Dosing & Uses
Dosage Forms & Strengths
tablet
- 2.5mg
- 5mg
- 7.5mg
- 10mg
- 15mg
- 20mg
tablet, orally disintegrating
- 5mg
- 10mg
- 15mg
- 20mg
IM injection, short-acting
- 10mg
IM injection, extended-release suspension
- 210mg/vial
- 300mg/vial
- 405mg/vial
Schizophrenia
PO
- 5-10 mg/day initially; if necessary, may be titrated upward in increments of 5 mg/day at intervals >1 week
- Maintenance: 10-20 mg/day; not to exceed 20 mg/day
Recommended IM, extended-release dose based on oral dosage
- Oral dosage 10 mg/day: 210 mg IM every 2 weeks or 405 mg IM every 4 weeks for 1st 8 weeks, then 150 mg every 2 weeks or 300 mg every 4 weeks
- Oral dosage 15 mg/day: 300 mg IM every 2 weeks for 1st 8 weeks, then 210 mg every 2 weeks or 405 mg every 4 weeks
- Oral dosage 20 mg/day: 300 mg IM every 2 weeks for 1st 8 weeks, then 300 mg every 2 weeks
Bipolar Mania
Indicated for acute/maintenance treatment of manic or mixed episodes associated with bipolar 1 disorder; may be used adjunctively to valproate or lithium in the treatment of manic or mixed episodes associated with bipolar disorder
Monotherapy: 10-15 mg/day PO initially; may be titrated upward in increments of 5 mg/day at intervals >24 hr
Adjunct to lithium or valproate: 10 mg/day PO initially
Maintenance: 5-20 mg/day PO; not to exceed 20 mg/day
Agitation Associated with Schizophrenia and Bipolar I Mania
IM, short-acting: 2.5-10 mg/dose; additional doses (up to 10 mg) may be considered; administer subsequent doses 2 hr after initial dose and 4 hr after 2nd dose if necessary; not to exceed 30 mg/day
See Dosing Considerations
Bipolar Depression
Indicated for depressive episodes associated with bipolar I disorder in combination with fluoxetine
5 mg PO in evening; adjusted to range of 5-12.5 mg/day
Safety of coadministered doses greater than olanzapine 18 mg with fluoxetine 75 mg have not been evaluated
Chemotherapy Associated Nausea or Vomiting (Off-label)
Off-label use for prevention of chemotherapy associated nausea or vomiting in combination with 5-HT3 antagonist and dexamethasone (N Engl J Med 2016;375[2]:134-42)
Breakthrough nausea and vomiting: 5-10 mg PO qDay for 3 days, when not used for acute and delayed emesis prevention
Acute and delayed emesis prevention
- Off-label use for prevention of chemotherapy associated nausea or vomiting in combination with 5-HT3 antagonist and dexamethasone
- In combination with dexamethasone and a 5-HT3 antagonist (eg, palonosetron, aprepitant)
- High emetic risk IV chemotherapy: 10 mg PO the day of chemotherapy (day 1), followed by 10 mg PO qDay (days 2-4)
- Moderate emetic risk IV chemotherapy: 10 mg PO the day of chemotherapy (day 1), followed by 10 mg PO qDay (days 2-3)
References
- J Clin Oncol 2017 Jul 31 (ASCO clinical practice guideline update) Support Care Cancer 2017;25(2):607-613 N Engl J Med 2016;375(2):134-42
Dosing Modifications
Renal impairment: Dose adjustment not necessary
Hepatic impairment: Dose adjustment may be necessary; use caution
Slow metabolism, initial dose for schizophrenia
- Initiate with 5 mg PO qDay for patients with risk factors which may slow olanzapine metabolism (eg, nonsmoking females ≥65 yr)
- Dose escalation should performed with caution
Dosing Considerations
Dosage adjustments, if necessary, should be made at intervals >24 hr
Dosage Forms & Strengths
tablet
- 2.5mg
- 5mg
- 7.5mg
- 10mg
- 15mg
- 20mg
tablet, orally disintegrating
- 5mg
- 10mg
- 15mg
- 20mg
Bipolar I Disorder (Manic or Mixed Episodes)
<13 years: Safety and efficacy not established
13-17 years: 2.5-5 mg/day PO initially; target dosage, 10 mg/day; adjust by increments/decrements of 2.5-5 mg; dosage range, 2.5-20 mg/day
Schizophrenia
<13 years: Safety and efficacy not established
13-17 years: 2.5-5 mg/day PO initially; target dosage, 10 mg/day; adjust by increments/decrements of 2.5-5 mg; dosage range, 2.5-20 mg/day
Bipolar Depression
Indicated for depressive episodes associated with bipolar I disorder in combination with fluoxetine
<10 years: Safety and efficacy not established
10-17 years: 2.5 mg PO qPM and fluoxetine 20 mg PO qPM initially; dosage adjustments, if indicated, should be made to individual components according to efficacy and tolerability
Safety of coadministered doses greater than olanzapine 12 mg with fluoxetine 50 mg have not been in pediatric clinical studies
Stuttering (Off-label)
≤12 years: 1.25 mg PO at bedtime for 4 weeks, then 2.5 mg at bedtime
>12 years: 2.5 mg PO at bedtime for 4 weeks, then 5 mg at bedtime
Not approved for dementia-related psychosis, because of increased risk of cardiovascular or infection-related mortality (see Black Box Warnings)
Consider lower starting dosage
Schizophrenia
2.5-5 mg/day PO initially
IM (extended-release): 150 mg every 4 weeks in patients who are debilitated or predisposed to hypotensive episodes; not studied in patients with renal or hepatic impairment; requires deep IM administration (muscle mass in elderly may be sufficient)
Schizophrenia or Bipolar-Related Agitation
IM (short-acting): 5 mg; consider 2.5 mg if patient is predisposed to hypotensive reactions
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (4)
- amisulpride
amisulpride, olanzapine. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Increases risk of neuroleptic malignant syndromeIncreases risk of neuroleptic malignant syndrome.
