Olanzapine Oral Tablet

Olanzapine is used to treat schizophrenia or certain types of bipolar disorders. It’s also used to treat depression that can’t be controlled with other drugs.

Olanzapine comes in the form of a tablet and a disintegrating tablet. Both are taken by mouth. (The disintegrating tablet will dissolve on your tongue.) This drug is also available as an injectable solution given only by a healthcare provider.

Olanzapine oral forms are available as the brand-name drugs Zyprexa (tablet) or Zyprexa Zydis (disintegrating tablet). They’re also available as generic drugs.

In adults, the more common side effects of this drug can include lack of energy, dry mouth, increased appetite, tiredness, or tremor (shakes). In children, they can also include headache, weight gain, or pain in the abdomen (stomach area).

This drug raises the risk of death and heart problems such as stroke in certain seniors (ages 65 years and older). This risk affects seniors who have confusion, memory loss, or dementia-related psychosis. This drug isn’t approved to treat dementia-related psychosis.

IMPORTANT INFORMATION

• FDA warning See Details

• Neuroleptic malignant syndrome See Details

• DRESS See Details

• Problems with control of body temperature See Details

What is olanzapine?

Olanzapine is a prescription drug. It comes in the form of a tablet and a disintegrating tablet that are taken by mouth. (The disintegrating tablet will dissolve on your tongue.) An injectable form is also available. This form is given only by a healthcare provider.

Olanzapine oral forms are available as the brand-name drugs Zyprexa (tablet) or Zyprexa Zydis (disintegrating tablet). They’re also available as generic drugs. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. Talk to your doctor to see if the generic version will work for you.

Olanzapine may be used as part of a combination therapy. This means you may need to take it with other medications, such as lithium, valproate, or fluoxetine.

Why it's used

Olanzapine is used to treat schizophrenia and bipolar I disorder. It’s also used with fluoxetine to treat other conditions.

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How it works

Olanzapine belongs to a class of drugs called atypical antipsychotics. A class of drugs is a group of medications that work in a similar way.

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More Common Side Effects

The adult side effects for olanzapine are slightly different from the side effects for children.

• Adult side effects can include: 

  • lack of energy
  • dry mouth
  • increased appetite
  • tiredness
  • tremor (shakes)
  • constipation (hard or infrequent stools)
  • dizziness
  • restlessness
  • changes in behavior that might be considered offensive to others

• Children’s and adolescent’s side effects can include the above, plus:

  • headache
  • pain in the abdomen (stomach area)
  • pain in the arms and legs
  • weight gain

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Stroke or mini strokes (transient ischemic attacks) or death. These can occur in seniors (ages 65 years and older) who have confusion, memory loss, and dementia-related psychosis. Symptoms of a stroke can include:

  • confusion
  • trouble speaking or slurred speech
  • numbness on one side of the body
  • weakness

• Drug reaction with eosinophilia and systemic symptoms (DRESS). Symptoms can include:

  • fever
  • rash or peeling skin
  • enlarge lymph nodes

• Hyperglycemia (high blood sugar). Symptoms can include:

  • frequent urination
  • increased thirst
  • fruity-smelling breath
  • blurry vision
  • increased hunger
  • feeling weak or tired
  • confusion

• High cholesterol and triglycerides. You may not have any symptoms, but your doctor will check your cholesterol levels before and during treatment with olanzapine.

