Skip to Content

olanzapine

Pronunciation

Generic Name: olanzapine (injection) (oh LAN za peen)
Brand Name: ZyPREXA, ZyPREXA Relprevv

What is olanzapine injection?

Olanzapine is an antipsychotic medication that affects chemicals in the brain.

Olanzapine injection is used to treat adults who are in an agitated state due to schizophrenia or bipolar disorder (manic depression). Olanzapine injection is not for daily use to treat any psychotic condition.

Olanzapine injection is available only under a special program. You must be registered in the program and understand the risks and benefits of taking this medication.

Olanzapine injection may also be used for purposes not listed in this medication guide.

What is the most important information I should know about olanzapine injection?

Olanzapine injection can cause symptoms of delirium (sudden severe confusion, disorientation, agitation, problems with speech or walking), or drowsiness severe enough for you to lapse into a coma. You will be watched closely for at least 3 hours after your injection, and you should not drive for the rest of the day.

Slideshow: Fighting the Fight: Fibromylagia Explained

What should I discuss with my healthcare provider before receiving olanzapine injection?

You should not receive this medication if you are allergic to olanzapine.

Olanzapine is not approved for use in psychotic conditions related to dementia. Olanzapine may increase the risk of death in older adults with dementia-related conditions.

If possible before you receive olanzapine injection, tell your doctor if you have:

  • diabetes;

  • high cholesterol;

  • heart disease;

  • seizures or epilepsy;

  • a history of heart attack or stroke;

  • if you are also using a sedative such as Valium.

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

Olanzapine can pass into breast milk and may harm a nursing baby. You may need to stop breast-feeding for a short time after receiving an olanzapine injection. Follow your doctor's instructions.

In an emergency situation, it may not be possible before you are treated with olanzapine to tell your caregivers if you are pregnant or breast feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medicine.

How is olanzapine injection given?

Olanzapine is injected into a muscle. You will receive this injection in a clinic or hospital setting.

An olanzapine injection is usually given only once. If you still have symptoms after 2 hours, your caregivers may use a second or third dose.

Olanzapine injection can cause symptoms of delirium (sudden severe confusion, disorientation, agitation, problems with speech or walking), or drowsiness severe enough for you to lapse into a coma. You will be watched closely for at least 3 hours after your injection.

What happens if I miss a dose?

Since olanzapine injection is given by a healthcare professional in an emergency setting, you are not likely to miss a dose.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving olanzapine injection?

Avoid drinking alcohol.

Olanzapine can cause severe drowsiness and may impair your thinking or reactions. You must remain at the healthcare facility for at least 3 hours after your injection, and you should not drive for the rest of the day.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Olanzapine injection side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Olanzapine injection can cause serious symptoms if the medicine gets into your bloodstream too fast. During the first 3 hours after your injection you will be watched for the following signs:

  • severe dizziness, drowsiness, or weakness;

  • confusion, anxiety, feeling angry or hostile;

  • feeling nervous or shaky;

  • trouble walking or talking;

  • seizure (convulsions); or

  • a light-headed feeling, like you might pass out.

Call your doctor at once if you have:

  • twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs;

  • trouble swallowing;

  • signs of dehydration--if you feel very thirsty or hot, are unable to urinate, and have heavy sweating or hot and dry skin;

  • weak immune system--sudden weakness or ill feeling, fever, chills, swollen gums, painful mouth sores, sore throat, trouble swallowing, skin sores, cold or flu symptoms, cough, trouble breathing;

  • high blood sugar--increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss; or

  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors.

