It is given as a shot into a muscle. Establish and maintain an airway and ensure adequate ventilation. Weight gain greater than or equal to 15% occurred in 14.1% of the SYMBYAX group and none of the placebo group. Nonetheless, SYMBYAX should be prescribed in a manner that is most likely to minimize the risk of tardive dyskinesia. It may also cause some people to have suicidal thoughts and tendencies. In a 47-week SYMBYAX study, the mean change from baseline to endpoint in fasting glucose was +4.81 mg/dL (n=130). When you are receiving ziprasidone, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. Pharmacy Author: Omudhome Ogbru, PharmD Medical and Pharmacy Editor:Jay W. Marks, MD Drug interactions overview. Patients should be monitored for these symptoms when discontinuing treatment with fluoxetine. advice about side effects. No specific antidote for either fluoxetine or olanzapine overdose is known. These fluoxetine toxicities in juvenile rats have not been observed in adult animals. Open-angle glaucoma is not a risk factor for angle-closure glaucoma. 0002-3232-30, Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. These highlights do not include all the information needed to use SYMBYAX safely and effectively. The proportion of olanzapine-treated patients who had changes (at least once) in total cholesterol, LDL cholesterol or triglycerides from normal or borderline to high, or changes in HDL cholesterol from normal or borderline to low, was greater in long-term studies (at least 48 weeks) as compared with short-term studies. This is of potential consequence when drug discontinuation is required or when drugs are prescribed that might interact with fluoxetine and norfluoxetine following the discontinuation of fluoxetine.In a study involving 24 healthy subjects, the mean elimination half-life of olanzapine was about 1.5 times greater in elderly subjects (≥65 years of age) than in non-elderly subjects (<65 years of age).The disposition of single doses of fluoxetine in healthy elderly subjects (≥65 years of age) did not differ significantly from that in younger normal subjects. SYMBYAX is not approved for use in children less than 10 years of age (Monitor for worsening and emergence of suicidal thoughts and behaviors (Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Table 14: Weight Gain with Olanzapine Use in Adolescents from 4 Placebo-Controlled TrialsTable 15: Weight Gain with Olanzapine Use in AdolescentsAdverse Reactions Associated with Discontinuation of Treatment in Short-Term, Controlled Studies Including Depressive Episodes Associated with Bipolar I Disorder and Treatment Resistant DepressionCommonly Observed Adverse Reactions in Controlled Studies Including Depressive Episodes Associated with Bipolar I Disorder and Treatment Resistant DepressionAdverse Reactions Occurring at an Incidence of 2% or More in Short-Term Controlled Studies Including Depressive Episodes Associated with Bipolar I Disorder and Treatment Resistant DepressionTable 16: Adverse Reactions: Incidence in the Short-Term Controlled Clinical Studies in Adults Caution should be exercised in patients with signs and symptoms of hepatic impairment, in patients with pre-existing conditions associated with limited hepatic functional reserve, and in patients who are being treated with potentially hepatotoxic drugs. Single-dose vials require reconstitution prior to administration. However, the syndrome can develop, although much less commonly, after relatively brief treatment periods at low doses or may even arise after discontinuation of treatment.The incidence of dyskinetic movement in SYMBYAX-treated patients was infrequent. Rat exposures to the major metabolite, norfluoxetine, are approximately 0.3-0.8, 1-8, and 3-20 times, respectively, the pediatric exposure at the MRHD. Follow all instructions closely. 0002-3234-30 Fatalities have been confounded by exposure to additional substances including alcohol, thioridazine, oxycodone, and propoxyphene.Among 633 adult patients who overdosed on fluoxetine alone, 34 resulted in a fatal outcome, 378 completely recovered, and 15 patients experienced sequelae after overdose, including abnormal accommodation, abnormal gait, confusion, unresponsiveness, nervousness, pulmonary dysfunction, vertigo, tremor, elevated blood pressure, erectile dysfunction, movement disorder, and hypomania. The effect of renal impairment on olanzapine metabolite elimination has not been studied.In depressed patients on dialysis (N=12), fluoxetine administered as 20 mg once daily for 2 months produced steady-state fluoxetine and norfluoxetine plasma concentrations comparable with those seen in patients with normal renal function. In both studies, SYMBYAX was statistically significantly superior to both olanzapine monotherapy and placebo in reduction of the MADRS total score.