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Olanzapine / Fluoxetine Coupon - Olanzapine / Fluoxetine 6mg/25mg capsule

olanzapine / fluoxetine

Generic Symbyax
Used for Depression, Bipolar Disorder
Used for Depression, Bipolar Disorder

Symbyax is a combination of two medications: olanzapine (an atypical antipsychotic) and fluoxetine (a selective serotonin reuptake inhibitor (SSRI). It's used to treat depressive episodes of bipolar 1 disorder in adults and children ages 10 years and older, as well as treatment-resistant depression in adults. Symbyax (olanzapine / fluoxetine) comes as capsules that are taken by mouth once per day. Some side effects include sleepiness, weight gain, and dry mouth. Symbyax is available as brand-name and generic medications.

Last reviewed on November 4, 2024
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What is Symbyax (olanzapine / fluoxetine)?

What is Symbyax (olanzapine / fluoxetine) used for?

How Symbyax (olanzapine / fluoxetine) works

Symbyax contains two medications that work together to help with mood:

Are you looking for information on olanzapine (Zyprexa) or fluoxetine (Prozac) instead?

Drug Facts

Common BrandsSymbyax
Drug ClassAtypical antipsychotic / SSRI
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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$385.99(save 21.87%)
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$301.59
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What are the side effects of Symbyax (olanzapine / fluoxetine)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Sleepiness (27%)
  • Weight gain (25%)
  • Large appetite (20%)
  • Dry mouth (15%)
  • Swelling from fluids (15%)
  • Tiredness (12%)
  • Shakiness (9%)
Note: Side effects listed were reported by adults in clinical studies.

Other Side Effects

  • Blurry vision
  • Weakness
  • Pain
  • Having a hard time paying attention
  • Feeling restless
  • Sexual dysfunction
  • Nervousness
  • Fever
  • Runny nose

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Suicidal thoughts or actions
  • Serious allergic and skin reactions: hives, blisters, skin reddening or peeling, swelling of the lips or tongue, difficulty breathing
  • Neuroleptic malignant syndrome: fever, sweating, stiff muscles, confusion, not aware of your surroundings, fast or irregular heartbeat
  • Serotonin syndrome: fast heart rate, dizziness, sweating, flushing, tremor (shakiness), muscle stiffness, muscle twitching or spasms, uncoordinated movement, distress, seizures, distress, hallucinations, coma
  • Difficulty swallowing
  • Seizures
  • Abnormal heart rhythm (QT prolongation): chest pounding, short of breath, chest pain, feeling faint or lightheaded
  • Dangerously high blood sugar: frequently thirsty, needing to urinate often, tiredness, nausea, vomiting, difficulty breathing, having fruity breath, having dry mouth
  • Low blood sodium levels: nausea, fatigue, headache, confusion, disoriented, hallucinations (seeing things that aren't real), seizures, unconsciousness

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Bloating or swelling of the face, arms, hands, lower legs, or feet

body aches or pain

confusion

congestion

cough

delusions

dementia

dryness or soreness of the throat

fever

hoarseness

rapid weight gain

runny nose

shakiness in the legs, arms, hands, or feet

tender, swollen glands in the neck

tingling of the hands or feet

trembling or shaking of the hands or feet

trouble with swallowing

unusual weight gain or loss

voice changes

Less common

Blurred vision

change in personality

change in vision

difficult or labored breathing

difficulty with sleeping

difficulty with speaking

dizziness

ear pain

headache

impaired vision

increase in body movements

loss of memory

nervousness

pounding in the ears

problems with memory

slow, fast, pounding, or irregular heartbeat or pulse

tightness in the chest

Rare

Inability to move the eyes

increased blinking or spasms of the eyelid

sticking out of the tongue

uncontrolled twisting movements of the neck, trunk, arms, or legs

unusual facial expressions

Incidence not known

Bloody or black, tarry stools

constipation

severe stomach pain

vomiting of blood or material that looks like coffee grounds

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea

dry mouth

increased appetite

lack or loss of strength

weight gain

Less common

Change or problem with discharge of semen

decreased interest in sexual intercourse

difficulty with moving

inability to have or keep an erection

loss in sexual ability, desire, drive, or performance

muscle pain or stiffness

not able to have an orgasm

pain, swelling, or redness in the joints

tooth disorder

twitching

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Symbyax (olanzapine / fluoxetine)

