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Drug Interactions between haloperidol and Zyprexa

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

haloperidol OLANZapine

Applies to: haloperidol and Zyprexa (olanzapine)

MONITOR: In general, the concurrent use of multiple neuroleptic agents may increase the risk of adverse effects such as sedation, orthostatic hypotension, and extrapyramidal symptoms due to overlapping pharmacodynamic activities. In one case report, the combination of haloperidol and olanzapine was associated with severe parkinsonism in an elderly patient with a history of bipolar disorder. Prior to the addition of olanzapine, the patient had been stabilized on haloperidol and exhibited mild symptoms of parkinsonism that were controlled with benztropine. While hospitalized, a decision was made to switch from haloperidol to olanzapine in an attempt to minimize the parkinsonism. Over the next 7 days, olanzapine dosage was gradually increased while haloperidol dosage simultaneously decreased. The patient developed increased rigidity, mumbling speech, and inability to walk, which did not resolve until 3 days after the cessation of haloperidol. Benztropine was then discontinued, and symptoms did not recur while the patient was maintained on olanzapine alone.

MANAGEMENT: The use of multiple neuroleptic agents should be approached with caution. Patients should be monitored closely and advised to notify their physician if they experience excessive sedation, orthostasis, or extrapyramidal symptoms (e.g., dystonic reactions, akathisia, parkinsonism, neuroleptic malignant syndrome, tardive dyskinesia).

References

  1. Gomberg RF "Interaction between olanzapine and haloperidol." J Clin Psychopharmacol 19 (1999): 272-3

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Drug and food interactions

Moderate

haloperidol food

Applies to: haloperidol

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
View all 4 references

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Moderate

OLANZapine food

Applies to: Zyprexa (olanzapine)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
View all 4 references

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Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Antipsychotics

Therapeutic duplication

The recommended maximum number of medicines in the 'antipsychotics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antipsychotics' category:

  • haloperidol
  • Zyprexa (olanzapine)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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