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ZYPREXA (OLANZAPINE)
- Agitation associated with bipolar mania
- Agitation associated with schizophrenia
- Depression associated with bipolar disorder, adjunct
- Mania associated with bipolar disorder
- Schizophrenia
- Bipolar disorder in remission
- Depression treatment adjunct
- Mixed bipolar I disorder
- Zyprexa Tablet
- Zyprexa Intramuscular Solution
- Olanzapine Tablet
- Olanzapine Intramuscular Solution
- By Indication
10 mg tablet
- 1 tablet (10 mg) by oral route once daily
15 mg tablet
- 1 tablet (15 mg) by oral route once daily
2.5 mg tablet
- 2 tablets (5 mg) by oral route once daily
20 mg tablet
- 1 tablet (20 mg) by oral route once daily
5 mg tablet
- 1 tablet (5 mg) by oral route once daily
7.5 mg tablet
- 1 tablet (7.5 mg) by oral route once daily
10 mg intramuscular solution
- Inject 2 milliliters (10 mg) by intramuscular route once
10 mg tablet
- 1 tablet (10 mg) by oral route once daily
15 mg tablet
- 1 tablet (15 mg) by oral route once daily
2.5 mg tablet
- 2 tablets (5 mg) by oral route once daily
20 mg tablet
- 1 tablet (20 mg) by oral route once daily
5 mg tablet
- 1 tablet (5 mg) by oral route once daily
7.5 mg tablet
- 1 tablet (7.5 mg) by oral route once daily
10 mg intramuscular solution
- Inject 2 milliliters (10 mg) by intramuscular route once
Agitation associated with bipolar mania
- Inject 1 milliliter (5 mg) by intramuscular route once
- Inject 2 milliliters (10 mg) by intramuscular route once
- Inject 0.5 milliliter (2.5 mg) by intramuscular route once
- Inject 1.5 milliliters (7.5 mg) by intramuscular route once
Agitation associated with schizophrenia
- Inject 1 milliliter (5 mg) by intramuscular route once
- Inject 2 milliliters (10 mg) by intramuscular route once
- Inject 0.5 milliliter (2.5 mg) by intramuscular route once
- Inject 1.5 milliliters (7.5 mg) by intramuscular route once
Depression associated with bipolar disorder, adjunct
- 1 tablet (5 mg) by oral route once daily in the evening
- 2 tablets (5 mg) by oral route once daily in the evening
- 1 tablet (10 mg) by oral route once daily in the evening
- 2 tablets (10 mg) by oral route once daily in the evening
- 1 tablet (7.5 mg) by oral route once daily in the evening
Depression treatment adjunct
- 1 tablet (5 mg) by oral route once daily in the evening
- 2 tablets (5 mg) by oral route once daily in the evening
- 1 tablet (10 mg) by oral route once daily in the evening
- 2 tablets (10 mg) by oral route once daily in the evening
- 1 tablet (7.5 mg) by oral route once daily in the evening
Mania associated with bipolar disorder
- 2 tablets (5 mg) by oral route once daily
- 1 tablet (5 mg) by oral route once daily
- 1 tablet (10 mg) by oral route once daily
- 2 tablets (10 mg) by oral route once daily
- 1 tablet (15 mg) by oral route once daily
- 2 tablets (15 mg) by oral route once daily
- 2 tablets (20 mg) by oral route once daily
- 1 tablet (20 mg) by oral route once daily
- 1 tablet (7.5 mg) by oral route once daily
Schizophrenia
- 2 tablets (5 mg) by oral route once daily
- 1 tablet (5 mg) by oral route once daily
- 1 tablet (10 mg) by oral route once daily
- 2 tablets (10 mg) by oral route once daily
- 1 tablet (15 mg) by oral route once daily
- 2 tablets (15 mg) by oral route once daily
- 2 tablets (20 mg) by oral route once daily
- 1 tablet (20 mg) by oral route once daily
- 1 tablet (7.5 mg) by oral route once daily
- metoclopramide HCl
- Metozolv Odt
- Reglan
Contraindicated
- Apokyn
- apomorphine
- Ativan
- cabergoline
- carbidopa-levodopa
- carbidopa-levodopa-entacapone
- Comtan
- diazepam
- entacapone
- lorazepam
- midazolam
- midazolam (PF)
- Mirapex
- Mirapex Er
- pramipexole
- Requip
- Requip Xl
- ropinirole
