Salveo ODT Drug Interactions

Alcohol: Coadministration of ethanol with olanzapine may potentiate the orthostatic hypotension, and have an additive effect in sedation observed with olanzapine administered alone.
Antihypertensive drugs: Since olanzapine may induce hypotension, olanzapine may enhance the effects of antihypertensive agents.
Antiparkinsonian drugs: The concomitant use of olanzapine with anti-Parkinsonian drugs is not recommended in patients with Parkinson's disease and dementia (see Precautions).
Charcoal: One gram of activated charcoal reduced the C_max and AUC of orally administered olanzapine by 50% to 60%. Charcoal should be taken two hours prior to or after dosing with olanzapine.
Since the C_max of olanzapine is attained six hours after dosing, charcoal may be used as treatment for olanzapine overdose.
CNS Acting Drugs: Given that olanzapine has primarily CNS effects, it should be used with caution when taken in combination with other centrally acting drugs, including alcohol.
CYP1A2 Inducers: CYP1A2 inducers only slightly to moderately increase the olanzapine clearance. Although clinical consequences of the interaction between olanzapine and CYP1A2 inducers are likely to be limited, clinical monitoring and increasing the olanzapine dose may be considered, if necessary.
Smoking: Concomitant smoking may induce the metabolism of olanzapine, resulting to a 33% decrease in clearance of olanzapine. Moreover, the terminal elimination half-life of non-smokers was 21% longer than those of smokers.
Carbamazepine: The administration of carbamazepine 200 mg twice a day increases the clearance of olanzapine by approximately 50%. Higher doses of carbamazepine, a potent CYP1A2 inducer, may further increase the olanzapine clearance.
Omeprazole and Rifampicin: These CYP inducers may increase the clearance of olanzapine.
CYP1A2 Inhibitors: Fluvoxamine: Fluvoxamine significantly inhibits the metabolism of olanzapine, thereby decreasing the clearance of olanzapine and increasing the mean C_max of olanzapine in female nonsmokers and male smokers by 54% and 77%, respectively. The mean lower doses of olanzapine should be considered in concomitant use with fluvoxamine.
CYP2A6 Inhibitors: Fluoxetine 60 mg administered either as a single dose or daily for eight days slightly increases the C_max and decrease the clearance of olanzapine (~16%). Since the impact of this interaction is small compared to the overall interindividual variability, dose modification is not routinely recommended.
Diazepam: The coadministration of diazepam with olanzapine potentiated the orthostatic hypotension observed with olanzapine administered alone.
Drug metabolizing enzymes: In vitro studies in human liver microsomes demonstrated that olanzapine has little potential to inhibit CYP1A2, CYP2C1, CYP2C19, CYP2D6, and CYP3A4. The maximum inhibition of CYP450 system by olanzapine would be <0.7%. The use of olanzapine is unlikely to produce clinically important interactions with drugs metabolized by these enzymes. However, the possibility that olanzapine may alter the metabolism of other drugs, or that other drugs may affect the metabolism of olanzapine, should be considered.
Drugs affecting QT interval: Olanzapine should be used in caution with drugs known to affect the QT interval (see Precautions).
Drugs causing electrolyte imbalance: Olanzapine should be used in caution with drugs known to cause electrolyte imbalance (see Precautions).
Drugs causing CNS depression: Olanzapine should be used in caution in patients who consume alcohol or other drugs that can cause CNS depression or those that induce hypotension, bradycardia, or respiratory depression.
Levodopa and Dopamine Agonists: Olanzapine may antagonize the effects of levodopa and dopamine agonists.
Valproate: In vitro studies using human liver microsomes demonstrated that olanzapine and valproate have little effect on the major metabolic pathways of each drug, which are oxidative metabolism and glucuronidation, respectively. Moreover, daily concomitant use of olanzapine 10 mg for two weeks in vivo did not alter the steady state plasma concentration of valproate. However, neutropenia, and the incidence of tremor, dry mouth, increased appetite, and weight gain may be more frequent in patients concomitantly taking olanzapine and valproate. Dosage adjustment of valproate during concomitant use of olanzapine is not required.