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Uses of Zyprexa

Zyprexa is a prescription medicine used to treat schizophrenia and bipolar disorder. When Zyprexa is combined with Prozac (fluoxetine) it is also used to treat:

  • depression that happens with bipolar disorder
  • depression that did not get better after 2 other medicines

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

Proper Usage

Take Zyprexa exactly as prescribed. Your doctor may need to change (adjust) the dose of Zyprexa until it is right for you. To prevent serious side effects, do not stop taking Zyprexa suddenly. If you need to stop taking Zyprexa, your doctor can tell you how to safely stop taking it.

Zyprexa can be taken with or without food. Zyprexa is usually taken one time each day. If you miss a dose of Zyprexa, take the missed dose as soon as you remember. If it is almost time for the next dose, just skip the missed dose and take your next dose at the regular time. Do not take two doses of Zyprexa at the same time.

Take Zyprexa Zydis as follows:

  • Be sure that your hands are dry.
  • Open the sachet and peel back the foil on the blister. Do not push the tablet through the foil.
  • As soon as you open the blister, remove the tablet and put it into your mouth.
  • The tablet will disintegrate quickly in your saliva so that you can easily swallow it with or without drinking liquid.

Call your doctor if you do not think you are getting better or have any concerns about your condition while taking Zyprexa.

Zyprexa FDA Warning

WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. Zyprexa (olanzapine) is not approved for the treatment of patients with dementia-related psychosis.

When using Zyprexa and fluoxetine in combination, also refer to the Boxed Warning section of the package insert for Symbyax.

Inform MD

Before starting Zyprexa, 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 Zyprexa ZYDIS contains phenylalanine
  • breast cancer
  • thoughts of suicide or hurting yourself
  • any other medical condition

Tell your doctor if you are pregnant or breastfeeding.

Tell your doctor if you exercise a lot or are in hot places often.

The symptoms of bipolar I disorder, treatment resistant depression, or schizophrenia may include thoughts of suicide or of hurting yourself or others. If you have these thoughts at any time, tell your doctor or go to an emergency room right away.

Tell your doctor about all the medicines that you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Zyprexa 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 Zyprexa with your other medicines. Do not start or stop any medicine while taking Zyprexa without talking to your doctor first.

Overview

Zyprexa (olanzapine) is an oral medication used primarily to treat schizophrenia and bipolar disorder. It was most recently approved to also treat resistant depressive disorder along with fluoxetine (Prozac). It is part of a class of medications called atypical antipsychotics.

Atypical antipsychotics were developed to be different from the older antipsychotic drugs that tended to cause extrapryimidal side effects (involuntary muscle contractions, tremor, slurred speech, restlessness, anxiety, distress, paranoia, and slowed thought) and increased the levels of a hormone called prolactin, which caused sexual and fertility side effects.

The mechanism of action of atypical antipsychotics has not been fully elucidated, but it is believed that all of them have some action on the dopamine receptors in the brain. Atypical antipsychotics have become the first line therapy for schizophrenia and bipolar disorder, and have generally replaced the old typical antipsychotics due to having a higher response rate, lower risk of suicide, and a better quality of life and functionality for patients. However, atypical antipsychotics still carry the risk of serious side effects, including the development of a movement disorder called tardive dyskinesia, neuroleptic malignant syndrome, and increased risks of developing stroke, blood clots, and diabetes.

Zyprexa and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant. It is not known if Zyprexa will harm your unborn baby.

Zyprexa Interactions

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • diazepam (Valium)
  • alcohol
  • carbamazepine (Tegretol)
  • fluvoxamine (Luvox)
  • fluoxetine (Prozac, Symbax)
  • levodopa
  • lorazepam
  • antidepressants
  • antihistamines
  • medicines for anxiety
  • medicines for high blood pressure

This is not a complete list Zyprexa drug interactions. Ask your doctor or pharmacist for more information.

 

 

Other Requirements

  • Store Zyprexa at room temperature, between 68°F to 77°F (20°C to 25°C).
  • Keep Zyprexa away from light.
  • Keep Zyprexa dry and away from moisture.

Keep Zyprexa and all medicines out of the reach of children.

Zyprexa Food Interactions

Grapefruit and grapefruit juice may interact with Zyprexa and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

FDA Black Box Warning

WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS

See full prescribing information for complete boxed warning. Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Zyprexa is not approved for the treatment of patients with dementia-related psychosis.

Overdose Information

In case of overdose, seek medical attention.

