Lybalvi (olanzapine/samidorphan) is a prescription drug that’s used to treat schizophrenia and bipolar I disorder. The drug comes as an oral tablet. It’s usually taken once per day.
Lybalvi is used in adults to treat:
For treatment of bipolar I disorder, Lybalvi can be used alone or with other drugs, such as lithium (Lithobid) or valproate, in certain situations.
Lybalvi contains two active ingredients: olanzapine and samidorphan. (An active ingredient is what makes a drug work.) Olanzapine is part of a group of drugs called atypical antipsychotics. Samidorphan is a kind of opioid antagonist.
This article describes Lybalvi’s dosages (the amount you may take and frequency), as well as its strengths and how to take it. To learn more about Lybalvi, see this in-depth article.
The dosages for Lybalvi are described below. Your doctor will prescribe the dosage that’s right for you.
Note: This chart highlights some basics of Lybalvi’s dosages. Be sure to read on for more details. This article lists the strengths of Lybalvi in the format “milligrams (mg) of olanzapine/mg of samidorphan.” For example, Lybalvi 5 mg/10 mg contains 5 mg of olanzapine and 10 mg of samidorphan.
| Condition Lybalvi treats | Usual Lybalvi starting doses, taken once per day | Usual Lybalvi maintenance doses, taken once per day |
|---|---|---|
| schizophrenia | • 5 mg/10 mg • 10 mg/10 mg | • 10 mg/10 mg • 15 mg/10 mg • 20 mg/10 mg |
| bipolar 1 disorder | • 10 mg/10 mg • 15 mg/10 mg | • 5 mg /10 mg • 10 mg/10 mg • 15 mg/10 mg • 20 mg/10 mg |
| bipolar 1 disorder, with lithium (Lithobid) or valproate | • 10 mg/10 mg | • 10 mg/10 mg • 15 mg/10 mg • 20 mg/10 mg |
What is Lybalvi’s form?
Lybalvi comes as tablets that you swallow.
What strengths does Lybalvi come in?
Lybalvi contains two active ingredients: olanzapine and samidorphan. (An active ingredient is what makes a drug work.) The tablets are available in the following strengths:
- 5 mg/10 mg
- 10 mg/10 mg
- 15 mg/10 mg
- 20 mg/10 mg
What are the usual dosages of Lybalvi?
Your doctor will likely start you on a low dosage of Lybalvi and adjust it over time to reach the right amount for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect, which is referred to as a maintenance dose.
There are different recommended starting dosages for Lybalvi. Your doctor will prescribe the dosage that’s right for you depending on certain factors, such as which condition you’re using the drug to treat.
Note that Lybalvi’s dosage is not calculated by a person’s weight.
The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.
Dosage for schizophrenia
For treating schizophrenia in adults, your doctor will likely prescribe a starting dosage of either 5 mg/10 mg once per day or 10 mg/10 mg once per day.
Each week, your doctor may increase your dose in increments of 5 mg, until you reach your maintenance dose. This may be 10 mg/10 mg, 15 mg/10 mg, or 20 mg/10 mg. Your exact dosage depends on how your body responds to Lybalvi and any side effects of the drug that you may develop.
The maximum dosage of Lybalvi for schizophrenia is 20 mg/10 mg once per day.
Dosage for bipolar I disorder
Lybalvi might be prescribed by itself or with other medications to treat acute (sudden) manic or mixed episodes of bipolar I disorder. It’s also used alone as maintenance therapy for bipolar I disorder. (This means the drug helps to manage symptoms of bipolar I disorder long term.)
When Lybalvi is used alone
When used alone to treat manic or mixed episodes, Lybalvi’s starting dosage is either 10 mg/10 mg or 15 mg/10 mg. You’ll take Lybalvi once per day.
Your doctor may adjust your dose in increments of 5 mg, at intervals of at least 24 hours. This depends on how your body responds to the medication and any side effects you have. The maximum dosage of Lybalvi for manic or mixed episodes is 20 mg/10 mg once per day.
Your doctor may recommend that you continue taking Lybalvi as maintenance therapy after your symptoms have eased. For this purpose, they may prescribe any of the following doses, which you’ll take once per day:
- 5 mg/10 mg
- 10 mg/10 mg
- 15 mg/10 mg
- 20 mg/10 mg
When Lybalvi is used with other medications
You may take Lybalvi with lithium (Lithobid) or valproate to treat manic or mixed episodes of bipolar I disorder. In this case, the starting dosage of Lybalvi is 10 mg/10 mg once per day.
Each week, your doctor may increase your dosage in increments of 5 mg, depending on how your body responds to Lybalvi and any side effects you may have. The maximum dosage of Lybalvi when taken with other drugs is 20 mg/10 mg once per day.
