Fluoxetine; Olanzapine capsules

What is this medicine?

FLUOXETINE; OLANZAPINE (floo OX e teen; oh LAN za peen) is used to treat episodes of depression that have not been relieved by the use of other medicines and depression caused by bipolar disorder.

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You can take this medicine with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking this medicine suddenly except upon the advice of your doctor. Stopping this medicine too quickly may cause serious side effects or your condition may worsen.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 10 years of age for selected conditions, precautions do apply.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• anxious

• breathing problems

• changes in vision

• confusion

• difficulty in speaking or swallowing

• elevated mood, decreased need for sleep, racing thoughts, impulsive behavior

• eye pain

• fast heartbeat

• fever or chills, sore throat

• flu-like symptoms

• muscle spasms or weakness

• painful or prolonged erections

• rash, fever, and swollen lymph nodes

• redness, blistering, peeling or loosening of the skin, including inside the mouth

• restlessness, pacing, inability to keep still

• seizures

• signs and symptoms of high blood sugar such as being more thirsty or hungry or having to urinate more than normal. You may also feel very tired or have blurry vision.

• stiff muscles

• suicidal thoughts or other mood changes

• trouble sleeping

• unusual bleeding or bruising

• unusually weak

• vomiting

• weight gain

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• change in sex drive or performance

• constipation

• diarrhea

• dizziness

• indigestion, nausea

• tired

• tremors

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• other medicines containing fluoxetine or olanzapine, such as Prozac, Sarafem, or Zyprexa

• cisapride

• dronedarone

• linezolid

• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

• methylene blue (injected into a vein)

• metoclopramide

• pimozide

• thioridazine

This medicine may also interact with the following medications:

• alcohol

• amphetamines

• aspirin or aspirin-like medicines

• carbamazepine

• certain medicines for depression, anxiety, or psychotic disturbances

• certain medicines for migraine headaches like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan

• digoxin

• diuretics

• fentanyl

• flecainide

• furazolidone

• isoniazid

• lithium

• medicines for high blood pressure

• medicines for Parkinson's disease

• medicines for sleep

• medicines that treat or prevent blood clots like warfarin, enoxaparin, and dalteparin

• NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen

• omeprazole

• other medicines that prolong the QT interval (cause an abnormal heart rhythm)

• phenytoin

• procarbazine

• propafenone

• rifampin

• ritonavir

• supplements like St. John's wort, kava kava, valerian

• tramadol

• tryptophan

• vinblastine

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from moisture. Keep container tightly closed. Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• dementia

• bleeding disorder

• diabetes

• glaucoma

• heart disease, irregular heartbeat, or previous heart attack

• high blood pressure treated with medication

• kidney disease

• liver disease

• low blood pressure

• low levels of potassium or magnesium in the blood

• Parkinson's disease

• receiving electroconvulsive therapy

• strokes or mini-strokes called transient ischemic attacks (TIAs)

• suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member

• an unusual or allergic reaction to fluoxetine, olanzapine, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Visit your health care professional for regular checks on your progress. Tell your health care professional if symptoms do not start to get better or if they get worse. Do not stop taking except on your health care professional's advice. You may develop a severe reaction. Your health care professional will tell you how much medicine to take.

This medicine may cause serious skin reactions. They can happen weeks to months after starting the medicine. Contact your health care provider right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips or lymph nodes in your neck or under your arms.

Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care provider.

This medicine may increase blood sugar. Ask your health care provider if changes in diet or medicines are needed if you have diabetes.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This drug can cause problems with controlling your body temperature. It can lower the response of your body to cold temperatures. If possible, stay indoors during cold weather. If you must go outdoors, wear warm clothes. It can also lower the response of your body to heat. Do not overheat. Do not over-exercise. Stay out of the sun when possible. If you must be in the sun, wear cool clothing. Drink plenty of water. If you have trouble controlling your body temperature, call your health care provider right away.