Symbyax: Oral capsule

What is this medicine?

What should I tell my health care provider before I take this medicine?

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They need to know if you have any of these conditions:
-Alzheimer's disease or dementia
-bleeding disorders
-diabetes
-glaucoma
-heart disease, irregular heartbeat, or previous heart attack
-high blood pressure treated with medication
-kidney disease
-liver disease
-low blood pressure
-low levels of potassium or magnesium in the blood
-Parkinson's disease
-receiving electroconvulsive therapy
-strokes, or mini-strokes called transient ischemic attacks (TIAs)
-suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
-an unusual or allergic reaction to fluoxetine, olanzapine, other medicines, foods, dyes, or preservatives
-pregnant or trying to get pregnant
-breast-feeding

How should I use this medicine?

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Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You can take this medicine with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking this medicine suddenly except upon the advice of your doctor. Stopping this medicine too quickly may cause serious side effects or your condition may worsen.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 10 years of age for selected conditions, precautions do apply.

What if I miss a dose?

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If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

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Do not take this medicine with any of the following medications:

-other medicines containing fluoxetine or olanzapine, such as Prozac, Sarafem, or Zyprexa
-cisapride
-dofetilide
-dronedarone
-linezolid
-MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
-methylene blue (injected into a vein)
-metoclopramide
-pimozide
-thioridazine
-ziprasidone

This medicine may also interact with the following medications:

-alcohol
-amphetamines
-aspirin or aspirin-like medicines
-carbamazepine
-certain medicines for depression, anxiety, or psychotic disturbances
-certain medicines for migraine headaches like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
-digoxin
-diuretics
-fentanyl
-flecainide
-furazolidone
-isoniazid
-lithium
-medicines for high blood pressure
-medicines for Parkinson's diseasemedicines for sleep
-medicines that treat or prevent blood clots like warfarin, enoxaparin, and dalteparin
-NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
-omeprazole
-other medicines that prolong the QT interval (cause an abnormal heart rhythm)
-phenytoin
-procarbazine
-propafenone
-rifampin
-ritonavir
-supplements like St. John's wort, kava kava, valerian
-tramadol
-tryptophan
-vinblastine

What should I watch for while using this medicine?

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Tell your doctor if your symptoms do not get better or if they get worse. Visit your doctor or health care professional for regular checks on your progress. Because it may take several weeks to see the full effects of this medicine, it is important to continue your treatment as prescribed by your doctor.

Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This medicine can reduce the response of your body to heat or cold. Dress warm in cold weather and stay hydrated in hot weather. If possible, avoid extreme temperatures like saunas, hot tubs, very hot or cold showers, or activities that can cause dehydration such as vigorous exercise.

What side effects may I notice from receiving this medicine?

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Side effects that you should report to your doctor or health care professional as soon as possible:

-allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
-anxious
-breathing problems
-changes in vision
-confusion
-difficulty in speaking or swallowing
-elevated mood, decreased need for sleep, racing thoughts, impulsive behavior
-excessive thirst and/or hunger
-eye pain
-fast heartbeat
-fever or chills, sore throat
-fever with rash, swollen lymph nodes, or swelling of the face
-flu-like symptoms
-frequently needing to urinate
-muscle spasms or weakness
-painful or prolonged erections
-redness, blistering, peeling or loosening of the skin, including inside the mouth
-restlessness, pacing, inability to keep still
-seizures
-stiff muscles
-suicidal thoughts or other mood changes
-trouble sleeping
-unusual bleeding or bruising
-unusually weak or tired
-vomiting
-weight gain

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

-change in sex drive or performance
-constipation
-diarrhea
-dizziness
-indigestion, nausea
-tired
-tremors