• Low levels of white blood cells or neutrophils. This can cause infections, with symptoms such as:

  • fever
  • sore throat

• Neuroleptic malignant syndrome. Symptoms can include:

  • high fever
  • excessive sweating
  • rigid muscles
  • confusion
  • changes in your breathing, heartbeat, or blood pressure

• Tardive dyskinesia (uncontrolled body movements). This condition can occur during or after treatment with this drug. It may go away after you stop treatment, or it may continue (be permanent). Symptoms can include:

  • uncontrolled movements in the face and tongue, or other parts of the body

• Orthostatic hypotension (decreased blood pressure when you change positions, especially when you stand up after sitting or lying down). This can cause falls or fainting. Symptoms can include:

  • dizziness
  • fast or slow heartbeat
  • feeling faint

• Seizures

• Trouble swallowing (this can cause food or fluids to get into the lungs)

• Problems with control of body temperature. Symptoms can include:

  • sweating too much or not at all
  • dry mouth
  • feeling very hot
  • feeling thirsty
  • not being able to produce urine

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Olanzapine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

Avoid the use of drinks that contain alcohol while taking olanzapine. Drinking alcohol while taking olanzapine raises your risk of orthostatic hypotension. When this occurs, your blood pressure drops too low after you stand up after sitting or lying down. Drinking alcohol can also increase the drowsiness caused by olanzapine.

If you drink alcohol, talk with your doctor about whether this drug is safe for you.

Medications that might interact with this drug

Interactions that increase your risk of side effects

• Increased side effects from olanzapine: Taking olanzapine with certain medications raises your risk of side effects from olanzapine. This is because the amount of olanzapine in your body is increased. Examples of these drugs include:
  • Benzodiazepines, such as diazepam. 
    • Increased side effects can include orthostatic hypotension. This is a drop in blood pressure that occurs when you stand after sitting or lying down. Symptoms can include dizziness, lightheadedness, or feeling faint. To prevent this problem, your doctor may decrease your olanzapine dosage.
  • Fluvoxamine.
    • Increased side effects can include tremor (shakes). To avoid this problem, your doctor may lower your dosage of olanzapine.
• Other increased side effects: Taking olanzapine with certain medications raises your risk of side effects that both olanzapine and these other drugs can cause. Examples of these drugs include:
  • Blood pressure medications. These include angiotensin II receptor blockers (ARBs), such as candesartan, irbesartan, or losartan. They also include angiotensin-converting enzyme (ACE) inhibitors, such as benazepril, captopril, or enalapril.
    • Increased side effects can include a dangerous decrease in your blood pressure. To help avoid this, your doctor may decrease your olanzapine dosage.

Interactions that can make your drugs less effective

• When olanzapine is less effective: When olanzapine is used with certain drugs, it may not work as well to treat your condition. This is because the amount of olanzapine in your body may be decreased. Examples of these drugs include:
  • Anticonvulsants, such as phenytoin or carbamazepine.
    • Your doctor may lower your dosage of these drugs.
  • Omeprazole.
    • Your doctor may increase your dosage of olanzapine or lower your dosage of omeprazole.
  • Rifampin.
    • Your doctor may increase your dosage of olanzapine or lower your dosage of rifampin.
• When other drugs are less effective: When certain drugs are used with olanzapine, they may not work as well. This is because the amount of these drugs in your body may be decreased. Examples of these drugs include
  • Levodopa and dopamine agonists, such as pramipexole and ropinirole.
    • If you’re taking levodopa or dopamine agonists for Parkinson’s disease, your doctor may stop your olanzapine treatment.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking. Olanzapine warnings

People with Alzheimer’s disease

Olanzapine isn’t approved to treat dementia-related psychosis or Alzheimer’s disease. Olanzapine raises the risk of death in seniors (ages 65 years or older) with dementia-related psychosis. Most of these deaths are caused by heart problems such as heart failure, or infectious conditions such as pneumonia.

People with seizures

Olanzapine can cause seizures. Tell your doctor if you have a history of seizures or epilepsy.

People with diabetes or high sugar levels

Olanzapine can increase your blood sugar levels. Your doctor should check your blood sugar levels before and during treatment with this drug. They may need to adjust the dosage of any diabetes medications you take. While you take this drug, watch for symptoms of high blood sugar. These can include feeling very thirsty, needing to urinate often, having an increased appetite, or feeling weak. If you have these symptoms, check your fasting blood sugar level and call your doctor.