Common side effects may include:

  • headache, back pain;

  • weight gain, increased appetite;

  • mild drowsiness;

  • dry mouth, nausea, vomiting, diarrhea;

  • sinus pain, runny or stuffy nose, cough; or

  • pain, bruising, swelling, or other irritation where the injection was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Olanzapine dosing information

Usual Adult Dose for Bipolar Disorder:

Monotherapy:
Initial dose: 10 or 15 mg orally once a day
Dose adjustments: If indicated, dose adjustments should occur at intervals of at least 24 hours in 5 mg increments/decrements
Maintenance dose: 5 to 20 mg orally once a day
Maximum dose: 20 mg orally once a day

Adjunctive Treatment with Lithium or Valproate:
-Initial dose: 10 mg orally once a day

For the Treatment of Depressive Episodes Associated with Bipolar I Disorder when used in Combination with Fluoxetine:
Initial dose: 5 mg orally once a day (with fluoxetine 20 mg)
Dose adjustments: Should be made with the individual components within the dose range of 5 to 12.5 mg as indicated according to efficacy and tolerability
Maximum dose: 12.5 mg per day (with fluoxetine 50 mg per day)

Uses:
-Acute treatment of manic or mixed episodes associated with bipolar I disorder and maintenance treatment of bipolar I disorder.
-Treatment of depressive episodes associated with bipolar I disorder when used in combination with fluoxetine.

Usual Adult Dose for Schizophrenia:

Initial dose: 5 to 10 mg orally once a day
Target dose: 10 mg orally once a day within the first several days; further dose adjustments, if needed, should occur at intervals of not less than 1 week in 5 mg increments/decrements
Maximum dose: 20 mg orally once a day

Comments:
-Efficacy has been demonstrated in doses of 10 to 15 mg per day; doses above 10 mg per day were not demonstrated as more efficacious.
-Dose increases above 10 mg per day should occur only after a clinical assessment.

Parenteral: Extended Release IM Suspension
-Establish tolerability with oral olanzapine prior to initiating IM extended-release therapy.

Dosing for Extended Release Injectable Suspension Based on Corresponding Oral Doses:
-If the target oral olanzapine dose is 10 mg/day, then dosing during the first 8 weeks is 210 mg/2 weeks or 405 mg/4 weeks; after 8 weeks, the maintenance dose is 150 mg/2 weeks or 300 mg/4 weeks
-If the target oral olanzapine dose is 15 mg/day, then the dosing during the first 8 weeks is 300 mg/2 weeks; after 8 weeks, the maintenance dose is 210 mg/2 weeks or 405 mg/4 weeks
-If the target oral olanzapine dose is 20 mg/day, then the dosing during the first 8 weeks is 300 mg/2 weeks; after 8 weeks the maintenance dose is 300 mg/2 weeks

Comments: Efficacy has been demonstrated with doses from 150 mg to 300 mg IM every 2 weeks and 405 mg IM every 4 weeks.

Use: Treatment of schizophrenia

Usual Adult Dose for Depression:

Initial dose: 5 mg orally once a day (with fluoxetine 20 mg)
Dose adjustments: Should be made with the individual components within the dose range of 5 to 20 mg as indicated according to efficacy and tolerability
Maximum dose: 18 mg per day (with fluoxetine 50 mg per day)

Comments:
-The safety of co-administration of doses above olanzapine 18 mg-fluoxetine 75 mg has not been evaluated in clinical studies.
-Monotherapy is not indicated for treatment resistant depression.

Uses:
-For the treatment of patients with treatment resistant depression defined as those with major depressive disorder who do not respond to 2 separate trials of different antidepressants of adequate dose and duration in the current episode.

Usual Adult Dose for Agitated State:

Immediate-Release Injection:
-Initial dose: 10 mg IM once; dose range 2.5 to 10 mg IM
-Subsequent doses up to 10 mg may be given every 2 hours for agitation that persists following the initial dose
-Maximum number of doses: 3 doses in 24 hours; additional doses in patients with clinically significant postural hypotension are not recommended

Comments:
-The efficacy of repeated doses in agitated patients has not been systematically evaluated in controlled clinical trials.
-The safety of total daily dose greater than 30 mg (or 10 mg injections given more frequently than 2 hours after the initial dose and 4 hours after the second dose) has not been evaluated in clinical trials; maximal dosing may be associated with significant orthostatic hypotension.
-If ongoing therapy is clinically indicated, oral olanzapine may be initiated in a range of 5 to 20 mg per day as soon as clinically appropriate.