- dronedarone
olanzapine and dronedarone both increase QTc interval. Contraindicated.
- fezolinetant
olanzapine will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitors
- thioridazine
olanzapine and thioridazine both increase QTc interval. Contraindicated.
Serious - Use Alternative (112)
- abametapir
abametapir will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.
- adagrasib
adagrasib, olanzapine. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.
- amiodarone
olanzapine and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.
- amisulpride
amisulpride and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- anagrelide
olanzapine and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.
- apomorphine
olanzapine decreases effects of apomorphine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
apomorphine and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - arsenic trioxide
olanzapine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
artemether and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- artemether/lumefantrine
olanzapine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine
olanzapine and asenapine both increase QTc interval. Avoid or Use Alternate Drug.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, olanzapine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- bromocriptine
olanzapine decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
- buprenorphine
olanzapine and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug. If concurrent use of olanzapine and buprenorphine is necessary, consider dose reduction of one or both drugs.
- buprenorphine buccal
buprenorphine buccal and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- buprenorphine subdermal implant
buprenorphine subdermal implant and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- buprenorphine transdermal
buprenorphine transdermal and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- cabergoline
olanzapine decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.
- calcium/magnesium/potassium/sodium oxybates
olanzapine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- ceritinib
ceritinib and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- chlorpromazine
olanzapine and chlorpromazine both increase QTc interval. Avoid or Use Alternate Drug.
- ciprofloxacin
olanzapine and ciprofloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- citalopram
citalopram and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- clarithromycin
clarithromycin and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- clozapine
clozapine and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- crizotinib
crizotinib and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- degarelix
degarelix and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- desflurane
desflurane and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- disopyramide
olanzapine and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.
- dopamine
olanzapine decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.
- droperidol
olanzapine and droperidol both increase QTc interval. Avoid or Use Alternate Drug.
- eliglustat
olanzapine and eliglustat both increase QTc interval. Avoid or Use Alternate Drug.
- encorafenib
encorafenib and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- entrectinib
olanzapine and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
- erdafitinib
olanzapine will increase the level or effect of erdafitinib by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. If coadministration of a strong CYP2C9 inhibitors is unavoidable, closely monitor adverse reactions and modify dose of erdafitinib accordingly. If strong CYP2C9 inhibitor is discontinued, consider increasing erdafitinib dose in the absence of any drug-related toxicities.
- eribulin
eribulin and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- erythromycin base
olanzapine and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin ethylsuccinate
olanzapine and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin lactobionate
olanzapine and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin stearate
olanzapine and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.
- fedratinib
olanzapine will increase the level or effect of fedratinib by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of fedratinib (a CYP3A4 and CYP2C19 substrate) with dual CYP3A4 and CYP2C19 inhibitor. Effect of coadministration of a dual CYP3A4 and CYP2C19 inhibitor with fedratinib has not been studied.
- fexinidazole
fexinidazole and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- fluvoxamine
fluvoxamine will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.
olanzapine and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug. - foscarnet
olanzapine and foscarnet both increase QTc interval. Avoid or Use Alternate Drug.
- givosiran
givosiran will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.
- glasdegib
olanzapine and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.
- goserelin
olanzapine and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- histrelin
olanzapine and histrelin both increase QTc interval. Avoid or Use Alternate Drug.
- hydrocodone
hydrocodone, olanzapine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- hydroxychloroquine sulfate
hydroxychloroquine sulfate and olanzapine both increase QTc interval. Avoid or Use Alternate Drug.
- ibutilide
olanzapine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.
- iloperidone
olanzapine and iloperidone both increase QTc interval. Avoid or Use Alternate Drug.
- inotuzumab
olanzapine and inotuzumab both increase QTc interval. Avoid or Use Alternate Drug.
- isoflurane
isoflurane and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- ivosidenib
ivosidenib and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.
- lefamulin
lefamulin and olanzapine both increase QTc interval. Avoid or Use Alternate Drug.
- leniolisib
leniolisib will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid leniolisib with CYP1A2 substrates that have a narrow therapeutic index
- lenvatinib
olanzapine and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.
- leuprolide
olanzapine and leuprolide both increase QTc interval. Avoid or Use Alternate Drug.
- levodopa
olanzapine decreases effects of levodopa by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
- levodopa inhaled
olanzapine decreases effects of levodopa inhaled by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Atypical (2nd generation) antipsychotics inhibit dopamine D2 receptors in varying degrees (clozapine and quetiapine are lower risk). .
- lisuride
olanzapine decreases effects of lisuride by pharmacodynamic antagonism. Contraindicated.
- lonafarnib
olanzapine will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.
- lopinavir
olanzapine and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.
- macimorelin
macimorelin and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.
- maprotiline
olanzapine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.
- mefloquine
mefloquine increases toxicity of olanzapine by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.
- methadone
olanzapine and methadone both increase QTc interval. Avoid or Use Alternate Drug.
- methyldopa
olanzapine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.
- metoclopramide intranasal
olanzapine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
olanzapine increases toxicity of metoclopramide intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potential for additive effects, including increased frequency and severity of tardive dyskinesia, other extrapyramidal symptoms, and neuroleptic malignant syndrome. - midostaurin
olanzapine and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.
- mobocertinib
mobocertinib and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.
- moxifloxacin
olanzapine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- olopatadine intranasal
olanzapine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- ondansetron
olanzapine and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.
- oxaliplatin
olanzapine and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
oxaliplatin and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - paliperidone
olanzapine and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.
- panobinostat
olanzapine and panobinostat both increase QTc interval. Avoid or Use Alternate Drug.
- paroxetine
olanzapine and paroxetine both increase QTc interval. Avoid or Use Alternate Drug.
- pazopanib
olanzapine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.
- pefloxacin
pefloxacin will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.
- pentamidine
olanzapine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.
- pimavanserin
olanzapine and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.
- pimozide
olanzapine and pimozide both increase QTc interval. Contraindicated.
- pitolisant
olanzapine and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- ponesimod
olanzapine and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.
