minimum required. Monitor closely for signs of respiratory depression and sedation.cannabidiolMonitor Closely (3)fluoxetine will increase the level or effect of cannabidiol by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a moderate CYP2C19 inhibitor. cannabidiol, olanzapine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate. cannabidiol will increase the level or effect of fluoxetine by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C9 activity. Consider reducing the dose when concomitantly using CYP2C9 substrates.captoprilMonitor Closely (1)olanzapine, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.carbamazepineMonitor Closely (2)fluoxetine will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor plasma levels when used concomitantly carbamazepine will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.carbinoxamineMonitor Closely (1)carbinoxamine and olanzapine both increase sedation. Use Caution/Monitor.carisoprodolMonitor Closely (1)carisoprodol and olanzapine both increase sedation. Use Caution/Monitor.carvedilolMonitor Closely (1)fluoxetine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluoxetine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.celandineMinor (1)celandine decreases effects of fluoxetine by pharmacodynamic antagonism. Minor/Significance Unknown. Based on animal studies.celecoxibMonitor Closely (3)fluoxetine will increase the level or effect of celecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. celecoxib will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. fluoxetine, celecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.ceritinibSerious - Use Alternative (2)ceritinib 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 instanceschasteberryMinor (1)chasteberry decreases effects of olanzapine by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).chloral hydrateMonitor Closely (1)chloral hydrate and olanzapine both increase sedation. Use Caution/Monitor.chlordiazepoxideMonitor Closely (1)chlordiazepoxide and olanzapine both increase sedation. Use Caution/Monitor.chloroquineMonitor Closely (1)chloroquine increases toxicity of olanzapine by QTc interval. Use Caution/Monitor.Minor (2)chloroquine increases toxicity of fluoxetine by QTc interval. Minor/Significance Unknown. chloroquine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.chlorpheniramineMonitor Closely (1)chlorpheniramine and olanzapine both increase sedation. Use Caution/Monitor.chlorpromazineMonitor Closely (3)chlorpromazine and olanzapine both increase sedation. Use Caution/Monitor. chlorpromazine and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely. chlorpromazine and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.Serious - Use Alternative (2)olanzapine 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.chlorpropamideMonitor Closely (2)fluoxetine increases effects of chlorpropamide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia. olanzapine, chlorpropamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.chlorzoxazoneMonitor Closely (1)chlorzoxazone and olanzapine both increase sedation. Use Caution/Monitor.choline magnesium trisalicylateMonitor Closely (1)fluoxetine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.cigarette smokingMonitor Closely (1)cigarette smoking will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.cilostazolMonitor Closely (1)fluoxetine increases toxicity of cilostazol by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider decreasing cilostazol dose; moderate CYP2C19 inhibitors may increase serum levels of 3,4-dehydrocilostazol (active metabolite).cimetidineMonitor Closely (2)cimetidine will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. cimetidine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluoxetine will increase the level or effect of cimetidine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.cinnarizineMonitor Closely (1)cinnarizine and olanzapine both increase sedation. Use Caution/Monitor.ciprofloxacinMonitor Closely (2)ciprofloxacin and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely. ciprofloxacin will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Olanzapine plasma concentrations may be elevated, increasing the risk of adverse reactions such as orthostatic hypotension or sedation. It is important to use caution and observe patient and adjust the olanzapine dosage as needed.Serious - Use Alternative (1)olanzapine and ciprofloxacin both increase QTc interval. Avoid or Use Alternate Drug.cisatracuriumMonitor Closely (3)cisatracurium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. cisatracurium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.citalopramMonitor Closely (1)citalopram and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (2)citalopram 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 instances citalopram 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.clarithromycinMonitor Closely (1)clarithromycin and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)clarithromycin 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 instancesclemastineMonitor Closely (1)clemastine and olanzapine both increase sedation. Use Caution/Monitor.clobazamMonitor Closely (2)olanzapine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression). clobazam