- Sinemet
- Sinemet Cr
- sodium oxybate
- Stalevo 100
- Stalevo 125
- Stalevo 150
- Stalevo 200
- Stalevo 50
- Stalevo 75
- Xyrem
Severe
Moderate
- Aplenzin
- Buproban
- bupropion HBr
- bupropion HCl
- fluvoxamine
- Forfivo Xl
- Luvox Cr
- Wellbutrin
- Wellbutrin Sr
- Wellbutrin Xl
- Zyban
- Neuroleptic malignant syndrome
Contraindicated
- Acute myocardial infarction
- Angle-closure glaucoma
- Benign prostatic hyperplasia with lower urinary tract sx
- Carcinoma of breast
- Cardiac arrhythmia
- Cerebrovascular accident
- Cerebrovascular disorder
- Chronic heart failure
- Dehydration
- Diabetes mellitus
- Esophageal dysmotility
- Hypercholesterolemia
- Hyperlipidemia
- Hypertriglyceridemia
- Hypotension
- Hypovolemia
- Leukopenia
- Lower seizure threshold
- Myocardial ischemia
- Neutropenic disorder
- Orthostatic hypotension
- Paralytic ileus
- Parkinsonism
- Predisposition to aspiration
- Seizure disorder
- Senile dementia
- Severe hepatic disease
- Suicidal ideation
- Tardive dyskinesia
- Transient cerebral ischemia
Severe
Moderate
- Abnormal hepatic function tests
- Bradycardia
- Congenital long QT syndrome
- Hyperprolactinemia
- Obesity
- Sinus tachycardia
- Tobacco smoker
- Weight gain
ZYPREXA (OLANZAPINE)
- Agitation associated with bipolar mania
- Agitation associated with schizophrenia
- Depression associated with bipolar disorder, adjunct
- Mania associated with bipolar disorder
- Schizophrenia
- Bipolar disorder in remission
- Depression treatment adjunct
- Mixed bipolar I disorder
- Akathisia
- Parkinsonism
- Personality disorders
- Amblyopia
- Back pain
- Constipation
- Disturbance of attention
- Dizziness
- Drowsy
- Fatigue
- General weakness
- Headache disorder
- Hyperprolactinemia
- Hypertriglyceridemia
- Increased appetite
- Orthostatic hypotension
- Rhinitis
- Sedation
- Tremor
- Weight gain
- Xerostomia
More Frequent
Severe
Less Severe
- Altered mental status
- Chest pain
- Euphoria
- Extrapyramidal disease
- Fever
- Memory impairment
- Peripheral edema
- Tardive dyskinesia
- Abdominal pain with cramps
- Abnormal hepatic function tests
- Arthralgias
- Chills
- Cough
- Dysarthria
- Dyspepsia
- Ecchymosis
- Edema
- Erectile dysfunction
- Gait abnormality
- Hypersomnia
- Hypertension
- Hypertonia
- Hypotension
- Insomnia
- Limb pain
- Muscle rigidity
- Nausea
- Nervousness
- Paresthesia
- Pharyngitis
- Polydipsia
- Sialorrhea
- Tachycardia
- Urinary incontinence
- Urinary tract infection
- Vomiting
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Accommodation disorder
- Acquired dystonia
- Agranulocytosis
- Anaphylaxis
- Angioedema
- Cerebrovascular accident
- Cholestatic hepatitis
- Diabetes mellitus
- Diabetic hyperosmolar coma
- Diabetic ketoacidosis
- DRESS syndrome
- Dysphagia
- Dyspnea
- Eosinophilia
- Esophageal dysmotility
- Exfoliative dermatitis
- Facial edema
- Heat stroke
- Hepatic failure
- Hepatitis
- Hyperbilirubinemia
- Hyperglycemia
- Hyperlipidemia
- Ileus
- Jaundice
- Leukopenia
- Lymphadenopathy
- Menstrual disorder
- Neuroleptic malignant syndrome
- Neutropenic disorder
- Osteoporosis
- Pancreatitis
- Priapism
- Rhabdomyolysis
- Seizure disorder
- Skin rash
- Sleep apnea
- Steatosis of liver
- Thrombocytopenic disorder
- Thromboembolic disorder
- Urinary retention
- Visual changes
Less Severe
- Acute confusion
- Alopecia
- Epistaxis
- Galactorrhea not associated with childbirth
- Gynecomastia
- Increased urinary frequency
- Libido changes
- Mastalgia
- Pruritus of skin
- Restless legs syndrome
- Skin photosensitivity
- Stuttering
- Urticaria
- Vasodilation of blood vessels
Contraindicated
None
Severe Precaution
Olanzapine (Oral)
Safety and efficacy not established age less than 10 years for combination with fluoxetine.
