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Olanzapine: uses, dosing, side effects & brands

Olanzapine is an atypical antipsychotic sold in the U.S. under 4 brand and generic names, for bipolar disorder, psychotic disorders and schizophrenia. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.

By the pharmaranks editorial teamReviewed against the FDA (openFDA label, NDC Directory & Enforcement) sourcesUpdated Jul 24, 2026How we research

Key facts

Drug class
Atypical Antipsychotic
Treats (across its forms)
Bipolar Disorder, Psychotic Disorders and Schizophrenia
Available as
Injectable · Tablet · Tablet, orally disintegrating · Kit
Sold as
4 products — Olanzapine, Zyprexa and Zyprexa Relprevv, and others
Prescription?
Prescription only
Generic available?
Yes
Half-life
about 21 to 54 hours (mean around 30 hours)
What the pharmacy pays
about $4 for a 30-count supply — not your price
Boxed warning
Boxed warning

How Zyprexa is dosed

From the FDA label for Zyprexa (application NDA021253). Other olanzapine products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.

Schizophrenia in adults ( 2.1 ) Oral: Start at 5-10 mg once daily; Target: 10 mg/day within several days Schizophrenia in adolescents ( 2.1 ) Oral: Start at 2.5-5 mg once daily; Target: 10 mg/day Bipolar I Disorder (manic or mixed episodes) in adults ( 2.2 ) Oral: Start at 10 or 15 mg once daily Bipolar I Disorder (manic or mixed episodes) in adolescents ( 2.2 ) Oral: Start at 2.5-5 mg once daily; Target: 10 mg/day Bipolar I Disorder (manic or mixed episodes) with lithium or valproate in adults ( 2.2 ) Oral: Start at 10 mg once daily Agitation associated with Schizophrenia and Bipolar I Mania in adults ( 2.4 ) IM: 10 mg (5 mg or 7.5 mg when clinically warranted) Assess for orthostatic hypotension prior to subsequent dosing (max. 3 doses 2-4 hrs apart) Depressive Episodes associated with Bipolar I Disorder in adults ( 2.5 ) Oral in combination with fluoxetine: Start at 5 mg of oral olanzapine and 20 mg of fluoxetine once daily Depressive Episodes associated with Bipolar I Disorder in children and adolescents ( 2.5 ) Oral in combination with fluoxetine: Start at 2.5 mg of oral olanzapine and 20 mg of fluoxetine once daily Treatment Resistant Depression in adults ( 2.6 ) Oral in combination with fluoxetine: Start at 5 mg of oral olanzapine and 20 mg of fluoxetine once daily Lower starting dose recommended in debilitated or pharmacodynamically sensitive patients or patients with…

Everything below is the FDA label for Zyprexa (tablet). Olanzapine is also sold as injectable, tablet, orally disintegrating and kit, and those are different medicines to take — follow the label for the one you were prescribed.

Zyprexa side effects

When using ZYPREXA and fluoxetine in combination, also refer to the Adverse Reactions section of the package insert for Symbyax. Most common adverse reactions (≥5% and at least twice that for placebo) associated with: Oral Olanzapine Monotherapy: Schizophrenia (Adults) – postural hypotension, constipation, weight gain, dizziness, personality disorder, akathisia. ( 6.1 ) Schizophrenia (Adolescents) – sedation, weight increased, headache, increased appetite, dizziness, abdominal pain, pain in extremity, fatigue, dry mouth. ( 6.1 ) Manic or Mixed Episodes, Bipolar I Disorder (Adults) – asthenia, dry mouth, constipation, increased appetite, somnolence, dizziness, tremor. ( 6.1 ) Manic or Mixed Episodes, Bipolar I Disorder (Adolescents) – sedation, weight increased, increased appetite, headache, fatigue, dizziness, dry mouth, abdominal pain, pain in extremity. ( 6.1 ) Combination of ZYPREXA and Lithium or Valproate: Manic or Mixed Episodes, Bipolar I Disorder (Adults) – dry mouth, weight gain, increased appetite, dizziness, back pain, constipation, speech disorder, increased salivation, amnesia, paresthesia. ( 6.1 ) ZYPREXA and Fluoxetine in Combination: Also refer to the Adverse Reactions section of the package insert for Symbyax. ( 6 ) ZYPREXA IntraMuscular for Injection: Agitation with Schizophrenia and Bipolar I Mania (Adults) – somnolence. ( 6.1 ) To report SUSPECTED ADVERSE…

