Class Name(s):

• 28:16.08.04 Atypical Antipsychotics

Pronunciation:

• (oh lan' za peen)

Brand Name(s):

• Zyprexa^®
• Zyprexa^® Zydis
• Symbyax^® (as a combination product containing Fluoxetine, Olanzapine); also available generically

IMPORTANT WARNING:

Older adults with dementia (loss of memory and brain function) may have an increased chance of death if treated with antipsychotic medications such as olanzapine. Older adults with dementia may also have a greater chance of having a stroke or mini-stroke during treatment with antipsychotics.

Olanzapine is not approved by the Food and Drug Administration (FDA) for the treatment of behavior disorders in older adults with dementia.

You will be given the Medication Guide. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit http://www.fda.gov/Drugs/DrugSafety/ ucm085729.htm to obtain the Medication Guide.

Talk to your doctor about the risks of receiving olanzapine.

WHY is this medicine prescribed?

Olanzapine is used to treat schizophrenia (a mental illness that affects how a person thinks, feels and behaves) and bipolar I disorder (a disease that causes depression, mania, and other abnormal moods). Olanzapine is in a class of medications called atypical antipsychotics. It works by changing the activity of certain natural substances in the brain.

HOW should this medicine be used?

Olanzapine comes as a tablet and an orally disintegrating tablet (tablet that dissolves quickly in the mouth) to take by mouth. Take once a day with or without food. Take olanzapine at around the same time every day.

Take olanzapine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Do not try to push the orally disintegrating tablet through the foil. Instead, use dry hands to peel back the foil packaging. Immediately take out the tablet and place it in your mouth. The tablet will quickly dissolve and can be swallowed with or without liquid.

Your doctor may start you on a low dose of olanzapine and gradually increase your dose.

Olanzapine may help control your symptoms, but it will not cure your condition. It may take several weeks or longer before you feel the full benefit of olanzapine. Continue to take olanzapine even if you feel well. Do not stop taking olanzapine without talking to your doctor.

Are there OTHER USES for this medication?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before taking olanzapine,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• some medications should not be taken with olanzapine. Other medications may cause dosing changes or extra monitoring when taken with olanzapine. Make sure you have discussed any medications you are currently taking or plan to take before starting olanzapine with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking olanzapine, please get the advice of your doctor or pharmacist.
• the following nonprescription products may interact with olanzapine: allergy medications (diphenhydramine, loratadine, fexofenadine, chlorpheniramine or cetirizine); omeprazole (Prilosec^®). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking olanzapine. Do not start any of these medications while taking olanzapine without discussing with your healthcare provider.
• tell your doctor if you use or have ever used street drugs or have overused prescription medications and if you have or have ever had a stroke, a mini-stroke, heart disease or a heart attack, an irregular heartbeat, heart failure, urinary problems, seizures, breast cancer, any condition that makes it difficult for you to swallow, trouble keeping your balance, high or low blood pressure, a high level of fats (cholesterol and triglycerides) in your blood, a low number of white blood cells, liver or prostate disease, paralytic ileus (condition in which food cannot move through the intestine); glaucoma (an eye condition), or high blood sugar, or if you or anyone in your family has or has ever had diabetes. Tell your doctor if you have constipation, severe vomiting or diarrhea or signs of dehydration now, or if you develop these symptoms at any time during your treatment. Also tell your doctor if you have ever had to stop taking a medication for mental illness because of severe side effects.
• tell your doctor if you are pregnant, if you plan to become pregnant or are breastfeeding. If you become pregnant while taking olanzapine, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking olanzapine.
• you should know that olanzapine may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• you should know that alcohol can add to the drowsiness caused by this medication. Do not drink alcohol while taking olanzapine.
• tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication.
• you should know that you may experience hyperglycemia (increases in your blood sugar) while you are taking this medication, even if you do not already have diabetes. If you have schizophrenia, you are more likely to develop diabetes than people who do not have schizophrenia, and taking olanzapine or similar medications may increase this risk. Tell your doctor immediately if you have any of the following symptoms while you are taking olanzapine: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important to call your doctor as soon as you have any of these symptoms, because high blood sugar can cause a serious condition called ketoacidosis. Ketoacidosis may become life-threatening if it is not treated at an early stage. Symptoms of ketoacidosis include: dry mouth, nausea and vomiting, shortness of breath, breath that smells fruity, and decreased consciousness.
• you should know that olanzapine may cause fast or slow heartbeat, dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking olanzapine. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
• you should know that olanzapine may make it harder for your body to cool down when it gets very hot. Tell your doctor if you plan to do vigorous exercise or be exposed to extreme heat.
• if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent damage to your brain that can cause severe intellectual disability), you should know that the orally disintegrating tablets contain aspartame that forms phenylalanine.
• you should know that when olanzapine is used to treat teenagers, it must be used as part of a total treatment program that may include counseling and educational support. Make sure that your child follows all of the doctor's and/or therapist's instructions.

What SPECIAL DIETARY instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Olanzapine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• restlessness
• unusual behavior
• depression
• difficulty falling asleep or staying asleep
• weakness
• constipation
• increased appetite, weight gain
• dry mouth
• pain in arms, legs, back, or joints
• breast enlargement or discharge
• late or missed menstrual periods
• decreased sexual ability

Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section or the SPECIAL PRECAUTIONS section, call your doctor immediately:

• seizures
• changes in vision
• swelling of the arms, hands, feet, ankles, or lower legs
• unusual movements of your face or body that you cannot control
• problems with coordination or increased falls
• sore throat, fever, chills, and other signs of infection
• fever; stiff muscles; sweating; confusion; sweating; or fast, pounding, or irregular heartbeat
• rash that may occur with fever, swollen glands, or swelling of the face
• hives, skin redness or peeling, difficulty breathing or swallowing

Olanzapine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Taking olanzapine may cause the level of fats in your blood to increase. Talk to your doctor about the risks of taking olanzapine.

Teenagers who take olanzapine are more likely than adults who take olanzapine to gain weight, have increased levels of fat in their blood, develop liver problems, and experience side effects such as sleepiness, breast enlargement, and discharge from the breasts. Talk to your child's doctor about the risks of treating your child with olanzapine.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at http://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• drowsiness
• slurred speech
• agitation
• fast heartbeat
• sudden movements that you cannot control
• coma (loss of consciousness for a period of time)

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Always store the orally disintegrating tablets in their sealed package, and use them immediately after opening the package.

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website http://goo.gl/c4Rm4p for more information.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to olanzapine.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™ Copyright, 2025. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: November 15, 2025.