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The central effects of other CNS depressants including alcohol may be enhanced by Olanzapine. Olanzapine may antagonize the actions of dopaminergics. Neutropenia may be more common when olanzapine is given with valproate. There is a theoretical risk of QT prolongation when olanzapine is given with other drugs that are known to cause this effect.
The metabolism of Olanzapine is mediated to some extent by the cytochrome P450 isoenzyme CYP1A2. Use with drugs that inhibit, induce, or act as a substrate to this isoenzyme may affect plasma concentrations of olanzapine and a dose adjustment of olanzapine may be required. The CYP1A2 inhibitor of fluvoxamine significantly inhibits the metabolism of Olanzapine. The clearance of Olanzapine is increased by tobacco smoking and carbamazepine.
