Olanzapine Extended Release IM/Ciprofloxacin; Fluvoxamine Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Ciprofloxacin or fluvoxamine may slow down how quickly your liver processes olanzapine.

What might happen:

The amount of olanzapine in your blood may increase and cause more side effects than normal.

What you should do about this interaction:

Make sure your healthcare professional (e.g. doctor or pharmacist) knows that you are taking these medicines together. They may want to adjust your olanzapine dose or change your ciprofloxacin or fluvoxamine to a different medicine. Get help right away if you have severe drowsiness, feel dizzy or weak, have trouble walking or talking, have stiff muscles or tremors, slowed breathing, or seizures.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

View Reference
  • 1.Chiu CC, Lane HY, Huang MC, Liu HC, Jann MW, Hon YY, Chang WH, Lu ML. Dose-dependent alternations in the pharmacokinetics of olanzapine during coadministration of fluvoxamine in patients with schizophrenia. J Clin Pharmacol 2004 Dec;44(12):1385-90.
  • 2.Hiemke C, Peled A, Jabarin M, Hadjez J, Weigmann H, Hartter S, Modai I, Ritsner M, Silver H. Fluvoxamine augmentation of olanzapine in chronic schizophrenia: pharmacokinetic interactions and clinical effects. J Clin Psychopharmacol 2002 Oct;22(5):502-6.
  • 3.Weigmann H, Gerek S, Zeisig A, Muller M, Hartter S, Hiemke C. Fluvoxamine but not sertraline inhibits the metabolism of olanzapine: evidence from a therapeutic drug monitoring service. Ther Drug Monit 2001 Aug;23(4):410-3.
  • 4.Zyprexa (olanzapine) Australian prescribing information. Eli Lilly Pty Ltd November 30, 2006.
  • 5.Zyprexa Relprevv (olanzapine ext-rel IM susp.) US prescribing information. Eli Lilly and Company February, 2017.
  • 6.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and- drug-interactions-table-substrates-inhibitors-and-inducers. Updated 11/14/2017.
  • 7.USFood and Drug Administration. FDA Drug Safety Communication: FDA is investigating two deaths following injection of long-acting antipsychotic Zyprexa Relprevv (olanzapine pamoate) Available at : http://www.fda.gov/Drugs/DrugSafety/ucm356971.htm. June 18, 2013.
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