trouble breathing or swallowing.
• Trouble sleeping, racing thoughts, feeling very nervous, energetic, restless, or having unusual or severe confusion.

If you notice these less serious side effects, talk with your doctor:

• Blurred vision.
• Diarrhea.
• Dry mouth, sore throat, or hoarseness.
• Increase in appetite.
• Joint pain or swelling.
• Mild muscle pain or shaking.
• Mild weakness or trouble concentrating.
• Sleepiness or unusual drowsiness.
• Trouble having sex.
• Weight gain.