- pramipexole
olanzapine decreases effects of pramipexole by pharmacodynamic antagonism. Contraindicated.
- procainamide
olanzapine and procainamide both increase QTc interval. Avoid or Use Alternate Drug.
- propafenone
olanzapine and propafenone both increase QTc interval. Avoid or Use Alternate Drug.
- quetiapine
olanzapine and quetiapine both increase QTc interval. Avoid or Use Alternate Drug.
- quinidine
olanzapine and quinidine both increase QTc interval. Avoid or Use Alternate Drug.
- ranolazine
olanzapine and ranolazine both increase QTc interval. Avoid or Use Alternate Drug.
- ribociclib
ribociclib increases toxicity of olanzapine by QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances.
- ropinirole
olanzapine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- safinamide
olanzapine decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.
- saquinavir
olanzapine and saquinavir both increase QTc interval. Avoid or Use Alternate Drug.
- selinexor
selinexor, olanzapine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
- sevoflurane
sevoflurane and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- siponimod
olanzapine will increase the level or effect of siponimod by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with drugs that cause moderate CYP2C9 AND a moderate or strong CYP3A4 inhibition is not recommended. Caution if siponimod coadministered with moderate CYP2C9 inhibitors alone.
olanzapine and siponimod both increase QTc interval. Avoid or Use Alternate Drug. - sodium oxybate
olanzapine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- sotalol
olanzapine and sotalol both increase QTc interval. Avoid or Use Alternate Drug.
- sufentanil SL
sufentanil SL, olanzapine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- tetrabenazine
olanzapine and tetrabenazine both increase QTc interval. Avoid or Use Alternate Drug.
- thiothixene
olanzapine and thiothixene both increase QTc interval. Avoid or Use Alternate Drug.
- toremifene
olanzapine and toremifene both increase QTc interval. Avoid or Use Alternate Drug.
- trazodone
olanzapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
- triptorelin
olanzapine and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- umeclidinium bromide/vilanterol inhaled
olanzapine increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
- vandetanib
olanzapine and vandetanib both increase QTc interval. Avoid or Use Alternate Drug.
- vemurafenib
olanzapine and vemurafenib both increase QTc interval. Avoid or Use Alternate Drug.
- vilanterol/fluticasone furoate inhaled
olanzapine increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
- ziprasidone
olanzapine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.
Monitor Closely (375)
- abobotulinumtoxinA
abobotulinumtoxinA increases effects of olanzapine by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.
- acarbose
olanzapine, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- aclidinium
aclidinium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
aclidinium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - acrivastine
acrivastine and olanzapine both increase sedation. Use Caution/Monitor.
- albiglutide
olanzapine, albiglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- albuterol
olanzapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - alfentanil
alfentanil and olanzapine both increase sedation. Use Caution/Monitor.
- alfuzosin
olanzapine and alfuzosin both increase QTc interval. Use Caution/Monitor.
alfuzosin and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - almotriptan
almotriptan, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- alprazolam
alprazolam and olanzapine both increase sedation. Use Caution/Monitor.
- amifostine
amifostine, olanzapine. Either increases effects of the other by anti-hypertensive channel blocking. Use Caution/Monitor. Due to its alpha adrenergic antagonism, atypical antipsychotic agents has the potential to enhance the effect of certain antihypertensive agents. Monitor blood pressure and adjust dose accordingly.
- amitriptyline
olanzapine and amitriptyline both increase sedation. Use Caution/Monitor.
olanzapine and amitriptyline both increase QTc interval. Use Caution/Monitor. - amobarbital
amobarbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
amobarbital and olanzapine both increase sedation. Use Caution/Monitor. - amoxapine
olanzapine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and amoxapine both increase sedation. Use Caution/Monitor.
olanzapine and amoxapine both increase QTc interval. Use Caution/Monitor. - anticholinergic/sedative combos
anticholinergic/sedative combos decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
anticholinergic/sedative combos decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - apomorphine
olanzapine and apomorphine both increase sedation. Use Caution/Monitor.
- arformoterol
olanzapine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
arformoterol and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - aripiprazole
aripiprazole and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and olanzapine both increase sedation. Use Caution/Monitor.
aripiprazole and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - armodafinil
armodafinil will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
olanzapine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - asenapine
asenapine and olanzapine both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
asenapine transdermal and olanzapine both increase sedation. Use Caution/Monitor. - atomoxetine
atomoxetine and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- atracurium
atracurium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - atropine
atropine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - atropine IV/IM
olanzapine increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atropine IV/IM decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine IV/IM decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. - avapritinib
olanzapine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
avapritinib and olanzapine both increase sedation. Use Caution/Monitor. - axitinib
olanzapine increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- azelastine
azelastine and olanzapine both increase sedation. Use Caution/Monitor.
- azithromycin
azithromycin increases toxicity of olanzapine by QTc interval. Use Caution/Monitor.
- baclofen
baclofen and olanzapine both increase sedation. Use Caution/Monitor.
- bedaquiline
olanzapine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely
- belladonna alkaloids
belladonna alkaloids decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna alkaloids decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - belladonna and opium
belladonna and opium and olanzapine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - benazepril
olanzapine, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced hypotensive effects.
- benperidol
benperidol and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
benperidol and olanzapine both increase sedation. Use Caution/Monitor. - benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen and olanzapine both increase sedation. Use Caution/Monitor.
- benzphetamine
olanzapine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- benztropine
olanzapine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .
- brexanolone
brexanolone, olanzapine. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- brexpiprazole
brexpiprazole and olanzapine both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and olanzapine both increase sedation. Use Caution/Monitor.
- brivaracetam
brivaracetam and olanzapine both increase sedation. Use Caution/Monitor.
- brompheniramine
brompheniramine and olanzapine both increase sedation. Use Caution/Monitor.
- buprenorphine
buprenorphine and olanzapine both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
buprenorphine buccal and olanzapine both increase sedation. Use Caution/Monitor.