Who shouldn’t take Zyprexa

None with ZYPREXA monotherapy. When using ZYPREXA and fluoxetine in combination, also refer to the Contraindications section of the package insert for Symbyax. For specific information about the contraindications of lithium or valproate, refer to the Contraindications section of the package inserts for these other products. None with ZYPREXA monotherapy. ( 4 ) When using ZYPREXA and fluoxetine in combination, also refer to the Contraindications section of the package insert for Symbyax ® . ( 4 ) When using ZYPREXA in combination with lithium or valproate, refer to the Contraindications section of the package inserts for those products. ( 4 )

Zyprexa drug interactions

The risks of using olanzapine in combination with other drugs have not been extensively evaluated in systematic studies. Diazepam: May potentiate orthostatic hypotension. ( 7.1 , 7.2 ) Alcohol: May potentiate orthostatic hypotension. ( 7.1 ) Carbamazepine: Increased clearance of olanzapine. ( 7.1 ) Fluvoxamine: May increase olanzapine levels. ( 7.1 ) ZYPREXA and Fluoxetine in Combination: Also refer to the Drug Interactions section of the package insert for Symbyax. ( 7.1 ) CNS Acting Drugs: Caution should be used when taken in combination with other centrally acting drugs and alcohol. ( 7.2 ) Antihypertensive Agents: Enhanced antihypertensive effect. ( 7.2 ) Levodopa and Dopamine Agonists: May antagonize levodopa/dopamine agonists. ( 7.2 ) Lorazepam (IM): Increased somnolence with IM olanzapine. ( 7.2 ) Other Concomitant Drug Therapy: When using olanzapine in combination with lithium or valproate, refer to the Drug Interactions sections of the package insert for those products. ( 7.2 ) 7.1 Potential for Other Drugs to Affect Olanzapine Diazepam — The co-administration of diazepam with olanzapine potentiated the orthostatic hypotension observed with olanzapine [see Drug Interactions ( 7.2 )] . Cimetidine and Antacids — Single doses of cimetidine (800 mg) or aluminum- and magnesium-containing antacids did not affect the oral bioavailability of olanzapine. Inducers of CYP1A2 — Carbamazepine therapy (200 mg bid) causes an approximately 50% increase in the clearance of olanzapine. This increase is likely due to the fact that carbamazepine is a potent inducer of CYP1A2 activity. Higher daily doses of carbamazepine may cause an even greater increase in olanzapine clearance. Alcohol — Ethanol (45 mg/70 kg single dose) did not have an effect on olanzapine pharmacokinetics. The co-administration of alcohol (i.e., ethanol) with olanzapine potentiated the orthostatic hypotension observed with olanzapine [see Drug Interactions ( 7.2 )] . Inhibitors of CYP1A2 Fluvoxamine: Fluvoxamine, a CYP1A2 inhibitor, decreases the clearance of olanzapine. This results in a mean increase in olanzapine Cmax following fluvoxamine of 54% in female nonsmokers and 77% in male smokers. The mean increase in olanzapine AUC is 52% and 108%, respectively. Lower doses of olanzapine should be considered in patients receiving concomitant treatment with fluvoxamine. Inhibitors of CYP2D6 Fluoxetine: Fluoxetine (60 mg single dose or 60 mg daily dose for 8 days) causes a small (mean 16%) increase in the maximum concentration of olanzapine and a small (mean 16%) decrease in olanzapine clearance. The magnitude of the impact of this factor is small in comparison to the overall variability between individuals, and therefore dose modification is not routinely recommended. When using ZYPREXA and fluoxetine in combination, also refer to the Drug Interactions section of the package insert for Symbyax. Warfarin — Warfarin (20 mg single