Fluvoxamine Maleate and Zyprexa

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using OLANZapine together with fluvoxaMINE may increase the effects of OLANZapine. Contact your doctor if you experience drowsiness, agitation, aggression, slurred speech, confusion, increased heart rate, jerky or uncontrolled muscle movements, trouble breathing, or fainting. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration with fluvoxamine may significantly increase the plasma concentrations of olanzapine. The mechanism is fluvoxamine inhibition of CYP450 1A2, the isoenzyme primarily responsible for the metabolic clearance of olanzapine. In an analysis of data from a therapeutic drug monitoring service, patients treated concomitantly with fluvoxamine had olanzapine plasma concentration to daily dose (C/D) ratios that were on average 2.3-fold higher than those of patients receiving olanzapine alone. The difference was as high as 4.2-fold in some patients. In contrast, coadministration with sertraline was not associated with increased C/D ratios compared to olanzapine alone, and a pharmacokinetic study involving 15 healthy volunteers also demonstrated no significant interaction with fluoxetine. Clinical toxicity has been cited in a case report of a patient treated with fluvoxamine and olanzapine for several months. The patient had mydriasis, hand tremors, and muscle rigidity in association with toxic olanzapine plasma levels. Significant reduction of the olanzapine dosage did not produce adequate results and the patient was switched to paroxetine with no further problems.

MANAGEMENT: Pharmacologic response and olanzapine plasma levels should be monitored more closely whenever fluvoxamine is added to or withdrawn from therapy in patients stabilized on their antipsychotic regimen, and the dosage adjusted as necessary. Alternatively, other selective serotonin reuptake inhibitors (SSRIs) such as citalopram, fluoxetine, paroxetine, and sertraline may be considered, since they do not inhibit CYP450 1A2 and are not expected to interact with olanzapine in this manner.

Fluvoxamine Maleate

Generic Name: fluvoxamine

Brand name: Luvox, Luvox CR

Synonyms: Fluvoxamine

What is Fluvoxamine Maleate?

Zyprexa

Generic Name: olanzapine

Brand name: Zyprexa, Zyprexa Zydis, Zyprexa Intramuscular, Zyprexa Relprevv

Synonyms: n.a.

What is Zyprexa?