- 1 Day – 10 Years
- Safety and efficacy not established age less than 10 years for combination with fluoxetine.
Management or Monitoring Precaution
Olanzapine (Inj)
Risk of somnolence, orthostatic hypotension. Long term risk of weight gain, glucose, lipid abnormalities, tardive dyskinesia. Safety and efficacy not established.
Increased risk of sedation, hyperlipidemia and increased prolactin levels. Monitor weight and liver functions tests.
- 1 Day – 18 Years
- Risk of somnolence, orthostatic hypotension. Long term risk of weight gain, glucose, lipid abnormalities, tardive dyskinesia. Safety and efficacy not established.
- 10 Years – 18 Years
- Risk of somnolence, orthostatic hypotension. Long term risk of weight gain, glucose, lipid abnormalities, tardive dyskinesia. Safety and efficacy not established.
Olanzapine (Oral)
Risk of somnolence, orthostatic hypotension. Long term risk of weight gain, glucose, lipid abnormalities, tardive dyskinesia. Safety and efficacy not established.
Increased risk of sedation, hyperlipidemia and increased prolactin levels. Monitor weight and liver functions tests.
- 1 Day – 18 Years
- Increased risk of sedation, hyperlipidemia and increased prolactin levels. Monitor weight and liver functions tests.
- 10 Years – 18 Years
- Increased risk of sedation, hyperlipidemia and increased prolactin levels. Monitor weight and liver functions tests.
Olanzapine
- Severity Level:
2
- Additional Notes: Non-teratogenic complications (resp, gi,cns) with exposure during 3rd trimester
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Olanzapine
Limited data suggest low levels excreted resulting in infant sedation
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Drug shown to have adverse effect | Limited data suggest low levels excreted resulting in infant sedation |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Olanzapine
Neuro/Psych-Higher risk of tardive dyskinesia. CNS effects; sedation, cognit impair and inc fall risk. Avoid use for behav probs of dementia or delirium unless fail nonpharm options. Inc risk of stroke, cognitive decline, and death when used w/senile dementia.Max 7.5mg/day. Endocrine-May exacerbate or cause SIADH or hyponatremia. Cardiovascular-May cause orthostatic hypotens, bradycardia. Gastrointestinal-Monitor for constipation. Genitourinary-Avoid in patients w/urinary retention.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | N | Y | Y | N | Y |
BEERS: Y HEDIS: Y STOPP: Y
No Known Risk
None
- There may be a slightly increased risk of serious, possibly fatal side effects (such as stroke, heart failure, fast/irregular heartbeat, pneumonia) when this medication is used by older adults with dementia. This medication is not approved for the treatment of dementia-related behavior problems. Discuss the risks and benefits of this medication, as well as other effective and possibly safer treatments for dementia-related behavior problems, with the doctor.