dose) did not affect olanzapine pharmacokinetics [see Drug Interactions ( 7.2 )] . Inducers of CYP1A2 or Glucuronyl Transferase — Omeprazole and rifampin may cause an increase in olanzapine clearance. Charcoal — The administration of activated charcoal (1 g) reduced the Cmax and AUC of oral olanzapine by about 60%. As peak olanzapine levels are not typically obtained until about 6 hours after dosing, charcoal may be a useful treatment for olanzapine overdose. Anticholinergic Drugs — Concomitant treatment with olanzapine and other drugs with anticholinergic activity can increase the risk for severe gastrointestinal adverse reactions related to hypomotility. ZYPREXA should be used with caution in patients receiving medications having anticholinergic (antimuscarinic) effects [see Warnings and Precautions ( 5.14 )] . 7.2 Potential for Olanzapine to Affect Other Drugs CNS Acting Drugs — Given the primary CNS effects of olanzapine, caution should be used when olanzapine is taken in combination with other centrally acting drugs and alcohol. Antihypertensive Agents — Olanzapine, because of its potential for inducing hypotension, may enhance the effects of certain antihypertensive agents. Levodopa and Dopamine Agonists — Olanzapine may antagonize the effects of levodopa and dopamine agonists. Lorazepam (IM) — Administration of intramuscular lorazepam (2 mg) 1 hour after intramuscular olanzapine for injection (5 mg) did not significantly affect the pharmacokinetics of olanzapine, unconjugated lorazepam, or total lorazepam. However, this co-administration of intramuscular lorazepam and intramuscular olanzapine for injection added to the somnolence observed with either drug alone [see Warnings and Precautions ( 5.7 )] . Lithium — Multiple doses of olanzapine (10 mg for 8 days) did not influence the kinetics of lithium. Therefore, concomitant olanzapine administration does not require dosage adjustment of lithium [see Warnings and Precautions ( 5.16 )] . Valproate — Olanzapine (10 mg daily for 2 weeks) did not affect the steady state plasma concentrations of valproate. Therefore, concomitant olanzapine administration does not require dosage adjustment of valproate [see Warnings and Precautions ( 5.16 )] . Effect of Olanzapine on Drug Metabolizing Enzymes — In vitro studies utilizing human liver microsomes suggest that olanzapine has little potential to inhibit CYP1A2, CYP2C9, CYP2C19, CYP2D6, and CYP3A. Thus, olanzapine is unlikely to cause clinically important drug interactions mediated by these enzymes. Imipramine — Single doses of olanzapine did not affect the pharmacokinetics of imipramine or its active metabolite desipramine. Warfarin — Single doses of olanzapine did not affect the pharmacokinetics of warfarin [see Drug Interactions ( 7.1 )] . Diazepam — Olanzapine did not influence the pharmacokinetics of diazepam or its active metabolite N-desmethyldiazepam. However, diazepam co-administered with olanzapine increased the orthostatic hypotension observed with either drug given alone [see Drug Interactions ( 7.1 )] . Alcohol — Multiple doses of olanzapine did not influence the kinetics of ethanol [see Drug Interactions ( 7.1 )] . Biperiden — Multiple doses of olanzapine did not influence the kinetics of biperiden. Theophylline — Multiple doses of olanzapine did not affect the pharmacokinetics of theophylline or its metabolites.

Every olanzapine product we track (4)

Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.

Olanzapine products
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What olanzapine pills look like

Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.

