Published December 8, 2023
A medicine, Lybalvi, used to treat adults with mental health disorders such as schizophrenia or bipolar 1 disorder, contains two ingredients: olanzapine and samidorphan. Olanzapine can be used alone or in combination with other medicines to treat schizophrenia or bipolar disorder. While effective in treating these conditions, olanzapine is known to cause weight gain in people who use it. The company that makes Lybalvi added the ingredient samidorphan to decrease the possibility of weight gain. Samidorphan decreases food cravings that people may experience while taking olanzapine, which can help to prevent weight gain. However, samidorphan also blocks the effects of opioids (powerful pain medicines such as oxycodone) and may cause severe opioid withdrawal symptoms.
A woman contacted our organization after experiencing severe opioid withdrawal after she began taking Lybalvi. She was being treated with Zyprexa (olanzapine) and was switched to Lybalvi to prevent weight gain. However, she was also taking buprenorphine, a medicine that contains an opioid and is used to treat opioid use disorders. The doctor who prescribed Lybalvi and her pharmacist did not warn her to stop taking the buprenorphine before starting the new medicine. The woman went into severe opioid withdrawal and required emergency care.
Here's what you can do: If you are prescribed Lybalvi, be sure to tell your primary doctor and pharmacist. If you are taking an opioid, you should stop taking it and wait at least 7 to 14 days (depending on the opioid) before starting Lybalvi. Tell your doctor or pharmacist if you plan to take an opioid (e.g., due to an injury or surgery) while being treated with Lybalvi. If you need to continue taking the opioid, discuss other treatment options with your doctor. If you have a history of chronic opioid use (or have an opioid use disorder), you may be at an increased risk of an opioid overdose if you begin using opioids again once Lybalvi is discontinued.
