Lybalvi (olanzapine/samidorphan) is a brand-name prescription medication. The Food and Drug Administration (FDA) has approved it to treat the following conditions in adults:
If you have bipolar I disorder, your doctor may recommend that you take Lybalvi along with other medications, such as lithium (Lithobid) or valproate.
Lybalvi comes as an oral tablet. At this time, Lybalvi is only available as a brand-name drug. There aren’t any generic versions of Lybalvi available.
Lybalvi contains two active drug ingredients: olanzapine and samidorphan. Olanzapine belongs to a drug class called atypical antipsychotics. Samidorphan belongs to a drug class called opioid blockers. These medications work together to treat symptoms of schizophrenia and bipolar I disorder.
For information about the dosage of Lybalvi, including its strengths and how to take the drug, keep reading. For a comprehensive look at Lybalvi, see this article.
This article describes typical dosages for Lybalvi provided by the drug’s manufacturer. When taking Lybalvi, always follow the dosage prescribed by your doctor.
Before you start treatment with Lybalvi, your doctor will discuss the best dosage of Lybalvi for you. This medication is not dosed by weight, so your doctor will likely start your treatment with a low dose of medication. And they may increase your dose over time until the drug eases your symptoms.
Lybalvi comes as an oral tablet.
Lybalvi comes in the following strengths:
- 5 milligram (mg) olanzapine/10 mg samidorphan (5 mg/10 mg)
- 10 mg/10 mg
- 15 mg/ 10 mg
- 20 mg/10 mg
Your doctor will typically start your treatment with a low dosage. Then, they may adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Dosage for bipolar I disorder
Lybalvi is approved to treat bipolar I disorder in adults. This medication can be taken alone or with other drugs to treat bipolar I disorder. Your doctor will discuss the best dosage of Lybalvi for you based on your condition.
Lybalvi taken alone
Lybalvi can be taken alone to treat a short-term episode of bipolar I disorder. Specifically, it can be used to treat a mixed or manic episode that’s already occurring.
The recommended starting dose of Lybalvi for this use is 10 mg/10 mg or 15 mg/10 mg. You’ll take this dose once daily. In some cases, your doctor may increase your dosage up to a maximum of 20 mg/10 mg once daily.
It’s possible for your doctor to increase your dose of Lybalvi as often as once every 24 hours until the medication is working for you. In some cases, they may recommend continuing treatment with Lybalvi even after your mixed or manic episode symptoms have eased.
Lybalvi taken alone as maintenance treatment
Lybalvi can also be taken alone as a maintenance (long-term) treatment for bipolar I disorder.
The recommended dose for this use is either 5 mg/10 mg, 10 mg/10 mg, 15 mg/10 mg, or 20 mg/10 mg. You’ll take this dose once daily as a long-term treatment.
Lybalvi administration with lithium or valproate
If you have bipolar I disorder, your doctor may recommend taking Lybalvi with lithium (Lithobid) or valproate.
In this case, the recommended starting dosage of Lybalvi is 10 mg/10 mg once daily. In some cases, your doctor may increase your dosage up to 15 mg/10 mg once daily. If this dosage doesn’t manage your symptoms effectively, your doctor may further increase your dosage to a maximum of 20 mg/10 mg once daily.
If your doctor recommends increasing your dosage of Lybalvi, they’ll likely have you take the drug for at least 1 week before the increase. This is so they can check whether the drug is effective for your condition before increasing your Lybalvi dosage.
Dosage for schizophrenia
The recommended starting dose of Lybalvi for schizophrenia is 5 mg/10 mg or 10 mg/10 mg. The frequency, or how often you’ll take your dose for this use, is once daily.
In some cases, your doctor may recommend increasing your dose of Lybalvi each week until you reach a dosage that works for you. They may increase your dosage to 15 mg/10 mg or 20 mg/10 mg once daily.
If you’re taking Lybalvi for a mixed or manic episode of bipolar I disorder, your doctor will likely recommend taking Lybalvi short term.
However, your doctor will recommend taking Lybalvi long term for certain uses. These include maintenance treatment of bipolar I disorder or schizophrenia treatment. If you and your doctor determine that Lybalvi is safe and effective for you, you’ll likely take it long term.
The Lybalvi dosage your doctor prescribes will depend on several factors. These include:
- the type and severity of the condition you’re taking the drug to treat
- other medications that you take with Lybalvi
- side effects* that you experience from the drug
Other medical conditions you have can also affect your Lybalvi dosage.
* To learn about side effects of Lybalvi, see this article.
In some cases, your doctor may recommend a dosage adjustment of Lybalvi.
For example, if you’re taking a medication that decreases the amount of Lybalvi in your body, Lybalvi may not be as effective as it should be. In this case, your doctor may recommend increasing your Lybalvi dose. Examples of these drugs may include:
- phenytoin (Dilantin)
- ritonavir (Norvir)
- rifampin (Rimactane)
If you’re taking a drug that may prevent your body from breaking down Lybalvi, you may have an increased risk of side effects from Lybalvi. In this case, your doctor may recommend a lower dose of Lybalvi to help prevent side effects. Examples of these drugs may include:
Note: You should not take Lybalvi with any opioid medications. Your doctor will recommend you avoid taking Lybalvi for at least 7 to 14 days after stopping an opioid. This is because Lybalvi can cause opioid withdrawal,* which can be severe. Your doctor will advise when you can start taking Lybalvi after stopping an opioid.
* With withdrawal, you experience uncomfortable symptoms when you stop receiving a substance your body is used to having.
You’ll take your dose of Lybalvi once daily by mouth. You can take your dose with or without food.
You should take Lybalvi tablets whole. Do not break or crush the tablets.
If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.
It may be helpful to take Lybalvi around the same time of day. This helps maintain a steady level of the drug in your body so Lybalvi can work effectively.
If you have questions about how to take Lybalvi or when to take it, talk with your doctor or pharmacist.
ACCESSIBLE DRUG LABELS AND CONTAINERS
If you’re having trouble reading your prescription label, talk with your doctor or pharmacist. Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.
If you’re having trouble opening medication bottles, ask your pharmacist about putting Lybalvi in an easy-open container. They also may recommend tools that can make it easier to open bottles.
If you miss your dose of Lybalvi, contact your doctor or pharmacist. They can recommend the best time for you to take your next dose.
Sometimes, your doctor or pharmacist may recommend taking your dose as soon as you remember. In other cases, if it’s almost time for your next dose, they may recommend skipping your missed dose. Then, you’ll take your next dose at your scheduled time.
If you take more Lybalvi than your doctor prescribes, you may develop serious side effects.
It’s important that you do not take more Lybalvi than your doctor advises.
Symptoms of an overdose
Overdose symptoms of Lybalvi can include:
- fast heart rate
- losing consciousness
- slurred speech
- heart problems, such as irregular heart rhythm
- trouble breathing
- changes in blood pressure, such as high or low blood pressure
If you take more than the recommended amount of Lybalvi
Call your doctor right away if you believe you’ve taken too much Lybalvi. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
The dosages in this article are typical dosages provided by the drug manufacturer. If your doctor recommends Lybalvi for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.
As with any drug, never change your dosage of Lybalvi without your doctor’s recommendation. If you have questions about the dosage of Lybalvi that’s best for you, talk with your doctor.
Besides learning about dosage, you may want other information about Lybalvi. These additional articles might be helpful to you:
- More about Lybalvi. For information about other aspects of Lybalvi, refer to this article.
- Details about your condition. For details about your condition, you can refer to our mental health hub. You can also see our bipolar disorder hub and list of schizophrenia articles.
Disclaimer: Medical News Today 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.