- buprenorphine subdermal implant
buprenorphine subdermal implant and olanzapine both increase sedation. Use Caution/Monitor.
- buprenorphine, long-acting injection
olanzapine increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.
- butabarbital
butabarbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
butabarbital and olanzapine both increase sedation. Use Caution/Monitor. - butalbital
butalbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
butalbital and olanzapine both increase sedation. Use Caution/Monitor. - butorphanol
butorphanol and olanzapine both increase sedation. Use Caution/Monitor.
- caffeine
olanzapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cannabidiol
cannabidiol, olanzapine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.
- captopril
olanzapine, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.
- carbamazepine
carbamazepine will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- carbinoxamine
carbinoxamine and olanzapine both increase sedation. Use Caution/Monitor.
- carisoprodol
carisoprodol and olanzapine both increase sedation. Use Caution/Monitor.
- chloral hydrate
chloral hydrate and olanzapine both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide and olanzapine both increase sedation. Use Caution/Monitor.
- chloroquine
chloroquine increases toxicity of olanzapine by QTc interval. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine and olanzapine both increase sedation. Use Caution/Monitor.
- chlorpromazine
chlorpromazine and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
chlorpromazine and olanzapine both increase sedation. Use Caution/Monitor. - chlorpropamide
olanzapine, chlorpropamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- chlorzoxazone
chlorzoxazone and olanzapine both increase sedation. Use Caution/Monitor.
- cigarette smoking
cigarette smoking will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- cimetidine
cimetidine will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- cinnarizine
cinnarizine and olanzapine both increase sedation. Use Caution/Monitor.
- ciprofloxacin
ciprofloxacin will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Olanzapine plasma concentrations may be elevated, increasing the risk of adverse reactions such as orthostatic hypotension or sedation. It is important to use caution and observe patient and adjust the olanzapine dosage as needed.
- cisatracurium
cisatracurium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
cisatracurium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - clemastine
clemastine and olanzapine both increase sedation. Use Caution/Monitor.
- clobazam
olanzapine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).
- clomipramine
olanzapine and clomipramine both increase sedation. Use Caution/Monitor.
olanzapine and clomipramine both increase QTc interval. Use Caution/Monitor. - clonazepam
clonazepam and olanzapine both increase sedation. Use Caution/Monitor.
- clonidine
clonidine, olanzapine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.
- clorazepate
clorazepate and olanzapine both increase sedation. Use Caution/Monitor.
- clozapine
clozapine and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
clozapine and olanzapine both increase sedation. Use Caution/Monitor. - codeine
codeine and olanzapine both increase sedation. Use Caution/Monitor.
- cyclizine
cyclizine and olanzapine both increase sedation. Use Caution/Monitor.
cyclizine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
cyclizine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cyclobenzaprine
cyclobenzaprine and olanzapine both increase sedation. Use Caution/Monitor.
cyclobenzaprine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
cyclobenzaprine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of cyclobenzaprine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cyproheptadine
cyproheptadine and olanzapine both increase sedation. Use Caution/Monitor.
- dantrolene
dantrolene and olanzapine both increase sedation. Use Caution/Monitor.
- daridorexant
olanzapine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- darifenacin
darifenacin decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
darifenacin decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of darifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - dasatinib
dasatinib and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- deferasirox
deferasirox will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- desipramine
olanzapine and desipramine both increase sedation. Use Caution/Monitor.
olanzapine and desipramine both increase QTc interval. Use Caution/Monitor. - deutetrabenazine
olanzapine and deutetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. The risk for parkinsonism, neuroleptic malignant syndrome, and akathisia may be increased by concomitant use of deutetrabenazine and dopamine antagonists or antipsychotics.
olanzapine and deutetrabenazine both increase sedation. Use Caution/Monitor.
deutetrabenazine and olanzapine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation). - dexchlorpheniramine
dexchlorpheniramine and olanzapine both increase sedation. Use Caution/Monitor.
- dexfenfluramine
olanzapine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
dexmedetomidine and olanzapine both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
olanzapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextroamphetamine
olanzapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextromethorphan
dextromethorphan, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- dextromoramide
dextromoramide and olanzapine both increase sedation. Use Caution/Monitor.
- diamorphine
diamorphine and olanzapine both increase sedation. Use Caution/Monitor.
- diazepam
diazepam and olanzapine both increase sedation. Use Caution/Monitor.
- dicyclomine
dicyclomine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
dicyclomine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - diethylpropion
olanzapine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and olanzapine both increase sedation. Use Caution/Monitor.
- difenoxin hcl
difenoxin hcl and olanzapine both increase sedation. Use Caution/Monitor.
- dihydroergotamine
dihydroergotamine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- dimenhydrinate
dimenhydrinate and olanzapine both increase sedation. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and olanzapine both increase sedation. Use Caution/Monitor.
diphenhydramine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
diphenhydramine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - diphenoxylate hcl
diphenoxylate hcl and olanzapine both increase sedation. Use Caution/Monitor.
- dipipanone
dipipanone and olanzapine both increase sedation. Use Caution/Monitor.
- dobutamine
olanzapine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dofetilide
dofetilide increases toxicity of olanzapine by QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances.
- dolasetron
dolasetron and olanzapine both increase QTc interval. Use Caution/Monitor.
- donepezil
donepezil and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- dopamine
olanzapine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
olanzapine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dosulepin
olanzapine and dosulepin both increase sedation. Use Caution/Monitor.
- doxepin
olanzapine and doxepin both increase sedation. Use Caution/Monitor.
doxepin and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - doxylamine
doxylamine and olanzapine both increase sedation. Use Caution/Monitor.
- droperidol
droperidol and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
droperidol and olanzapine both increase sedation. Use Caution/Monitor. - efavirenz
efavirenz and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- eletriptan
eletriptan, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- ephedrine
olanzapine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
olanzapine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
olanzapine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ergoloid mesylates
ergoloid mesylates, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- ergotamine
ergotamine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- erythromycin base
erythromycin base will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- erythromycin lactobionate
erythromycin lactobionate will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- erythromycin stearate
erythromycin stearate will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- escitalopram
escitalopram increases toxicity of olanzapine by QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances.