People with heart problems

Olanzapine can cause a sudden drop in blood pressure. If you have certain heart problems, talk with your doctor about whether this drug is safe for you. These problems include heart disease, a history of heart attack or stroke, heart failure, or problems with blood flow through the heart. They also include any conditions that may get worse if your blood pressure drops too low.

People with high cholesterol

Olanzapine can cause high cholesterol levels. This risk is higher in children ages 13–17 years. Very large increases in cholesterol can occur with no symptoms. Be sure to have your cholesterol levels checked when your doctor suggests it.

People with blood problems

Olanzapine can cause low levels of white blood cells or neutrophils. These low levels raise your risk of infections. If you have a history of blood problems or are on other drugs that can lower levels of these blood cells, your doctor should check your blood often during the first few months of treatment with this drug. They should also monitor you for fever or any signs of infection. Your doctor might have to stop your treatment with olanzapine until your blood cell levels return to normal.

People with liver problems

If you have liver problems or a history of liver disease, you may not be able to clear this drug from your body well. This may increase the levels of olanzapine in your body and cause more side effects. This drug can also damage your liver.

People with enlarged prostate

In men, olanzapine may worsen symptoms of an enlarged prostate or benign prostatic hyperplasia (BPH). If you have an enlarged prostate, talk with your doctor about whether this drug is safe for you.

People with narrow-angle glaucoma

Olanzapine may worsen your glaucoma symptoms. if you have narrow-angle glaucoma, talk with your doctor about whether this drug is safe for you.

People with bowel problems

Olanzapine may worsen any bowel obstruction or blockages. If you have any bowel problems, talk with your doctor about whether this drug is safe for you.

Pregnant women

Olanzapine is a category C pregnancy drug. That means two things:

1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding

Olanzapine passes into breast milk and may cause side effects in a child who is breast-fed. You should not breast-feed if you’re using olanzapine.

Talk to your doctor if you breast-feed your child. You should decide whether to stop breast-feeding or stop taking this medication.

For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

For children

• Schizophrenia: It hasn’t been established that this drug is safe and effective for treatment of schizophrenia in children younger than 13 years.
• Bipolar I disorder: It hasn’t been established that this drug is safe and effective for treatment of bipolar I disorder in children younger than 13 years.
• Treatment-resistant depression: It hasn’t been established that this drug is safe and effective for use with fluoxetine in the treatment of treatment-resistant depression in children younger than 18 years.
• Bipolar depression: It hasn’t been established that this drug is safe and effective for use with fluoxetine in the treatment of bipolar depression in children younger than 10 years.

When to call the doctor

Call your doctor if you become pregnant while taking this drug.

Allergies

Olanzapine can cause a severe allergic reaction. Symptoms can include:

• trouble breathing
• swelling of your throat or tongue
• itching
• hives  

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

What are you taking this medication for?

Schizophrenia

Generic: olanzapine

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg Form: Oral disintegrating tablet Strengths: 5 mg, 10 mg, 15 mg, 20 mg

Brand: Zyprexa

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg

Brand: Zyprexa Zydis

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg Adult dosage (ages 18 years and older)

• Typical starting dosage: 5–10 mg once per day.
• Dosage increases: If you’re started on a daily dose of 5 mg, within several days, your doctor may increase your dosage to a daily dose of 10 mg. Any further dosage changes will likely occur after at least 1 week of treatment. Your dosage will likely be changed by 5 mg at a time.
• Maximum dosage: 20 mg per day.

Child dosage (ages 13–17 years)

• Typical starting dosage: 2.5–5 mg once per day.
• Dosage increases: Your doctor may increase your dosage to 10 mg daily. Your dosage will likely be changed by 2.5 mg or 5 mg at a time.
• Maximum dosage: 20 mg per day.

Child dosage (ages 0–12 years)

It hasn’t been confirmed that olanzapine is safe and effective for the treatment of schizophrenia in people younger than 13 years.

Bipolar I disorder

Generic: olanzapine

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg Form: Oral disintegrating tablet Strengths: 5 mg, 10 mg, 15 mg, 20 mg

Brand: Zyprexa

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg

Brand: Zyprexa Zydis

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg Adult dosage (ages 18 years and older)

Use of olanzapine alone:

• Typical starting dosage: 10–15 mg once per day.
• Dosage increases: Dosage changes are typically not done more often than every 24 hours. They’re typically changed by 5 mg at a time. 
• Maximum dosage: 20 mg. 

Use in combination with lithium or valproate:

• Typical starting dosage: 10 mg olanzapine once per day.
• Maximum dosage: 20 mg olanzapine.

Child dosage (ages 13–17 years)

• Typical starting dosage: 2.5–5 mg once per day.
• Dosage increases: Your doctor may increase your dosage to 10 mg daily. Your dosage will likely be changed by 2.5 mg or 5 mg at a time.
• Maximum dosage: 20 mg per day.

Child dosage (ages 0–12 years)

It hasn’t been confirmed that olanzapine is safe and effective for the treatment of bipolar I disorder in people younger than 13 years.

Treatment-resistant depression

Generic: olanzapine

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg Form: Oral disintegrating tablet Strengths: 5 mg, 10 mg, 15 mg, 20 mg

Brand: Zyprexa

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg

Brand: Zyprexa Zydis

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg Adult dosage (ages 18 years and older)

• NOTE: Olanzapine must be used together with fluoxetine for this condition.
• Typical starting dosage: 5 mg olanzapine and 20 mg fluoxetine, taken once per day in the evening.
• Dosage increases: Your doctor can adjust your dosage based on how well this drug works for you. The dosage range is 5–20 mg olanzapine used with 20–50 mg fluoxetine.
• Maximum dosage: 18 mg olanzapine with 75 mg fluoxetine.

Child dosage (ages 0–17 years)

It hasn’t been confirmed that olanzapine is safe and effective for the treatment of treatment-resistant depression in people younger than 18 years.

Senior dosage (ages 65 years and older)

Typical starting dosage: 2.5–5 mg olanzapine with 20 mg fluoxetine per day. Your doctor may carefully increase your dosage as needed.

Bipolar depression

Generic: olanzapine

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg Form: Oral disintegrating tablet Strengths: 5 mg, 10 mg, 15 mg, 20 mg

Brand: Zyprexa

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg

Brand: Zyprexa Zydis

Form: Oral tablet Strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg Adult dosage (ages 18 years and older)

• NOTE: Olanzapine must be used together with fluoxetine for this condition.
• Typical starting dosage: 5 mg olanzapine and 20 mg fluoxetine, taken once per day in the evening.
• Dosage increases: Your doctor can adjust your dosage based on how well this drug works for you. The dosage range is 5–12.5 mg olanzapine used with 20–50 mg fluoxetine.
• Maximum dosage: 18 mg olanzapine with 75 mg fluoxetine.

Child dosage (ages 10–17 years)

• Typical starting dosage: 2.5 mg olanzapine and 20 mg fluoxetine, taken once per day in the evening.
• Dosage increases: Your doctor may change your dosage based on how well this drug works for you.
• Maximum dosage: 12 mg olanzapine with 50 mg fluoxetine.

Child dosage (ages 0–9 years)

It hasn’t been confirmed that olanzapine is safe and effective for the treatment of bipolar depression in people younger than 10 years.

Senior dosage (ages 65 years and older)

Typical starting dosage: 2.5–5 mg olanzapine with 20 mg fluoxetine per day. Your doctor may carefully increase your dosage as needed.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you. Important considerations for taking olanzapine

You can take olanzapine with or without food

Take olanzapine at the time(s) recommended by your doctor

You can cut or crush the tablet

Store this drug carefully

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A prescription for this medication is refillable

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Travel

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Self-management

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Clinical monitoring

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Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead

Hidden costs

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Insurance

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Are there any alternatives?