Use: For the treatment of acute agitation associated with schizophrenia and bipolar I mania.

Usual Geriatric Dose for Agitated State:

Immediate-Release Injection:
-Initial dose: 5 mg IM once
-Subsequent doses may be given for agitation that persists following the initial dose
-Maximum dose: 10 mg IM 2 to 4 hours apart; additional doses in patients with clinically significant postural hypotension are not recommended

Comments:
-The efficacy of repeated doses in agitated patients has not been systematically evaluated in controlled clinical trials.
-The safety of total daily dose greater than 30 mg (or 10 mg injections given more frequently than 2 hours after the initial dose and 4 hours after the second dose) has not been evaluated in clinical trials; maximal dosing may be associated with significant orthostatic hypotension.
-If ongoing therapy is clinically indicated, oral olanzapine may be initiated in a range of 5 to 20 mg per day as soon as clinically appropriate.

Use: For the treatment of acute agitation associated with schizophrenia and bipolar I mania.

Usual Pediatric Dose for Schizophrenia:

Age 13 years or older:
Initial dose: 2.5 to 5 mg orally once a day
Target dose: 10 mg orally once a day; further dose adjustments, if needed, should occur at intervals of not less than 1 week in 2.5 to 5 mg increments/decrements.
Maximum dose: 20 mg orally once a day

Comments:
-Efficacy has been demonstrated in the range of 2.5 to 20 mg per day; a mean modal dose of 12.5 mg per day (mean dose 11.1 mg per day) was demonstrated in adolescent schizophrenia efficacy trials.
-Medication therapy for adolescents should be initiated only after a thorough diagnostic evaluation and careful consideration given to the risks associated with treatment; medication treatment should be part of a total treatment program that includes psychological, educational, and social interventions.
-When deciding among the alternative treatments, clinicians should consider the increased potential for weight gain and dyslipidemia in this population compared to adults.

Use: Treatment of schizophrenia

Usual Pediatric Dose for Bipolar Disorder:

For the Treatment of Manic or Mixed Episodes Associated with Bipolar I Disorder:
Age: 13 years or older:
Initial dose: 2.5 to 5 mg orally once a day
Target dose: 10 mg orally once a day; dose adjustments, if needed, should occur at intervals of not less than 1 week in 2.5 to 5 mg increments/decrements.
Maximum dose: 20 mg orally once a day

Comment: Efficacy has been demonstrated in the range of 2.5 to 20 mg per day; a mean modal dose of 10.7 mg per day (mean dose 8.9 mg per day) was demonstrated in adolescent clinical trials.

For the Treatment of Depressive Episodes Associated with Bipolar I Disorder when used in Combination with Fluoxetine:
Age: 10 years or older:
Initial dose: 2.5 mg orally once a day (with fluoxetine 20 mg)
Dose adjustments: Should be made with the individual components within the dose range of 5 to 12.5 mg as indicated according to efficacy and tolerability
Maximum dose: 12.5 mg per day (with fluoxetine 50 mg per day)

Comments:
-Medication therapy for adolescents should be initiated only after a thorough diagnostic evaluation and careful consideration given to the risks associated with treatment; medication treatment should be part of a total treatment program that includes psychological, educational, and social interventions.
-When deciding among the alternative treatments, clinicians should consider the increased potential for weight gain and dyslipidemia in this population compared to adults.

Uses:
-Acute treatment of manic or mixed episodes associated with bipolar I disorder and maintenance treatment of bipolar I disorder.
-Treatment of depressive episodes associated with bipolar I disorder when used in combination with fluoxetine.

What other drugs will affect olanzapine injection?

Taking other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with olanzapine injection, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about olanzapine injection.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.03. Revision Date: 2015-06-11, 12:29:36 PM.

Hide