is not clear, use caution. Use Caution/Monitor.aripiprazoleMonitor Closely (3)aripiprazole and olanzapine both increase sedation. Use Caution/Monitor. aripiprazole and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. aripiprazole and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesSerious - Use Alternative (2)fluoxetine 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.armodafinilMonitor Closely (2)armodafinil will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. olanzapine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.arsenic trioxideSerious - Use Alternative (2)arsenic 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.artemetherSerious - Use Alternative (2)artemether 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/lumefantrineContraindicated (1)artemether/lumefantrine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.Monitor Closely (1)fluoxetine and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)olanzapine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.asenapineMonitor Closely (3)asenapine and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely. asenapine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. asenapine and olanzapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)olanzapine and asenapine both increase QTc interval. Avoid or Use Alternate Drug.asenapine transdermalMonitor Closely (3)asenapine transdermal and olanzapine both increase sedation. Use Caution/Monitor. asenapine transdermal and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely. asenapine transdermal and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesaspirinMonitor Closely (1)fluoxetine, aspirin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.aspirin rectalMonitor Closely (1)fluoxetine, aspirin rectal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.aspirin/citric acid/sodium bicarbonateMonitor Closely (1)fluoxetine, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.atogepantMonitor Closely (1)fluoxetine will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atomoxetineMonitor Closely (2)fluoxetine will increase the level or effect of atomoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Reduced initial doses of atomoxetine are recommended with strong CYP2D6 inhibitors. atomoxetine and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesSerious - Use Alternative (1)atomoxetine and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.atracuriumMonitor Closely (3)atracurium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atracurium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropineMonitor Closely (3)atropine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atropine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine IV/IMMonitor Closely (3)olanzapine increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. atropine IV/IM decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atropine IV/IM decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.avapritinibMonitor Closely (3)avapritinib and olanzapine both increase sedation. Use Caution/Monitor. olanzapine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. fluoxetine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.axitinibMonitor Closely (2)fluoxetine increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. olanzapine increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.azelastineMonitor Closely (1)azelastine and olanzapine both increase sedation. Use Caution/Monitor.azithromycinMonitor Closely (1)azithromycin increases toxicity of olanzapine by QTc interval. Use Caution/Monitor.Minor (1)azithromycin and fluoxetine both increase QTc interval. Minor/Significance Unknown.baclofenMonitor Closely (1)baclofen and olanzapine both increase sedation. Use Caution/Monitor.bedaquilineMonitor Closely (2)fluoxetine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely olanzapine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelladonna alkaloidsMonitor Closely (3)belladonna alkaloids decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. belladonna alkaloids decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.belladonna and opiumMonitor Closely (4)belladonna and opium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. belladonna and opium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. belladonna and opium and olanzapine both increase sedation. Use Caution/Monitor.benazeprilMonitor Closely (1)olanzapine, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced hypotensive effects.benperidolMonitor Closely (2)benperidol and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. benperidol and olanzapine both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenMonitor Closely (2)benzhydrocodone/acetaminophen, fluoxetine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. benzhydrocodone/acetaminophen and olanzapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)benzhydrocodone/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.benzphetamineMonitor Closely (1)olanzapine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benztropineMonitor Closely (1)olanzapine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .betrixabanMonitor Closely (1)fluoxetine increases effects of betrixaban by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.bosentanMonitor Closely (1)fluoxetine will increase the level or effect of bosentan by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.brexanoloneMonitor Closely (1)brexanolone, olanzapine. Either increases toxicity of the other by sedation. Use Caution/Monitor.brexpiprazoleMonitor Closely (2)fluoxetine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP2D6 inhibitors. If also administered with a strong/moderate CYP3A4 inhibitor, administer a quarter of brexpiprazole dose. NOTE: In MDD clinical trials, brexpiprazole dosage was not adjusted for strong CYP2D6 inhibitors (eg, paroxetine, fluoxetine); thus, CYP considerations are already factored into general dosing recommendations and brexpiprazole may be administered without dosage adjustment in patients with MDD. brexpiprazole and olanzapine both increase sedation. Use Caution/Monitor.brimonidineMonitor Closely (1)brimonidine and olanzapine both increase sedation. Use Caution/Monitor.Minor (1)brimonidine increases effects of olanzapine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.brivaracetamMonitor Closely (1)brivaracetam and olanzapine both increase sedation. Use Caution/Monitor.bromocriptineSerious - Use Alternative (1)olanzapine decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.brompheniramineMonitor Closely (1)brompheniramine and olanzapine both increase sedation. Use Caution/Monitor.bumetanideMinor (1)bumetanide, fluoxetine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.buprenorphineMonitor Closely (1)buprenorphine and olanzapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)olanzapine 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 buccalMonitor Closely (1)buprenorphine buccal and olanzapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)buprenorphine 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 implantMonitor Closely (2)buprenorphine subdermal implant and olanzapine both increase sedation. Use Caution/Monitor. fluoxetine, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.Serious - Use Alternative (2)buprenorphine 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 transdermalMonitor Closely (1)buprenorphine transdermal and olanzapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)buprenorphine 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 injectionMonitor Closely (3)olanzapine increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate. fluoxetine, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected. buprenorphine, long-acting injection and olanzapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)buprenorphine, 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 instancesbupropionMonitor Closely (1)bupropion will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluoxetine increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.buspironeSerious - Use Alternative (1)fluoxetine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.butabarbitalMonitor Closely (2)butabarbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. butabarbital and olanzapine both increase sedation. Use Caution/Monitor.butalbitalMonitor Closely (2)butalbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. butalbital and olanzapine both increase sedation. Use Caution/Monitor.butorphanolMonitor Closely (1)butorphanol and olanzapine both increase sedation. Use Caution/Monitor.cabergolineSerious - Use Alternative (1)olanzapine decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.caffeineMonitor Closely (1)olanzapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.calcium/magnesium/potassium/sodium oxybatesSerious - Use Alternative (1)olanzapine, 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