Symbyax Capsule: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Symbyax Capsule combines olanzapine and fluoxetine hydrochloride, a psychotherapeutic combination of an atypical antipsychotic and an SSRI antidepressant. It is used for the short-term treatment of depression associated with Bipolar I Disorder and for depression that has not responded to two other antidepressant medicines. It is taken by mouth, usually once a day in the evening, and carries important warnings, including an increased risk of suicidal thoughts in younger people.

What is Symbyax Capsule

Symbyax is a prescription capsule that combines two medicines, olanzapine and fluoxetine. Olanzapine is an antipsychotic medicine, and fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant. Together they are used for certain types of depression.

Symbyax Capsule uses

• Short-term treatment of depression that happens with Bipolar I Disorder
• Short-term treatment of depression that has not responded to two other antidepressant medicines (treatment-resistant depression)

Benefits of Symbyax Capsule

• Helps treat bipolar depression
• May improve mood and emotional well-being
• May reduce persistent sadness
• May help restore interest in daily activities
• May help in depression that has not responded to other treatments

How Symbyax Capsule works

Symbyax combines two medicines that work differently. Olanzapine helps balance brain chemicals called dopamine and serotonin, which can reduce symptoms like hallucinations and delusions. Fluoxetine raises the level of serotonin in the brain, which helps improve mood and lessen depression.

Symbyax Capsule dosage

Take this medicine by mouth, usually once a day in the evening. It can be taken with or without food. Take it at the same time each day. Do not stop taking this medicine suddenly; your doctor will tell you how to lower the dose gradually if you need to stop. It may take up to several weeks before you notice improvement in your symptoms. If you miss a dose, take it as soon as you remember, but if it is almost time for your next dose, skip the missed one and go back to your normal schedule; do not take two doses at once.

Available forms and strengths

• Capsule

Side effects of Symbyax Capsule

Common

• Drowsiness or tiredness
• Dizziness
• Weight gain
• Dry mouth
• Increased appetite
• Fatigue
• Nausea
• Tremor or shakiness
• Trouble sleeping (insomnia)
• Sexual dysfunction or changes in performance
• Blurred vision
• Swelling in hands or feet
• Trouble concentrating

Serious

• Thoughts of suicide or self-harm, especially in children, teens, and young adults
• Serotonin syndrome (agitation, hallucinations, fast heartbeat, fever, muscle stiffness, loss of coordination, nausea, vomiting, diarrhea)
• Neuroleptic malignant syndrome (high fever, stiff muscles, confusion, changes in heart rate or blood pressure, sweating)
• Severe allergic reactions or DRESS syndrome (rash, hives, swelling of face/lips/tongue/throat, difficulty breathing, fever, swollen glands)
• Tardive dyskinesia (uncontrollable movements of face, tongue, or body that may not go away)
• High blood sugar or new diabetes
• High cholesterol or triglyceride levels, especially in teenagers
• Significant weight gain, especially in teenagers
• Low sodium levels (headache, confusion, weakness, memory problems, feeling unsteady)
• Low blood pressure when standing, causing dizziness or fainting
• Seizures
• Difficulty swallowing
• Abnormal bleeding or bruising
• Signs of mania (extreme increase in energy, talking, impulsive behavior)
• Increased risk of death and stroke in elderly people with dementia-related psychosis

Warnings and precautions

• This medicine can increase the risk of suicidal thoughts and actions, especially in children, teenagers, and young adults, particularly during the first few months of treatment or after a dose change.
• This medicine is linked to a higher risk of death in elderly people with dementia-related psychosis and is not approved for that use.
• This medicine can cause high blood sugar, which could lead to serious problems like diabetic ketoacidosis, coma, or death, even in people without diabetes.
• This medicine can raise cholesterol and triglyceride levels, and this risk may be higher in teenagers.
• Weight gain is common with this medicine, and teenagers may be more likely to gain a lot of weight.
• Do not take this medicine with an MAOI antidepressant or within 14 days of stopping one, since this can cause a dangerous, life-threatening reaction.
• Do not take this medicine with thioridazine (Mellaril) or pimozide (Orap), since this can cause serious heart rhythm problems.
• Never stop taking this medicine suddenly without talking to your doctor, since this can cause other symptoms or a return of your original condition.
• Using this medicine during pregnancy, especially in later months, may cause health problems in the newborn, including persistent blood pressure problems and abnormal muscle movements. Tell your doctor right away if you become pregnant.
• This medicine can pass into breast milk and may harm a nursing baby. You should not breastfeed while taking this medicine; talk to your doctor about the best way to feed your baby.
• People with severe liver disease should avoid this medicine because it is processed by the liver.
• Avoid drinking alcohol while taking this medicine, since it can increase sleepiness and other side effects.
• This medicine can cause sleepiness and affect your ability to think clearly or react quickly. Do not drive or operate heavy machinery until you know how it affects you.

Storage

• Store at room temperature, between 59°F to 86°F (15°C to 30°C)
• Keep away from light
• Keep dry and away from moisture; keep the container closed tightly
• Keep out of the reach of children

When to see a doctor

• Get medical help right away if you have thoughts of suicide, a suicide attempt, or sudden changes in mood, behavior, or thoughts.
• Seek emergency care if you notice signs of a severe allergic reaction, such as swelling of the face, lips, tongue, or throat, or trouble breathing.
• Get immediate medical attention if you have signs of neuroleptic malignant syndrome, such as high fever, stiff muscles, confusion, or changes in heartbeat or blood pressure.
• Seek emergency help if you have symptoms of serotonin syndrome, such as agitation, hallucinations, racing heartbeat, muscle stiffness, or loss of coordination.
• Call your doctor right away if you notice high blood sugar symptoms such as extreme thirst, frequent urination, hunger, weakness, or confusion.
• Tell your doctor right away if you develop uncontrollable movements of the face, tongue, or body, which could be a sign of tardive dyskinesia.
• If you take too much of this medicine, get emergency medical help right away or contact poison control.

Alternatives

• Cariprazine
• Fluoxetine
• Olanzapine