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Olanzapine (Zyprexa)



Olanzapine (Zyprexa) works by regulating a variety of natural chemicals within the body including dopamine, serotonin, and norepinephrine in order to be achieve its effects in the treatment of conditions such as bipolar disorder, schizophrenia, and depression.



How to Use


Take this medication by mouth with water, it can be taken with or without food.


Take it exactly as directed, do not take it more than directed.


It is important to not stop taking this medication unless directed by a doctor.


If you miss a dose, take it as soon as you can. If it is already almost time for your next dose, take only that next dose. Do not double up on any dose.



Important Information


Be sure to have regular check ups with your doctor while on this medication. Keep record of your response to the medication and go over it with your doctor at each visit. It is important to tell your doctor if your symptoms are not improving, are getting worse, or if you develop new types of symptoms such as changes in mood or feelings.


Do not self treat yourself for coughs and colds, diarrhea or other conditions without consulting with a healthcare professional. Over the counter medications have ingredients that can lead to more side effects.


Do not operate heavy machinery, drive a car, or engage in other activity that requires fine motor skills until you are sure of how this medication affects you.


Avoid alcohol consumption, alcohol can increase chances of dizziness or drowsiness.


This medication can make your mouth dry, drinking water, chewing sugarless gum, or sucking on candy can help this side effect.


Talk to your doctor as soon as possible if you notice increased thirst, increased hunger, nausea, vomiting, or fruity breath odor. This could mean your blood sugar has increased. If you have diabetes, be sure to monitor your blood sugar closely while taking this medication.


Tell you doctor if you smoke or if you suddenly stop smoking while taking this medication.



Be sure that your prescribing doctor is aware if you have any of the the following conditions before taking this medication


Breast cancer history, trouble swallowing, diabetes, family history of diabetes, dementia, cigarette smoking, glaucoma, heart conditions or previous heart attacks, brain tumor or history of brain trauma, kidney disease, liver disease, low blood pressure or dizziness, Parkinson’s Disease, suicidal thoughts or actions, Pregnancy, breastfeeding, trying to become pregnant.



Side effects that should be immediately reported to your healthcare provider


Allergic reactions(hives, rashes, itching, swelling of the face or mouth), trouble breathing, trouble swallowing or speaking, excessive thirst or hunger, heartbeat changes, fever, chills, soar throat, fever along with a rash and swelling in the lymph nodes or face, frequent urination, inability to control muscle movements in the face, mouth, arms or legs, seizures, spasms, trembling.



Other Side Effects


Changes in libido, constipation, dizziness (if severe or persistent contact healthcare provider), drowsiness.



Adult Doses


Treatment Resistant Depression When Used With Fluoxetine


Olanzapine 5 mg with fluoxetine 20mg by mouth once daily taken in the evening. The dose can then be adjusted to between 5-20mg of olanzapine and 25-50 mg of fluoxetine.



Agitation in Patients with Schizophrenia or Bipolar Disorder


Intramuscular Injection: 10 mg as an initial intramuscular injection. Lower doses of 5-10 mg can be given. The effective dose range is 2.5-10 mg. The dose may be given two more times if needed to a max dose of 3 separate 10 mg injections given 2-4 hours apart. It is important to monitor closely for dizziness if repeated doses have been given.





5-10 mg by mouth daily as a starting dose. The target dose is 10 mg per day. The dose should be adjusted by 5 mg at increments of no less than 1 week.



Bipolar One Disorder(manic or mixed episodes)


10-15 mg by mouth once daily. Dose adjustments are made by increments of 5 mg at intervals no less than 24 hours.



If used in combination with lithium or valproate: 10 mg by mouth daily.  Dose adjustments are made by increments of 5 mg at intervals no less than 24 hours.



Bipolar One Maintenance Therapy(mono therapy)


5-20 mg by mouth daily(after 2 weeks of good response).



Bipolar One Disorder(in combination with fluoxetine)


5 mg of olanzapine and 20 mg of fluoxetine once daily taken in the evening as a starting dose. The dose can then be adjusted to between 5-12.5 mg of olanzapine and 20-50 mg of fluoxetine depending on tolerability.





1. Zyprexa ® oral tablets, olanzapine oral tablets[package insert]. Indianapolis, IN: Lilly USA, LLC (per FDA); 2013.


2. Zyprexa ® ZYDIS(R) oral disintegrating tablets, olanzapine oral disintegrating tablets[package insert]. Indianapolis, IN: Lilly USA, LLC (per FDA); 2013.


3. Zyprexa ® IntraMuscular intramuscular injection powder for solution, olanzapine intramuscular injection powder for solution[package insert]. Indianapolis, IN: Lilly USA, LLC (per FDA); 2013.


4. Zyprexa (olanzapine, all formulations) [package insert]. Indianapolis, IN: Eli Lilly and Company; 2015.

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