Know the basics
What is olanzapine used for?
Olanzapine is used to treat certain mental/mood conditions (such as schizophrenia,bipolar disorder). It may also be used in combination with other medication to treat depression. This medication can help to decrease hallucinations and help you to think more clearly and positively about yourself, feel less agitated, and take a more active part in everyday life.
Olanzapine belongs to a class of drugs called atypical antipsychotics. It works by helping to restore the balance of certain natural substances in the brain.
Talk to the doctor about the risks and benefits of treatment (especially when used by teenagers).
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This medication may also be used to prevent nausea and vomiting caused by cancer drug treatment (chemotherapy).
How should I take olanzapine?
Take this medication by mouth with or without food as directed by your doctor, usually once daily.
The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully.
Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication as prescribed even if you feel well. Do not stop taking this medication without consulting your doctor.
Tell your doctor if your condition persists or worsens.
How do I store olanzapine?
Olanzapine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store olanzapine in the bathroom or the freezer. There may be different brands of olanzapine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.
You should not flush olanzapine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.
Know the precautions & warnings
What should I know before using olanzapine?
Before taking olanzapine,
- tell your doctor and pharmacist if you are allergic to olanzapine or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antidepressants; antihistamines; carbamazepine (Tegretol); dopamine agonists such as bromocriptine (Parlodel), cabergoline (Dostinex), levodopa (Dopar, Larodopa), pergolide (Permax), and ropinirole (Requip); fluoroquinolone antibiotics including ciprofloxacin (Cipro), gatifloxacin (Tequin) (not available in the United States), levofloxacin (Levaquin), norfloxacin (Noroxin), ofloxacin (Floxin), others; fluvoxamine (Luvox); ipratropium (Atrovent); medications for anxiety, high blood pressure, irritable bowel disease, mental illness, motion sickness, Parkinson’s disease, seizures, ulcers, or urinary problems; omeprazole (Prilosec); rifampin (Rifadin); sedatives; sleeping pills; ticlopidine (Ticlid); and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you use or have ever used street drugs or have overused prescription medications and if you have or have ever had a stroke, a mini-stroke, heart disease or a heart attack, an irregular heartbeat, seizures, breast cancer, any condition that makes it difficult for you to swallow, high or low blood pressure, a high level of fats (cholesterol and triglycerides) in your blood, a low number of white blood cells, liver or prostate disease, paralytic ileus (condition in which food cannot move through the intestine); glaucoma (an eye condition), or high blood sugar, or if you or anyone in your family has or has ever had diabetes. Tell your doctor if you have severe vomiting or diarrhea or signs of dehydration now, or if you develop these symptoms at any time during your treatment. Also tell your doctor if you have ever had to stop taking a medication for mental illness because of severe side effects.
- tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breast-feeding. If you become pregnant while taking olanzapine, call your doctor. Olanzapine may cause problems in newborns following delivery if it is taken during the last months of pregnancy.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking olanzapine.
- you should know that olanzapine may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- you should know that alcohol can add to the drowsiness caused by this medication. Do not drink alcohol while taking olanzapine.
- tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication.
- you should know that you may experience hyperglycemia (increases in your blood sugar) while you are taking this medication, even if you do not already have diabetes. If you have schizophrenia, you are more likely to develop diabetes than people who do not have schizophrenia, and taking olanzapine or similar medications may increase this risk. Tell your doctor immediately if you have any of the following symptoms while you are taking olanzapine: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important to call your doctor as soon as you have any of these symptoms, because high blood sugar can cause a serious condition called ketoacidosis. Ketoacidosis may become life-threatening if it is not treated at an early stage. Symptoms of ketoacidosis include: dry mouth, nausea and vomiting, shortness of breath, breath that smells fruity, and decreased consciousness.
- you should know that olanzapine may cause fast or slow heartbeat, dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking olanzapine. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
- you should know that olanzapine may make it harder for your body to cool down when it gets very hot. Tell your doctor if you plan to do vigorous exercise or be exposed to extreme heat.
- if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that the orally disintegrating tablets contain aspartame that forms phenylalanine.
- you should know that when olanzapine is used to treat teenagers, it must be used as part of a total treatment program that may include counseling and educational support. Make sure that your child follows all of the doctor’s and/or therapist’s instructions.
Is it safe to take olanzapine during pregnancy or breast-feeding?
There isn’t enough information about the safety of using this medication during pregnancy and breast-feeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication.
Know the side effects
What are the side effects of olanzapine?
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using olanzapine and call your doctor at once if you have any of these serious side effects:
- very stiff (rigid) muscles, high fever, tremors, sweating, confusion, fast or uneven heartbeats, slow heart rate, feeling like you might pass out;
- twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs;
- trouble speaking or swallowing;
- dry mouth, thirst, feeling very hot (with or without sweating), urinating less than usual or not at all;
- high blood sugar (increased thirst, loss of appetite, fruity breath odor, increased urination, drowsiness, dry skin, nausea, and vomiting);
- sudden numbness or weakness, confusion, or problems with vision, speech, or balance;
- fever, chills, body aches, flu symptoms, sores in your mouth and throat;
- swelling in your hands or feet;
- changes in personality, unusual thoughts or behavior, hallucinations, or thoughts about hurting yourself; or
- upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
- weight gain (more likely in teenagers), increased appetite;
- headache, dizziness, drowsiness, feeling tired or restless;
- memory problems;
- stomach pain, constipation, loss of bladder control;
- back pain, pain in your arms or legs;
- numbness or tingly feeling;
- breast swelling or discharge (in women or men); or
- missed menstrual periods.
Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.
Know the interactions
What drugs may interact with olanzapine?
