AdultPediatricDosage Forms & Strengths olanzapine/samidorphan tablet 5mg/10mg 10mg/10mg 15mg/10mg 20mg/10mg Schizophrenia Indicated for treatment of schizophrenia in adults Initial dose: Olanzapine 5 mg/samidorphan 10 mg OR olanzapine 10 mg/samidorphan 10 mg PO qDay Maintenance dose: May adjust dosage at weekly intervals of 5 mg (based on the olanzapine component) depending on clinical response and tolerability; not to exceed olanzapine 20 mg/samidorphan 10 mg qDay Bipolar I Disorder Adjunctive to lithium or valproate Indicated for acute treatment of manic or mixed episodes as an adjunct to lithium or valproate in adults with bipolar I disorder Initial dose: 1 tablet (olanzapine 10 mg/samidorphan 10 mg) PO qDay Maintenance dose: May adjust dosage at weekly intervals of 5 mg (based on the olanzapine component) depending on clinical response and tolerability; not to exceed olanzapine 20 mg/samidorphan 10 mg qDay Monotherapy Indicated for acute treatment of manic or mixed episodes as monotherapy and maintenance monotherapy in adults with bipolar I disorder Initial dose: Olanzapine 10 mg/samidorphan 10 mg OR olanzapine 15mg/samidorphan 10 mg PO qDay Adjust dose in increments/decrements of 5 mg (based on olanzapine component), if necessary, at intervals ≥24 hr; not to exceed olanzapine 20 mg/samidorphan 10 mg qDay Maintenance monotherapy: Not to exceed olanzapine 20 mg/samidorphan 10 mg qDay Dosage Modifications Hypotensive patients Patients who have a higher risk of hypotensive reactions, are at risk of slower olanzapine metabolism, or may be more pharmacodynamically sensitive to olanzapine If dose escalation is necessary, increase dose slowly Renal impairment Mild-to-severe (eGFR 15-89 mL/min/1.73 m2): No dosage adjustment necessary Severe (eGFR 15 to 29 mL/minute/1.73 m2): Plasma exposure to olanzapine and samidorphan was higher compared with patients with normal renal function End-stage renal disease (eGFR <15 mL/min/1.73 m2): Not studied; not recommended Hepatic impairment No dosage adjustment necessary Moderate: Olanzapine and samidorphan plasma exposures were found to be higher compared with patients with normal hepatic function, but not clinically relevant Severe: Not studied Dosing Considerations Initiation in patients using opioids Contraindicated in patients using opioids or undergoing acute opioid withdrawal Delay initiation if currently using opioids Short-acting opioids: At least for 7 days after last opioid use Long-acting opioids : At least for 14 days after last opioid use Safety and efficacy not establishedInteraction CheckerEnter a drug name and olanzapine/samidorphanNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (4)amisulprideamisulpride, olanzapine. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Increases risk of neuroleptic malignant syndromeIncreases risk of neuroleptic malignant syndrome.dronedaroneolanzapine and dronedarone both increase QTc interval. Contraindicated.fezolinetantolanzapine will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitorsthioridazineolanzapine and thioridazine both increase QTc interval. Contraindicated.Serious - Use Alternative (114)abametapirabametapir will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.adagrasibadagrasib, olanzapine. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.amiodaroneolanzapine and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.amisulprideamisulpride and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesanagrelideolanzapine and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.apomorphineolanzapine decreases effects of apomorphine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.apomorphine and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesarsenic trioxideolanzapine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.artemetherartemether and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesartemether/lumefantrineolanzapine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.asenapineolanzapine and asenapine both increase QTc interval. Avoid or Use Alternate Drug.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen, olanzapine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.bromocriptineolanzapine decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.buprenorphineolanzapine and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug. If concurrent use of olanzapine and buprenorphine is necessary, consider dose reduction of one or both drugs.buprenorphine buccalbuprenorphine buccal and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesbuprenorphine subdermal implantbuprenorphine subdermal implant and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesbuprenorphine transdermalbuprenorphine transdermal and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesbuprenorphine, long-acting injectionbuprenorphine, long-acting injection and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancescabergolineolanzapine decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.calcium/magnesium/potassium/sodium oxybatesolanzapine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.ceritinibceritinib and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instanceschlorpromazineolanzapine and chlorpromazine both increase QTc interval. Avoid or Use Alternate Drug.ciprofloxacinolanzapine and ciprofloxacin both increase QTc interval. Avoid or Use Alternate Drug.citalopramcitalopram and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesclarithromycinclarithromycin and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesclozapineclozapine and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancescrizotinibcrizotinib and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesdegarelixdegarelix and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesdesfluranedesflurane and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesdiazepam intranasaldiazepam intranasal, samidorphan. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.disopyramideolanzapine and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.dopamineolanzapine decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.droperidololanzapine and droperidol both increase QTc interval. Avoid or Use Alternate Drug.eliglustatolanzapine and eliglustat both increase QTc interval. Avoid or Use Alternate Drug.encorafenibencorafenib and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesentrectinibolanzapine and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.erdafitinibolanzapine will increase the level or effect of erdafitinib by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. If coadministration of a strong CYP2C9 inhibitors is unavoidable, closely monitor adverse reactions and modify dose of erdafitinib accordingly. If strong CYP2C9 inhibitor is discontinued, consider increasing erdafitinib dose in the absence of any drug-related toxicities.eribulineribulin and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instanceserythromycin baseolanzapine and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.erythromycin ethylsuccinateolanzapine and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.erythromycin lactobionateolanzapine and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.erythromycin stearateolanzapine and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.fedratinibolanzapine will increase the level or effect of fedratinib by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of fedratinib (a CYP3A4 and CYP2C19 substrate) with dual CYP3A4 and CYP2C19 inhibitor. Effect of coadministration of a dual CYP3A4 and CYP2C19 inhibitor with fedratinib has not been studied.fexinidazolefexinidazole and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.fluvoxaminefluvoxamine will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.olanzapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.foscarnetolanzapine and foscarnet both increase QTc interval. Avoid or Use Alternate Drug.givosirangivosiran will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.glasdegibolanzapine and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.goserelinolanzapine and goserelin both increase QTc interval. Avoid or Use Alternate Drug.histrelinolanzapine and histrelin both increase QTc interval. Avoid or Use Alternate Drug.hydrocodonehydrocodone, olanzapine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.hydroxychloroquine sulfatehydroxychloroquine sulfate and olanzapine both increase QTc interval. Avoid or Use Alternate Drug.ibutilideolanzapine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.iloperidoneolanzapine and iloperidone both increase QTc interval. Avoid or Use Alternate Drug.inotuzumabolanzapine and inotuzumab both increase QTc interval. Avoid or Use Alternate Drug.isofluraneisoflurane and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesivosidenibivosidenib and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.lefamulinlefamulin and olanzapine both increase QTc interval. Avoid or Use Alternate Drug.leniolisibleniolisib will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid leniolisib with CYP1A2 substrates that have a narrow therapeutic indexlenvatinibolanzapine and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.leuprolideolanzapine and leuprolide both increase QTc interval. Avoid or Use Alternate Drug.levodopaolanzapine decreases effects of levodopa by pharmacodynamic antagonism. Avoid or Use Alternate Drug.levodopa inhaledolanzapine decreases effects of levodopa inhaled