Drug interactions
Deutetrabenazine + Olanzapine
Severity: Major
Deutetrabenazine and Olanzapine: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Deutetrabenazine depletes presynaptic monoamines and can cause parkinsonism, akathisia, sedation and depression. With olanzapine, which blocks dopamine receptors, these effects and the risk of neuroleptic malignant syndrome may be increased, and QT effects may be additive.
What this interaction means in plain words
Deutetrabenazine and Olanzapine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Deutetrabenazine belongs to Central Nervous System; Olanzapine belongs to Central Nervous System.
Why it happens
Additive dopaminergic suppression (VMAT2 inhibition plus D2 blockade), with additive sedation and possible QT effects.
What to do
Monitor for parkinsonism, akathisia, rigidity, fever and sedation, and consider ECG monitoring in patients at risk. Reduce the dose of either drug if movement disorders develop.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- Olanzapine 10 mg orodispersible tablets - SmPC sections 4.3/4.5 (class statement: medicinal products known to increase QTc interval; "Caution should be used if olanzapine is being administered concomitantly with medicinal products known to increase QTc interval (see section 4.4).") — electronic medicines compendium (UK SmPC)
Other interactions of Olanzapine
Other interactions of Deutetrabenazine
- Deutetrabenazine + Isocarboxazid Contraindicated
- Deutetrabenazine + Linezolid Contraindicated
- Deutetrabenazine + Phenelzine Contraindicated
- Deutetrabenazine + Rasagiline Contraindicated
- Deutetrabenazine + Safinamide Contraindicated
- Deutetrabenazine + Selegiline Contraindicated
Frequently asked questions
Can I take Deutetrabenazine with Olanzapine?
MediHelp rates the interaction as major. Deutetrabenazine and Olanzapine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Deutetrabenazine depletes presynaptic monoamines and can cause parkinsonism, akathisia, sedation and depression. With olanzapine, which blocks dopamine receptors, these effects and the risk of neuroleptic malignant syndrome may be increased, and QT effects may be additive.
How serious is the interaction between Deutetrabenazine and Olanzapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for parkinsonism, akathisia, rigidity, fever and sedation, and consider ECG monitoring in patients at risk. Reduce the dose of either drug if movement disorders develop.
What other medicines interact with Olanzapine?
MediHelp also lists interactions of Olanzapine with, for example, Amisulpride, Amoxapine, Apomorphine. The full list is on the Olanzapine page.
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