| Agitation associated with bipolar mania | |
| R45.1 | Restlessness and agitation |
| Agitation associated with schizophrenia | |
| R45.1 | Restlessness and agitation |
| Bipolar disorder in remission | |
| F31.7 | Bipolar disorder, currently in remission |
| F31.70 | Bipolar disorder, currently in remission, most recent episode unspecified |
| F31.71 | Bipolar disorder, in partial remission, most recent episode hypomanic |
| F31.72 | Bipolar disorder, in full remission, most recent episode hypomanic |
| F31.73 | Bipolar disorder, in partial remission, most recent episode manic |
| F31.74 | Bipolar disorder, in full remission, most recent episode manic |
| F31.75 | Bipolar disorder, in partial remission, most recent episode depressed |
| F31.76 | Bipolar disorder, in full remission, most recent episode depressed |
| F31.77 | Bipolar disorder, in partial remission, most recent episode mixed |
| F31.78 | Bipolar disorder, in full remission, most recent episode mixed |
| Depression associated with bipolar disorder, adjunct | |
| F31.3 | Bipolar disorder, current episode depressed, mild or moderate severity |
| F31.30 | Bipolar disorder, current episode depressed, mild or moderate severity, unspecified |
| F31.31 | Bipolar disorder, current episode depressed, mild |
| F31.32 | Bipolar disorder, current episode depressed, moderate |
| F31.4 | Bipolar disorder, current episode depressed, severe, without psychotic features |
| F31.5 | Bipolar disorder, current episode depressed, severe, with psychotic features |
| Depression treatment adjunct | |
| F32 | Major depressive disorder, single episode |
| F32.0 | Major depressive disorder, single episode, mild |
| F32.1 | Major depressive disorder, single episode, moderate |
| F32.2 | Major depressive disorder, single episode, severe without psychotic features |
| F32.3 | Major depressive disorder, single episode, severe with psychotic features |
| F32.4 | Major depressive disorder, single episode, in partial remission |
| F32.5 | Major depressive disorder, single episode, in full remission |
| F32.9 | Major depressive disorder, single episode, unspecified |
| F33 | Major depressive disorder, recurrent |
| F33.0 | Major depressive disorder, recurrent, mild |
| F33.1 | Major depressive disorder, recurrent, moderate |
| F33.2 | Major depressive disorder, recurrent severe without psychotic features |
| F33.3 | Major depressive disorder, recurrent, severe with psychotic symptoms |
| F33.4 | Major depressive disorder, recurrent, in remission |
| F33.40 | Major depressive disorder, recurrent, in remission, unspecified |
| F33.41 | Major depressive disorder, recurrent, in partial remission |
| F33.42 | Major depressive disorder, recurrent, in full remission |
| F33.8 | Other recurrent depressive disorders |
| F33.9 | Major depressive disorder, recurrent, unspecified |
| Mania associated with bipolar disorder | |
| F31.1 | Bipolar disorder, current episode manic without psychotic features |
| F31.10 | Bipolar disorder, current episode manic without psychotic features, unspecified |
| F31.11 | Bipolar disorder, current episode manic without psychotic features, mild |
| F31.12 | Bipolar disorder, current episode manic without psychotic features, moderate |
| F31.13 | Bipolar disorder, current episode manic without psychotic features, severe |
| F31.2 | Bipolar disorder, current episode manic severe with psychotic features |
| F31.73 | Bipolar disorder, in partial remission, most recent episode manic |
| Mixed bipolar I disorder | |
| F31.6 | Bipolar disorder, current episode mixed |
| F31.60 | Bipolar disorder, current episode mixed, unspecified |
| F31.61 | Bipolar disorder, current episode mixed, mild |
| F31.62 | Bipolar disorder, current episode mixed, moderate |
| F31.63 | Bipolar disorder, current episode mixed, severe, without psychotic features |
| F31.64 | Bipolar disorder, current episode mixed, severe, with psychotic features |
| F31.77 | Bipolar disorder, in partial remission, most recent episode mixed |
| F31.78 | Bipolar disorder, in full remission, most recent episode mixed |
| Schizophrenia | |
| F20 | Schizophrenia |
| F20.0 | Paranoid schizophrenia |
| F20.1 | Disorganized schizophrenia |
| F20.2 | Catatonic schizophrenia |
| F20.3 | Undifferentiated schizophrenia |
| F20.5 | Residual schizophrenia |
