Olanzapine, Oral/Injection

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KEY POINTS

• This medicine is taken by mouth or given by injection to treat the symptoms of schizophrenia, bipolar disorder, and depression. Use it exactly as directed.
• Older adults with dementia are at greater risk for side effects, including death. This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• If you are receiving the long-acting injection form of this medicine, you need to be watched closely for serious symptoms. If you have these symptoms, you need medical care right away.
• This medicine may interact with many other medicines. Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antipsychotic

Generic and brand names: olanzapine, oral; Zyprexa; Zyprexa Zydis; olanzapine, injection; Zyprexa IntraMuscular; Zyprexa Relprevv

What is this medicine used for?

This medicine is taken by mouth or given by injection to treat the symptoms of mental disorders such as schizophrenia, bipolar disorder, and depression.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A blockage in the intestines, Crohn's disease, or ulcerative colitis
• A stroke or transient ischemic attack (TIA)
• Alzheimer's disease or dementia
• Breast cancer
• Diabetes
• Glaucoma
• Heart disease, a heart attack, or heart failure
• High cholesterol or high triglycerides
• Liver disease
• Low or high blood pressure
• Phenylketonuria (PKU) (The disintegrating tablet contains phenylalanine.)
• Problems with dehydration
• Seizures
• Thoughts of suicide
• Trouble swallowing
• Trouble urinating or an enlarged prostate gland

Tell your healthcare provider if you are taking or planning to take any other prescription or nonprescription medicines during treatment with this medicine.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant while taking this medicine. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine. Taking this medicine during the last 3 months of pregnancy may cause problems for the baby. Symptoms the baby may have include agitation, tight muscles, floppy muscles, shaking, trouble breathing, or trouble feeding. Talk with your provider about this.

How do I use it?

Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill or injection.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as directed by your healthcare provider. Usually your healthcare provider will start you with a small dosage and increase it gradually after several days. Do not increase the dosage on your own. Do not stop taking this medicine without your healthcare provider's approval. Your dosage may need to be reduced gradually.

Check with your healthcare provider before using this medicine in children.

If you have the tablets, take them with a glass of water, with or without food.

If you have the disintegrating tablets, make sure your hands are dry before you handle the tablet. Do not open the blister pack that contains the tablet until you are ready to take it. Peel back the foil, then take the tablet out. Do not push the tablet through the foil. Place the tablet in your mouth and let it melt quickly.

Shots of this medicine will be given by a healthcare provider. Keep all appointments.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take a double dose the next day. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: drowsiness, restlessness, aggressiveness, slurred speech, confusion, fast or irregular heartbeat, uncontrolled muscle movements, trouble breathing, fainting, coma, seizures.

What should I watch out for?

Older adults with dementia are at greater risk for side effects, including death. Talk with your provider about this.

If you are receiving the long-acting injection form of this medicine, you must register in and agree to the rules of the Patient Care Program. You will be watched closely for at least 3 hours after your injection. Someone must be with you after you leave the clinic. You should not drive or use heavy machinery for the rest of the day after you receive an injection. Symptoms to watch for include:

• Feeling very angry, nervous, or anxious
• Severe drowsiness, weakness, or dizziness
• Severe confusion
• Trouble talking or walking
• Stiff or shaking muscles
• Seizures
• Coma

If you have any of these symptoms, contact your healthcare provider or go to an emergency room right away.

This medicine can cause low blood pressure, especially when you start taking it, or if you take it with alcohol or sedatives. Low blood pressure may make you feel lightheaded or dizzy. Getting up slowly when sitting or lying down may help. Take care to avoid falling.

This medicine can cause drowsiness, dizziness, and problems with judgment. Do not drive or operate machinery until you are fully alert.

While taking this medicine, be careful when you exercise, especially when it is hot. This medicine affects your body's ability to cool down, and you may get too hot. If you get too hot, you might vomit, feel dizzy, have a fast heartbeat, get very stiff muscles, or be confused. Contact your provider right away if you have these symptoms.

Using this medicine for a long time may cause muscle spasms, twitching in the face and body, and uncontrolled tongue or jaw movement. Talk to your healthcare provider about this.

This medicine may lower the number of certain types of blood cells in your body. It may also increase the total cholesterol and triglyceride levels in your blood. You will need blood tests regularly to see how this medicine affects you. Keep all appointments for tests.

