effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.oxybutynin transdermalMonitor Closely (3)oxybutynin transdermal decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.oxycodoneMonitor Closely (1)oxycodone and olanzapine both increase sedation. Use Caution/Monitor.oxymorphoneMonitor Closely (1)oxymorphone and olanzapine both increase sedation. Use Caution/Monitor.ozanimodMonitor Closely (1)ozanimod and olanzapine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.paliperidoneMonitor Closely (2)olanzapine and paliperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. olanzapine and paliperidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)olanzapine and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.pancuroniumMonitor Closely (3)pancuronium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. pancuronium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.panobinostatSerious - Use Alternative (1)olanzapine and panobinostat both increase QTc interval. Avoid or Use Alternate Drug.papaveretumMonitor Closely (1)papaveretum and olanzapine both increase sedation. Use Caution/Monitor.papaverineMonitor Closely (1)olanzapine and papaverine both increase sedation. Use Caution/Monitor.paroxetineMonitor Closely (1)paroxetine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).Serious - Use Alternative (1)olanzapine and paroxetine both increase QTc interval. Avoid or Use Alternate Drug.pasireotideMonitor Closely (1)olanzapine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibSerious - Use Alternative (1)olanzapine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.pefloxacinSerious - Use Alternative (1)pefloxacin will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.peginterferon alfa 2aMonitor Closely (1)peginterferon alfa 2a will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.pentamidineSerious - Use Alternative (1)olanzapine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.pentazocineMonitor Closely (1)pentazocine and olanzapine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (2)pentobarbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. pentobarbital and olanzapine both increase sedation. Use Caution/Monitor.perphenazineMonitor Closely (3)olanzapine and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. olanzapine and perphenazine both increase sedation. Use Caution/Monitor. olanzapine and perphenazine both increase QTc interval. Use Caution/Monitor.phendimetrazineMonitor Closely (1)olanzapine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenelzineMonitor Closely (1)phenelzine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).phenobarbitalMonitor Closely (2)phenobarbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. phenobarbital and olanzapine both increase sedation. Use Caution/Monitor.phentermineMonitor Closely (1)olanzapine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrineMonitor Closely (1)olanzapine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrine POMonitor Closely (1)olanzapine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .pholcodineMonitor Closely (1)olanzapine and pholcodine both increase sedation. Use Caution/Monitor.pimavanserinSerious - Use Alternative (1)olanzapine and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.pimozideMonitor Closely (2)olanzapine and pimozide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. olanzapine and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)olanzapine and pimozide both increase QTc interval. Contraindicated.pioglitazoneMonitor Closely (1)olanzapine, pioglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.pipemidic acidMonitor Closely (1)pipemidic acid will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.pirbuterolMonitor Closely (1)olanzapine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pitolisantSerious - Use Alternative (1)olanzapine and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.ponesimodSerious - Use Alternative (1)olanzapine and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.posaconazoleMonitor Closely (1)olanzapine and posaconazole both increase QTc interval. Use Caution/Monitor.pralidoximeMonitor Closely (3)pralidoxime decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. pralidoxime decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of pralidoxime by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pramipexoleSerious - Use Alternative (1)olanzapine decreases effects of pramipexole by pharmacodynamic antagonism. Contraindicated.pramlintideMonitor Closely (1)olanzapine, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.primaquineMonitor Closely (1)olanzapine and primaquine both increase QTc interval. Use Caution/Monitor.primidoneMonitor Closely (2)primidone will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. primidone and olanzapine both increase sedation. Use Caution/Monitor.procainamideSerious - Use Alternative (1)olanzapine and procainamide both increase QTc interval. Avoid or Use Alternate Drug.procarbazineMonitor Closely (1)procarbazine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).prochlorperazineMonitor Closely (3)olanzapine and prochlorperazine both decrease QTc interval. Use Caution/Monitor. olanzapine and prochlorperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. olanzapine and prochlorperazine both increase sedation. Use Caution/Monitor.promethazineMonitor Closely (4)promethazine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). olanzapine and promethazine both decrease QTc interval. Use Caution/Monitor. olanzapine and promethazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. promethazine and olanzapine both increase sedation. Use Caution/Monitor.propafenoneSerious - Use Alternative (1)olanzapine and propafenone both increase QTc interval. Avoid or Use Alternate Drug.propanthelineMonitor Closely (3)propantheline decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. propantheline decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of propantheline by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.propofolMonitor Closely (1)propofol and olanzapine both increase sedation. Use Caution/Monitor.propylhexedrineMonitor Closely (1)olanzapine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylineMonitor Closely (2)olanzapine and protriptyline both increase sedation. Use Caution/Monitor. olanzapine and protriptyline both increase QTc interval. Use Caution/Monitor.quazepamMonitor Closely (1)quazepam and olanzapine both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (2)olanzapine and quetiapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. olanzapine and quetiapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)olanzapine and quetiapine both increase QTc interval. Avoid or Use Alternate Drug.quinidineSerious - Use Alternative (1)olanzapine and quinidine both increase QTc interval. Avoid or Use Alternate Drug.quinineMonitor Closely (1)olanzapine and quinine both increase QTc interval. Use Caution/Monitor.ramelteonMonitor Closely (1)olanzapine and ramelteon both increase sedation. Use Caution/Monitor.ranolazineSerious - Use Alternative (1)olanzapine and ranolazine both increase QTc interval. Avoid or Use Alternate Drug.rapacuroniumMonitor Closely (3)rapacuronium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. rapacuronium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of rapacuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.remimazolamMonitor Closely (1)remimazolam, olanzapine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.repaglinideMonitor Closely (1)olanzapine, repaglinide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.ribociclibSerious - Use Alternative (1)ribociclib increases toxicity of olanzapine by 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 instances.rifampinMonitor Closely (1)rifampin will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.rilpivirineMonitor Closely (1)olanzapine and rilpivirine both increase QTc interval. Use Caution/Monitor.rimabotulinumtoxinBMonitor Closely (1)olanzapine, rimabotulinumtoxinB. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Anticholinergics may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.risperidoneMonitor Closely (3)olanzapine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. olanzapine and risperidone both increase sedation. Use Caution/Monitor. olanzapine and risperidone both increase QTc interval. Use Caution/Monitor.ritlecitinibMonitor Closely (1)ritlecitinib will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Ritlecitinib inhibits CYP1A2 substrates; coadministration increases AUC and peak plasma concentration sensitive substrates, which may increase risk of adverse reactions. Additional monitoring and dosage adjustment may be needed in accordance with product labeling of CYP1A2 substrates. ritonavirMonitor Closely (1)ritonavir decreases levels of olanzapine by increasing metabolism. Use Caution/Monitor.rocuroniumMonitor Closely (3)rocuronium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. rocuronium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.romidepsinMonitor Closely (1)olanzapine and romidepsin both increase QTc interval. Use Caution/Monitor.ropiniroleSerious - Use Alternative (1)olanzapine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.rosiglitazoneMonitor Closely (1)olanzapine, rosiglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.rucaparibMonitor Closely (1)rucaparib will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.ruxolitinibMinor (1)olanzapine will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinib topicalMinor (1)olanzapine will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.safinamideSerious - Use Alternative (1)olanzapine decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.sageMinor (1)olanzapine and sage both increase sedation. Minor/Significance Unknown.salmeterolMonitor Closely (1)olanzapine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.saquinavirSerious - Use Alternative (1)olanzapine and saquinavir both increase QTc interval. Avoid or Use Alternate Drug.saxagliptinMonitor Closely (1)olanzapine, saxagliptin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.scopolamineMonitor Closely (3)scopolamine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. scopolamine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.scullcapMonitor Closely (1)olanzapine and scullcap both increase sedation. Use Caution/Monitor.secobarbitalMonitor Closely (2)secobarbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. secobarbital and olanzapine both increase sedation. Use Caution/Monitor.selegilineMonitor Closely (1)selegiline, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).selinexorSerious - Use Alternative (1)selinexor, olanzapine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking