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Zyprexa

Pronunciation: zy-PREX-a, zy-PREX-a ZY-dis, zy-PREX-a RELL-prev
Generic name: Olanzapine
Dosage form: oral tablets, orally disintegrating tablets (Zyprexa Zydis), intramuscular injection (Zyprexa IM), long-acting intramuscular injection (Zyprexa Relprevv)
Drug class: Atypical antipsychotics

Medically reviewed by Carmen Pope, BPharm. Last updated on Apr 23, 2024.

What is Zyprexa?

Zyprexa (olanzapine) is an atypical antipsychotic that may be used to treat adults and adolescents aged 13 and older with schizophrenia or bipolar I disorder. For bipolar I disorder, it may be used:

For treatment-resistant depression, olanzapine is used in combination with fluoxetine (Symbyax).

Zyprexa is available as oral tablets, orally disintegrating tablets, or an injection that is given into a muscle (intramuscular [IM]). The Zyprexa IM preparation is only for acute agitation associated with schizophrenia and bipolar I mania in adults. Zyprexa Relprevv IM is only available through a restricted distribution program, and the prescriber, healthcare facility, patient, and pharmacy must all be enrolled in the Zyprexa Relprevv Patient Care Program.

Zyprexa may work by blocking certain receptors in the brain, notably dopamine and serotonin, although the exact way it works in schizophrenia and bipolar I disorder is unknown.

Zyprexa was FDA approved on September 30, 1996.

Zyprexa side effects

Zyprexa may cause serious side effects such as an increased risk of death or stroke in elderly patients with dementia, a higher risk of suicide when taken with fluoxetine, metabolic changes, tardive dyskinesia, low blood pressure, and blood cell disorders. See the warnings below for a full list of serious side effects.

Common side effects of Zyprexa that affect 5% or more people who take it include postural hypotension (a drop in blood pressure when going from a lying or sitting position to standing)

Other side effects may include increased salivation, speech disorder, forgetfulness, and the feeling of pins and needles in your limbs.

Teenagers experienced greater increases in prolactin, liver enzymes, and sleepiness, when compared with adults.

Tell your doctor about any side effect that bothers you or does not go away.

These are not all the possible side effects of Zyprexa. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Warnings

Zyprexa may cause serious side effects, including:

May cause drowsiness and impair judgment, thinking, and motor skills. Use with caution when driving or operating machinery until you know how olanzapine affects you.

Zyprexa has not been approved for use in:

Zyprexa cost

The cost of prescription drugs varies depending on your insurance plan and which pharmacy you use. Refer to our price guide page for more information about the cost of Zyprexa or the cost of Zyprexa Zydis.

You may also be eligible for a Zyprexa coupon, or Zyprexa copay card. Ask your doctor or pharmacist if you qualify. Generic Zyprexa is available under the name olanzapine.

Before taking

Zyprexa may not be right for you. Before starting, tell your doctor if you have or had:

Tell your doctor if you exercise a lot or live or holiday in hot places.

Pregnancy

Taking antipsychotic medication, such as Zyprexa, in the last 3 months of pregnancy may cause breathing problems, feeding problems, or withdrawal symptoms in the newborn. If you get pregnant, tell your doctor right away but do not stop taking Zyprexa without your doctor's advice.

Talk to your healthcare provider about registering with the National Pregnancy Registry for Atypical Antipsychotics. You can register by calling 1-866-961-2388 or go to http://womensmentalhealth.org/clinical-andresearch-programs/pregnancyregistry/

Breastfeeding

Zyprexa passes into your breast milk. If you are breastfeeding, tell your doctor if you notice severe drowsiness, irritability, feeding problems, tremors, or unusual muscle movements in the nursing baby. Talk to your doctor about the best way to feed your baby if you take Zyprexa.

How should I take Zyprexa?

Take Zyprexa exactly as prescribed. Your doctor may need to change (adjust) the dose of Zyprexa until it is right for you.

The usual starting dose for adults with:

Zyprexa tablets

Zyprexa is usually taken once a day.

Zyprexa Zydis

Zyprexa Zydis is an orally disintegrating tablet that dissolves in your mouth without water.

Zyprexa IM injection

Zyprexa IM is a short-acting formulation that may be given to adults with schizophrenia or bipolar I mania if they have become agitated.