- esketamine intranasal
esketamine intranasal, olanzapine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- estazolam
estazolam and olanzapine both increase sedation. Use Caution/Monitor.
- ethanol
olanzapine and ethanol both increase sedation. Use Caution/Monitor.
- ethinylestradiol
ethinylestradiol will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- exenatide injectable solution
olanzapine, exenatide injectable solution. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- exenatide injectable suspension
olanzapine, exenatide injectable suspension. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- fenfluramine
olanzapine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
olanzapine decreases effects of fenfluramine by pharmacodynamic antagonism. Use Caution/Monitor. Potent serotonin receptor antagonists may decrease fenfluramine efficacy. If coadministered, monitor appropriately. - fentanyl
fentanyl, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- fesoterodine
fesoterodine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
fesoterodine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of fesoterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - fexinidazole
fexinidazole will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- finerenone
olanzapine will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.
- fingolimod
fingolimod and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- flavoxate
flavoxate decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
flavoxate decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of flavoxate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - flecainide
olanzapine and flecainide both increase QTc interval. Use Caution/Monitor.
- flibanserin
olanzapine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.
flibanserin, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - fluconazole
olanzapine and fluconazole both increase QTc interval. Use Caution/Monitor.
- fluoxetine
olanzapine and fluoxetine both increase QTc interval. Use Caution/Monitor.
- fluphenazine
fluphenazine and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
fluphenazine and olanzapine both increase sedation. Use Caution/Monitor.
olanzapine and fluphenazine both increase QTc interval. Use Caution/Monitor. - flurazepam
flurazepam and olanzapine both increase sedation. Use Caution/Monitor.
- formoterol
olanzapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fostemsavir
olanzapine and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- frovatriptan
frovatriptan, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- gadobenate
gadobenate and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- ganaxolone
olanzapine and ganaxolone both increase sedation. Use Caution/Monitor.
- gemifloxacin
gemifloxacin and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- gemtuzumab
olanzapine and gemtuzumab both increase QTc interval. Use Caution/Monitor.
- gilteritinib
gilteritinib and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- glimepiride
olanzapine, glimepiride. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- glipizide
olanzapine, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- glyburide
olanzapine, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- glycopyrrolate
olanzapine increases effects of glycopyrrolate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
- glycopyrrolate inhaled
glycopyrrolate inhaled decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
glycopyrrolate inhaled decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - granisetron
granisetron and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- guanfacine
guanfacine, olanzapine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.
- haloperidol
haloperidol and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
haloperidol and olanzapine both increase sedation. Use Caution/Monitor.
haloperidol and olanzapine both increase QTc interval. Use Caution/Monitor. - henbane
henbane decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
henbane decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of henbane by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - homatropine
homatropine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
homatropine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of homatropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - hydromorphone
hydromorphone and olanzapine both increase sedation. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and olanzapine both increase sedation. Use Caution/Monitor.
hydroxyzine and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - hyoscyamine
hyoscyamine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
hyoscyamine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of hyoscyamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - hyoscyamine spray
olanzapine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
hyoscyamine spray decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
hyoscyamine spray decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. - iloperidone
iloperidone and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
iloperidone and olanzapine both increase sedation. Use Caution/Monitor. - imipramine
olanzapine and imipramine both increase sedation. Use Caution/Monitor.
olanzapine and imipramine both increase QTc interval. Use Caution/Monitor. - incobotulinumtoxinA
olanzapine increases effects of incobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
- insulin aspart
olanzapine, insulin aspart. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin degludec
olanzapine decreases effects of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.
- insulin degludec/insulin aspart
olanzapine decreases effects of insulin degludec/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.
- insulin detemir
olanzapine, insulin detemir. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin glargine
olanzapine, insulin glargine. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin glulisine
olanzapine, insulin glulisine. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin inhaled
olanzapine decreases effects of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.
- insulin lispro
olanzapine, insulin lispro. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin NPH
olanzapine, insulin NPH. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin regular human
olanzapine, insulin regular human. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- ipratropium
ipratropium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
ipratropium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - isavuconazonium sulfate
olanzapine will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- isoniazid
isoniazid will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- isoproterenol
olanzapine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- isradipine
olanzapine and isradipine both increase QTc interval. Use Caution/Monitor.
- itraconazole
itraconazole and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- ivacaftor
olanzapine increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors .
- ketotifen, ophthalmic
olanzapine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- lapatinib
olanzapine and lapatinib both increase QTc interval. Use Caution/Monitor.
- lasmiditan
lasmiditan, olanzapine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
olanzapine will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.
lemborexant, olanzapine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects. - levalbuterol
olanzapine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levofloxacin
olanzapine and levofloxacin both increase QTc interval. Use Caution/Monitor.
- levomilnacipran
levomilnacipran, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- levorphanol
levorphanol and olanzapine both increase sedation. Use Caution/Monitor.
- linezolid
linezolid, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- liraglutide
olanzapine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- lisdexamfetamine
olanzapine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lithium
lithium, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
lithium and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - lofepramine
olanzapine and lofepramine both increase sedation. Use Caution/Monitor.
- lofexidine
olanzapine and lofexidine both increase sedation. Use Caution/Monitor.
olanzapine and lofexidine both increase QTc interval. Use Caution/Monitor. - lomitapide
olanzapine increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.
- loperamide
olanzapine and loperamide both increase QTc interval. Use Caution/Monitor.
- loprazolam
loprazolam and olanzapine both increase sedation. Use Caution/Monitor.
- lorazepam
lorazepam and olanzapine both increase sedation. Use Caution/Monitor.
- lorcaserin
lorcaserin, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- lormetazepam
lormetazepam and olanzapine both increase sedation. Use Caution/Monitor.
