Olanzapine

Olanzapine (brand name Zyprexa) 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: alone for manic or mixed episodes, or in combination with lithium or valproate with fluoxetine for depressive episodes in people aged 10 and older. For treatment-resistant depression, olanzapine is used in combination with fluoxetine (Symbyax). Olanzapine is available as oral tablets, orally disintegrating tablets, or an injection that is given into a muscle (intramuscular [IM]). The olanzapine IM preparation is only for acute agitation associated with schizophrenia and bipolar I mania in adults. Olanzapine 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. Olanzapine was FDA approved on September 30, 1996, under the brand name Zyprexa. Generic olanzapine is available.

Olanzapine (brand name Zyprexa) 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: alone for manic or mixed episodes, or in combination with lithium or valproate with fluoxetine for depressive episodes in people aged 10 and older. For treatment-resistant depression, olanzapine is used in combination with fluoxetine (Symbyax). Olanzapine is available as oral tablets, orally disintegrating tablets, or an injection that is given into a muscle (intramuscular [IM]). The olanzapine IM preparation is only for acute agitation associated with schizophrenia and bipolar I mania in adults. Olanzapine 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. Olanzapine was FDA approved on September 30, 1996, under the brand name Zyprexa. Generic olanzapine is available.

Olanzapine may not be right for you. Before starting, tell your doctor if you have or had: heart problems seizures 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 some olanzapine disintegrating tablets may contain phenylalanine. breast cancer thoughts of suicide or hurting yourself any other medical condition are pregnant or plan to become pregnant are breastfeeding or plan to breastfeed. Tell your doctor if you exercise a lot or live or holiday in hot places.

Olanzapine 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 olanzapine 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) Constipation Weight gain and increased appetite Dizziness Personality disorder Restlessness Sedation Headache Abdominal pain Pain in the extremities Tiredness or lack of energy Dry mouth Tremor. 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.

Olanzapine carries a Boxed warning for an increased risk of death in elderly patients with dementia-related psychosis. An increased risk of death, strokes, or “mini-strokes” called transient ischemic attacks (TIAs) have been reported in elderly people taking olanzapine who are confused, have memory loss, or have lost touch with reality (dementia-related psychosis). These people should not be given olanzapine. Olanzapine may cause the following serious side effects. A higher risk of suicide when olanzapine is used in combination with fluoxetine for people with depression. High blood sugar (hyperglycemia). This 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), coma, and death. Your doctor should do tests to check your blood sugar before you start taking olanzapine and during treatment. 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. High-fat levels in your blood (increased cholesterol and triglycerides), especially in teenagers aged 13 to 17 or when used in combination with fluoxetine in children aged 10 to 17. Your healthcare provider should do blood tests to check your cholesterol and triglyceride levels before you start taking olanzapine and during treatment. Weight gain . This is very common in people who take olanzapine, especially in teenagers aged 13 to 17, or when used in combination with fluoxetine in children aged 10 to 17. Some people gain a lot of weight. 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. Neuroleptic Malignant Syndrome (NMS) . This is a rare but serious side effect of antipsychotics, such as olanzapine that may be fatal. NMS can cause death and must be treated in a hospital. Call your doctor right away if you become severely ill and have symptoms such as high fever, excessive sweating, rigid muscles, confusion, changes in your breathing, heartbeat, and blood pressure. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) . This is a serious drug hypersensitivity syndrome with symptoms such as an extensive rash, fever, swollen lymph nodes, liver inflammation, and blood abnormalities. Tell your doctor immediately if you experience any of these signs. Tardive Dyskinesia. This condition causes persistent body movements that usually affect the face and tongue which you cannot control. It may not go away even if you stop taking olanzapine and may start after you stop taking olanzapine. Tell your doctor if you get any body movements that you cannot control. Decreased blood pressure when you go from a lying or sitting position to standing. Symptoms may include dizziness, fast or slow heartbeat, or fainting. Difficulty swallowing , which may cause food or liquid to get stuck in your lungs Seizures . Tell your doctor if you have had a seizure before or if you have one during treatment with olanzapine Changes in your blood cells . Your doctor will monitor your blood cell counts especially if you have a history of significantly low white blood cell counts or drug-induced leukopenia or neutropenia Problems with control of body temperature. You could become very hot, for instance when you exercise a lot or live or holiday in a very hot area. You need to drink water to avoid dehydration. Call your doctor right away if you become severely ill and have any of these symptoms sweating too much or not at all, dry mouth, feeling very hot, feeling thirsty, or not able to produce enough urine. 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. Olanzapine has not been approved for use in: children under 13 years of age when used to treat schizophrenia or bipolar I disorder children under 10 years of age when used in combination with fluoxetine for depressive episodes. Tell your doctor about any side effect that bothers you or does not go away. These are not all the possible side effects of olanzapine. 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.