thumbs-up

Pros

Conveniently combines two medications in one pill

Taken once daily

Can be taken with or without food

An option for children ages 10 years and older (in bipolar disorder)

thumbs-down

Cons

Can lower blood pressure (orthostatic hypotension), which raises risk of falls

Stopping too suddenly can lead to withdrawal symptoms, like dizziness and nausea

Drinking alcohol at the same time can worsen sleepiness

Can cause sexual problems as side effects

pharmacist-tips

Pharmacist tips for Symbyax (olanzapine / fluoxetine)

pharmacist
  • It's best to take Symbyax (olanzapine / fluoxetine) in the evening. Because this medication can make you sleepy and dizzy, taking it closer to bedtime can make these side effects less bothersome during the day. Don't drive or do anything that needs a lot of focus or attention until you know how this medication affects you.

    • Symbyax (olanzapine / fluoxetine) can make you feel dizzy or faint, which can lead to falls. To lower this risk, get up slowly and hold onto something when you're trying to stand from a sitting or lying position.

      • Symbyax (olanzapine / fluoxetine) can make it harder for your body to cool down if your body temperature gets too high. This makes it more likely for you to become dehydrated and your body to overheat. It's important to drink enough water to stay hydrated when you're taking this medication. Avoid spending extended time outside when it's hot. Get medical help if you have symptoms of heat exhaustion, including muscle cramps, nausea, and headache.

        • Symbyax (olanzapine / fluoxetine) might worsen suicidal thoughts. Contact your psychiatrist right away if you or your loved ones notice any new or worsening changes in your behavior or mood while taking the medication.

          • Don't suddenly stop taking Symbyax (olanzapine / fluoxetine) without talking to your prescriber first. Doing so can cause withdrawal symptoms, such as anxiety and balance issues. If you want to stop the medication, your healthcare team can help you do so safely by lowering your dose slowly over time.

            • Both olanzapine and fluoxetine interact with many medications. Tell your care team about all of the medications you're taking before starting Symbyax (olanzapine / fluoxetine) so they can help you check for interactions.

              • Olanzapine and fluoxetine in Symbyax can get into breastmilk. This can cause side effects in breastfed babies, such as fussiness and sleepiness. Let your psychiatrist know if you're breastfeeding. They'll discuss with you the risks and benefits of continuing Symbyax (olanzapine / fluoxetine).

                faqs

                Frequently asked questions about Symbyax (olanzapine / fluoxetine)

                Is Symbyax (olanzapine / fluoxetine) an antipsychotic?
                Yes, olanzapine in Symbyax is an atypical antipsychotic. It works in the brain to balance the levels of certain chemicals to help regulate mood. The other medication in Symbyax is fluoxetine, a selective serotonin reuptake inhibitors (SSRIs) antidepressant.
                How quickly does Symbyax (olanzapine / fluoxetine) start to work?
                A study suggests that Symbyax (olanzapine / fluoxetine) can help improve mood within a week in adults with bipolar I depression. But it can take a couple months to get the full benefit from the medication. Contact your psychiatrist if you're not sure if Symbyax (olanzapine / fluoxetine) is working for you.
                Does Symbyax (olanzapine / fluoxetine) make you sleepy?
                Yes, sleepiness is the most common side effect of Symbyax (olanzapine / fluoxetine), which is why it's recommended to take your dose in the evening. You're at higher risk for this side effect if you're also taking other medications that cause sleepiness. When you first start Symbyax (olanzapine / fluoxetine), don't drive or do anything that requires concentration until you know how this medication affects you. Contact your prescriber if Symbyax (olanzapine / fluoxetine) is making you too sleepy and it's affecting your ability to go about your day.
                Does Symbyax (olanzapine / fluoxetine) cause weight gain?
                Yes, Symbyax (olanzapine / fluoxetine) can cause weight gain. Olanzapine in Symbyax can raise your blood sugar and cholesterol levels, and also make you feel more hungry, all of which can lead to weight gain. If you're concerned about the risk of weight gain, talk with your healthcare team. They can recommend ways to maintain a healthy body weight while taking this medication, such as planning balanced and nutritious meals with ingredients, such as lean proteins, whole-grains, fruits, and vegetables. They can also help build a regular exercise routine that's appropriate for you.
                Is Symbyax (olanzapine / fluoxetine) a controlled substance?
                No, Symbyax (olanzapine / fluoxetine) isn't a controlled substance because it doesn't have a risk of addition or dependence.
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                warings-icon

                What are the risks and warnings for Symbyax (olanzapine / fluoxetine)?

                Symbyax (olanzapine / fluoxetine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                risk-warning

                Worsening depression, suicidal thoughts and behavior

                • Risk factors: Age under 24 years old | History of depression or other mental health conditions

                  Taking Symbyax (olanzapine / fluoxetine) might raise the risk of worsening depression and thoughts of self-harm. If you or anyone around you notice that you have suicidal thoughts or unusual behavior (e.g., anxiety, panic attacks, difficulty sleeping, feeling angry or irritated, restlessness) while taking Symbyax (olanzapine / fluoxetine), get medical help right away.

                  risk-warning

                  Higher risk of death in older people with dementia-related psychosis

                  • Risk factors: Age 65 years and older with dementia and psychosis

                    People 65 years and older with dementia sometimes have symptoms of schizophrenia, like delusions and hallucinations (believing, seeing, or hearing things that aren't real). This is called dementia-related psychosis. Older people with dementia-related psychosis have a high risk of death if they take antipsychotic medications like olanzapine in Symbax. Because of this risk, Symbyax (olanzapine / fluoxetine) shouldn't be taken by older adults with dementia-related psychosis. Let your prescriber know if you or your loved one has dementia before starting Symbyax (olanzapine / fluoxetine).

                    risk-warning

                    Neuroleptic malignant syndrome

                    Taking antipsychotic medications like olanzapine in Symbax can cause a rare, but life-threatening condition called neuroleptic malignant syndrome. Symptoms include fever, sweating, stiff muscles, confusion, not aware of your surroundings, and fast or irregular heartbeat. If you experience any of these symptoms while taking Symbyax (olanzapine / fluoxetine), get medication attention as soon as possible. Your prescriber will likely have you stop taking Symbyax (olanzapine / fluoxetine) and switch you to something else.

                    risk-warning

                    Difficulty concentrating and extreme sleepiness

                    • Risk factors: Taking high doses of Symbyax (olanzapine / fluoxetine) | Age 65 years or older | Drinking alcohol | Taking other medications that can cause sleepiness

                      Symbyax (olanzapine / fluoxetine) can cause extreme sleepiness and lower your ability to think, react, and focus. Your risk is higher if you're also taking other medications that can cause drowsiness, such as benzodiazepines, anxiety medications, muscle relaxants, and sleep medications. Make sure you know how this medication affects you before driving a car or doing activities that require your concentration. Talk to your healthcare professional right away if you feel too sleepy from taking Symbyax (olanzapine / fluoxetine).

                      risk-warning

                      Severe allergic skin reactions

                      Although rare, Symbyax (olanzapine / fluoxetine) can cause serious skin reactions, such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). If you notice changes in your skin (e.g., rash, blisters, swollen lymph nodes, skin reddening, skin peeling) or experience swelling in your face or trouble breathing, stop using Symbyax (olanzapine / fluoxetine) and get medical attention right away.

                      risk-warning

                      Weight gain, higher blood sugar, and higher cholesterol levels

                      • Risk factors: Diabetes | High cholesterol | Obesity

                        Olanzapine in Symbyax can raise your blood sugar and cholesterol levels as well as raise your appetite, all of which can lead to weight gain. Your prescriber might order blood tests regularly throughout treatment with Symbyax (olanzapine / fluoxetine) to make sure your blood sugar and cholesterol aren't too high. Make sure to have a healthy and balanced diet low in fat and sugar and maintain a regular exercise routine while taking Symbyax (olanzapine / fluoxetine).

