Zyprexa (Olanzapine)

Description

Zyprexa (olanzapine) is a medicine used to treat schizophrenia and manic or mixed episodes of bipolar I disorder. It may also be used with fluoxetine to treat depression linked to bipolar I disorder or depression that has not improved with other treatments. Olanzapine helps balance certain chemicals in the brain that affect mood, thoughts, and behavior. It is available as a regular tablet to swallow or as a tablet that dissolves on the tongue.

Directions

Zyprexa is usually taken once daily, with or without food. For adults with schizophrenia, the starting dose is often 5 to 10 mg daily, usually increasing to 10 mg within several days. For bipolar I manic or mixed episodes, adults often start at 10 or 15 mg daily, and adolescents usually start at 2.5 to 5 mg and increase toward 10 mg. A healthcare provider will adjust the dose based on treatment response and side effects, up to a usual maximum of 20 mg daily.

Swallow regular Zyprexa tablets whole with water. For Zyprexa Zydis dissolving tablets, peel back the blister foil, use dry hands, and place the tablet on your tongue to dissolve without chewing. Take it at the same time each day, and do not stop taking it without talking with your healthcare provider, as symptoms may return.

Ingredients

The active ingredient in Zyprexa is olanzapine. Inactive ingredients in the tablets may include carnauba wax, crospovidone, hydroxypropyl cellulose, hypromellose, lactose, magnesium stearate, and microcrystalline cellulose, along with a color coating that contains titanium dioxide, plus FDandC Blue No. 2 aluminum lake in the 15 mg tablet and synthetic red iron oxide in the 20 mg tablet. Zyprexa Zydis orally disintegrating tablets also contain gelatin, mannitol, aspartame, sodium methylparaben, and sodium propylparaben.

Cautions

• Before using this medication, you may want to consult a healthcare provider about the following:
  • Any existing health conditions
  • Any allergies
  • A list of all medications currently being taken
• Zyprexa is not approved for psychosis related to dementia. Older adults with dementia who take antipsychotics have a higher risk of death and of stroke or mini-stroke.
• Olanzapine can increase blood sugar, so it’s important to monitor glucose before starting and throughout treatment, especially in those with diabetes.
• Weight gain and changes in cholesterol and triglycerides are common, so it’s important to monitor weight and blood lipids.
• Dizziness or fainting can happen when standing up, particularly when starting the medication or increasing the dose, so get up slowly.
• Mention any history of seizures, low white blood cell counts, liver problems, heart disease, low blood pressure, trouble urinating, an enlarged prostate, constipation, or narrow-angle glaucoma before starting.
• Olanzapine can cause drowsiness and slow thinking or reflexes, so avoid driving or operating machinery until you know how it affects you.
• Alcohol can add to the drowsiness and low blood pressure this medication can cause.
• Watch for new or worsening depression, unusual changes in behavior, or thoughts of self-harm, especially early in treatment or after a dose change.
• Olanzapine can make it harder for the body to cool itself, so avoid getting overheated or dehydrated.
• Tell a healthcare provider about pregnancy or plans to become pregnant. Babies exposed during the third trimester can have muscle stiffness, tremors, or feeding problems after birth.
• Avoid breastfeeding while on olanzapine.

Contraindications

There are no contraindications for Zyprexa on its own in the drug label. When olanzapine is used together with fluoxetine, lithium, or valproate, it's important to check the contraindications for those medications.

Side Effects

Common side effects of Zyprexa include:

• Drowsiness or sedation
• Weight gain
• Increased appetite
• Dry mouth
• Constipation
• Dizziness
• Tremor
• Restlessness or an urge to keep moving
• Weakness or fatigue
• Lightheadedness when standing up

Get medical help for a high fever along with very stiff muscles, confusion, heavy sweating, and a fast or irregular heartbeat, which can be signs of neuroleptic malignant syndrome. Uncontrolled twitching or repetitive movements of the face, tongue, or limbs may be tardive dyskinesia and should be reported immediately. Consult a healthcare provider about signs of very high blood sugar such as extreme thirst, frequent urination, unusual hunger, weakness, or fruity-smelling breath; signs of infection such as fever, chills, or a sore throat, which can point to a drop in white blood cells; or yellowing of the skin or eyes, dark urine, and upper stomach pain, which can suggest liver problems. A rash with fever and swollen glands can be part of a serious drug reaction and requires immediate medical attention.

References

Zyprexa Prescribing Information. Indianapolis, IN: Lilly USA, LLC; 2026.

Zyprexa Drug Label Information. Montgomery, AL: H2-Pharma LLC; 2026.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....