Highlights for olanzapine
Olanzapine is a prescription drug. It comes in the form of a tablet and a disintegrating tablet. (The disintegrating tablet will dissolve on your tongue.) Both forms are taken by mouth.
An injectable form is also available. This form is given only by a healthcare professional.
Olanzapine oral tablets are available as the brand-name drugs Zyprexa (oral tablet) and Zyprexa Zydis (disintegrating tablet). They’re also available as generic drugs. Generic drugs usually cost less than the brand-name versions. In some cases, they may not be available in every strength or form as the brand-name drugs.
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.
Olanzapine is used to treat schizophrenia and bipolar I disorder. It’s also used with fluoxetine to treat other conditions. These include depression caused by bipolar I disorder as well as depression that can’t be controlled with other drugs.
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. These drugs are often used to treat similar conditions.
It’s not known exactly how olanzapine works. It’s thought that it may help to regulate the amount of certain chemicals (dopamine and serotonin) in your brain to help control your mood.
Olanzapine oral tablet may cause drowsiness. Don’t drive, use machinery, or do dangerous activities until you know how this drug affects you. This drug can also cause other side effects.
The adult side effects for olanzapine are slightly different from the side effects for children.
Adult side effects can include:
Children and adolescent side effects can include the above, plus:
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 with your doctor or pharmacist.
Call your doctor right away if you have serious side effects. Call 911 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:
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 professional who knows your medical history.
Olanzapine oral tablet 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 with your doctor or pharmacist.
Examples of drugs that can cause interactions with olanzapine are listed below.
Benzodiazepines, such as diazepam. Increased side effects can include orthostatic hypotension, drowsiness, tiredness, and dizziness. Your doctor will monitor you closely during therapy.
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.
Anticholinergics, such as atropine or dicyclomine. Increased side effects can include constipation, trouble urinating, and falls. Your doctor will monitor you closely during therapy.
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 professional about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
This drug comes with several warnings.
Olanzapine can cause a severe allergic reaction. Symptoms can include:
If you develop these symptoms, call 911 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).
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.
For 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.
For people with seizures: Olanzapine can cause seizures. Tell your doctor if you have a history of seizures or epilepsy.
For 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.
For 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.
For people with high cholesterol: Olanzapine can cause high cholesterol levels. Very large increases in cholesterol can occur with no symptoms. Be sure to have your or your child’s cholesterol levels checked when your doctor suggests it.
For 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.
For 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.
For 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.
For 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.
For 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.
For pregnant women: Olanzapine is a category C pregnancy drug. That means two things:
Talk with 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.
If you become pregnant while taking this drug, call your doctor right away.
For women who are breastfeeding: Olanzapine passes into breast milk and may cause side effects in a child who is breastfed. You should not breastfeed if you’re using olanzapine. Talk with your doctor if you breastfeed your child. You should decide whether to stop breastfeeding 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, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.
For children:
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:
Generic: Olanzapine
Brand: Zyprexa
Brand: Zyprexa Zydis
Adult dosage (ages 18 years and older)
Child dosage (ages 13–17 years)
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.
Adult dosage (ages 18 years and older)
Use of olanzapine alone:
Use in combination with lithium or valproate:
Child dosage (ages 13–17 years)
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.
Note: Olanzapine must be used together with fluoxetine for this condition.
Adult dosage (ages 18 years and older)
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)
Note: Olanzapine must be used together with fluoxetine for this condition.
Adult dosage (ages 18 years and older)
Child dosage (ages 10–17 years)
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)
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 speak with your doctor or pharmacist about dosages that are right for you.
Olanzapine oral tablet is used for long-term treatment of schizophrenia, and short-term or long-term treatment of bipolar I disorder. It’s used with lithium or valproate for long-term treatment of bipolar I disorder. It’s also used with fluoxetine for long-term treatment of treatment-resistant depression or bipolar depression.
This drug comes with serious risks if you don’t take it as prescribed.
If you stop taking the drug suddenly or don’t take it at all: Your symptoms won’t be controlled. This could cause serious complications. These include suicidal thoughts or behaviors, or thoughts of hurting others.
If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.
If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:
If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.
What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.
How to tell if the drug is working: You should have decreased symptoms of schizophrenia, bipolar I disorder, bipolar depression, or treatment-resistant depression.
Keep these considerations in mind if your doctor prescribes olanzapine for you.
A prescription for this medication is not refillable. You or your pharmacy will have to contact your doctor for a new prescription if you need this medication refilled.
When traveling with your medication:
Tips for taking the orally disintegrating tablets (Zyprexa Zydis):
You and your doctor should monitor certain health issues during your treatment. This can help make sure you stay safe while you take olanzapine. These issues include:
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.
You may need to have blood tests or other tests during your treatment with olanzapine. The cost of these tests will depend on your insurance coverage.
Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.
There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.
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 other 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.
Last medically reviewed on August 16, 2021
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