                        risk-warning

                        Serotonin syndrome

                        • Risk factors: Taking other medications that raise serotonin levels in your brain

                          Some people taking Symbyax (olanzapine / fluoxetine) have developed a rare, but potentially life-threatening condition called serotonin syndrome. This condition happens where there's too much serotonin in the brain. Your risk for serotonin syndrome is higher if you take Symbyax (olanzapine / fluoxetine) with other medications that can raise your serotonin levels, such as certain antidepressants, mental health medications, pain medications, and migraine medications. Let your psychiatrist know about all the medications you take before starting Symbyax (olanzapine / fluoxetine). Also, don't start any new medications without talking to your psychiatrist first. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Get medical help right away if you have any of these symptoms.

                          risk-warning

                          Glaucoma

                          • Risk factors: History of angle-closure glaucoma

                            Symbyax (olanzapine / fluoxetine) can lead to or worsen angle-closure glaucoma. You might need to see your optometrist regularly and get eye exams to check your eyes and make sure your vision isn't worsening. Contact your optometrist or psychiatrist if you notice changes in your vision after starting Symbyax (olanzapine / fluoxetine).

                            risk-warning

                            Difficulty controlling body movements

                            Olanzapine in Symbyax can cause uncontrolled body movements, such as eye-twitching or lip-smacking. This is more likely to happen the longer you take medications like Symbyax (olanzapine / fluoxetine). This can become permanent if it's not caught in time. If you experience any uncontrolled movements and aren't able to stop them, talk to your healthcare professional right away.

                            risk-warning

                            Risk of bleeding

                            • Risk factors: Taking blood-thinners or other medications that raise your risk of bleeding

                              Fluoxetine in Symbyax (olanzapine / fluoxetine) can raise your risk of severe bleeding or bruising, especially if you're also taking antiplatelets (e.g., aspirin, clopidogrel (Plavix)) or anticoagulants (e.g., warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto)). Get medical help if you get bruising that doesn't improve, black-colored stools, pink or red-colored urine, coughing up or vomiting blood, or unusual bleeding from the nose or gums.

                              risk-warning

                              Lower white blood cell counts

                              • Risk factors: History of low blood cell counts

                                Though not common, olazapine in Symbyax can lower your white blood cell (WBC) counts, especially if you already have low WBC levels from other medical conditions. This can raise your risk of serious infection. You'll need to get blood tests done regularly during the first few months of taking Symbyax (olanzapine / fluoxetine) so your prescriber can make sure your blood cell counts are in the normal range. If your WBC levels drop too low, you'll likely need to stop taking Symbyax (olanzapine / fluoxetine). If you develop any signs of infection, such as fever, tiredness, chills, cough, or trouble breathing, and they don't go away, contact your prescriber right away.

                                risk-warning

                                Low blood sodium levels

                                • Risk factors: Older adults | Taking diuretic medications

                                  Though rare, fluoxetine in Symbyax can cause low blood sodium levels. Your prescriber might closely monitor your blood sodium levels before and during treatment with Symbyax (olanzapine / fluoxetine). Get medical help right away if you experience weakness, confusion, difficulty concentrating, headache, or memory problems because these could be signs of low blood sodium levels, which is a medical emergency.

                                  risk-warning

                                  Life-threatening abnormal heart rhythm (QT prolongation)

                                  • Risk factors: Low blood potassium or magnesium levels | Older age | Kidney problems | History of heart problems, slow heart rate, or other abnormal heart rhythms (arrhythmias) | Personal or family history of long QT syndrome | Taking other medications that cause QT prolongation

                                    Fluoxetine in Symbyax can can cause a serious heart rhythm problem called QT prolongation. You're at higher risk for this problem if you're taking other medications that cause heart rhythm problems, such as amiodarone (Pacerone). Because people who have QT prolongation typically don't experience symptoms, your psychiatrist or primary care provider might periodically monitor your heart with electrocardiograms (EKGs), if needed. If you feel your chest pounding, have shortness of breath, have chest pain, or feel faint or lightheaded while taking Symbyax (olanzapine / fluoxetine), call 911 right away.

                                    risk-warning

                                    Anticholinergic side effects

                                    Olanzapine in Symbyax might cause anticholinergic side effects, including trouble urinating, constipation, and bowel movement problems. The risk of these side effects are higher if you're taking other anticholinergic medications, such as certain ones for treating overactive bladder or motion sickness. Before starting Symbyax (olanzapine / fluoxetine), ask your healthcare team to help you check for medication interactions.