Olanzapine pill imprints
ImprintStrengthColourShape
APO;OLA;55 mgwhiteround
R20;016820 mgwhiteoval
R2625 mgyellowcapsule
R26310 mgyellowcapsule
R26415 mgyellowcapsule
R26520 mgyellowcapsule
R5;01645 mgwhiteoval
R7;5;01657.5 mgwhiteoval
R10;016610 mgwhiteoval
CL4420 mgpinkoval
R15;016715 mgwhiteround

Combination products containing olanzapine

A combination is a different drug — different dosing, different warnings. It is listed here so you can find it, not so you can substitute it.

Olanzapine recalls

From the FDA Enforcement database. A recall covers specific lots — not the drug as a whole.

How long olanzapine keeps

No olanzapine label we read sets a separate limit for after opening, but they do specify how it must be stored — and the stability behind any date assumes those conditions.

Does olanzapine expire? The in-use limits and storage rules from its labels

Olanzapine and breastfeeding

From LactMed, the US National Library of Medicine’s Drugs and Lactation Database — quoted, not rewritten.

Maternal doses of olanzapine up to 20 mg daily produce low levels in milk and undetectable levels in the serum of breastfed infants. In most cases, short-term side effects have not been reported, but sedation, irritability, poor feeding, tremors and abnormal muscle movements have occurred. Limited long-term follow-up of infants exposed to olanzapine indicates that infants generally developed normally. A safety scoring system finds olanzapine to be acceptable during breastfeeding. Systematic reviews of second-generation antipsychotics concluded that olanzapine seems to be a first-line agent during breastfeeding. Monitor the infant for drowsiness, irritability, poor feeding, tremors and abnormal muscle movements in the short-term, and developmental milestones over time, especially if other antipsychotics are used concurrently.

Full LactMed record for olanzapine: levels in milk, effects in breastfed infants, and the drugs it would consider instead

National Institute of Child Health and Human Development, record revised April 15, 2026. LactMed states its information is not a substitute for professional judgement.

What people report to the FDA about olanzapine

The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 71,100 reports naming olanzapine, and the FDA flagged 92% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:

  • weight increased2,938 reports
  • somnolence2,894 reports
  • nausea2,830 reports
  • vomiting2,420 reports
  • fatigue2,414 reports
  • neuroleptic malignant syndrome2,220 reports
  • confusional state2,200 reports
  • anxiety2,107 reports

Read these as a signal, not a rate. A report does not mean olanzapine caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.

Source: openFDA drug/event (FAERS), retrieved August 25, 2026.

How long olanzapine stays in your system

The elimination half-life of olanzapine is about 21 to 54 hours (mean around 30 hours). The label gives the half-life as a population range: 21 to 54 hours (5th to 95th percentile, mean 30 hr) for oral olanzapine. The major circulating metabolites (10-N-glucuronide and 4'-N-desmethyl olanzapine) are explicitly described as lacking pharmacological activity, so there is no active metabolite that outlasts the parent to worry about. Half-life is longer in older adults: the mean elimination half-life was about 1.5 times greater in elderly (65+) than in younger subjects. Renal impairment: little effect (only ~7% excreted unchanged; not removed by dialysis; no dose adjustment). Hepatic impairment: a study in mild-to-moderate cirrhosis (Child-Pugh A/B) showed little effect on pharmacokinetics. Clearance is also ~30% lower in women and ~40% lower in nonsmokers, which lengthens half-life. This is the oral tablet; the long-acting olanzapine pamoate injection is a different formulation.

Olanzapine tablet — DailyMed label, Section 12.3 Pharmacokinetics

Half-life is how long the body takes to clear half a dose. It is not the same as how long a drug test can detect it, and it varies with age, kidney and liver function.

Is olanzapine safe during pregnancy?