Is Lybalvi used long term?
How long you take Lybalvi depends on the condition you’re taking the drug to treat.
If you’re using the drug to treat schizophrenia, you’ll likely take it long term.
If you’re using the drug to treat bipolar I disorder, you may take the drug short term or long term. For treating mixed or manic episodes of bipolar I disorder, your doctor may prescribe Lybalvi short term. And they might recommend that you continue taking Lybalvi long term after your symptoms have eased.
If you and your doctor determine that Lybalvi is safe and effective for your condition, you’ll likely take it long term.
Dosage adjustments
There are different recommended starting dosages of Lybalvi. Your doctor will prescribe the starting dosage that’s right for you.
Your doctor may recommend a lower starting dosage if you have either of the following conditions:
- a risk of orthostatic hypotension (a sudden drop in blood pressure when you stand quickly)
- sensitivity to the effects of olanzapine, one of Lybalvi’s active ingredients (active ingredients are what make a drug work)
- slow metabolism of olanzapine (when your body breaks down olanzapine more slowly than usual)
If you take certain other medications, your doctor may also adjust your Lybalvi dosage to prevent drug interactions. Before you start taking Lybalvi, discuss with your doctor the other medications you take.
The dosage of Lybalvi you’re prescribed may depend on several factors. These include:
- which condition you’re using the drug to treat
- the severity of your condition
- how your body responds to the medication
- other conditions you may have or medications you may take (see “Dosage adjustments” just above)
Lybalvi comes as tablets that you swallow whole. You’ll take your dose once per day. You can take your dose with or without food.
Lybalvi tablets should not be broken, chewed, or crushed. If you have trouble swallowing tablets, see this article for tips on how to take this form of medication.
For information on the expiration, storage, and disposal of Lybalvi, see this article.
What time of day should you take Lybalvi?
You can take Lybalvi at any time of day. It’s recommended that you take your dose around the same time each day. This helps maintain a steady level of Lybalvi in your body.
It doesn’t make a difference whether you take Lybalvi in the morning, afternoon, or at night.
Accessible drug containers and labels
Some pharmacies provide medication labels that:
- have large print or use braille
- feature a code you can scan with a smartphone to change the text to audio
Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.
If you have trouble opening medication bottles, let your pharmacist know. They may be able to supply Lybalvi in an easy-open container. They may also have tips to help make it simpler to open the drug’s container.
If you miss a dose of Lybalvi, contact your doctor or pharmacist. They can recommend when to take your next dose. They may advise you to either take the missed dose right away or wait until you’d usually take your next dose.
To help make sure you don’t miss a dose, try using a medication reminder. You can also download a reminder app on your phone.
Do not take more Lybalvi than your doctor prescribes as this can lead to serious side effects.
Symptoms of overdose
Symptoms caused by an overdose can include:
- uncontrollable movements or other movement problems
- heart problems, such as fast heart rate
- aggression or agitation
- slurred or slow speech
- slow breathing
- delirium
- blood pressure changes
- reduced level or loss of consciousness
What to do in case you take too much Lybalvi
Call your doctor right away if you think you’ve taken too much Lybalvi. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.
In studies, Lybalvi didn’t cause withdrawal symptoms or dependence. However, since Lybalvi became available for use, withdrawal symptoms have been reported. These include sweating nausea, and vomiting.
Withdrawal symptoms are side effects that can occur when a person stops taking a drug their body is physically dependent on. With dependence, a person’s body gets used to a drug and needs it to function as usual.
One of Lybalvi’s active ingredients is samidorphan, which is an opioid antagonist. This means it blocks the effect of opioids. As a result, Lybalvi can cause opioid withdrawal in people who are taking opioid medications. Symptoms of opioid withdrawal can be severe.
Before you start taking Lybalvi, let your doctor know if you take an opioid medication. In this case, they likely will not prescribe Lybalvi. If you’ve just stopped taking an opioid medication, it’s recommended that you wait at least 14 days before starting Lybalvi treatment.
The sections above describe the usual Lybalvi dosages provided by the drugmaker. If your doctor recommends this drug for you, they’ll prescribe the dosage that’s right for you.
Remember, you should not change your dosage of Lybalvi without your doctor’s recommendation. Only take Lybalvi exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.
Here are some examples of questions you may want to ask your doctor:
- How will you determine my starting dose of Lybalvi?
- Am I at greater risk of side effects with higher dosages of Lybalvi?
- If I have other health conditions, will you adjust my dosage of Lybalvi?
- What other medications that I take might affect my Lybalvi dosage?
To learn more about Lybalvi, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.