| F20.8 | Other schizophrenia |
| F20.81 | Schizophreniform disorder |
| F20.89 | Other schizophrenia |
| F20.9 | Schizophrenia, unspecified |
| 0-9 | A-Z |
|---|---|
| F20 | Schizophrenia |
| F20.0 | Paranoid schizophrenia |
| F20.1 | Disorganized schizophrenia |
| F20.2 | Catatonic schizophrenia |
| F20.3 | Undifferentiated schizophrenia |
| F20.5 | Residual schizophrenia |
| F20.8 | Other schizophrenia |
| F20.81 | Schizophreniform disorder |
| F20.89 | Other schizophrenia |
| F20.9 | Schizophrenia, unspecified |
| F31.1 | Bipolar disorder, current episode manic without psychotic features |
| F31.10 | Bipolar disorder, current episode manic without psychotic features, unspecified |
| F31.11 | Bipolar disorder, current episode manic without psychotic features, mild |
| F31.12 | Bipolar disorder, current episode manic without psychotic features, moderate |
| F31.13 | Bipolar disorder, current episode manic without psychotic features, severe |
| F31.2 | Bipolar disorder, current episode manic severe with psychotic features |
| F31.3 | Bipolar disorder, current episode depressed, mild or moderate severity |
| F31.30 | Bipolar disorder, current episode depressed, mild or moderate severity, unspecified |
| F31.31 | Bipolar disorder, current episode depressed, mild |
| F31.32 | Bipolar disorder, current episode depressed, moderate |
| F31.4 | Bipolar disorder, current episode depressed, severe, without psychotic features |
| F31.5 | Bipolar disorder, current episode depressed, severe, with psychotic features |
| F31.6 | Bipolar disorder, current episode mixed |
| F31.60 | Bipolar disorder, current episode mixed, unspecified |
| F31.61 | Bipolar disorder, current episode mixed, mild |
| F31.62 | Bipolar disorder, current episode mixed, moderate |
| F31.63 | Bipolar disorder, current episode mixed, severe, without psychotic features |
| F31.64 | Bipolar disorder, current episode mixed, severe, with psychotic features |
| F31.7 | Bipolar disorder, currently in remission |
| F31.70 | Bipolar disorder, currently in remission, most recent episode unspecified |
| F31.71 | Bipolar disorder, in partial remission, most recent episode hypomanic |
| F31.72 | Bipolar disorder, in full remission, most recent episode hypomanic |
| F31.73 | Bipolar disorder, in partial remission, most recent episode manic |
| F31.73 | Bipolar disorder, in partial remission, most recent episode manic |
| F31.74 | Bipolar disorder, in full remission, most recent episode manic |
| F31.75 | Bipolar disorder, in partial remission, most recent episode depressed |
| F31.76 | Bipolar disorder, in full remission, most recent episode depressed |
| F31.77 | Bipolar disorder, in partial remission, most recent episode mixed |
| F31.77 | Bipolar disorder, in partial remission, most recent episode mixed |
| F31.78 | Bipolar disorder, in full remission, most recent episode mixed |
| F31.78 | Bipolar disorder, in full remission, most recent episode mixed |
| F32 | Major depressive disorder, single episode |
| F32.0 | Major depressive disorder, single episode, mild |
| F32.1 | Major depressive disorder, single episode, moderate |
| F32.2 | Major depressive disorder, single episode, severe without psychotic features |
| F32.3 | Major depressive disorder, single episode, severe with psychotic features |
| F32.4 | Major depressive disorder, single episode, in partial remission |
| F32.5 | Major depressive disorder, single episode, in full remission |
| F32.9 | Major depressive disorder, single episode, unspecified |
| F33 | Major depressive disorder, recurrent |
| F33.0 | Major depressive disorder, recurrent, mild |
| F33.1 | Major depressive disorder, recurrent, moderate |
| F33.2 | Major depressive disorder, recurrent severe without psychotic features |
| F33.3 | Major depressive disorder, recurrent, severe with psychotic symptoms |
| F33.4 | Major depressive disorder, recurrent, in remission |
| F33.40 | Major depressive disorder, recurrent, in remission, unspecified |
| F33.41 | Major depressive disorder, recurrent, in partial remission |
| F33.42 | Major depressive disorder, recurrent, in full remission |
| F33.8 | Other recurrent depressive disorders |
| F33.9 | Major depressive disorder, recurrent, unspecified |
| R45.1 | Restlessness and agitation |
| R45.1 | Restlessness and agitation |
Formulary Reference Tool