Zyprexa Relprevv IM injection

Zyprexa Relprevv is a long-acting formulation that may be administered by a healthcare provider every 2 to 4 weeks by deep intramuscular gluteal injection. It should only be administered once tolerance to oral olanzapine has been established.

Zyprexa: Other information

You may need regular medical tests while you are taking Zyprexa to check your cholesterol levels.

If you are diabetic, check your blood sugar levels regularly, because Zyprexa can cause high blood sugar levels, even in people who are not diabetic.

Olanzapine may cause you to gain weight more easily. Be conscious of your weight and what you eat. Exercise regularly. Talk to your healthcare provider if you are putting on too much weight.

Call your healthcare provider if you do not think you are getting better or have any concerns about your condition while taking Zyprexa.

What should I avoid while taking Zyprexa?

Zyprexa can cause sleepiness and may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how it affects you.

Avoid drinking alcohol. Dangerous side effects could occur.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Avoid becoming overheated or dehydrated. Drink plenty of fluids, especially in hot weather and during exercise. It is easier to become dangerously overheated and dehydrated while you are taking Zyprexa.

Avoid stopping Zyprexa suddenly. You should never stop taking it without your doctor’s advice. When it comes time to stop Zyprexa, it should be withdrawn slowly over several weeks under a doctor’s supervision. One survey reported at least 72% of people taking antipsychotics such as olanzapine experienced withdrawal symptoms.

Zyprexa withdrawal

Common symptoms of Zyprexa withdrawal include nausea, headaches, dizziness, sleep disturbances, brain zaps, and psychological symptoms, such as anxiety, irritability, mood swings, and difficulty concentrating.

What happens if I miss a dose?

If you miss a dose of Zyprexa, take the missed dose as soon as you remember. If it is almost time for the next dose, just skip the missed dose and take your next dose at the regular time. Do not take two doses at the same time.

What happens if I overdose?

If you take too much Zyprexa, call your doctor or poison control center at 1-800-222­-1222 right away, or get emergency treatment.

Overdose symptoms may include drowsiness, agitation, aggression, slurred speech, confusion, increased heart rate, jerky or uncontrolled muscle movements, trouble breathing, or fainting.

What other drugs will affect Zyprexa?

Tell your doctor about all the medicines that you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Zyprexa and some medicines may interact with each other and may not work as well, or cause possible serious side effects. Your doctor can tell you if it is safe to take Zyprexa with your other medicines. Do not start or stop any medicine while taking Zyprexa without talking to your doctor first. Especially tell your doctor if you take:

Anticholinergics (antimuscarinics), such as benztropine. Use with caution in patients with urinary retention, prostatic conditions, constipation, and some other conditions

Alcohol may also make side effects such as sleepiness and orthostatic hypotension worse.

Taking Zyprexa with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

This is not a complete list of interactions. Talk to your healthcare provider or pharmacist for a full list of interactions.

Does Zyprexa interact with my other drugs?

Enter medications to view a detailed interaction report using our Drug Interaction Checker.

Storage

Store Zyprexa at room temperature, between 68°F to 77°F (20°C to 25°C), away from light. Keep it dry and away from moisture.

Keep out of the reach of children.

Ingredients

Zyprexa tablets

Active ingredient: olanzapine.

Inactive ingredients: carnauba wax, crospovidone, hydroxypropyl cellulose, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, and other inactive ingredients.

Color coating: Titanium Dioxide, FD&C Blue No. 2 Aluminum Lake, or Synthetic Red Iron Oxide.

Zyprexa is available as 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, and 20 mg tablets. Tablets are not scored.

Zyprexa Zydis

Active ingredient: olanzapine.

Inactive ingredients: gelatin, mannitol, aspartame, sodium methyl paraben, and sodium propylparaben.

Zyprexa Zydis orally disintegrating tablets are available as 5 mg, 10 mg, 15 mg, and 20 mg tablets. Tablets are not scored.

Zyprexa injection

Active ingredient: olanzapine.

Inactive ingredients: lactose monohydrate, tartaric acid, hydrochloric acid, sodium hydroxide.

Zyprexa injection is available as a 10 mg vial.

Zyprexa Relprevv injection

Active ingredient: olanzapine pamoate.

Inactive ingredients: carboxymethylcellulose sodium, unspecified, polysorbate 80, hydrochloric acid, sodium hydroxide, water.

Manufacturer

Eli Lilly and Company.

Frequently asked questions

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.