Zyprexa (Olanzapine) – Oral

Warning:

The Food and Drug Administration (FDA) assigned a black box warning to Zyprexa (olanzapine). In general, this medication isn't approved for treating dementia-related psychosis. In older adults over 65 years, antipsychotic medications—like Zyprexa—for dementia-related psychosis increase the risk of death.

What Is Zyprexa?

Zyprexa (olanzapine) is a prescription medication typically used to treat mental health conditions. The oral (by mouth) dosage forms of Zyprexa are generally prescribed for schizophrenia or bipolar disorder.

The oral dosage forms are available in a regular Zyprexa tablet or Zyprexa Zydis. Zyprexa Zydis is an orally disintegrating tablet (ODT). This means it easily dissolves (breaks apart) with just your saliva, and no additional liquid is needed to take it.

In general, Zyprexa is an atypical, or second-generation, antipsychotic (SGA). It's thought to work by interfering with the activity of two naturally occurring brain chemicals called dopamine and serotonin.

Drug Facts

Generic Name: Olanzapine

Brand Name(s): Zyprexa and Zyprexa Zydis

Drug Availability: Prescription

Therapeutic Classification: Atypical or second-generation antipsychotic

Available Generically: Yes

Controlled Substance: No

Administration Route: Oral (by mouth)

Active Ingredient: Olanzapine

Dosage Form(s): Regular and ODT tablets

What Is Zyprexa Used For?

Regular and ODT Zyprexa tablets are used to treat schizophrenia in people 13 years and older.

These tablets can also be used for the short-term relief of manic or mixed episodes in people with bipolar I. There are three types of bipolar disorder:

  • Bipolar I disorder is manic episodes lasting at least seven days or manic symptoms requiring hospitalization. Depressive episodes may also occur and last around two weeks. Manic and depressive and manic symptoms may also occur at the same time.
  • Bipolar II disorder is a pattern of hypomanic and depressive episodes. However, the episodes tend to be less severe than in bipolar I.
  • Cyclothymic disorder (also called cyclothymia) is depressive and hypomanic symptoms not intense enough, or not lasting long enough, to qualify as full episodes.

To relieve manic or mixed episodes, regular and ODT Zyprexa tablets can be used alone in people 13 years and older. They can also be used with either lithium or valproate—but only in adults. After manic or mixed episodes go away, adults may use either type of Zyprexa tablet as a maintenance (long-term) treatment for bipolar I.

Mental health conditions are common in the United States. Every year, mental health conditions affect 1 in 5 adults and 1 in 6 children between 6 and 17 years of age.

For schizophrenia, it's estimated that 1.5 million in the United States live with this condition. Schizophrenia symptoms may include:

  • Abnormal thoughts
  • Decreased expression of emotions
  • Delusions
  • Difficulties with making decisions
  • Hallucinations
  • Impaired movements
  • Little or low motivation
  • Problems with memory or concentration (focus)
  • Relationship troubles

Bipolar disorder, on the other hand, affects roughly 7 million people in the United States. There are different types of bipolar. In general, regular and ODT Zyprexa tablets are used for bipolar I. People with this type of bipolar shift between periods of mania and periods of depression. Some people with bipolar I might also experience mixed episodes, which are symptoms of both mania and depression at the same time.

How to Take Zyprexa

You can take regular or ODT Zyprexa by mouth once daily with or without food.

The following are some additional steps on how to take Zyprexa Zydis ODT.

  1. Use dry hands to peel the backing of the blister pack.
  2. Remove the Zyprexa Zydis ODT from the blister pack without pushing the tablet through the foil. Don't remove the tablet from the blister pack until you're ready to take it immediately.
  3. Place the Zyprexa Zydis ODT on your tongue and allow the tablet to dissolve quickly.
  4. Swallow the tablet without water.

Storage

When you receive your regular or ODT Zyprexa tablets from the pharmacy, keep the medication at room temperature between 68 degrees and 77 degrees Fahrenheit (F)—with a short-term safety storage range between 59 degrees and 86 degrees F.

These tablets should also be protected from light and moisture. Keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet.

Avoid pouring unused and expired drugs down the drain or in the toilet. Visit the FDA's website to know where and how to discard all unused and expired medications. You can also find safe pharmacy disposal boxes in your area. Ask your pharmacist or healthcare provider if you have any questions about the best ways to dispose of your medications.

If you plan to travel with your Zyprexa tablets, become familiar with your final destination's regulations. Checking with the U.S. Embassy or Consulate might be a helpful resource. In general, however, make a copy of your Zyprexa prescription. It's also a good idea to keep your medication in its original container from your pharmacy with your name on the label. Ask your pharmacist or healthcare provider any questions you have about traveling with your medicine.

Off-Label Uses

Healthcare providers might use oral dosage forms of Zyprexa for some of the following off-label uses:

Agitation in people with dementia-related psychosis: The FDA hasn't approved Zyprexa for agitation in people with dementia-related psychosis. Using antipsychotics—like Zyprexa—for this condition in older adults over age 65 may increase the risk of death. Some studies, however, support Zyprexa's use for this condition.

Anorexia: The American Psychiatric Association (APA) guidelines and a few studies support using Zyprexa to improve weight gain in people with anorexia.

Chemotherapy-induced nausea and vomiting (CINV): Many people receiving chemotherapy (chemo) experience nausea and vomiting (NV), especially with moderate to high-risk chemo drugs.

Thankfully, there are medications to prevent or relieve CINV. Experts recommend Zyprexa in combination with other anti-nausea medications to prevent CINV that is acute (happens within 24 hours of chemo) or delayed (happens after 24 hours of chemo). Experts also support using Zyprexa in people experiencing breakthrough CINV—even if they already took or currently take preventive CINV medications.

Delusional infestation: A case report suggests that Zyprexa might help people with delusional infestation. People with this condition mistakenly believe they're infested (infected) with bugs, worms, or other creatures.

Depression with psychotic features: Some people with depression also have additional symptoms of psychosis (e.g., hallucinations, delusions). The APA guidelines and one study support using oral Zyprexa with an antidepressant—like Zoloft (sertraline) or Prozac (fluoxetine)—for this condition.

Hyperactive delirium: People with delirium may experience confusion and impaired awareness. There are different types of delirium. If you have hyperactive delirium, you might also have symptoms of restlessness and agitation.

Experts don't typically recommend antipsychotics—like olanzapine—for delirium in an intensive care unit (ICU) or non-ICU setting. Instead, nondrug measures should be tried first. A healthcare provider, however, may suggest the short-term use of antipsychotics in an ICU setting if there are distressing symptoms, such as anxiety and agitation. In a non-ICU environment, the healthcare provider might also consider short-term antipsychotic use if the person with hyperactive delirium is distressed and is a danger to themselves or others.

Nausea and vomiting in people with advanced cancer: People with advanced cancer may experience nausea and vomiting unrelated to their chemotherapy treatment. Incomplete bowel (gut) obstruction (blockage) in advanced cancer is also linked to nausea and vomiting.

How Long Does Zyprexa Take to Work?

You might begin to notice some improvement in your symptoms after two weeks of taking Zyprexa. This medication might require several more weeks for maximum effectiveness.

What Are the Side Effects of Zyprexa?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of regular and ODT Zyprexa tablets may include:

Severe Side Effects

Get medical help right away if you develop the following serious side effects:

  • Severe allergic reaction: If you have a severe allergic reaction to Zyprexa, symptoms may include breathing difficulties, swelling, and itchiness.
  • Abnormal white blood cell (WBC) amount: Zyprexa may lead to low WBC levels. This might raise your risk of infections. Be on the lookout for symptoms of an infection.
  • Cerebrovascular effects: Zyprexa is linked to cerebrovascular effects in older adults over 65 with dementia-related psychosis. Cerebrovascular effects may include stroke or transient ischemic attack (TIA), also known as a ministroke.
  • Cognitive and movement impairment: Zyprexa is connected to some cognitive impairment. Symptoms of cognitive impairment may include trouble with memory, concentration (focus), and decision-making. Some people may also experience muscle movement impairment. Use caution when driving or handling heavy machinery until you know how Zyprexa will affect you.
  • Drug reaction with eosinophilia and systemic symptoms (DRESS): DRESS is a severe drug allergy connected to high amounts of eosinophils (a type of white blood cell). Symptoms may include fever, rash, kidney injury, and liver injury. Be on the lookout for blood in foamy urine, dark urine, and yellowing of the skin or eyes (jaundice).
  • Drying effects: Zyprexa has a drying effect, which may lead to dry mouth and constipation. While these are common side effects, they can become severe and excessive.
  • Hyperprolactinemia: Zyprexa might result in too much prolactin hormone in your body. If you have high prolactin levels, you might experience enlarged breasts, milky nipple discharge, and an absence of menstrual periods. Some people may also have erection or orgasm problems.
  • Postural (positional) hypotension: You might experience low blood pressure if you suddenly get up from sitting or lying down. Take your time and hold onto something stable when you get up to prevent dizziness and fainting spells.
  • Metabolic changes: Zyprexa is linked to a high risk of metabolic changes, which include high blood pressure, high cholesterol, and weight gain.
  • Neuroleptic malignant syndrome (NMS): Antipsychotics—like Zyprexa—might cause a rare but life-threatening condition called NMS. Symptoms of NMS may include excessive sweating, fever, and stiff (rigid) muscles. Some people may also experience confusion and blood pressure changes.
  • Seizures: Seizures are possible with Zyprexa. If you have a history of seizures, this will further increase the risk of this side effect.
  • Suicidal thoughts or behaviors: Schizophrenia and bipolar come with a risk of suicide. Keep a close eye on abnormal changes in thoughts or behavior.
  • Tardive dyskinesia (TD): Zyprexa might increase your likelihood of having TD. People with TD have uncontrollable muscle movements of the face and tongue.

Call 911 if your symptoms feel life-threatening.

Long-Term Side Effects

Possible long-term side effects with Zyprexa may include:

  • Cerebrovascular effects.
  • Hyperprolactinemia.
  • Metabolic changes.
  • TD.

Report Side Effects

Regular and ODT Zyprexa tablets may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Zyprexa Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (orally disintegrating tablets, regular tablets):
    • For treatment of schizophrenia:
      • Adults—At first, 5 to 10 milligrams (mg) once a day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 20 mg per day.
      • Children 13 to 17 years of age—At first, 2.5 or 5 mg once a day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 20 mg per day.
      • Children younger than 13 years of age—Use and dose must be determined by your doctor.
    • For treatment of mania or mixed episodes with bipolar disorder (olanzapine alone):
      • Adults—At first, 10 to 15 milligrams (mg) once a day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 20 mg per day.
      • Children 13 to 17 years of age—At first, 2.5 or 5 mg once a day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 20 mg per day.
      • Children younger than 13 years of age—Use and dose must be determined by your doctor.
    • For treatment of mania or mixed episodes with bipolar disorder (olanzapine with lithium or valproate):
      • Adults—At first, 10 milligrams (mg) once a day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 20 mg per day.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of depression with bipolar disorder (olanzapine with fluoxetine):
      • Adults—At first, 5 milligrams (mg) of olanzapine and 20 mg of fluoxetine once a day in the evening. Your doctor may adjust your dose as needed. However the dose is usually not more than 18 mg of olanzapine and 75 mg of fluoxetine per day.
      • Children 10 to 17 years of age—At first, 2.5 milligrams (mg) of olanzapine and 20 mg of fluoxetine once a day in the evening. Your doctor may adjust your dose as needed. However the dose is usually not more than 12 mg of olanzapine and 50 mg of fluoxetine per day.
      • Children younger than 10 years of age—Use and dose must be determined by your doctor.
    • For treatment resistant depression (olanzapine with fluoxetine):
      • Adults—At first, 5 milligrams (mg) of olanzapine and 20 mg of fluoxetine once a day in the evening. Your doctor may adjust your dose as needed. However the dose is usually not more than 18 mg of olanzapine and 75 mg of fluoxetine per day.
      • Children—Use and dose must be determined by your doctor.

Modifications

The following modifications (changes) should be kept in mind when using regular or ODT Zyprexa tablets:

Severe allergic reaction: Avoid using Zyprexa if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: Side effects are possible in newborns exposed to Zyprexa late in the pregnancy (e.g., third trimester). Some newborns will quickly recover from these side effects after birth, but others may require more time.

Your newborn could experience side effects if you used Zyprexa while pregnant. However, there are also risks to having untreated mental health conditions during pregnancy. Discuss with your healthcare provider if you plan to become pregnant or are pregnant. They will help weigh the benefits and risks of your taking Zyprexa during your pregnancy.

They can also enroll you in the pregnancy exposure registry by visiting the National Pregnancy Registry for Psychiatric Medications website or calling 866-961-2388.

People assigned female at birth with childbearing or reproductive potential: Zyprexa may result in high prolactin hormone levels, which might negatively affect your fertility (ability to become pregnant). These effects, however, are reversible.

Breastfeeding: Low levels of olanzapine are present in breast milk, but little has been found in the bloodstream of nursing infants. Some experts support olanzapine as a go-to antipsychotic during breastfeeding, but nursing infants might experience some side effects.

Get hold of your child's healthcare provider (pediatrician) if you notice excessive drowsiness or sleepiness, fussiness, and abnormal muscle movements. Some nursing babies may also have poor feeding.

Talk with your healthcare provider if you plan to breastfeed. Your healthcare provider can help you weigh the benefits and risks of Zyprexa while nursing. They can also discuss the different ways available to feed your baby.

Older adults over 65: According to studies, there were no differences in responses between older and younger adults. Zyprexa in older adults with dementia-related psychosis was linked to a stroke, TIAs, and other side effects.

Children: The FDA approved regular and ODT Zyprexa tablets to treat schizophrenia in people at least 13 years of age. These tablets can also be used for short-term relief of manic or mixed episodes in bipolar 1 for this age group.

Compared to adults, however, children and teenagers taking oral (by mouth) Zyprexa tend to experience more changes in their cholesterol, liver-related labs, prolactin hormone levels, and other side effects.

History of low WBC counts: Zyprexa might result in low WBC levels. If you had a history of low WBC counts from a medical condition such as human immunodeficiency virus (HIV) or medication (e.g., clozapine, an antipsychotic), you might be at a higher risk of having this side effect. Therefore, your healthcare provider will closely monitor your WBC levels—especially during the first few months of treatment with Zyprexa.

Seizures: Seizures are possible with Zyprexa. If you have a history of seizures, your healthcare provider will closely monitor your condition.

Missed Dose

If you accidentally forget your Zyprexa dose, take it as soon as you remember. If it's already close to your next scheduled dose, skip the missed dose and take the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed dose.

Try to find ways to help remember to keep your appointments and take your medication routinely. If you miss too many doses, Zyprexa might be less effective at treating your condition.

Overdose: What Happens If I Take Too Much Zyprexa?

The symptoms of a suspected overdose with Zyprexa may include:

  • Agitation
  • Coma
  • Drowsiness
  • Rapid heartbeat
  • Sudden and uncontrollable movements

If you think that you're experiencing an overdose or life-threatening symptoms, seek immediate medical attention.

What Happens If I Overdose on Zyprexa?

If you think you or someone else may have overdosed on Zyprexa, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Zyprexa, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Olanzapine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these unwanted effects, tell your doctor right away.

This medicine may cause a condition called drug reaction with eosinophilia and systemic symptoms (DRESS). Call your doctor right away if you have a rash, red, swollen skin, fever, chills, cough, trouble breathing, swollen glands, or unusual bleeding, bruising, or weakness after using this medicine.

This medicine may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or increased urination. If you or your child have diabetes, you may notice a change in the results of your urine or blood sugar tests. If you have any questions, check with your doctor.

This medicine may increase your cholesterol and fats in the blood. If this condition occurs, your doctor may give you or your child some medicines that can lower the amount of cholesterol and fats in the blood.

This medicine may increase your weight. Your doctor may need to check your or your child's weight on a regular basis while you are using this medicine.

Check with your doctor right away if you have difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, seizures, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you or your child have lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

This medicine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid people with infections. Check with your doctor immediately if you or your child think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

Olanzapine may cause drowsiness, trouble with thinking, trouble with controlling body movements, or trouble with your vision, which may lead to falls, fractures or other injuries. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to think or see well.

This medicine may add to the effects of alcohol and other central nervous system (CNS) depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicines for allergies or colds, sedatives, tranquilizers, or sleeping medicines, prescription pain medicines or narcotics, medicines for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any CNS depressants while you are taking this medicine.

This medicine may make it more difficult for your body to cool down. It might reduce how much you sweat. Your body could get too hot if you do not sweat enough. If your body gets too hot, you might feel dizzy, weak, tired, or confused. You might vomit or have an upset stomach. Do not get too hot while you are exercising. Avoid places that are very hot. Call your doctor if you are too hot and can not cool down.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines) and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Zyprexa?

Before taking Zyprexa, talk with your healthcare provider if any of the following applies to you:

  • Severe allergic reaction: If you have a severe allergic reaction to Zyprexa or its components (ingredients), this medication isn't a viable option for you.
  • Pregnancy: Your newborn may experience side effects if exposed to Zyprexa during late pregnancy (e.g., third trimester). Some newborns will quickly recover, but others might require more time. While there's a chance that your newborn might have side effects from Zyprexa, there are certain risks with untreated mental health conditions, too. Discuss with your healthcare provider the benefits and risks of Zyprexa during pregnancy.
  • Breastfeeding: Low levels of olanzapine are present in breast milk, but little has been detected in the bloodstream of nursing infants. Some experts support olanzapine as a go-to antipsychotic during breastfeeding, but nursing infants might experience some side effects. Reach out to your healthcare provider for a discussion about the benefits and harms of Zyprexa while nursing.
  • Children: The FDA approved regular and ODT Zyprexa tablets to treat schizophrenia in people at least 13 years of age. These tablets can also be used for short-term relief of manic or mixed episodes in bipolar I for this age group. Compared to adults, however, children and teenagers taking oral (by mouth) Zyprexa tend to experience more side effects.
  • Older adults: According to human study, there were no differences in responses to oral Zyprexa between older and younger adults. Zyprexa in older adults with dementia-related psychosis was linked to a stroke, TIAs, and other side effects.

What Other Medications Interact With Zyprexa?

Use caution when taking Zyprexa with the following substances:

  • Alcohol: Alcohol may worsen Zyprexa's low blood pressure effects.
  • Anticholinergics: Anticholinergics are medications that block a naturally occurring chemical in the body called acetylcholine. This can result in several side effects, such as constipation and urination difficulties. Zyprexa can cause these side effects, too. So, taking it with other anticholinergics (e.g., diphenhydramine for allergies) might worsen these side effects.
  • Antihypertensives: Antihypertensives are used to treat high blood pressure. These medications may have additive blood pressure-lowering effects with Zyprexa. Examples of antihypertensives include lisinopril and hydrochlorothiazide.
  • Benzodiazepines: Benzodiazepines (e.g., diazepam, lorazepam) may worsen drowsiness, sleepiness, and low blood pressure effects.
  • CYP1A2-inducing medications: CYP1A2 is a liver protein responsible for breaking down medications, such as Zyprexa. Taking CYP1A2-inducing medications—like carbamazepine for seizures—might result in the faster breakdown of Zyprexa. This may lead to a quicker clearance of Zyprexa from your body, making the medication less effective.
  • CYP1A2-inhibiting medications: CYP1A2-inhibiting medications—like fluvoxamine for obsessive-compulsive disorder (OCD)—prevent CYP1A2 from working. This may lead to a build-up of Zyprexa levels and more side effects.
  • Medications that induce glucuronyl transferase proteins: The glucuronyl transferase protein makes some modifications (changes) to certain medications, such as Zyprexa. These changes help clear Zyprexa from your body. Medications—like rifampin for tuberculosis (TB)—induce (encourage) this process, which may lead to low and ineffective Zyprexa levels.
  • Levodopa and dopamine agonists: Levodopa and dopamine agonists (like pramipexole) are typically used in Parkinson's disease (PD). Zyprexa might work against the effects of these medications.

For more detailed information about medication interactions with Zyprexa, talk with your pharmacist or healthcare provider.

And be sure to let your healthcare provider know about any other medicines you take or plan to take, including over-the-counter, nonprescription products, vitamins, herbs, or plant-based medicines.

What Medications Are Similar?

Zyprexa (olanzapine) is a second-generation or atypical antipsychotic. Other similar antipsychotics may include:

  • Abilify (aripiprazole)
  • Clozaril (clozapine)
  • Fanapt (iloperidone)
  • Geodon (ziprasidone)
  • Invega (paliperidone)
  • Latuda (lurasidone)
  • Rexulti (brexpiprazole)
  • Risperdal (risperidone)
  • Saphris (asenapine)
  • Seroquel (quetiapine)
  • Vraylar (cariprazine)

The following is some interesting information about these antipsychotics:

  • Clozapine, olanzapine, and risperidone are better at relieving overall schizophrenia symptoms.
  • Olanzapine, paliperidone, and risperidone are better at relieving positive schizophrenia symptoms, such as hallucinations and delusions.
  • Clozapine and olanzapine—with risperidone to a lesser extent—are better at relieving negative schizophrenia symptoms, such as low motivation and decreased expression of emotions.
  • Clozapine and olanzapine are better at treating depression symptoms.
  • Brexipiprazole, lurasidone, olanzapine, paliperidone, and quetiapine are linked to improved social interactions.
  • Experts recommend olanzapine or risperidone as treatment options for manic or mixed episodes in people with bipolar.
  • Olanzapine was linked to more weight gain.
  • Lurasidone, olanzapine, paliperidone, and risperidone were linked to higher prolactin levels.
  • Clozapine, iloperidone, olanzapine, quetiapine, and risperidone are linked to more anticholinergic side effects, such as blurry vision, dry mouth, and urination difficulties.

While all of these are antipsychotics, healthcare providers may use multiple antipsychotics together for mental health conditions such as schizophrenia.

Frequently Asked Questions

  • Where are regular or ODT Zyprexa tablets available?

    Zyprexa (both oral tablets and ODT) is available with a healthcare provider's prescription at your pharmacy. If your pharmacy doesn't carry these tablets, the pharmacy staff can order the medication for you.

  • How much does regular or ODT Zyprexa tablets cost?

    Both regular and ODT Zyprexa tablets are available in generic versions. This may save you on costs.

    The Lilly manufacturer offers a Lilly Care Foundation patient assistance program if cost is a concern. This program, however, is likely only for the brand-name versions.

    Some other potentially helpful resources may include RxAssist, NeedyMeds, FundFinder, Simplefill, BenefitsCheckUp, Medicare Rights Center, State Pharmaceutical Assistance Programs (SPAPs), and Rx Outreach.

  • Will I need other medications in addition to Zyprexa?

    The number of medications varies per person. In general, people with bipolar disorder typically require multiple medications to control symptoms. Some people with schizophrenia may also require more than one medication to experience symptom control.

  • How long do I need to take Zyprexa?

    It depends.

    If you're taking regular or ODT Zyprexa tablets for manic or mixed episodes in bipolar I, then you may only need to take Zyprexa until these episodes go away.

    If you and your healthcare provider decide to continue Zyprexa after your manic or mixed episode, then Zyprexa would be considered a maintenance treatment. You will likely take Zyprexa for long-term treatment of bipolar I. Zyprexa, however, isn't a typical go-to choice for maintenance treatment, except in certain situations—like to control or prevent psychosis symptoms.

    If you're taking regular or ODT Zyprexa tablets for schizophrenia, on the other hand, then Zyprexa is likely a lifelong medication.

  • If I'm having tardive dyskinesia while taking Zyprexa, what do I do?

    If you're experiencing TD, don't suddenly stop your Zyprexa medication. Abruptly discontinuing Zyprexa might result in serious side effects.

    Instead, reach out right away to your healthcare provider. They will advise you on next steps. If stopping Zyprexa is necessary, they will likely discuss how to slowly and safely stop this medication.

How Can I Stay Healthy While Taking Zyprexa?

If you're taking Zyprexa, chances are your bipolar or schizophrenia conditions have been affecting your quality of life. You may have tried different approaches or treatments.

While living with a mental health condition does have its challenges, there are ways to help improve your quality of life. Refer to the below information for some general suggestions to help you manage bipolar disorder:

  • Take mood-related medications as recommended by your healthcare provider.
  • Share your condition with loved ones when you're ready. Having strong social support is essential.
  • Consider keeping a diary to record your moods and become more aware of your triggers.
  • Eat a healthy diet.
  • Exercise regularly.
  • Find ways to manage stress.
  • Make sure that you get enough sleep.

The following are more general tips to help you manage schizophrenia:

  • Take schizophrenia-related medications as recommended by your healthcare provider.
  • Consider therapy and psychosocial support to help you manage symptoms and daily challenges at school and work. These treatments and support may also help you to develop life-management and social skills. They may also help you manage stress and allow you to notice any warning signs of a possible relapse of your schizophrenia symptoms.
  • Share your schizophrenia diagnosis with your loved ones when you're ready. This is a difficult step. The sooner you let them know, however, they can find educational and support programs to learn more about schizophrenia and find ways to give you the support you need.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

33 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Olanzapine.

  2. Food and Drug Administration. Zyprexa.

  3. National Institute of Mental Health. Bipolar Disorder.

  4. National Alliance on Mental Illness. Mental health by the numbers.

  5. National Institute of Mental Health. Schizophrenia.

  6. National Alliance on Mental Illness. Bipolar disorder.

  7. Sultzer DL, Davis SM, Tariot PN, et al. Clinical symptom responses to atypical antipsychotic medications in Alzheimer's disease: phase 1 outcomes from the CATIE-AD effectiveness trial. The American Journal of Psychiatry. 2008;165(7):844-854. doi: https://doi.org/10.1176%2Fappi.ajp.2008.07111779

  8. Street JS, Clark WS, Gannon KS, et al. Olanzapine treatment of psychotic and behavioral symptoms in patients with Alzheimer disease in nursing care facilities: a double-blind, randomized, placebo-controlled trial. Archives of General Psychiatry. 2000;57(10):968-976. doi: 10.1001/archpsyc.57.10.968

  9. Schneider LS, Tariot PN, Dagerman KS, et al. Effectiveness of atypical antipsychotic drugs inpatients with Alzheimer's disease. The New England Journal of Medicine. 2006;355:1525-1538. doi: 10.1056/NEJMoa061240

  10. Yager J, Devlin MJ, Halmi KA, et al. Guideline watch (August 2012): Practice guideline for the treatment of patients with eating disorders, 3rd edition. The American Psychiatric Association. 2012:1-18.