This medicine may also cause you to gain weight. Talk with your provider about this.

This medicine increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol while you are taking this medicine. Do not take other medicines unless your healthcare provider tells you to.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine may increase the risk of diabetes, especially if you are overweight or have a family history of diabetes. If you have diabetes, this medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking.

Serious (Report these to your healthcare provider right away.): Thoughts of suicide; unusual mood or behavior changes; new or worsening depression; seizures; increased thirst; increased urination; trouble urinating; extreme hunger; uncontrolled muscle movements; fever; sweating; stiff muscles; confusion; memory problems; swelling in the feet or legs; trouble standing or walking; severe dizziness or fainting; slow, fast, or irregular heartbeat; unexplained fever, sore throat, or cough; trouble swallowing or breathing; severe drowsiness.

Other: Drowsiness, tiredness, dizziness, restlessness, runny nose, headache, constipation, dry mouth, stomach pain, tremors or shaking, weight gain, increased appetite, trouble sleeping, back pain, breast swelling, erectile dysfunction, injection site pain.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), and terazosin
• Anagrelide (Agrylin)
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antianxiety medicines such as alprazolam (Xanax), buspirone, clonazepam (Klonopin), clorazepate (Gen-Xene, Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• Antibiotics such as ciprofloxacin (Cipro), linezolid (Zyvox), ofloxacin, and rifampin (Rifadin)
• Antidepressants such as amitriptyline, citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), imipramine (Tofranil), and nortriptyline (Pamelor)
• Antipsychotic medicines such as asenapine (Saphris), brexpiprazole (Rexulti), chlorpromazine, clozapine (Clozaril, FazaClo), fluphenazine, haloperidol (Haldol), iloperidone (Fanapt), paliperidone (Invega), perphenazine, pimozide (Orap), quetiapine (Seroquel), thioridazine, trifluoperazine, and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), phenobarbital, and primidone (Mysoline)
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), nebivolol (Bystolic), pindolol, and sotalol (Betapace, Sorine)
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Cancer medicines such as arsenic trioxide (Trisenox), nilotinib (Tasigna), toremifene (Fareston), vandetanib (Caprelsa), and vemurafenib (Zelboraf)
• Cough, cold, or allergy medicines such as chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl)
• Dextromethorphan, an ingredient in many cough, cold, or allergy medicines such as Robitussin-DM
• Diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Doxepin (Silenor)
• Eliglustat (Cerdelga)
• Heart medicines such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dronedarone (Multaq), mexiletine, procainamide, and quinidine
• HIV medicines such as lopinavir/ritonavir (Kaletra), ritonavir (Norvir), and saquinavir (Invirase)
• Lithium (Lithobid)
• Lorcaserin (Belviq)
• Malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, mefloquine, primaquine, and quinine
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Methoxsalen (8-MOP, Oxsoralen Ultra, Uvadex)
• Metoclopramide (Metozolv, Reglan)
• Migraine medicines such as almotriptan (Axert), dihydroergotamine (D.H.E. 45, Migranal), eletriptan (Relpax), ergotamine (Ergomar), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Alsuma, Imitrex, Sumavel), and zolmitriptan (Zomig)
• Muscle relaxants such as baclofen (Gablofen, Lioresal), carisoprodol (Soma), cyclobenzaprine (Amrix), methocarbamol (Robaxin), orphenadrine (Norflex), and tizanidine (Zanaflex)
• Natural remedies such as gotu kola, kava, St. John's wort, and valerian
• Omeprazole (Prilosec)
• Pain medicines such as codeine, fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone (Hysingla, Zohydro), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Roxicodone), oxycodone/acetaminophen (Percocet, Roxicet), pentazocine (Talwin), tapentadol (Nucynta), and tramadol (ConZip, Ultram)
• Parkinson’s disease medicines such as apomorphine (Apokyn), bromocriptine (Cycloset, Parlodel), levodopa/carbidopa (Duopa, Rytary, Sinemet), pramipexole (Mirapex), and ropinirole (Requip)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Sleeping pills such as butabarbital (Butisol), flurazepam, suvorexant (Belsomra), temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo)
• Tetrabenazine (Xenazine)
• Thalidomide (Thalomid)

Do not drink alcohol while you are taking this medicine.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.