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Symbyax (olanzapine/fluoxetine) is a medication used to treat certain mental health conditions. It is essential to be aware of the potential risks and necessary precautions associated with its use. Below is a comprehensive overview of important safety information.

• Worsening Mental Health Symptoms: There is a risk of worsening depression and suicidal thoughts, particularly in individuals under 25. Notify your healthcare provider immediately if you or someone around you experiences new or worsening symptoms such as anxiety, panic attacks, trouble sleeping, irritability, or any thoughts of self-harm.

• Elderly Patients with Dementia: Symbyax is not approved for treating dementia-related psychosis in individuals aged 65 and older due to an increased risk of death. Discuss alternative treatments with your healthcare provider if you or a loved one has dementia.

• Neuroleptic Malignant Syndrome: This rare but life-threatening condition may occur. Symptoms include high fever, muscle stiffness, confusion, and irregular heartbeat. Seek immediate medical attention if these symptoms develop.

• Drowsiness and Concentration Issues: Symbyax may cause significant drowsiness and impair your ability to focus. Avoid driving or operating heavy machinery until you understand how this medication affects you. Be cautious if consuming alcohol or taking other sedatives.

• Severe Allergic Reactions: Rare but serious skin reactions can occur. Discontinue use and get medical help if you notice rashes, blisters, or have difficulty breathing.

• Metabolic Changes: The medication may lead to weight gain and increased blood sugar and cholesterol levels. Regular monitoring and a healthy lifestyle are recommended to manage these effects.

• Serotonin Syndrome: This potentially life-threatening condition can occur, especially if taken with other medications that increase serotonin levels. Symptoms include rapid heartbeat, sweating, and confusion. Immediate medical attention is necessary if symptoms appear.

• Glaucoma: Symbyax can exacerbate angle-closure glaucoma. Regular eye exams are recommended, and any changes in vision should be reported to your healthcare provider.

• Movement Disorders: Long-term use may lead to uncontrollable body movements. Notify your healthcare provider if such symptoms develop.

• Bleeding Risk: Caution is advised if taking blood thinners, as Symbyax can increase bleeding risk. Look out for unusual bruising or bleeding and consult a healthcare provider if they occur.

• Blood Cell Count: Symbyax may lower white blood cell counts, increasing infection risk. Regular blood tests are advised, and any signs of infection should be promptly reported.

• Low Sodium Levels: Rarely, Symbyax can lead to low blood sodium levels, particularly in older adults or those on diuretics. Symptoms like weakness and confusion require immediate medical attention.

• Heart Rhythm Issues: Symbyax can cause QT prolongation, a serious heart rhythm disorder. Those with a history of heart issues should be monitored closely.

• Anticholinergic Effects: These may include constipation and urinary difficulties, especially if using other anticholinergic medications. Consult your healthcare provider for interactions.

• High Prolactin Levels: This condition can affect fertility and cause other hormonal issues. Regular monitoring of prolactin levels may be necessary.

Contraindications: Avoid using Symbyax if you are taking MAOIs, linezolid, methylene blue, pimozide, or thioridazine, as these combinations may pose serious health risks. Always consult with your healthcare provider about your current medications and health conditions before starting Symbyax.

When taking this medication, some common side effects may include dizziness, lightheadedness, drowsiness, diarrhea, dry mouth, constipation, increased appetite, weight gain, and trouble sleeping. These effects are usually mild, but it's important to inform your healthcare provider if they persist or worsen. Be cautious with dizziness and lightheadedness, as they can increase the risk of falls; rise slowly from sitting or lying down to minimize this risk.

More serious side effects, although rare, require immediate medical attention. These include severe mental or mood changes, such as confusion or nervousness, unusual thoughts, and swelling of the hands, ankles, or feet. Other serious concerns may include restlessness, muscle spasms, easy bruising, severe stomach pain, or changes in heartbeat. Black stools, vomit resembling coffee grounds, severe headaches, seizures, and vision changes also indicate a need for urgent care.

In rare instances, this medication can lead to conditions like neuroleptic malignant syndrome, characterized by fever, muscle stiffness, and altered mental status, or serotonin syndrome, which includes symptoms like rapid heartbeat and hallucinations. Additionally, it may affect blood sugar levels, potentially worsening diabetes, and require adjustments to diabetes management. The drug can also elevate blood cholesterol and hormone levels, impacting sexual function and menstrual cycles.

Uncontrolled movements, especially in the face, and a painful, prolonged erection are other rare but serious side effects. An allergic reaction, though uncommon, demands immediate medical attention if you notice symptoms like rash, swelling, or trouble breathing. Always stay informed about potential side effects and contact your healthcare provider with any concerns.

Fluoxetine, a component of this medication, can remain in your system for several weeks after your last dose and may interact with other medications. If you've taken it within the past five weeks, consult your doctor or pharmacist before starting any new medications.

Some potential interactions include medications such as fosamprenavir/ritonavir, metoprolol, and diuretics like furosemide. It may also interact with drugs that increase bleeding risk, such as antiplatelet medications like clopidogrel, NSAIDs like ibuprofen and naproxen, and anticoagulants like dabigatran and warfarin. Additionally, it can interact with blood pressure medications and Parkinson's disease treatments like cabergoline.

A serious, potentially fatal interaction can occur if MAO inhibitors are taken with this medication. Avoid using MAO inhibitors, including isocarboxazid, linezolid, moclobemide, phenelzine, rasagiline, selegiline, and tranylcypromine, during treatment. Most MAO inhibitors should not be taken for two weeks before and at least five weeks after stopping this medication. Consult your doctor for specific guidance on timing.

This medication can slow the removal of other drugs from your body, affecting their efficacy. This includes drugs like cimetidine, phenytoin, pimozide, vinblastine, certain antipsychotics, antiarrhythmics, and tricyclic antidepressants.

The risk of bleeding increases when aspirin is taken with this medication. If your doctor has advised low-dose aspirin for heart attack or stroke prevention, continue its use unless directed otherwise by your doctor.

There is an increased risk of serotonin syndrome/toxicity if you are using other serotonin-enhancing drugs. This includes other SSRIs, SNRIs, street drugs like MDMA, St. John's wort, and tryptophan. The risk is higher when starting or increasing doses of these drugs.

Inform your doctor if you use products causing drowsiness, such as opioid painkillers, alcohol, cannabis, sleep or anxiety medications, muscle relaxants, or antihistamines. Also, check labels as some products may contain drowsiness-inducing ingredients.

Smoking may reduce the effectiveness of this medication. Notify your doctor if you smoke or have recently quit.

This medication might interfere with certain medical tests, possibly leading to false results. Ensure all healthcare providers and lab personnel are aware of your medication use.