- loxapine
loxapine and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
loxapine and olanzapine both increase sedation. Use Caution/Monitor. - loxapine inhaled
loxapine inhaled and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
loxapine inhaled and olanzapine both increase sedation. Use Caution/Monitor. - lurasidone
lurasidone, olanzapine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
- maprotiline
olanzapine and maprotiline both increase sedation. Use Caution/Monitor.
- maraviroc
maraviroc, olanzapine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.
- marijuana
olanzapine and marijuana both increase sedation. Use Caution/Monitor.
- mavacamten
olanzapine will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose.
- meclizine
meclizine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
meclizine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of meclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - melatonin
olanzapine and melatonin both increase sedation. Use Caution/Monitor.
- meperidine
meperidine and olanzapine both increase sedation. Use Caution/Monitor.
meperidine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - meprobamate
olanzapine and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
olanzapine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
metaxalone and olanzapine both increase sedation. Use Caution/Monitor.
- metformin
olanzapine, metformin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- methadone
methadone and olanzapine both increase sedation. Use Caution/Monitor.
methadone, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - methamphetamine
olanzapine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methocarbamol
methocarbamol and olanzapine both increase sedation. Use Caution/Monitor.
- methscopolamine
methscopolamine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
methscopolamine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of methscopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - methylenedioxymethamphetamine
olanzapine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methylergonovine
methylergonovine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- methylphenidate
olanzapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.
- metoclopramide
olanzapine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- mexiletine
mexiletine will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- midazolam
midazolam and olanzapine both increase sedation. Use Caution/Monitor.
- midazolam intranasal
olanzapine will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.
midazolam intranasal, olanzapine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect. - midodrine
olanzapine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mifepristone
mifepristone, olanzapine. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.
- miglitol
olanzapine, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- milnacipran
milnacipran, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- mirtazapine
olanzapine and mirtazapine both increase sedation. Use Caution/Monitor.
mirtazapine and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
olanzapine and mirtazapine both increase QTc interval. Use Caution/Monitor. - modafinil
modafinil will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
olanzapine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - morphine
morphine and olanzapine both increase sedation. Use Caution/Monitor.
- motherwort
olanzapine and motherwort both increase sedation. Use Caution/Monitor.
- moxonidine
olanzapine and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
olanzapine and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
nalbuphine and olanzapine both increase sedation. Use Caution/Monitor.
- naratriptan
naratriptan, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- nateglinide
olanzapine, nateglinide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- norepinephrine
olanzapine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
olanzapine and nortriptyline both increase sedation. Use Caution/Monitor.
olanzapine and nortriptyline both increase QTc interval. Use Caution/Monitor. - ofloxacin
olanzapine and ofloxacin both increase QTc interval. Use Caution/Monitor.
- oliceridine
oliceridine, olanzapine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- onabotulinumtoxinA
onabotulinumtoxinA decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
onabotulinumtoxinA decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - opium tincture
opium tincture and olanzapine both increase sedation. Use Caution/Monitor.
- orphenadrine
orphenadrine and olanzapine both increase sedation. Use Caution/Monitor.
- osilodrostat
osilodrostat and olanzapine both increase QTc interval. Use Caution/Monitor.
- osimertinib
osimertinib and olanzapine both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.
- oxaliplatin
oxaliplatin will increase the level or effect of olanzapine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- oxazepam
oxazepam and olanzapine both increase sedation. Use Caution/Monitor.
- oxybutynin
oxybutynin decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
oxybutynin decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oxybutynin topical
oxybutynin topical decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
oxybutynin topical decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oxybutynin transdermal
oxybutynin transdermal decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
oxybutynin transdermal decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oxycodone
oxycodone and olanzapine both increase sedation. Use Caution/Monitor.
- oxymorphone
oxymorphone and olanzapine both increase sedation. Use Caution/Monitor.
- ozanimod
ozanimod and olanzapine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.
- paliperidone
olanzapine and paliperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and paliperidone both increase sedation. Use Caution/Monitor. - pancuronium
pancuronium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - papaveretum
papaveretum and olanzapine both increase sedation. Use Caution/Monitor.
- papaverine
olanzapine and papaverine both increase sedation. Use Caution/Monitor.
- paroxetine
paroxetine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- pasireotide
olanzapine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.
- peginterferon alfa 2a
peginterferon alfa 2a will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- pentazocine
pentazocine and olanzapine both increase sedation. Use Caution/Monitor.
- pentobarbital
pentobarbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
pentobarbital and olanzapine both increase sedation. Use Caution/Monitor. - perphenazine
olanzapine and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and perphenazine both increase sedation. Use Caution/Monitor.
olanzapine and perphenazine both increase QTc interval. Use Caution/Monitor. - phendimetrazine
olanzapine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenelzine
phenelzine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- phenobarbital
phenobarbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
phenobarbital and olanzapine both increase sedation. Use Caution/Monitor. - phentermine
olanzapine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
olanzapine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine PO
olanzapine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
olanzapine and pholcodine both increase sedation. Use Caution/Monitor.
- pimozide
olanzapine and pimozide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and pimozide both increase sedation. Use Caution/Monitor. - pioglitazone
olanzapine, pioglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- pipemidic acid
pipemidic acid will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- pirbuterol
olanzapine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- posaconazole
olanzapine and posaconazole both increase QTc interval. Use Caution/Monitor.
- pralidoxime
pralidoxime decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pralidoxime decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of pralidoxime by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pramlintide
olanzapine, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- primaquine
olanzapine and primaquine both increase QTc interval. Use Caution/Monitor.
- primidone
primidone will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
primidone and olanzapine both increase sedation. Use Caution/Monitor. - procarbazine
procarbazine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- prochlorperazine
olanzapine and prochlorperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and prochlorperazine both increase sedation. Use Caution/Monitor.
olanzapine and prochlorperazine both decrease QTc interval. Use Caution/Monitor. - promethazine
olanzapine and promethazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
promethazine and olanzapine both increase sedation. Use Caution/Monitor.
promethazine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
olanzapine and promethazine both decrease QTc interval. Use Caution/Monitor. - propantheline
propantheline decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
propantheline decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of propantheline by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - propofol
propofol and olanzapine both increase sedation. Use Caution/Monitor.