Olanzapine carries a Boxed warning for an increased risk of death in elderly patients with dementia-related psychosis. An increased risk of death, strokes, or “mini-strokes” called transient ischemic attacks (TIAs) have been reported in elderly people taking olanzapine who are confused, have memory loss, or have lost touch with reality (dementia-related psychosis). These people should not be given olanzapine. Olanzapine may cause the following serious side effects. A higher risk of suicide when olanzapine is used in combination with fluoxetine for people with depression. High blood sugar (hyperglycemia). This 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), coma, and death. Your doctor should do tests to check your blood sugar before you start taking olanzapine and during treatment. 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. High-fat levels in your blood (increased cholesterol and triglycerides), especially in teenagers aged 13 to 17 or when used in combination with fluoxetine in children aged 10 to 17. Your healthcare provider should do blood tests to check your cholesterol and triglyceride levels before you start taking olanzapine and during treatment. Weight gain . This is very common in people who take olanzapine, especially in teenagers aged 13 to 17, or when used in combination with fluoxetine in children aged 10 to 17. Some people gain a lot of weight. 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. Neuroleptic Malignant Syndrome (NMS) . This is a rare but serious side effect of antipsychotics, such as olanzapine that may be fatal. NMS can cause death and must be treated in a hospital. Call your doctor right away if you become severely ill and have symptoms such as high fever, excessive sweating, rigid muscles, confusion, changes in your breathing, heartbeat, and blood pressure. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) . This is a serious drug hypersensitivity syndrome with symptoms such as an extensive rash, fever, swollen lymph nodes, liver inflammation, and blood abnormalities. Tell your doctor immediately if you experience any of these signs. Tardive Dyskinesia. This condition causes persistent body movements that usually affect the face and tongue which you cannot control. It may not go away even if you stop taking olanzapine and may start after you stop taking olanzapine. Tell your doctor if you get any body movements that you cannot control. Decreased blood pressure when you go from a lying or sitting position to standing. Symptoms may include dizziness, fast or slow heartbeat, or fainting. Difficulty swallowing , which may cause food or liquid to get stuck in your lungs Seizures . Tell your doctor if you have had a seizure before or if you have one during treatment with olanzapine Changes in your blood cells . Your doctor will monitor your blood cell counts especially if you have a history of significantly low white blood cell counts or drug-induced leukopenia or neutropenia Problems with control of body temperature. You could become very hot, for instance when you exercise a lot or live or holiday in a very hot area. You need to drink water to avoid dehydration. Call your doctor right away if you become severely ill and have any of these symptoms sweating too much or not at all, dry mouth, feeling very hot, feeling thirsty, or not able to produce enough urine. 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. Olanzapine has not been approved for use in: children under 13 years of age when used to treat schizophrenia or bipolar I disorder children under 10 years of age when used in combination with fluoxetine for depressive episodes. Tell your doctor about any side effect that bothers you or does not go away. These are not all the possible side effects of olanzapine. 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.

5 to 10 mg (7.5 (7.5)) 24 hourly PO — Maximum dose 20 mg. Scraped Dose — Take olanzapine exactly as prescribed. Your doctor may need to change (adjust) the dosage of olanzapine until it is right for you. Olanzapine is usually taken once a day. Olanzapine can be taken with or without food. The usual starting dosage of olanzapine for adults with: Schizophrenia is olanzapine 5 mg to 10 mg once a day. Bipolar I disorder is olanzapine 10 mg to 15 mg once a day.

( ) — Not recommended in this age group

( ) — Not recommended in this age group

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. Especially tell your doctor if you take: Diazepam, lorazepam, or other benzodiazepines. This may make some side effects such as orthostatic hypotension worse Carbamazepine. May reduce the effect of olanzapine. Fluvoxamine. May increase levels of olanzapine and make side effects worse Fluoxetine. This may increase the risk of suicidal thoughts and behaviors Other medications that affect the brain, such as sedatives or sedating antihistamines. These can make side effects worse, especially when combined with alcohol Heart medications that lower blood pressure. Olanzapine may cause an enhanced effect Levodopa and dopamine Agonists. Olanzapine may counteract the effects of these drugs. 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 olanzapine 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.

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