Olanzapine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval, especially with:
- Tramadol because the risk of seizures may be increased
- Alpha-blockers (eg, doxazosin), diazepam, or medicine for high blood pressure because the risk of low blood pressure and fainting may be increased
- Anticholinergics (eg, scopolamine), benzodiazepines (eg, lorazepam), or fluvoxamine because they may increase the risk of olanzapine’s side effects
- Carbamazepine, HIV protease inhibitors (eg, ritonavir), omeprazole, or rifampin because they may decrease olanzapine’s effectiveness
Dopamine receptor agonists (eg, pramipexole) or levodopa because their effectiveness may be decreased by olanzapine.
Does food or alcohol interact with olanzapine?
Olanzapine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug, especially grape fruit juice, especially:
- Blood vessel disease or circulation problems or
- Dehydration or
- Heart attack or stroke, history of or
- Heart disease or
- Heart failure or
- Heart rhythm problems or
- Hypotension (low blood pressure) or
- Hypovolemia (low blood volume)—May cause side effects to become worse.
- Breast cancer, prolactin-dependent or
- Glaucoma, narrow-angle or
- Hyperlipidemia (high cholesterol or fat in the blood) or
- Hyperprolactinemia (high prolactin in the blood) or
- Liver disease or
- Paralytic ileus (severe intestinal problem), history of or
- Prostatic hypertrophy (enlarged prostate) or
- Seizures, history of—Use with caution. This medicine may make these conditions worse.
- Diabetes or
- Hyperglycemia (high blood sugar)—Use with caution. This medicine may raise blood sugar levels.
- Phenylketonuria (PKU, a genetic disease of metabolism)—The orally disintegrating tablet (Zyprexa® Zydis®) contains phenylalanine, which can make this condition worse.
What health conditions may interact with olanzapine?
Olanzapine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.
Understand the dosage
The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this medication.
What is the dose of olanzapine for an adult?
Usual Adult Dose for Bipolar Disorder
Initial dose: 10 to 15 mg orally once a day.
Oral (combination therapy with lithium or valproate):
Initial dose: 10 mg orally once a day.
Initial dose: 10 mg IM once.
Usual Adult Dose for Schizophrenia
Initial dose: 5 to 10 mg orally once a day.
Initial dose: 10 mg IM once.
What is the dose of olanzapine for a child?
Usual Pediatric Dose for Schizophrenia
8 to 12 years (Limited data available):
Initial: 2.5 to 5 mg once daily; increase dose in 2.5 or 5 mg increments at weekly intervals to target dose of 10 mg once daily; maximum dose: 20 mg/day.
13 to 17 years old:
Initial dose: 2.5 to 5 mg orally once a day
Usual Pediatric Dose for Bipolar Disorder
4 to 5 years: Limited data available: Initial: 1.25 mg orally once daily; increase at weekly intervals according to response and tolerability to target dose: 10 mg/day.
6 to 12 years: Limited data available: Initial: 2.5 mg orally once daily; increase dose in 2.5 or 5 mg increments at weekly intervals to target dose of 10 mg once daily; maximum dose: 20 mg/day.
13 to 17 years old:
Initial dose: 2.5 mg to 5 mg orally once a day
Usual Pediatric Dose for Anorexia Nervosa
9 years and older: (Limited data available): 1.25 to 2.5 mg orally once daily has been shown in one small trial and several case reports to improve BMI and other disease related symptoms (e.g., eating attitudes, anxiety); another case series used initial doses of 2.5 mg once daily and final doses of 5 mg to 10 mg once daily; reported range: 1.25 to 12.5 mg/day; however, it has been suggested that higher doses (greater than 2.5 mg once daily) may not be associated with greater efficacy. Further studies are needed.
Usual Pediatric Dose for Tourette’s Syndrome
Tourette syndrome, tic disorder:
7 years and older: Limited data available:
Patient weight less than 40 kg: Initial: 2.5 mg orally every other day for 3 days, increase to 2.5 mg every day for remainder of week; increase to 5 mg/day by second week if needed; then increase in 5 mg increments at weekly intervals as tolerated; maximum dose: 20 mg/day
Patient weight greater than 40 kg: Initial: 2.5 mg every day for 3 days; increase to 5 mg every day for remainder of week if needed, then increase in 5 mg increments at weekly intervals as tolerated; maximum dose: 20 mg/day
An open-label study of 10 pediatric patients (7 to 13 years of age) reported significant reductions in tic severity [Yale Global Tic Severity Scale (YGTSS)] from baseline at a mean final dose of 14.5 mg/day after 8 weeks of treatment. An open-label trial of 12 children and adolescents (7 to 14 years of age) reported a significant reduction (30%) in total tic severity (YGTSS) at a final mean dose of 11.3 mg/day (range: 2.5 to 20 mg/day).
How is olanzapine available?
Olanzapine is available in the following dosage forms and strengths:
Powder for solution, Intramuscular: 10 mg/2 mL.
What should I do in case of an emergency or overdose?
In case of an emergency or an overdose, call your local emergency services (115) or go to your nearest emergency room.
Symptoms of overdose may include:
- slurred speech
- fast heartbeat
- sudden movements that you cannot control
- coma (loss of consciousness for a period of time)
What should I do if I miss a dose?
If you miss a dose of olanzapine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: May 30, 2016 | Last Modified: January 4, 2017
Olanzapine. http://www.webmd.com/drugs/2/drug-1644-9274/olanzapine-oral/olanzapine---oral/details. Accessed July 14, 2016.
Olanzapine. https://www.drugs.com/cdi/olanzapine-tablets.html. Accessed July 14, 2016.
Olanzapine. https://medlineplus.gov/druginfo/meds/a601213.html. Accessed July 14, 2016.