- propylhexedrine
olanzapine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
olanzapine and protriptyline both increase sedation. Use Caution/Monitor.
olanzapine and protriptyline both increase QTc interval. Use Caution/Monitor. - quazepam
quazepam and olanzapine both increase sedation. Use Caution/Monitor.
- quetiapine
olanzapine and quetiapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and quetiapine both increase sedation. Use Caution/Monitor. - quinine
olanzapine and quinine both increase QTc interval. Use Caution/Monitor.
- ramelteon
olanzapine and ramelteon both increase sedation. Use Caution/Monitor.
- rapacuronium
rapacuronium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rapacuronium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of rapacuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - remimazolam
remimazolam, olanzapine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.
- repaglinide
olanzapine, repaglinide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- rifampin
rifampin will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- rilpivirine
olanzapine and rilpivirine both increase QTc interval. Use Caution/Monitor.
- rimabotulinumtoxinB
olanzapine, rimabotulinumtoxinB. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Anticholinergics may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.
- risperidone
olanzapine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and risperidone both increase sedation. Use Caution/Monitor.
olanzapine and risperidone both increase QTc interval. Use Caution/Monitor. - ritonavir
ritonavir decreases levels of olanzapine by increasing metabolism. Use Caution/Monitor.
- rocuronium
rocuronium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - romidepsin
olanzapine and romidepsin both increase QTc interval. Use Caution/Monitor.
- rosiglitazone
olanzapine, rosiglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- rucaparib
rucaparib will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.
- salmeterol
olanzapine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- saxagliptin
olanzapine, saxagliptin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- scopolamine
scopolamine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - scullcap
olanzapine and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
secobarbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
secobarbital and olanzapine both increase sedation. Use Caution/Monitor. - selegiline
selegiline, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- selpercatinib
selpercatinib increases toxicity of olanzapine by QTc interval. Use Caution/Monitor.
- sertraline
olanzapine and sertraline both increase QTc interval. Use Caution/Monitor.
- shepherd's purse
olanzapine and shepherd's purse both increase sedation. Use Caution/Monitor.
- sitagliptin
olanzapine, sitagliptin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- smoking
smoking will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of olanzapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases effects of olanzapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- solifenacin
solifenacin decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
solifenacin decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
olanzapine and solifenacin both increase QTc interval. Use Caution/Monitor. - sorafenib
sorafenib and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- stiripentol
stiripentol, olanzapine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP1A2 inhibitor and inducer. Monitor CYP1A2 substrates coadministered with stiripentol for increased or decreased effects. CYP1A2 substrates may require dosage adjustment.
stiripentol, olanzapine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence. - sufentanil
sufentanil and olanzapine both increase sedation. Use Caution/Monitor.
- sumatriptan
sumatriptan, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- sumatriptan intranasal
sumatriptan intranasal, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- sunitinib
olanzapine and sunitinib both increase QTc interval. Use Caution/Monitor.
- tacrolimus
olanzapine and tacrolimus both increase QTc interval. Use Caution/Monitor.
- tapentadol
tapentadol and olanzapine both increase sedation. Use Caution/Monitor.
- tazemetostat
olanzapine will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- telavancin
olanzapine and telavancin both increase QTc interval. Use Caution/Monitor.
- temazepam
temazepam and olanzapine both increase sedation. Use Caution/Monitor.
- terbutaline
olanzapine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- teriflunomide
teriflunomide decreases levels of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- tetrabenazine
olanzapine and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.
- thioridazine
olanzapine and thioridazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and thioridazine both increase sedation. Use Caution/Monitor. - thiothixene
olanzapine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and thiothixene both increase sedation. Use Caution/Monitor. - tinidazole
olanzapine will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tiotropium
tiotropium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
tiotropium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - tobacco use
tobacco use will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- tolazamide
olanzapine, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- tolbutamide
olanzapine, tolbutamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- tolterodine
tolterodine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
tolterodine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of tolterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - topiramate
olanzapine and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
tramadol and olanzapine both increase sedation. Use Caution/Monitor.
- tranylcypromine
tranylcypromine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- trazodone
olanzapine and trazodone both increase sedation. Use Caution/Monitor.
- triazolam
triazolam and olanzapine both increase sedation. Use Caution/Monitor.
- triclabendazole
triclabendazole and olanzapine both increase QTc interval. Use Caution/Monitor.
- triclofos
triclofos and olanzapine both increase sedation. Use Caution/Monitor.
- trifluoperazine
olanzapine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and trifluoperazine both increase sedation. Use Caution/Monitor.
olanzapine and trifluoperazine both decrease QTc interval. Use Caution/Monitor. - trihexyphenidyl
olanzapine increases effects of trihexyphenidyl by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive anticholinergic effects.
- trimipramine
olanzapine and trimipramine both increase sedation. Use Caution/Monitor.
olanzapine and trimipramine both increase QTc interval. Use Caution/Monitor. - triprolidine
triprolidine and olanzapine both increase sedation. Use Caution/Monitor.
- trospium chloride
trospium chloride decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - valbenazine
valbenazine and olanzapine both increase QTc interval. Use Caution/Monitor.
- vardenafil
olanzapine and vardenafil both increase QTc interval. Use Caution/Monitor.
- vecuronium
vecuronium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
vecuronium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - venlafaxine
venlafaxine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
olanzapine and venlafaxine both decrease QTc interval. Use Caution/Monitor. - verapamil
verapamil will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- vilazodone
vilazodone, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- voclosporin
voclosporin, olanzapine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- voriconazole
olanzapine and voriconazole both increase QTc interval. Use Caution/Monitor.
- vorinostat
olanzapine and vorinostat both increase QTc interval. Use Caution/Monitor.
