Consumer Information

Add to List

Symbyax

On This Page

Treatment & Uses
Side Effects
Treating Overdose
Safety Information
Before Using

Generic Name: fluoxetine and olanzapine (floo OX eh teen and oh LAN za peen)
Brand Names: Symbyax

What is Symbyax?

Feedback for Symbyax

User Reviews	Avg User Rating
14 Reviews		8.4	Rate it!

Symbyax contains a combination of fluoxetine and olanzapine. Fluoxetine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs).

Olanzapine is an antipsychotic medication. These drugs affect chemicals in the brain.

Symbyax is used to treat depression caused by bipolar disorder (manic depression).

Symbyax is also used to treat depression after at least 2 other medications have been tried without successful treatment of symptoms.

Symbyax may also be used for other purposes not listed here.

Important information about Symbyax

Symbyax is not for use in psychotic conditions related to dementia. Symbyax may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions. Do not take Symbyax together with pimozide (Orap), thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), rasagiline (Azilect), phenelzine (Nardil), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms while taking Symbyax such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Olanzapine can cause high blood sugar (hyperglycemia). If you are diabetic, check your blood sugar levels on a regular basis while you are taking Symbyax.

SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Symbyax, do not stop taking the medication without first talking to your doctor.

What should I discuss with my healthcare provider before taking Symbyax?

pimozide (Orap);
thioridazine (Mellaril); or
a MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam).

Serious and sometimes fatal reactions can occur when these medicines are taken with Symbyax. You must wait at least 14 days after stopping a MAO inhibitor before you can take this medicine. You must wait 5 weeks after stopping this medicine before you can take thioridazine (Mellaril) or a MAO inhibitor.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take Symbyax:

liver disease;
heart disease, high or low blood pressure, or a history of heart attack or stroke;
diabetes;
high cholesterol or triglycerides;
seizures or epilepsy;
glaucoma;
paralytic ileus (a stomach disorder);
enlarged prostate; or
a history of drug abuse or suicidal thoughts.

You may have thoughts about suicide when you first start taking an antidepressant such as Symbyax, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Symbyax, do not stop taking the medication without first talking to your doctor. Fluoxetine and olanzapine can pass into breast milk and may harm a nursing baby. Do not use Symbyax without telling your doctor if you are breast-feeding a baby. Do not give Symbyax to anyone younger than 18 years old without the advice of a doctor.

How should I take Symbyax?

Take Symbyax exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Symbyax can be taken with or without food. Try to take it at the same time each day.

It may take up to 4 weeks of using Symbyax before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment.

Symbyax can cause high blood sugar (hyperglycemia). If you are diabetic, check your blood sugar levels on a regular basis while you are taking this medicine.

Store this medicine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of Symbyax. Overdose symptoms may include nausea, vomiting, tremor, problems with speech or vision, seizure (convulsions), and coma.

What should I avoid while taking Symbyax?

Drink plenty of fluids, especially in hot weather and during exercise. It is easier to become dangerously overheated and dehydrated while you are taking Symbyax. Avoid drinking alcohol, which can increase some of the side effects of this medicine.

Symbyax can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Symbyax side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Symbyax: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

sudden and severe headache, blurred vision, confusion, chest pain, numbness, and problems with vision, speech, or balance;
increased thirst, frequent urination, excessive hunger, or weakness;
fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, trouble breathing;
jerky muscle movements you cannot control;
seizure (convulsions);
feeling like you might pass out;
easy bruising or bleeding; or
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious Symbyax side effects may include:

trouble swallowing, runny nose, sore throat;
weight gain, swelling in your hands of feet;
drowsiness, trouble concentrating, sleep problems (insomnia);
dry mouth, diarrhea, changes in appetite; or
decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Symbyax?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with Symbyax may cause you to bruise or bleed easily.

Before using Symbyax, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety). They can add to sleepiness caused by Symbyax.

The following drugs can interact with Symbyax. Tell your doctor if you are using any of these:

vinblastine (Velban);
heart rhythm or blood pressure medication;
tryptophan (sometimes called L-tryptophan);
lithium, clozapine (Clozaril, Fazaclo), haloperidol (Haldol);
phenytoin (Dilantin), carbamazepine (Carbatrol, Tegretol);
a blood thinner such as warfarin (Coumadin);
another form of fluoxetine or olanzapine such as Prozac, Prozac Weekly, Sarafem, or Zyprexa;
theophylline (Theo-Dur, TheoBid, Uniphyl, Slo-Bid, Elixophyllin, and others);
medicine to treat Parkinson's disease, such as bromocriptine (Parlodel), pergolide (Permax), pramipexole (Mirapex), ropinorole (Requip), or cabergoline (Cabaser);
almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
any other antidepressants.

This list is not complete and there may be other drugs that can interact with Symbyax. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about Symbyax.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Symbyax only for the indication prescribed.
Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.li>