Consider therapy modification Chlorphenesin Carbamate: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Avoid combination CNS Depressants: Monitor therapy Dimethindene Topical: Consider dose reductions of droperidol or of other CNS agents e. Consider therapy modification Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline.
Monitor therapy Gastrointestinal Agents Prokinetic: Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents Prokinetic.
Specifically, the risk of gastrointestinal adverse effects may be increased. Monitor therapy Glycopyrrolate Oral Inhalation: Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate Oral Inhalation. Antipsychotic Agents may diminish the therapeutic effect of Guanethidine.
Avoid concomitant use of hydrocodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Consider therapy modification HydrOXYzine: Specifically, the risk for seizures may be increased. Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iohexol.
Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic anticonvulsants. Consider therapy modification Iomeprol: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iomeprol. Consider therapy modification Iopamidol: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iopamidol.
Consider therapy modification Ipratropium Oral Inhalation: Anticholinergic Agents may diminish the therapeutic effect of Itopride.
Monitor therapy Kava Kava: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. May enhance the neurotoxic effect of Antipsychotic Agents. Lithium may decrease the serum concentration of Antipsychotic Agents. Specifically noted with chlorpromazine. Monitor therapy Magnesium Sulfate: Antipsychotic Agents may enhance the arrhythmogenic effect of Mequitazine. Consider alternatives to one of these agents when possible. While this combination is not specifically contraindicated, mequitazine labeling describes this combination as discouraged.
Consider therapy modification Methotrimeprazine: Further CNS depressant dosage adjustments should be initiated only after clinically effective methotrimeprazine dose is established. Consider therapy modification Methylphenidate: Though the drugs listed here have uncertain QT-prolonging effects, they all have some possible association with QT prolongation and should generally be avoided when possible. Consider therapy modification Minocycline: Anticholinergic Agents may decrease the absorption of Nitroglycerin.
Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Monitor therapy Obeticholic Acid: Anticholinergic Agents may enhance the anticholinergic effect of OnabotulinumtoxinA. Monitor therapy Opioid Analgesics: Avoid concomitant use of opioid analgesics and benzodiazepines or other CNS depressants when possible.
Consider therapy modification Orphenadrine: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. Consider therapy modification Paraldehyde: Avoid combination Peginterferon Alfa-2b: Patients taking perampanel with any other drug that has CNS depressant activities should avoid complex and high-risk activities, particularly those such as driving that require alertness and coordination, until they have experience using the combination.
Consider therapy modification Piribedil: Antipsychotic Agents may diminish the therapeutic effect of Piribedil. Piribedil may diminish the therapeutic effect of Antipsychotic Agents. Use of piribedil with antiemetic neuroleptics is contraindicated, and use with antipsychotic neuroleptics, except for clozapine, is not recommended.
Avoid combination Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride.
Avoid combination Potassium Citrate: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate. These effects are specific to the GI tract. Avoid such combinations when possible. Use should be accompanied by close monitoring for evidence of QT prolongation or other alterations of cardiac rhythm. Antipsychotic Agents may diminish the therapeutic effect of Quinagolide. Anticholinergic Agents may enhance the constipating effect of Ramosetron.
Anticholinergic Agents may enhance the anticholinergic effect of RimabotulinumtoxinB. Specifically, sleepiness and dizziness may be enhanced. Anticholinergic Agents may diminish the therapeutic effect of Secretin. Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Consider therapy modification Selective Serotonin Reuptake Inhibitors: Specifically, the risk of psychomotor impairment may be enhanced.
Monitor therapy Serotonin Modulators: Specifically, serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotic Agents may enhance the serotonergic effect of Serotonin Modulators. This could result in serotonin syndrome. Monitor therapy Sodium Oxybate: Consider alternatives to combined use.
When combined use is needed, consider minimizing doses of one or more drugs. Use of sodium oxybate with alcohol or sedative hypnotics is contraindicated. Consider therapy modification Sulpiride: Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended.
Consider therapy modification Tapentadol: Avoid concomitant use of tapentadol and benzodiazepines or other CNS depressants when possible.
Consider therapy modification Teriflunomide: Avoid combination Thiazide and Thiazide-Like Diuretics: Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. Avoid combination Valproate Products: Consider alternatives to such combinations whenever possible, particularly if the CYP1A2 substrate has a relatively narrow therapeutic index. Consider therapy modification Zolpidem: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.
No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. Frequency not always defined. Unless otherwise noted, adverse events are reported for placebo-controlled trials in adult patients on extended release IM injection Zyprexa Relprevv. The safety of doses greater than 20 mg per day has not been determined.
Olanzapine is eliminated from the body more quickly in young people than in older over age 60 individuals, in men than in women, and in smokers faster than in non-smokers.
Dosage adjustments may be needed based upon individual patient characteristics. Precautions Caution should be used in patients with heart disease because the drug may cause blood pressure to fall too low resulting in dizziness, rapid heartbeats, or fainting.
Olanzapine should be used carefully in people with known seizure disorders since olanzapine may alter properties of the brain making seizures occur more easily. People with liver disease should have their liver function monitored regularly while taking olanzapine. Women who are pregnant or breast-feeding should not take olanzapine. People with phenylketonuria, a disorder in which the body is unable to metabolize a protein called phenylalanine, should avoid olanzapine disintegrating tablets, because this form of the drug contains phenylalanine.
Other side effects that are possible include rash, body aches and pains, elevated liver enzymes, vision abnormalities, chest pain, or rapid heartbeats. Olanzapine has the potential to produce a serious side effect called tardive dyskinesia. This syndrome consists of involuntary, uncoordinated movements that may appear late in therapy and not disappear even after the drug is stopped.
Tardive dyskinesia involves involuntary movements of the tongue, jaw, mouth or face or other groups of skeletal muscles. The incidence of tardive dyskinesia increases with increasing age and with increasing dosage of olanzapine.
Women are at greater risk than men for developing tardive dyskinesia. There is no known effective treatment for tardive dyskinesia, although gradual but rarely complete improvement may occur over a long period.
An occasionally reported side effect of olanzapine is neuroleptic malignant syndrome. The recommended treatment for resistant depression is mg of olanzapine combined with mg of fluoxetine once daily in the evening while the recommended treatment for depression associated with bipolar disorder is Which drugs or supplements interact with olanzapine? Carbamazepine Tegretol can reduce blood concentrations of olanzapine, possibly necessitating higher doses of olanzapine.
Other drugs that may also reduce blood levels of olanzapine are omeprazole Prilosec and rifampin. Smoking may reduce blood concentrations of olanzapine. Ciprofloxacin Cipro , diltiazem Cardizem , Dilacor, Tiazac , erythromycin , and fluvoxamine Luvox may have the opposite effect, that is, they may increase blood levels of olanzapine, and the dose of olanzapine may need to be reduced.
Olanzapine can cause orthostatic hypotension , a drop in blood pressure upon standing up that may cause dizziness or even fainting. Taking olanzapine with either diazepam Valium , other related benzodiazepines or alcohol can exaggerate the orthostatic hypotension caused by olanzapine. Is olanzapine safe to take if I'm pregnant or breastfeeding?
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