  11. Bissada H, Tasca GA, Barber AM, et al. Olanzapine in the treatment of low body weight and obsessive thinking in women with anorexia nervosa: a randomized, double-blind, placebo-controlled trial. The American Journal of Psychiatry. 2008;165(10):1281-1288. doi: https://doi.org/10.1176/appi.ajp.2008.07121900

  12. Attia E, Steinglass JE, Walsh BT, et al. Olanzapine versus placebo in outpatient adults with anorexia nervosa: a randomized clinical trial. The American Journal of Psychiatry. 2019;176(6):449-456. doi: https://doi.org/10.1176%2Fappi.ajp.2018.18101125

  13. American Society of Clinical Oncology. ASCO Guidelines. Antiemetics: ASCO Guideline Update: Drug, Dose, Schedule Recommendations for Antiemetic Regimens.

  14. National Institutes of Health. National Cancer Institute. Nausea and Vomiting Related to Cancer Treatment (PDQ®)-Health Professional Version.

  15. Hesketh PJ, Kris MG, Bohlke K, et al. Antiemetics: American Society of Clinical Oncology practice guideline updateJournal of Clinical Oncology. 2017. Doi: 10.1200/JCO.2017.74.4789

  16. American Cancer Society. Nausea and Vomiting. Nausea and Vomiting Caused by Cancer Treatment.

  17. Meraj A, Din AU, Larsen L, et al. Self inflicted corneal abrasions due to delusional parasitosis. BMJ Case Reports. 2011. doi: https://doi.org/10.1136%2Fbcr.04.2011.4106

  18. Gelenburg AJ, Freeman MP, Markowitz JC, et al. Practice guideline for the treatment of patients with major depressive disorder. American Psychiatric Association. 2010:1-152.

  19. Meyers BS, Flint AJ, Rothschild AJ, et al. A double-blind randomized controlled trial of olanzapine plus sertraline vs olanzapine plus placebo for psychotic depression -- The STOP-PD Study. Archives of General Psychiatry. 2009;66(8):838-847. doi: https://doi.org/10.1001%2Farchgenpsychiatry.2009.79

  20. National Clinical Guideline Centre. Delerium: diagnosis, prevention and management.

  21. Devlin JW, Skrobik Y, Gelinas C, et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Critical Care Medicine. 2018;46(9):e825-e873. doi: 10.1097/CCM.0000000000003299

  22. Navari RM, Pywell CM, Le-Rademacher JG, et al. Olanzapine for the treatment of advanced cancer-related chronic nausea and/or vomiting. JAMA Oncology. 2020;6(6):1-5. doi: https://doi.org/10.1001%2Fjamaoncol.2020.1052

  23. Kaneishi K, Kawabata M, Morita T. Olanzapine for the relief of nausea in patients with advanced cancer and incomplete bowel obstruction. Journal of Pain and Symptom Management. 2012;44(4):P604-607. doi: https://doi.org/10.1016/j.jpainsymman.2011.10.023

  24. LiverTox. Acute liver failure.

  25. National Kidney Foundation. 10 signs you may have kidney disease.

  26. LactMed. Olanzapine.

  27. ScienceDirect. CYP1A2.

  28. MedlinePlus. Glucuronyl transferase.

  29. Huhn M, Nikolakopoulou A, Schneider-Thoma J, et al. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. The Lancet. 2019;394(10202):939-951. doi: https://doi.org/10.1016/S0140-6736(19)31135-3

  30. Hirschfeld RMA, Bowden CL, Gitlin MJ, et al. Practice guideline for the treatment of patients with bipolar disorder. American Psychiatric Association. 2010:1-82.

  31. Tiihonen J, Taipale H, Mehtala J, et al. Association of antipsychotic polypharmacy vs monotherapy with psychiatric rehospitalization among adults with schizophrenia. JAMA Psychiatry. 2019;76(5):499-507. doi: https://doi.org/10.1001/jamapsychiatry.2018.4320

  32. Food and Drug Administration. Drugs@FDA: FDA-approved drugs.

  33. American Psychiatric Association. What is schizophrenia?.

By Ross Phan, PharmD, BCACP, BCGP, BCPS
Ross is a writer for Verywell with years of experience practicing pharmacy in various settings. She is also a board-certified clinical pharmacist and the founder of Off Script Consults.