Symptoms of overdose may include:

  • Agitation/aggressiveness
  • Drowsiness
  • Hypertension
  • Slurred speech
  • Coma (loss of consciousness for a period of time)
  • Fast heartbeat
  • Delirium
  • Uncontrollable movements
Zyprexa Usage

  • Take Zyprexa exactly as prescribed. Your doctor may need to change (adjust) the dose of Zyprexa until it is right for you.
  • If you miss a dose of Zyprexa, take the missed dose as soon as you remember. If it is almost time for the next dose, just skip the missed dose and take your next dose at the regular time. Do not take two doses of Zyprexa at the same time.
  • To prevent serious side effects, do not stop taking Zyprexa suddenly. If you need to stop taking Zyprexa, your doctor can tell you how to safely stop taking it.
  • If you take too much Zyprexa, call your doctor or poison control center at 1-800-222-1222 right away, or get emergency treatment.
  • Zyprexa can be taken with or without food.
  • Zyprexa is usually taken one time each day.
  • Take Zyprexa ZYDIS as follows:
    • Be sure that your hands are dry.
    • Open the sachet and peel back the foil on the blister. Do not push the tablet through the foil.
    • As soon as you open the blister, remove the tablet and put it into your mouth.
    • The tablet will disintegrate quickly in your saliva so that you can easily swallow it with or without drinking liquid.
  • Call your doctor if you do not think you are getting better or have any concerns about your condition while taking Zyprexa.
Other Information

Active Ingredients:

 Olanzapine

For more information on the conditions Zyprexa treats go to :

1-800-Therapist Depression Encyclopedia

1-800-Therapist Schizophrenia Encyclopedia

1-800-Therapist Bipolar Disorder Encyclopedia

It is important to keep a list of all medications you are currently taking. This should include all prescription, over the counter, and supplemental medications. This list should be kept with you at all times. Whenever you are beginning a new medication, be sure to consult your doctor and provide him or her with your list of medications.

For further information on Zyprexa speak with a pharmacist.  

Conditions Treated

Zyprexa is a prescription medicine used to treat:

Schizophrenia in people age 13 or older.

Bipolar disorder, including:

  • Manic or mixed episodes that happen with bipolar I disorder in people age 13 or older.
  • Manic or mixed episodes that happen with bipolar I disorder, when used with the medicine lithium or valproate, in adults.
  • Long-term treatment of bipolar I disorder in adults.

Episodes of depression that happen with bipolar I disorder, when used with the medicine fluoxetine (Prozac®), in adults.

Episodes of depression that do not get better after 2 other medicines, also called treatment resistant depression, when used with the medicine fluoxetine (Prozac), in adults.

Zyprexa Precautions

Zyprexa may cause serious side effects, including:

  1. Increased risk of death in elderly people who are confused, have memory loss and have lost touch with reality (dementia-related psychosis).
  2. High blood sugar (hyperglycemia).
  3. High fat levels in your blood (increased cholesterol and triglycerides), especially in teenagers age 13 to 17.
  4. Weight gain, especially in teenagers age 13 to 17.

These serious side effects are described below.

1. Increased risk of death in elderly people who are confused, have memory loss and have lost touch with reality (dementia-related psychosis). Zyprexa is not approved for treating psychosis in elderly people with dementia.

2. High blood sugar (hyperglycemia). High blood sugar 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
  • death

Your doctor should do tests to check your blood sugar before you start taking Zyprexa and during treatment. In people who do not have diabetes, sometimes high blood sugar goes away when Zyprexa is stopped. People with diabetes and some people who did not have diabetes before taking Zyprexa need to take medicine for high blood sugar even after they stop taking Zyprexa. 

If you have diabetes, follow your doctor’s instructions about how often to check your blood sugar while taking Zyprexa. 

Call your doctor if you have any of these symptoms of high blood sugar (hyperglycemia) while taking Zyprexa:

  • 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

3. High fat levels in your blood (cholesterol and triglycerides). High fat levels may happen in people treated with Zyprexa, especially in teenagers (13 to 17 years old). You may not have any symptoms, so your doctor should do blood tests to check your cholesterol and triglyceride levels before you start taking Zyprexa and during treatment.

4. Weight gain. Weight gain is very common in people who take Zyprexa. Teenagers (13 to 17 years old) are more likely to gain weight and to gain more weight than adults. Some people may gain a lot of weight while taking Zyprexa, so 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.

  • Zyprexa can cause sleepiness and may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how Zyprexa affects you.
  • Avoid drinking alcohol while taking Zyprexa. Drinking alcohol while you take Zyprexa may make you sleepier than if you take Zyprexa alone.
Forms of Zyprexa

Zyprexa tablets are available in the following strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, and 20 mg.

Zyprexa Zydis (olanzapine orally disintegrating tablets) are available in the following strengths: 5 mg, 10 mg, 15 mg, and 20 mg.

Active ingredient: olanzapine

Inactive ingredients:

Tablets — carnauba wax, crospovidone, hydroxypropyl cellulose, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, and other inactive ingredients. The color coating contains: Titanium Dioxide, FD&C Blue No. 2 Aluminum Lake, or Synthetic Red Iron Oxide.

ZYDIS — gelatin, mannitol, aspartame, sodium methyl paraben, and sodium propyl paraben.

