Jeffrey Panko NP Psychiatry · Patient education
Olanzapine
Zyprexa / Zydis / Relprevv / Generic formulations
A guide for adults taking olanzapine.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Standard and dissolving tablets, short-acting injections, and the long-acting pamoate injection Relprevv have different instructions. Combination formulations have additional precautions.
What it is used for
Olanzapine treats schizophrenia and bipolar I mania or mixed episodes, and can be used for maintenance. Combined with fluoxetine, it treats bipolar I depression and treatment-resistant depression under separate labeling.
How it works
It blocks dopamine and serotonin receptors. Other receptor effects contribute to sedation, appetite changes, and metabolic effects.
What to expect over time
Some symptoms improve earlier than others. Changes in hallucinations, mood, or organized thinking often develop over several weeks. Track practical goals, such as regular sleep and daily activities, and report side effects or limited benefit.
Taking your medication
- Take oral doses consistently, with or without food. Use dry hands for dissolving tablets.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
- Keep injection appointments. Relprevv requires at least three hours of observation after every injection and a responsible escort afterward.
- Do not drive for the rest of the day after Relprevv; follow the clinic’s discharge instructions.
When to get help
Emergency symptoms. Get emergency care for fever with severe muscle stiffness and confusion, a seizure, fainting with an irregular heartbeat, or trouble breathing. Fever and stiffness can signal neuroleptic malignant syndrome, a rare but serious reaction.
Prompt medical advice. Contact your provider promptly for new involuntary movements, trouble swallowing, severe restlessness, or symptoms of high blood sugar such as unusual thirst and frequent urination.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Sleepiness or dizziness
- Increased appetite and weight gain
- Constipation or dry mouth
- Movement symptoms or sexual changes
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Expect periodic checks of weight, blood pressure, blood sugar, cholesterol, and movement symptoms. Some changes, such as higher blood sugar, may occur before you feel different.
Report new mouth, tongue, face, or limb movements. Tardive dyskinesia is a movement disorder that can persist after medication is stopped.
Weight, blood sugar, and lipid changes can be substantial. Report unusual thirst, frequent urination, marked fatigue, or rapid weight gain.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss diabetes, heart-rhythm problems, fainting, seizures, low blood counts, swallowing difficulties, and kidney or liver disease. Antipsychotics increase the risk of death in older adults with dementia-related psychosis.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Smoking changes can alter olanzapine levels; tell your provider if you start or stop smoking. Nicotine replacement is not the same enzyme interaction as smoke.
Alcohol and sedatives add impairment. Injectable benzodiazepines with short-acting intramuscular olanzapine require special precautions because of cardiorespiratory risk.
Everyday tips
Stand up slowly. Avoid driving until you know how the medication affects alertness and coordination.
Stay hydrated and take breaks in hot weather. Some antipsychotics interfere with temperature regulation.
Discuss appetite or weight changes early, and keep scheduled monitoring visits.
Your questions answered
Can I stop when I feel better?
Consult with your provider. Continuing treatment may prevent symptoms from returning. Abrupt stopping can cause withdrawal symptoms or a relapse.
What if I cannot sit still?
An inner urge to keep moving can be akathisia, a medication side effect. Tell your provider promptly; it can be mistaken for worsening anxiety.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.