The label reports no clear risk

The label states that overall available data from published epidemiologic studies of pregnant women exposed to olanzapine have NOT established a drug-associated risk of major birth defects, miscarriage, or adverse maternal/fetal outcomes. However, it flags a real third-trimester concern: neonates exposed to antipsychotics (including olanzapine) during the third trimester are at risk for extrapyramidal and/or withdrawal symptoms after delivery (agitation, abnormal muscle tone, tremor, somnolence, respiratory distress, feeding difficulty) that vary in severity — some resolve in hours/days, some require prolonged hospitalization — so neonates should be monitored. The label also notes real risks from untreated schizophrenia or bipolar I disorder (relapse, hospitalization, suicide). A pregnancy exposure registry for atypical antipsychotics exists (National Pregnancy Registry, 1-866-961-2388). Discuss use in pregnancy with your prescriber; do not start or stop on your own.

This is what olanzapine’s FDA label says — not a recommendation to take or stop it. In pregnancy, that decision is your prescriber’s; do not start or stop a medicine on your own.

Olanzapine Tablets — DailyMed FDA Label (Section 8.1 Pregnancy; Warnings/Adverse Reactions)

Does olanzapine cause weight gain?

The label reports weight gain

The label clearly reports weight gain as an adverse reaction and dedicates a Metabolic Changes / Weight Gain warning to it. Weight gain is listed among the most common adverse reactions in adult schizophrenia (occurring at least twice the placebo rate). Pooled data from 86 adult clinical trials (Table 6) show clinically significant weight gain across all baseline BMI categories, with the proportion of patients gaining weight increasing over time (e.g., over 24 months). It notes that adolescents have an even greater potential for weight gain than adults, which may lead clinicians to consider other drugs first. Discontinuation due to weight gain occurred in about 1% of olanzapine-treated adults vs 0% on placebo in placebo-controlled trials. The label advises considering the potential consequences of weight gain before starting olanzapine.

Only what the FDA label reports — many drugs blamed for weight change online have no weight effect in their label, and we say so rather than repeat the folklore.

Olanzapine Tablets — DailyMed FDA Label (Section 8.1 Pregnancy; Warnings/Adverse Reactions)

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Frequently asked questions

What is Zyprexa?

Zyprexa (Olanzapine) is an atypical antipsychotic used to treat Bipolar Disorder, Psychotic Disorders, Schizophrenia.

What kind of drug is olanzapine?

The FDA classifies olanzapine as an atypical antipsychotic. Atypical antipsychotics block dopamine D2 receptors and serotonin 5-HT2A receptors in the brain, rebalancing these signaling chemicals to reduce hallucinations, delusions, and mood symptoms in conditions like schizophrenia and bipolar disorder. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.

Is olanzapine safe during pregnancy?

The label states that overall available data from published epidemiologic studies of pregnant women exposed to olanzapine have NOT established a drug-associated risk of major birth defects, miscarriage, or adverse maternal/fetal outcomes. However, it flags a real third-trimester concern: neonates exposed to antipsychotics (including olanzapine) during the third trimester are at risk for extrapyramidal and/or withdrawal symptoms after delivery (agitation, abnormal muscle tone, tremor, somnolence, respiratory distress, feeding difficulty) that vary in severity — some resolve in hours/days, some require prolonged hospitalization — so neonates should be monitored. The label also notes real risks from untreated schizophrenia or bipolar I disorder (relapse, hospitalization, suicide). A pregnancy exposure registry for atypical antipsychotics exists (National Pregnancy Registry, 1-866-961-2388). Discuss use in pregnancy with your prescriber; do not start or stop on your own. This is what olanzapine's FDA label says; whether to use it in pregnancy is your prescriber's decision.

Does olanzapine cause weight gain?

The label clearly reports weight gain as an adverse reaction and dedicates a Metabolic Changes / Weight Gain warning to it. Weight gain is listed among the most common adverse reactions in adult schizophrenia (occurring at least twice the placebo rate). Pooled data from 86 adult clinical trials (Table 6) show clinically significant weight gain across all baseline BMI categories, with the proportion of patients gaining weight increasing over time (e.g., over 24 months). It notes that adolescents have an even greater potential for weight gain than adults, which may lead clinicians to consider other drugs first. Discontinuation due to weight gain occurred in about 1% of olanzapine-treated adults vs 0% on placebo in placebo-controlled trials. The label advises considering the potential consequences of weight gain before starting olanzapine.

How long does olanzapine stay in your system?

The elimination half-life of olanzapine is about 21 to 54 hours (mean around 30 hours) — that is how long the body takes to clear half of a dose. The label gives the half-life as a population range: 21 to 54 hours (5th to 95th percentile, mean 30 hr) for oral olanzapine. The major circulating metabolites (10-N-glucuronide and 4'-N-desmethyl olanzapine) are explicitly described as lacking pharmacological activity, so there is no active metabolite that outlasts the parent to worry about. Half-life is longer in older adults: the mean elimination half-life was about 1.5 times greater in elderly (65+) than in younger subjects. Renal impairment: little effect (only ~7% excreted unchanged; not removed by dialysis; no dose adjustment). Hepatic impairment: a study in mild-to-moderate cirrhosis (Child-Pugh A/B) showed little effect on pharmacokinetics. Clearance is also ~30% lower in women and ~40% lower in nonsmokers, which lengthens half-life. This is the oral tablet; the long-acting olanzapine pamoate injection is a different formulation. Half-life is not the same as how long a drug test can detect the drug, and it varies with age, kidney and liver function.

Can you take olanzapine with other medicines?

It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run olanzapine against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.

What brand names is olanzapine sold under?

We track 4 olanzapine-containing products in the U.S.: Olanzapine, Zyprexa, Zyprexa Relprevv and Zyprexa Zydis. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.

What forms does olanzapine come in?

Across the brands we track, olanzapine is currently marketed as injectable, tablet, tablet, orally disintegrating and kit, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.

Is there a generic olanzapine?

Yes. Our catalog lists 1 generic olanzapine product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.

Has olanzapine been recalled?

The FDA's Enforcement database lists 1 recall record whose product description mentions olanzapine. The most recent: Olanzapine Tablets (Nov 25, 2024). A recall applies to specific lots, not to the drug as a whole — check the record for the affected lot numbers.

What are the common side effects of olanzapine?

The most common are drowsiness or sedation, increased appetite, and weight gain, which can be significant. Dizziness, dry mouth, and constipation are also frequent. Sedation is often strongest early on and may lessen; weight gain, by contrast, tends to build over time and should be monitored, since it ties into the drug's metabolic risks.

Does olanzapine carry a boxed warning?

Yes. Olanzapine has a boxed warning that elderly patients with dementia-related psychosis who take antipsychotics have an increased risk of death, including from stroke and heart-related causes. It is not approved to treat dementia-related psychosis. This is an important reason it is used cautiously, if at all, in older adults with dementia.

What serious side effects of olanzapine should I watch for?

Olanzapine can raise blood sugar and cholesterol and cause new-onset diabetes; watch for excessive thirst, frequent urination, hunger, weakness, or confusion, which can signal dangerously high blood sugar. Get emergency care for neuroleptic malignant syndrome: high fever, stiff muscles, confusion, and irregular heartbeat. Report uncontrollable face or body movements (tardive dyskinesia), fainting from low blood pressure, or a serious rash with fever and swelling. Because of the metabolic risks, your doctor should track weight, blood sugar, and lipids.

Which olanzapine effects are expected versus a reason to seek help?

Some drowsiness, dry mouth, increased appetite, and mild dizziness are common and often improve. Seek urgent help for high fever with muscle stiffness and confusion, symptoms of very high blood sugar, fainting, or a spreading rash with fever. Ongoing weight gain and rising blood sugar or cholesterol are not emergencies but do need to be managed with your doctor rather than ignored.

Cite this page
APA
pharmaranks. (2026, July 24). Olanzapine: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/olanzapine
MLA
“Olanzapine: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/olanzapine.

We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.

Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.

Read the full FDA label for olanzapine on DailyMed (NIH) ↗ — including its boxed warning in full.