will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly. clomipramineMonitor Closely (3)olanzapine and clomipramine both increase sedation. Use Caution/Monitor. clomipramine and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely. olanzapine and clomipramine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (2)fluoxetine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug. fluoxetine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.clonazepamMonitor Closely (1)clonazepam and olanzapine both increase sedation. Use Caution/Monitor.clonidineMonitor Closely (2)clonidine, fluoxetine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects. clonidine, olanzapine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.clopidogrelMonitor Closely (1)fluoxetine increases effects of clopidogrel by pharmacodynamic synergism. Use Caution/Monitor. SSRIs affect platelet activation; coadministration of SSRIs with clopidogrel may increase the risk of bleeding.Serious - Use Alternative (1)fluoxetine 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. .clorazepateMonitor Closely (1)clorazepate and olanzapine both increase sedation. Use Caution/Monitor.clozapineMonitor Closely (4)fluoxetine increases levels of clozapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Plasma levels of clozapine may be increased, resulting in increased pharmacologic and toxic effects. Adjust clozapine dose as needed when initiating or discontinuing certain SSRIs. . clozapine and olanzapine both increase sedation. Use Caution/Monitor. clozapine and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. clozapine and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)clozapine 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 instancescobicistatMonitor Closely (1)cobicistat will increase the level or effect of fluoxetine by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with SSRIs and cobicistat. cocaine topicalMonitor Closely (1)fluoxetine and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.codeineMonitor Closely (2)codeine and olanzapine both increase sedation. Use Caution/Monitor. fluoxetine will decrease the level or effect of codeine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Prevents conversion of codeine to its active metabolite morphineMinor (1)fluoxetine decreases effects of codeine by decreasing metabolism. Minor/Significance Unknown. Decreased conversion of codeine to active metabolite morphine.crizotinibMonitor Closely (1)crizotinib and fluoxetine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.Serious - Use Alternative (1)crizotinib 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 instancescyclizineMonitor Closely (4)cyclizine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. cyclizine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. cyclizine and olanzapine both increase sedation. Use Caution/Monitor.cyclobenzaprineMonitor Closely (4)olanzapine increases effects of cyclobenzaprine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. cyclobenzaprine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. cyclobenzaprine and olanzapine both increase sedation. Use Caution/Monitor. cyclobenzaprine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.Serious - Use Alternative (1)fluoxetine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.cyproheptadineMonitor Closely (2)cyproheptadine decreases effects of fluoxetine by pharmacodynamic antagonism. Use Caution/Monitor. Cyproheptadine may diminish the serotonergic effect of SSRIs. cyproheptadine and olanzapine both increase sedation. Use Caution/Monitor.dacomitinibSerious - Use Alternative (1)dacomitinib 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. dantroleneMonitor Closely (1)dantrolene and olanzapine both increase sedation. Use Caution/Monitor.daridorexantMonitor Closely (2)fluoxetine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. olanzapine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darifenacinMonitor Closely (3)olanzapine increases effects of darifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. darifenacin decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. darifenacin decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.Minor (1)darifenacin will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.darunavirMonitor Closely (1)darunavir will increase the level or effect of fluoxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with SSRIs, TCAs, or trazodone may require dose titration of antidepressant to desired effect (eg, using the lowest feasible initial or maintenance dose). Monitor for antidepressant response.dasatinibMonitor Closely (2)dasatinib 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 instances dasatinib and fluoxetine both increase QTc interval. Use Caution/Monitor.deferasiroxMonitor Closely (1)deferasirox will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.defibrotideMonitor Closely (1)defibrotide increases effects of fluoxetine by Other (see comment). Use Caution/Monitor. Comment: Defibrotide may enhance effects of platelet inhibitors.degarelixMonitor Closely (1)degarelix and fluoxetine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)degarelix 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 instancesdesfluraneSerious - Use Alternative (2)desflurane 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