Zyprexa (olanzapine)
Brand name: Zyprexa® and Zyprexa® Zydis®.
Active ingredient name: Olanzapine.
Type of medication: Atypical antipsychotic.
Available in Canada from: Eli Lilly Canada Inc.
Form: Oral tablets, orally disintegrating tablets.
Generic: Yes: Apo-Olanzapine, Apo-Olanzapine ODT (Apotex Inc.); CO Olanzapine, CO Olanzapine ODT (Cobalt Pharmaceuticals Co.); Mylan-Olanzapine (Mylan Pharmaceuticals ULC); Jamp Olanzapine FC (Jamp Pharma Cooperation); Mar-Olanzapine (Marcan Pharmaceuticals Inc); Mint-Olanzapine ODT (Mint Pharmaceuticals Inc.), Olanzapine (Sanis Health Inc.); PMS-Olanzapine, PMS-Olanzapine ODT (Pharmascience Inc.); Ran-Olanzapine (Ranbaxy Pharmaceuticals Inc); Sandoz Olanzapine, Sandoz Olanzapine ODT (Sandoz Canada Inc.); Teva-Olanzapine, Teva-Olanzapine ODT (Teva Canada Ltd.); Van-Olanzapine (Vanc Pharmaceuticals Inc).
Listed on Ontario formulary: Yes.
OHIP+ coverage: Yes.
Note: Zyprexa® is also available as an injection—Zyprexa® IntraMuscular.
This short-acting intramuscular injection is approved for use in Canada and is used primarily for acute situations. It is discussed in more detail below. There is also Zyprexa® long-acting depot injection however it is not approved for use in Canada. It is available for use in the United States.
What is Zyprexa used for?
Zyprexa is used to treat symptoms of schizophrenia and related psychotic illnesses in adults. It may also be used to treat bipolar disorder. Zyprexa is sometimes used to treat other conditions. Talk to your doctor to understand what you are using Zyprexa for.
How should I take Zyprexa?
- Zyprexa can be taken with or without food. It can be taken once daily.
- Zyprexa is available in 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, and 20 mg tablets. Zyprexa Zydis orally-disintegrating tablets are available in 5 mg, 10 mg, 15 mg, and 20 mg doses. The usual dose range for Zyprexa is 5 mg - 20 mg daily. Your doctor may prescribe doses greater than 20 mg based on your clinical situation. Talk to your doctor about your specific dose.
What are the most common side effects seen with Zyprexa?
The most common side effects of Zyprexa include:
- Drowsiness
- Weight gain (can be significant)
- Increased appetite
- Dizziness
- Constipation
- Dry mouth
- Hyperglycemia (high blood sugar)
- Hyperlipidemia (increase in cholesterol and/or triglycerides)
What are rare but potentially serious side effects seen with Zyprexa?
- Decreased white blood cell count (agranulocytosis)
- Cerebrovascular event (stroke)
- Anaphylactic reaction (severe allergy)
- Pancreatitis
- Diabetic ketoacidosis (DKA)
- Neuroleptic malignant syndrome (NMS)
Warnings/Precautions
Elderly individuals with dementia-related psychosis treated with antipsychotic medication are at an increased risk of death compared to individuals not receiving antipsychotics. Most deaths appear to be either cardiovascular or infectious. Zyprexa Intramuscular is not approved for the treatment of dementia-related psychosis. Some individuals with dementia may, however, be treated with this medication. Discuss the potential risks and benefits of this medication with your doctor for this indication.
What medications interact with Zyprexa?
Tell all your doctors, pharmacists and dentist that you are taking Zyprexa. You should also tell your doctor or pharmacist if you are taking any other medications, including those obtained without a prescription, and herbal and vitamin products. When the levels of a medication are increased or decreased in your bloodstream, this can affect the medication’s efficacy and safety.
The following medications might
increase the levels of Zyprexa in the bloodstream
- fluvoxamine (anti-depressant)
- ketoconazole (anti-fungal)
- ciprofloxacin (antibiotic)
The following medications might
decrease the levels of Zyprexa in the bloodstream
- Omeprazole (proton pump inhibitor)
- Cigarettes
Smoking cigarettes interacts with Zyprexa by decreasing the levels in the blood. If you smoke regularly inform your healthcare provider and indicate approximately how many cigarettes you smoke per day. If you decide to quit and/or reduce the number of cigarettes you smoke, it is important to tell your doctor or pharmacist as your Zyprexa dose may need to be adjusted.
The following types of medications may interact with Zyprexa:
- Certain medications for allergies (e.g., Benadryl [diphenhydramine])
- Certain medications for sleep (e.g., lorazepam, zopiclone)
- Certain medications for pain (e.g., fentanyl)
It is best to avoid drinking alcohol or using illegal drugs while taking Zyprexa.