olanzapine 20 mg-samidorphan 10 mg tablet

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Medication name

Generic name:
Olanzapine/samidorphan - oral

Pronunciation
(oh-LAN-za-peen/SAM-i-DOR-fan)

Brand name(s)
Lybalvi

Warning

There may be a slightly increased risk of serious, possibly fatal side effects (such as stroke, heart failure, fast/irregular heartbeat, pneumonia) when this product is used by older adults with dementia. This product is not approved for the treatment of dementia-related behavior problems. Discuss the risks and benefits of this product, as well as other effective and possibly safer treatments for dementia-related behavior problems, with the doctor.

Uses

This combination medication is used to treat certain mental/mood disorders (such as schizophrenia, bipolar disorder). Olanzapine belongs to a class of drugs called atypical antipsychotics. It works by helping to restore the balance of certain natural substances in the brain. Samidorphan belongs to a class of drugs known as opioid antagonists. It reduces the risk of weight gain caused by olanzapine.

How to use

Read the Medication Guide provided by your pharmacist before you start taking olanzapine/samidorphan and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this product by mouth with or without food as directed by your doctor, usually once daily. Swallow the tablet whole. Do not split the tablet.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this product at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.

Take this product regularly to get the most benefit from it. To help you remember, take it at the same time each day. Keep taking this product even if you feel well. Do not stop taking this product without consulting your doctor.

Tell your doctor if your condition does not get better or if it gets worse.

Side effects

Drowsiness, dizziness, lightheadedness, stomach upset, dry mouth, constipation, increased appetite, or weight gain may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position.

Remember that this product has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this product do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

  • difficulty swallowing
  • shaking (tremor)
  • slow heartbeat
  • fainting
  • mental/mood changes (such as confusion, restlessness)
  • numbness/tingling of arms/legs
  • yellowing eyes/skin
  • severe stomach/abdominal pain
  • trouble urinating
  • interrupted breathing during sleep

This product may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

This product may also cause significant weight gain and a rise in your blood cholesterol (or triglyceride) levels. These effects, along with diabetes, may increase your risk for developing heart disease. Discuss the risks and benefits of treatment with your doctor. (See also Notes section.)

This product may rarely cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any unusual/uncontrolled movements (especially of the face, lips, mouth, tongue, arms or legs).

This product may increase a certain natural substance (prolactin) made by your body. For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor right away.

Get medical help right away if you have any very serious side effects, including:

  • seizures

This product may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms:

  • fever
  • muscle stiffness/pain/tenderness/weakness
  • severe tiredness
  • severe confusion
  • sweating
  • fast/irregular heartbeat
  • dark urine
  • signs of kidney problems (such as change in the amount of urine)

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • fever
  • swollen lymph nodes
  • rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking olanzapine/samidorphan, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

  • personal or family history of a substance use disorder (such as overuse of or addiction to opioids)
  • opioid withdrawal
  • liver problems
  • seizures
  • difficulty swallowing
  • low white blood cell count
  • dementia
  • difficulty urinating (for example, due to enlarged prostate)
  • glaucoma (narrow angle)
  • stomach/intestinal problems (such as blockage, chronic constipation, paralytic ileus)
  • smoking
  • personal or family history of diabetes
  • heart disease
  • high cholesterol/triglyceride levels
  • breathing trouble during sleep (sleep apnea)

This product may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This product may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.

Older adults may be more sensitive to the side effects of this drug, especially drowsiness, constipation, trouble urinating, confusion, dizziness, and lightheadedness. Drowsiness, confusion, dizziness, and lightheadedness can increase the risk of falling.

During pregnancy, this product should be used only when clearly needed. Babies born to mothers who have used olanzapine during the last 3 months of pregnancy may rarely develop symptoms including muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away.

Since untreated mental/mood problems (such as schizophrenia, bipolar disorder) can be a serious condition, do not stop taking this product unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, discuss with your doctor right away the benefits and risks of using this product during pregnancy.

Olanzapine passes into breast milk and may have undesirable effects on a nursing infant. It is unknown if samidorphan passes into breast milk. Tell the doctor right away if your baby develops symptoms such as muscle stiffness or shakiness, unusual sleepiness, or difficulty feeding. Consult your doctor before breastfeeding.

Drug interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

A product that may interact with this drug is:

  • metoclopramide

Taking opioid pain medications (such as morphine, methadone) with this product may cause opioid withdrawal. Do not take any opioids during treatment with this product. The risk of opioid overdose is also higher if you take opioids after recently stopping olanzapine/samidorphan. Opioids should not be taken too soon before and after treatment with olanzapine/samidorphan. Ask your doctor when to start or stop taking olanzapine/samidorphan, and how long to wait before using opioids.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

This medication may interfere with certain lab tests (such as drug tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: severe drowsiness/dizziness, fast/irregular heartbeat, unusual/uncontrolled movements, seizures.

Notes

Do not share this medication with others.

Lab and/or medical tests (such as blood sugar, weight, blood pressure, blood cholesterol/triglyceride levels, liver function tests) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

Missed dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Important note

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Information last revised May 2024.

Selected from NATIONAL DRUG DATA FILE (NDDF) data included with permission and copyrighted by First Databank, Inc., 2019. This copyrighted material has been downloaded from a licensed data provider.

The above information is intended to supplement, not substitute for, the expertise and judgment of your health care professional. You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment.