Olanzapine is used to treat the symptoms of schizophrenia. Olanzapine can cause weight gain and can increase cholesterol levels, blood sugar, and blood pressure.
Olanzapine is a prescription medication used to treat schizophrenia. It is also used to treat bipolar disorder. Olanzapine belongs to a group of drugs called atypical antipsychotics, which work by altering the activity and levels of certain natural chemicals in the brain.
This medication comes in a tablet and an orally disintegrating tablet. Olanzapine is taken once a day, with or without food.
The orally disintegrating tablet is placed on the tongue, and the tablet will disintegrate quickly in your saliva so that you can easily swallow it with or without drinking liquid. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.
Olanzapine is also available in a short-acting injection and in a long acting injection and is to be given directly into the muscle.
Common side effects of olanzapine include lack of energy, dry mouth, increased appetite, somnolence, and tremor (shakes).
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Uses of Olanzapine
Olanzapine is a prescription medicine used to treat schizophrenia and bipolar disorder. When olanzapine is combined with Prozac (fluoxetine) it is also used to treat:
- depression that happens with bipolar I (one) disorder
- depression that did not get better after 2 other medications
This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
Olanzapine Brand Names
Olanzapine Drug Class
Olanzapine is part of the drug class:
Side Effects of Olanzapine
Serious side effects may happen when you take olanzapine, including:
- See "Drug Precautions", which describes the increased risk of death in elderly people with dementia-related psychosis and the risks of high blood sugar, high cholesterol and triglyceride levels, and weight gain.
- Increased incidence of stroke or “mini-strokes” called transient ischemic attacks (TIAs) in elderly people with dementia-related psychosis (elderly people who have lost touch with reality due to confusion and memory loss). Olanzapine is not approved for these patients.
- Neuroleptic Malignant Syndrome (NMS): NMS is a rare but very serious condition that can happen in people who take antipsychotic medicines, including olanzapine. NMS can cause death and must be treated in a hospital. Call your doctor right away if you become severely ill and have any of these symptoms:
- high fever
- excessive sweating
- rigid muscles
- changes in your breathing, heartbeat, and blood pressure.
- Tardive Dyskinesia: This condition causes body movements that keep happening and that you can not control. These movements usually affect the face and tongue. Tardive dyskinesia may not go away, even if you stop taking olanzapine. It may also start after you stop taking olanzapine. Tell your doctor if you get any body movements that you can not control.
- Decreased blood pressure when you change positions, with symptoms of dizziness, fast or slow heartbeat, or fainting.
- Difficulty swallowing, that can cause food or liquid to get into your lungs.
- Seizures: Tell your doctor if you have a seizure during treatment with olanzapine.
- Problems with control of body temperature: You could become very hot, for instance when you exercise a lot or stay in an area that is very hot. It is important for you to drink water to avoid dehydration. Call your doctor right away if you become severely ill and have any of these symptoms of dehydration:
- sweating too much or not at all
- dry mouth
- feeling very hot
- feeling thirsty
- not able to produce urine.
Common side effects of olanzapine include: lack of energy, dry mouth, increased appetite, sleepiness, tremor (shakes), having hard or infrequent stools, dizziness, changes in behavior, or restlessness.
Other common side effects in teenagers (13-17 years old) include: headache, stomach-area (abdominal) pain, pain in your arms or legs, or tiredness. Teenagers experienced greater increases in prolactin, liver enzymes, and sleepiness, as compared with adults.
Tell your doctor about any side effect that bothers you or that does not go away.
These are not all the possible side effects with olanzapine. For more information, ask your doctor or pharmacist.
Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:
- diazepam (Valium)
- carbamazepine (Tegretol)
- fluvoxamine (Luvox)
- fluoxetine (Prozac, Symbax)
- medicines for anxiety
- medicines for high blood pressure
This is not a complete list of olanzapine drug interactions. Ask your doctor or pharmacist for more information.
Olanzapine may cause serious side effects, including:
- Increased risk of death in elderly people who are confused, have memory loss and have lost touch with reality (dementia-related psychosis).
- High blood sugar (hyperglycemia).
- High fat levels in your blood (increased cholesterol and triglycerides), especially in teenagers age 13 to 17.
- Weight gain, especially in teenagers age 13 to 17.
These serious side effects are described below.
1. Increased risk of death in elderly people who are confused, have memory loss and have lost touch with reality (dementia-related psychosis). Olanzapine is not approved for treating psychosis in elderly people with dementia.
2. High blood sugar (hyperglycemia). High blood sugar can happen if you have diabetes already or if you have never had diabetes. High blood sugar could lead to:
- a build up of acid in your blood due to ketones (ketoacidosis)
Your doctor should do tests to check your blood sugar before you start taking olanzapine and during treatment. In people who do not have diabetes, sometimes high blood sugar goes away when olanzapine is stopped. People with diabetes and some people who did not have diabetes before taking olanzapine need to take medicine for high blood sugar even after they stop taking olanzapine.
If you have diabetes, follow your doctor's instructions about how often to check your blood sugar while taking olanzapine.
Call your doctor if you have any of these symptoms of high blood sugar (hyperglycemia) while taking olanzapine:
- feel very thirsty
- need to urinate more than usual
- feel very hungry
- feel weak or tired
- feel sick to your stomach
- feel confused or your breath smells fruity
3. High fat levels in your blood (cholesterol and triglycerides). High fat levels may happen in people treated with olanzapine, especially in teenagers (13 to 17 years old). You may not have any symptoms, so your doctor should do blood tests to check your cholesterol and triglyceride levels before you start taking olanzapine and during treatment.
4. Weight gain. Weight gain is very common in people who take olanzapine. Teenagers (13 to 17 years old) are more likely to gain weight and to gain more weight than adults. Some people may gain a lot of weight while taking olanzapine, so you and your doctor should check your weight regularly. Talk to your doctor about ways to control weight gain, such as eating a healthy, balanced diet, and exercising.
- Olanzapine 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 olanzapine affects you.
- Avoid drinking alcohol while taking olanzapine. Drinking alcohol while you take olanzapine may make you sleepier than if you take olanzapine alone.
Olanzapine Intramuscular Injection
- It is recommended patients requiring subsequent intramuscular (IM) injections be assessed for orthostatic hypotension prior to the administration of any subsequent doses of intramuscular olanzapine for injection.
Olanzapine Food Interactions
Grapefruit and grapefruit juice may interact with olanzapine and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.
Before starting olanzapine, tell your doctor if you have or had:
- heart problems
- diabetes or high blood sugar levels (hyperglycemia)
- high cholesterol or triglyceride levels in your blood
- liver problems
- low or high blood pressure
- strokes or “mini-strokes” also called transient ischemic attacks (TIAs)
- Alzheimer's disease
- narrow-angle glaucoma
- enlarged prostate in men
- bowel obstruction
- phenylketonuria, because the dissolvable tablet form of olanzapine contains phenylalanine
- breast cancer
- thoughts of suicide or hurting yourself
- any other medical condition
Tell your doctor if you are pregnant or breastfeeding
Tell your doctor if you exercise a lot or are in hot places often.
The symptoms of bipolar I disorder, treatment resistant depression, or schizophrenia may include thoughts of suicide or of hurting yourself or others. If you have these thoughts at any time, tell your doctor or go to an emergency room right away.
Tell your doctor about all the medicines that you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Olanzapine 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 olanzapine with your other medicines. Do not start or stop any medicine while taking olanzapine without talking to your doctor first.
Olanzapine and Pregnancy
Tell your doctor if you are pregnant or plan to become pregnant. It is not known if olanzapine will harm your unborn baby.
Olanzapine and Lactation
Tell your doctor if you are breastfeeding or plan to breastfeed. Olanzapine may be excreted in human breast milk. It may harm your nursing baby.
- Take olanzapine exactly as prescribed. Your doctor may need to change (adjust) the dose of olanzapine until it is right for you.
- If you miss a dose of olanzapine, 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 of olanzapine at the same time.
- To prevent serious side effects, do not stop taking olanzapine suddenly. If you need to stop taking olanzapine, your doctor can tell you how to safely stop taking it.
- If you take too much olanzapine, call your doctor or poison control center at 1-800-222-1222 right away, or get emergency treatment.
- Olanzapine can be taken with or without food.
- Olanzapine is usually taken one time each day.
Orally disintegrating tablets:
- Be sure that your hands are dry.
- Keep the tablet in its blister pack until you are ready to take it. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.
- As soon as you open the blister, remove the tablet and put it into your mouth.
- The tablet will disintegrate quickly in your saliva so that you can easily swallow it with or without drinking liquid. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.
Olanzapine Intramuscular Injection:
- Is intended for intramuscular use only.
- Do not administer intravenously or subcutaneously.
- Inject slowly, deep into the muscle mass.
Call your doctor if you do not think you are getting better or have any concerns about your condition while taking olanzapine.
Take olanzapine exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you, after weighing a number of factors including:
- condition, and severity of condition being treated
- your age
- your other medical conditions
- other medicines you currently take.
For the treatment of schizophrenia, the recommended starting dose of olanzapine in adults is 5 mg to 10 mg taken once daily. The maximum recommended daily dose is 20 mg.
For the treatment of bipolar disorder, the recommended starting dose of olanzapine in adults is 10 mg to 15 mg taken once daily. The maximum recommended daily dose is 20 mg.
The recommended dose for short-acting intramuscular olanzapine for injection is 10 mg with a dose range of 2.5 mg to 10 mg. A lower dose of 5 or 7.5 mg may be considered when clinical factors warrant.
The recommended dose range for long acting intramuscular olanzapine for injection is 150 mg to 300 mg administered every 2 weeks and with 405 mg administered every 4 weeks.
If you take too much olanzapine, call your local Poison Control Center or seek emergency medical attention right away.
- Store olanzapine at room temperature, between 68°F to 77°F (20°C to 25°C).
- Keep olanzapine away from light.
- Keep olanzapine dry and away from moisture.
- Protect olanzapine for Injection from light, do not freeze.
Keep olanzapine and all medicines out of the reach of children.
Olanzapine FDA Warning
WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. Olanzapine is not approved for the treatment of patients with dementia-related psychosis.