AdultPediatricGeriatricDosage Forms & Strengths fluoxetine/olanzapine capsule 25mg/3mg 25mg/6mg 50mg/6mg 25mg/12mg 50mg/12mg Depression Associated with Bipolar I Disorder Indicated for acute depressive episodes in bipolar I disorder Initial: 25 mg/6 mg PO qDay in evening If needed, may titrate with 25-50 mg fluoxetine/6-12 mg olanzapine; not to exceed 75 mg/18 mg per day Treatment of Resistant Depression Indicated for treatment resistant depression (ie, major depressive disorder in patients who do not respond to 2 separate trials of different antidepressants of adequate dose and duration in the current episode) Initial: 25 mg/6 mg PO qDay in evening If needed, may titrate with 25-50 mg fluoxetine/6-12 mg olanzapine; not to exceed 75 mg/18 mg per day Dosage Modifications Hypotensive diathesis, hepatic impairment, or slow metabolism: Initiate with 25 mg/3 mg to 25 mg/6 mg PO qDay Slow metabolism observed in females, elderly, and nonsmokers Discontinue gradually Coadministration with other monoamine oxidase inhibitor (MAOI)s (eg, linezolid or methylene blue) Do not start fluoxetine/olanzapine in patients treated with linezolid or IV methylene blue due to the increased risk of serotonin syndrome If alternatives to linezolid or IV methylene blue treatment are not available and potential benefits of linezolid or intravenous methylene blue are judged to outweigh risks of serotonin syndrome, promptly stop fluoxetine/olanzapine, and linezolid or intravenous methylene blue can be administered Monitor for symptoms of serotonin syndrome for 5 weeks or until 24 hr after the last dose of linezolid or IV methylene blue, whichever comes first; resume 24 hr after the last dose of linezolid or IV methylene blue Dosing Considerations Switching to or from a MAOIs to treat psychiatric disorders Allow at least 14 days to elapse prior to starting fluoxetine/olanzapine after discontinuation of an MAOI intended to treat psychiatric disorders Conversely, allow at least 5 weeks after stopping fluoxetine/olanzapine before starting an MAOI intended to treat psychiatric disorders Dosage Forms & Strengths fluoxetine/olanzapine capsule 25mg/3mg 25mg/6mg 50mg/6mg 25mg/12mg 50mg/12mg Depression Associated with Bipolar I Disorder Indicated for acute depressive episodes in bipolar I disorder in children and adolescents aged 10-17 years <10 years: Safety and efficacy not established 10-17 years Initial: 25 mg/3 mg PO qDay in evening If needed, may titrate with 25-50 mg fluoxetine/6-12 mg olanzapine; not to exceed 50 mg/12 mg per day Clinical studies of fluoxetine/olanzapine did not include sufficient numbers of patients ≥65 year; use with caution Initiate with 25 mg/3 mg to 25 mg/6 mg PO qDayInteraction CheckerEnter a drug name and fluoxetine/olanzapineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (7)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.artemether/lumefantrineartemether/lumefantrine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.dronedaroneolanzapine and dronedarone both increase QTc interval. Contraindicated.eliglustatfluoxetine increases levels of eliglustat by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated. If coadministered with strong or moderate CYP2D6 inhibitors, reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive and intermediate metabolizers; eliglustat is contraindiated if strong or moderate CYP2D6 inhibitors are given concomitantly with strong or moderate CYP3A inhibitors.fezolinetantfluoxetine 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 inhibitorsolanzapine 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 inhibitorsgoserelingoserelin increases toxicity of fluoxetine by QTc interval. Contraindicated. Increases risk of torsades de pointes.thioridazineolanzapine and thioridazine both increase QTc interval. Contraindicated.Serious - Use Alternative (197)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.adagrasib, fluoxetine. 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.alfentanilalfentanil, fluoxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.amiodaroneolanzapine and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.amiodaroneamiodarone and fluoxetine 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 instancesamisulpride and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amitriptylinefluoxetine will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.fluoxetine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.anagrelideolanzapine and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.amoxapinefluoxetine and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.anagrelideanagrelide and fluoxetine 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 instancesaripiprazolefluoxetine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.aripiprazole and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.arsenic trioxidearsenic trioxide and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.olanzapine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.artemetherartemether and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.artemether 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.atomoxetineatomoxetine and fluoxetine 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 and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalbuprenorphine buccal and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine 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 fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine 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 fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine 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 fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, 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 instancesbupropionfluoxetine increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.cabergolineolanzapine decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.buspironefluoxetine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.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.carvedilolfluoxetine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.ceritinibceritinib and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.ceritinib 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.fluoxetine will increase the level or effect of chlorpromazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.cimetidinefluoxetine will increase the level or effect of cimetidine by affecting hepatic enzyme CYP2C19 metabolism. 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 instancescitalopram and fluoxetine both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions. ECG monitoring is recommended, along with drugs that may prolong the QT interval.clarithromycinclarithromycin 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 instancesclomipraminefluoxetine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.fluoxetine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.clopidogrelfluoxetine decreases effects of clopidogrel by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Clopidogrel efficacy may be reduced by drugs that inhibit CYP2C19. Inhibition of platelet aggregation by clopidogrel is entirely due to an active metabolite. Clopidogrel is metabolized to this active metabolite in part by CYP2C19. .clozapineclozapine 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 instancescyclobenzaprinefluoxetine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.dacomitinibdacomitinib will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. degarelixdegarelix 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 fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.desflurane 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 instancesdesipraminefluoxetine will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.fluoxetine and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.disopyramideolanzapine and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.desvenlafaxinefluoxetine and desvenlafaxine both increase serotonin levels.