olanzapine and samidorphan (Lybalvi)

Brand Names: Lybalvi

Generic Name: olanzapine and samidorphan

What is olanzapine and samidorphan (Lybalvi)?

Olanzapine and samidorphan is a combination antipsychotic medicine that is used to treat schizophrenia in adults.

Olanzapine and samidorphan is also used to treat manic or mixed episodes in adults with bipolar I disorder. This medicine is sometimes used together with lithium or valproate to treat these conditions.

Olanzapine and samidorphan may also be used for purposes not listed in this medication guide.

What are the possible side effects of olanzapine and samidorphan (Lybalvi)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Long-term use of olanzapine and samidorphan can cause a serious movement disorder that may not be reversible. The longer you use olanzapine and samidorphan, the more likely you are to develop this disorder, especially if you are a woman or an older adult.

Samidorphan can make you more sensitive to the effects of opioid medicine, and you could have a fatal opioid overdose. If you use opioid medicine, a person caring for you should seek emergency medical attention if you have severe dizziness or drowsiness, confusion, slow breathing with long pauses, or if you are hard to wake up.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;
  • uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);
  • trouble swallowing;
  • a seizure;
  • impotence, sexual problems, missed menstrual periods, breast swelling or discharge;
  • low white blood cell counts--fever, chills, weakness, sore throat, cough, mouth sores, skin sores;
  • signs of a stroke--sudden numbness or weakness, severe headache, slurred speech, problems with vision or balance;
  • high blood sugar--increased thirst, increased urination, dry mouth, fruity breath odor; or
  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Common side effects may include:

  • increased appetite, weight gain;
  • dizziness, drowsiness, weakness;
  • problems with speech or memory;
  • tremor, numbness, tingling, burning pain;
  • headache;
  • dry mouth, upset stomach, constipation;
  • back pain; or
  • increased salivation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about olanzapine and samidorphan (Lybalvi)?

Olanzapine and samidorphan is not approved for use in older adults with dementia-related psychosis.

What should I discuss with my healthcare provider before taking olanzapine and samidorphan (Lybalvi)?

You should not use this medicine if you are allergic to olanzapine or samidorphan.

Do not take this medicine if you use opioid medication or you are going through withdrawal from opioid dependency. Opioids include oxycodone, morphine, hydrocodone, buprenorphine, fentanyl, and others.

Samidorphan can interact with opioid medication and cause a fatal overdose or severe opioid withdrawal that may need to be treated in a hospital.

Tell your doctor if you have used an opioid medication within the past 7 to 14 days. Be sure to tell your doctor the specific type of opioid medicine you used (such as controlled-release, extended-released, or transdermal skin patch).

Olanzapine and samidorphan may increase the risk of death in older adults with dementia-related psychosis and is not approved for this use.

Tell your doctor if you have ever had:

Taking antipsychotic medicine in the last 3 months of pregnancy may cause serious problems in the newborn. Tell your doctor right away if you get pregnant. Do not stop the medicine without your doctor's advice.

It may be harder for you to get pregnant while you are using this medicine. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of olanzapine and samidorphan on the baby.

Olanzapine can pass into breast milk. If you are breastfeeding, tell your doctor if you notice severe drowsiness, irritability, feeding problems, tremors, or unusual muscle movements in the nursing baby.

Not approved for use by anyone younger than 18 years old.

How should I take olanzapine and samidorphan (Lybalvi)?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take olanzapine and samidorphan with or without food.

Swallow the tablet whole and do not crush, chew, or break it.

Do not change your dose or stop using this medicine without your doctor's advice.

Olanzapine can cause high blood sugar (hyperglycemia). If you are diabetic, check your blood sugar levels on a regular basis.

Drink plenty of liquids while you are taking this medicine.

You may gain weight or have high cholesterol and triglycerides (types of fat) while taking this medicine. You may need frequent blood tests.

Read the Patient Wallet Card about a dangerous interaction with opioid medication. Keep the card with you at all times. In an emergency, your medical caregivers will need to know that you take olanzapine and samidorphan.

Store tightly closed at room temperature, away from moisture and heat. Keep the tablets in their original container, along with the packet or canister of moisture-absorbing preservative.


Schizophrenia: Symptoms, Types, Causes, Treatment See Slideshow

What happens if I miss a dose (Lybalvi)?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose (Lybalvi)?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking olanzapine and samidorphan (Lybalvi)?

Avoid drinking alcohol.

It is easier to become dangerously overheated and dehydrated while you are taking this medicine. Avoid exercising too much, being in sunlight, or being outside in hot weather. Avoid wearing heavy clothing.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

What other drugs will affect olanzapine and samidorphan (Lybalvi)?

If you use an opioid (prescription medication or illegal street drug) it will not work the same way while you are taking olanzapine and samidorphan. Samidorphan blocks the effects of opioids, including pain relief or feelings of well-being that can lead to opioid abuse. Trying to make an opioid work by taking large amounts can lead to overdose or death.

Do not use opioid medication during treatment with olanzapine and samidorphan and for at least 5 days after your last dose of this medicine.

The opioid-blocking effects of olanzapine and samidorphan decrease slowly after you stop using this medicine, and you may be more sensitive to opioids. If you used an opioid on a regular basis and plan to start using it again after you stop olanzapine and samidorphan, you may need a lower dose of the opioid medicine.

Tell your doctor if you use any other medicine that contains olanzapine (Zyprexa, Symbyax).

Many drugs can affect olanzapine and samidorphan, and some drugs should not be used at the same time. Tell your doctor about all other medicines you use. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Where can I get more information (Lybalvi)?

Your pharmacist can provide more information about olanzapine and samidorphan.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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Reviewed on 10/12/2022

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