Potential Side Effects

Common side effects of Zyprexa include:

  • Lack of energy
  • Dry mouth
  • Increased appetite
  • Sleepiness
  • Tremor (shakes)
  • Having hard or infrequent stools
  • Dizziness
  • Changes in behavior
  • Restlessness.

Other common side effects in teenagers (13-17 years old) include:

  • Headache
  • Stomach-area (abdominal) pain
  • Pain in your arms or legs
  • Tiredness
  • Teenagers experienced greater increases in prolactin, liver enzymes, and sleepiness, as compared with adults

Zyprexa may cause serious side effects, including:

  • Increased risk of death in elderly people who are confused, have memory loss and have lost touch with reality (dementia-related psychosis).Zyprexa is not approved for treating psychosis in elderly people with dementia.
  • High blood sugar (hyperglycemia). High blood sugar 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, or death.
  • High fat levels in your blood (increased cholesterol and triglycerides), especially in teenagers age 13 to 17. High fat levels may happen in people treated with Zyprexa, especially in teenagers (13 to 17 years old). You may not have any symptoms, so your doctor should do blood tests to check your cholesterol and triglyceride levels before you start taking Zyprexa and during treatment.
  • Weight gain, especially in teenagers age 13 to 17. Weight gain is very common in people who take Zyprexa. Teenagers (13 to 17 years old) are more likely to gain weight and to gain more weight than adults. Some people may gain a lot of weight while taking Zyprexa, so 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
  • Increased incidence of stroke or “mini-strokes” called transient ischemic attacks (TIAs) in elderly people with dementia-related psychosis (elderly people who have lost touch with reality due to confusion and memory loss). Zyprexa is not approved for these patients.
  • Neuroleptic Malignant Syndrome (NMS). NMS is a rare but very serious condition that can happen in people who take antipsychotic medicines, including Zyprexa. NMS can cause death and must be treated in a hospital. Call your doctor right away if you become severely ill and have any of these symptoms: High fever, excessive sweating, rigid muscles, confusion, changes in your breathing, heartbeat, and blood pressure.
  • Tardive Dyskinesia. This condition causes body movements that keep happening and that you can not control. These movements usually affect the face and tongue. Tardive dyskinesia may not go away, even if you stop taking Zyprexa. It may also start after you stop taking Zyprexa. Tell your doctor if you get any body movements that you can not control.
  • Decreased blood pressure when you change positions, with symptoms of dizziness, fast or slow heartbeat, or fainting.
  • Difficulty swallowing, that can cause food or liquid to get into your lungs.
  • Seizures: Tell your doctor if you have a seizure during treatment with Zyprexa.
  • Problems with control of body temperature: You could become very hot, for instance when you exercise a lot or stay in an area that is very hot. It is important for you to drink water to avoid dehydration. Call your doctor right away if you become severely ill and have any of these symptoms of dehydration: Sweating too much or not at all, dry mouth, feeling very hot, feeling thirsty, not able to produce urine.
Precautions to Take

Zyprexa can cause sleepiness and may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how Zyprexa affects you.

Avoid drinking alcohol while taking Zyprexa. Drinking alcohol while you take Zyprexa may make you sleepier than if you take Zyprexa alone.

Zyprexa Relprevv may not be right for you. Before starting Zyprexa Relprevv, 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
  • breast cancer
  • thoughts of suicide or hurting yourself
  • any other medical condition
  • are pregnant or plan to become pregnant. It is not known if Zyprexa Relprevv will harm your unborn baby.
  • are breast-feeding or plan to breast-feed. Zyprexa Relprevv can pass into your breast milk and may harm your baby. You should not breast-feed while taking Zyprexa Relprevv. Talk to your doctor about the best way to feed your baby if you take Zyprexa Relprevv.
  • Tell your doctor if you exercise a lot or are in hot places often.
  • The symptoms of schizophrenia may include thoughts of suicide or of hurting yourself or others. If you have these thoughts at any time, tell your doctor or go to an emergency room right away.
  • Tell your doctor about all the medicines that you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.
  • Zyprexa Relprevv 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 Zyprexa Relprevv with your other medicines. Do not start or stop any medicine while taking Zyprexa Relprevv without talking to your doctor first.
Zyprexa Dosage

Take Zyprexa exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you, after weighing a number of factors including:

  • condition, and severity of condition being treated
  • your age
  • your other medical conditions
  • other medicines you currently take.

For the treatment of schizophrenia, the recommended starting dose of Zyprexa in adults is 5 mg to 10 mg taken once daily. The maximum recommended daily dose is 20 mg. 

For the treatment of bipolar disorder, the recommended starting dose of Zyprexa in adults is 10 mg to 15 mg taken once daily. The maximum recommended daily dose is 20 mg.

 

 

Zyprexa and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed. Zyprexa may be excreted in human breast milk. It may harm your nursing baby.