Olanzapine

Generic Name: olanzapine (oral) (oh LANZ a peen)
Brand Name: ZyPREXA, ZyPREXA Zydis

What is olanzapine?

Olanzapine is an antipsychotic medication that affects chemicals in the brain.

Olanzapine is used to treat the symptoms of psychotic conditions such as schizophrenia and bipolar disorder (manic depression) in adults and children who are at least 13 years old. Olanzapine is sometimes used together with other antipsychotic medications or antidepressants.

Olanzapine may also be used for purposes not listed in this medication guide.

Important Information

Olanzapine is not approved for use in psychotic conditions related to dementia. Olanzapine may increase the risk of death in older adults with dementia-related conditions.

Before taking this medicine

Olanzapine is not approved for use in psychotic conditions related to dementia. Olanzapine may increase the risk of death in older adults with dementia-related conditions.

You should not take olanzapine if you are allergic to it.

Long-term use of olanzapine can cause a serious movement disorder that may not be reversible. Symptoms include uncontrollable muscle movements of your lips, tongue, eyes, face, arms, or legs. The longer you take olanzapine, the more likely you are to develop this movement disorder. The risk of this side effect is higher in women and older adults.

To make sure olanzapine is safe for you, tell your doctor if you have ever had:

liver disease;
heart disease, high or low blood pressure;
low white blood cell (WBC) counts;
high cholesterol or triglycerides;
heart failure, heart attack, or stroke;
breast cancer;
seizures or epilepsy;
diabetes;
an enlarged prostate or difficulty urinating;
bowel problems; or
narrow-angle glaucoma.

Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Taking antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant while taking olanzapine, do not stop taking it without your doctor's advice.

Olanzapine can pass into breast milk and may harm a nursing baby. You should not breast-feed while using olanzapine.

The olanzapine orally disintegrating tablet (Zyprexa Zydis) may contain phenylalanine. Talk to your doctor before using this form of olanzapine if you have phenylketonuria (PKU).

What should I avoid while taking olanzapine?

Olanzapine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Dizziness or severe drowsiness can cause falls, fractures, or other injuries.

Avoid drinking alcohol. Dangerous side effects could occur.

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 olanzapine.

Olanzapine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have symptoms of a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, flu-like symptoms, unusual bruising, or jaundice (yellowing of your skin or eyes).

Call your doctor at once if you have:

uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);
trouble speaking or swallowing;
swelling in your hands or feet;
confusion, unusual thoughts or behavior, hallucinations, or thoughts about hurting yourself;
sudden weakness or ill feeling, fever, chills, sore throat, swollen gums, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough;
signs of dehydration--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;
liver problems--upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
high blood sugar--increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss; or
severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Common side effects may include:

weight gain (more likely in teenagers), increased appetite;
headache, dizziness, drowsiness, feeling tired or restless;
problems with speech or memory;
tremors or shaking, numbness or tingly feeling;
changes in personality;
dry mouth, or increased salivation;
stomach pain, constipation; or
pain in your arms or legs.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

What other drugs will affect olanzapine?

Taking olanzapine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with olanzapine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

In Summary

Commonly reported side effects of olanzapine include: asthenia, dizziness, drowsiness, extrapyramidal reaction, hyperkinetic muscle activity, akinesia, cogwheel rigidity, drug-induced parkinson's disease, dyspepsia, mask-like face, and xerostomia. Other side effects include: abnormal gait, back pain, constipation, fever, orthostatic hypotension, weight gain, myoclonus, and personality disorder. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to olanzapine: oral tablet, oral tablet disintegrating

Other dosage forms:

intramuscular powder for solution, intramuscular powder for suspension extended release

Warning

Oral route (Tablet; Tablet, Disintegrating)

Risk of death is increased in elderly patients with dementia-related psychosis treated with antipsychotic drugs. Although the causes of death in clinical trials were varied, most of the deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature. Observational studies suggest that antipsychotic drugs may increase mortality. It is unclear from these studies to what extent the mortality findings may be attributed to the antipsychotic drug as opposed to patient characteristics. Olanzapine is not approved for the treatment of patients with dementia-related psychosis.

Along with its needed effects, olanzapine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking olanzapine:

More common

Bloating or swelling of the face, arms, hands, lower legs, or feet
blurred vision
change in vision
change in walking and balance
clumsiness or unsteadiness
difficulty with speaking
difficulty with swallowing
drooling
impaired vision
inability to sit still
loss of balance control
mask-like face
muscle trembling, jerking, or stiffness
need to keep moving
rapid weight gain
restlessness
shuffling walk
slowed movements
slurred speech
stiffness of the arms and legs
tic-like (jerky) movements of the head, face, mouth, and neck
tingling of the hands or feet
trembling or shaking of the fingers, hands, feet, legs, or arms
twisting movements of the body
uncontrolled movements, especially of the face, neck, and back
unusual weight gain or loss

Less common

Bladder pain
bloody or cloudy urine
bruising
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chest pain
difficult or labored breathing
difficult, burning, or painful urination
dizziness
excessive muscle tone
frequent urge to urinate
headache
inability to move the eyes
increased blinking or spasms of the eyelid
itching of the vagina or genital area
lack of coordination
large, flat, blue, or purplish patches in the skin
loss of bladder control
loss of memory
lower back or side pain
muscle tension or tightness
nervousness
pain during sexual intercourse
pounding in the ears
problems with memory
rhythmic movement of the muscles
slow, fast, pounding, or irregular heartbeat or pulse
speaking is less clear than usual
sticking out the tongue
thick, white vaginal discharge with no odor or with a mild odor
tightness in the chest
twitching
uncontrolled twisting movements of the neck, trunk, arms, or legs
unusual or incomplete body or facial movements
weakness of the arms and legs

Some side effects of olanzapine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Acid or sour stomach
back pain
belching
change in personality
difficulty having a bowel movement (stool)
discouragement
feeling sad or empty
fever
heartburn
increased appetite
increased cough
indigestion
lack of appetite
lack or loss of strength
loss of interest or pleasure
runny nose
sneezing
stomach discomfort, upset, or pain
stuffy nose
thirst
trouble sleeping
trouble with concentrating
watering of the mouth

Less common

Blemishes on the skin
body aches or pain
chills
cold sweats
congestion
cough
dry skin
dryness or soreness of the throat
false or unusual sense of well-being
heavy menstrual bleeding (periods)
hoarseness
joint pain
lack of feeling or emotion
leg cramps
pain in the arms or legs
pimples
sweating
tender, swollen glands in the neck
uncaring feelings
voice change
vomiting

A total of 577 drugs are known to interact with olanzapine.

42 major drug interactions
525 moderate drug interactions
10 minor drug interactions

Most frequently checked interactions

View interaction reports for olanzapine and the medicines listed below.

Olanzapine alcohol/food interactions

There are 4 alcohol/food interactions with olanzapine

Olanzapine disease interactions

There are 19 disease interactions with olanzapine which include: