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Combination of
OlanzapineAtypical antipsychotic
SamidorphanOpioid antagonist
Trade namesLybalvi
Other namesALKS-3831; OLZ/SAM
Clinical data
Main usesSchizophrenia, bipolar I disorder[1]
Side effectsWeight gain, sleepiness, dry mouth, headache, tremor, constipation[1]
Routes of
By mouth
External links
AHFS/Drugs.comMicromedex Detailed Consumer Information
License data
Legal status

Olanzapine/samidorphan (OLZ/SAM), sold under the brand name Lybalvi, is a combination medication used to treat schizophrenia and bipolar I disorder.[1] It is taken by mouth.[1] It contains olanzapine, an atypical antipsychotic, and samidorphan, an opioid antagonist.[1]

Common side effects include weight gain, sleepiness, dry mouth, headache, tremor, and constipation.[1] Other side effects may include an increased risk of death in people with dementia, opioid withdrawal, neuroleptic malignant syndrome, diabetes, tardive dyskinesia, low blood pressure with standing, and low white blood cells.[1] It should not be used in people taking opioids.[1] How olanzapine works is unclear.[1] Samidorphan is present to try to reduce the weight gain from olanzapine.[3][4]

The combination was approved for medical use in the United States in 2021.[1] It is not available in the United Kingdom or Europe as of 2022.[5] In the United States it costs about 1,500 USD per month as of 2022.[6]

Medical uses


It may be used at a dose of 5 mg/10 mg up to 20 mg/10 mg.[1]


  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 "DailyMed - LYBALVI- olanzapine and samidorphan l-malate tablet, film coated". dailymed.nlm.nih.gov. Archived from the original on 29 October 2022. Retrieved 29 October 2022.
  2. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/213378s000lbl.pdf Archived 2022-10-28 at the Wayback Machine[bare URL PDF]
  3. Citrome L, Graham C, Simmons A, Jiang Y, Todtenkopf MS, Silverman B, DiPetrillo L, Cummings H, Sun L, McDonnell D (2021). "An Evidence-Based Review of OLZ/SAM for Treatment of Adults with Schizophrenia or Bipolar I Disorder". Neuropsychiatr Dis Treat. 17: 2885–2904. doi:10.2147/NDT.S313840. PMC 8437420. PMID 34526769.
  4. Paik J (August 2021). "Olanzapine/Samidorphan: First Approval". Drugs. 81 (12): 1431–1436. doi:10.1007/s40265-021-01568-0. PMID 34304374. S2CID 236215923.
  5. "Olanzapine + samidorphan". SPS - Specialist Pharmacy Service. 18 January 2017. Archived from the original on 29 November 2021. Retrieved 29 October 2022.
  6. "Lybalvi Prices, Coupons, Copay & Patient Assistance". Drugs.com. Retrieved 29 October 2022.

External links

  • "Olanzapine". Drug Information Portal. U.S. National Library of Medicine. Archived from the original on 2022-10-28. Retrieved 2022-03-14.
  • "Samidorphan". Drug Information Portal. U.S. National Library of Medicine.