                                    risk-warning

                                    High prolactin levels

                                    Antipsychotics like olanzapine in Symbyax can raise the levels of prolactin in your body. High prolactin can lead to fertility problems, enlarged male breasts, sexual dysfunction, and absence or irregular menstrual periods. Your healthcare professional will likely measure your prolactin levels during treatment to make sure they aren't too high.

                                    dosage

                                    Symbyax (olanzapine / fluoxetine) dosage forms

                                    The average cost for 30 capsules of 6mg/25mg of Symbyax (olanzapine / fluoxetine) is $407.86 with a free GoodRx coupon. This is 19.71% off the average retail price of $507.99.
                                    capsule
                                    Capsule
                                    DosageQuantityPrice as low asPrice per unit
                                    3mg/25mg30 capsules$301.59$10.05
                                    6mg/25mg30 capsules$407.86$13.60

                                    Typical dosing for Symbyax (olanzapine / fluoxetine)

                                    Adults

                                    • Depressive episodes of bipolar 1 disorder and treat-resistant depression: The typical starting dose for Symbyax is 6 mg/25 mg (olanzapine/fluoxetine) by mouth once per day in the evening. The maximum dose is 18 mg/75 mg (olanzapine/fluoxetine) per day.

                                    Children ages 10 years and older

                                    • Depressive episodes of bipolar 1 disorder: The typical starting dose for Symbyax is 3 mg/25 mg (olanzapine/fluoxetine) by mouth once a day in the evening. The maximum dose is 12 mg/50 mg (olanzapine/fluoxetine) per day.

                                    Your dose might differ if you have a higher risk of low blood pressure, have liver problems, are female, are non-smoking, or 65 years or older.

                                    More on Symbyax (olanzapine / fluoxetine) dosage forms

                                    interactions

                                    Interactions between Symbyax (olanzapine / fluoxetine) and other drugs

                                    Symbyax (olanzapine / fluoxetine) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Symbyax (olanzapine / fluoxetine). Please note that only the generic name of each medication is listed below.

                                    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                                    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                                    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                                    drug-cost

                                    How much does Symbyax (olanzapine / fluoxetine) cost?

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                                    contraindications-icon

                                    Symbyax (olanzapine / fluoxetine) contraindications

                                    Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Symbyax (olanzapine / fluoxetine) will not be safe for you to take.
                                    alternatives

                                    What are alternatives to Symbyax (olanzapine / fluoxetine)?

                                    There are a number of medications that your doctor can prescribe in place of Symbyax (olanzapine / fluoxetine). Compare a few possible alternatives below.
                                    Symbyax (olanzapine / fluoxetine)
                                    Used for:
                                    $301.59 Lowest GoodRx priceView Prices
                                    Used for:
                                    • Treatment of manic episodes of bipolar disorder

                                    • Long-term maintenance treatment of bipolar disorder

                                    $33.82 Lowest GoodRx priceView Prices
                                    Used for:
                                    $8.98 Lowest GoodRx priceView Prices
                                    images

                                    Symbyax (olanzapine / fluoxetine) images

                                    Orange Teva 5504 - Olanzapine and Fluoxetine 6mg-25mg Capsule
                                    This medicine is Orange Capsule Imprinted With "Teva 5504".Orange Teva 5504 - Olanzapine and Fluoxetine 6mg-25mg Capsule
                                    Yellow 250 Par - Olanzapine and Fluoxetine 6mg-25mg Capsule
                                    This medicine is Yellow Capsule Imprinted With "250 Par".Yellow 250 Par - Olanzapine and Fluoxetine 6mg-25mg Capsule

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                                    References

                                    Best studies we found

                                    American College of Obstetricians and Gynecologists. (2023). Depression during pregnancy.

                                    Drugs and Lactation Database (LactMed®). (2024). Olanzapine. National Institute of Child Health and Human Development.

                                    Teva Pharmaceuticals USA, Inc. (2024). Olanzapine and fluoxetine capsule [package insert]. DailyMed.

                                    View All References (2)

                                    Tohen, M., et al. (2003). Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar I depression. Archives of General Psychiatry.

                                    You and Your Hormones. (2023). Prolactin.

                                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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