- xylometazoline
olanzapine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
olanzapine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
olanzapine and ziconotide both increase sedation. Use Caution/Monitor.
- zileuton
zileuton will increase the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- ziprasidone
olanzapine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and ziprasidone both increase sedation. Use Caution/Monitor. - zolmitriptan
zolmitriptan, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- zotepine
olanzapine and zotepine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and zotepine both increase sedation. Use Caution/Monitor.
Minor (8)
- brimonidine
brimonidine increases effects of olanzapine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
- chasteberry
chasteberry decreases effects of olanzapine by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).
- ethanol
ethanol, olanzapine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.
- eucalyptus
olanzapine and eucalyptus both increase sedation. Minor/Significance Unknown.
- omeprazole
omeprazole will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.
- ruxolitinib
olanzapine will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ruxolitinib topical
olanzapine will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- sage
olanzapine and sage both increase sedation. Minor/Significance Unknown.
Adverse Effects
>10%
Orthostatic hypotension (≥20%)
Weight gain, dose dependent (5-40%)
Hypertriglyceridemia (≤39%)
Hypercholesterolemia (≤39%)
Somnolence, dose dependent (6-39%)
Extrapyramidal symptoms (EPS), dose dependent (15-32%)
Xerostomia (9-22%)
Weakness (2-20%)
Dizziness (4-18%)
Accidental injury (12%)
Insomnia (12%)
Elevated alanine aminotransferase (ALT) level (5-12%)
Constipation (9-11%)
Dyspepsia (7-11%)
Hyperprolactinemia (30%)
Hyperglycemia (12.8%)
1-10%
Hypotension (2%)
Postural hypotension (1%)
Tremor (1%)
Asthenia (2%)
Akathisia reactions (2%)
Parkinsonism reactions (4%)
<1%
Syncope
Sudden cardiac death
Hyperglycemia
Diabetic coma with ketoacidosis
Diabetic ketoacidosis
Acute hemorrhagic pancreatitis
Venous thromboembolism
Immune hypersensitivity reaction
Cerebrovascular disease
Seizure, status epilepticus
Suicidal intent
Pulmonary embolism
Death
Neuroleptic malignant syndrome (NMS)
Tardive dyskinesia
Postmarketing Reports
Eosinophilia and Systemic Symptoms (DRESS)
Falls
Restless legs syndrome
Salivary hypersecretion
Warnings
Black Box Warnings
Not approved for dementia-related psychosis; elderly patients with dementia-related psychosis who are treated with antipsychotic drugs are at increased risk of death, as shown in short-term controlled trials; in these trials, deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature
Patients are at risk for severe sedation (including coma) or delirium after each injection and must be observed for at least 3 hours in registered facility with ready access to emergency response services
Because of this risk, olanzapine is available only through restricted distribution program
Contraindications
Documented hypersensitivity
Refer to the package insert for Symbyax contraindications, when using PO olanzapine and fluoxetine in combination
Cautions
Possibility of suicide attempt is inherent in schizophrenia and bipolar I disorder, and close supervision of high-risk patients should accompany drug therapy; when using in combination with fluoxetine, also refer to Boxed Warning and Precautions sections of package insert for Symbyax
Irreversible, involuntary, dyskinetic movements may develop with antipsychotic drugs; prevalence appears to be highest among elderly individuals, especially elderly women; discontinue if clinically appropriate
Tardive dyskinesia may remit, partially or completely, if antipsychotic treatment withdrawn; however, antipsychotic treatment, itself, may suppress (or partially suppress) signs and symptoms of syndrome and possibly mask underlying process; effect symptomatic suppression has upon long-term course of syndrome unknown
Neutropenia, leukopenia, and agranulocytosis reported; discontinue therapy at first sign of blood dyscrasias or if absolute neutrophil count <1000/mm³
Cerebrovascular effects including, stroke and transient ischemic attack resulting in death reported
FDA warning regarding off-label use for dementia in elderly (see Black Box Warnings)
Use caution in patients with history of seizures or with conditions that potentially lower seizure threshold
Changes from normal to high prolactin levels observed in controlled studies (incidence, 30%)
Use caution with strenuous exercise, dehydration, heat exposure, and medications with anticholinergic effects; impaired core body temperature regulation may occur
Use with caution in patients with current diagnosis or prior history of urinary retention
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) reported with olanzapine exposure; DRESS may present with a cutaneous reaction (such as rash or exfoliative dermatitis), eosinophilia, fever, and/or lymphadenopathy with systemic complications such as hepatitis, nephritis, pneumonitis, myocarditis, and/or pericarditis; DRESS is sometimes fatal; discontinue olanzapine if DRESS suspected
May cause somnolence, postural hypotension, motor and sensory instability, which may lead to falls and, consequently, fractures or other injuries; for patients with diseases, conditions, or medications that could exacerbate these effects, complete fall risk assessments when initiating antipsychotic treatment and recurrently for patients on long-term antipsychotic therapy
Has potential to impair judgment, thinking, and motor skills; use caution when operating machinery
Olanzapine indicated as integral part of comprehensive treatment program for pediatric patients with schizophrenia and bipolar disorder, which may include other measures (eg, psychological, educational, social) as well IM, extended-release: Risk of postinjection delirium/sedation syndrome, availability is restricted and requires registration (call 877-772-9390)
Use in patients with concomitant illnesses
- Use caution in patients with clinically significant prostatic hypertrophy, narrow angle glaucoma, or a history of paralytic ileus or related conditions; olanzapine exhibits in vitro muscarinic activity
- May induce orthostatic hypotension associated with dizziness, tachycardia, bradycardia and, in some patients, syncope, especially during initial dose-titration period, probably as consequence of alpha1-adrenergic antagonistic propertie
Metabolic changes
-
Weight gain
- Increased potential (in adolescents as compared with adults) for weight gain and hyperlipidemia; clinicians prescribing to adolescents should consider potential long-term risks, which in many cases may lead them to prescription of other drugs first in this population
- Appropriate clinical monitoring is recommended, including fasting blood lipid testing at the beginning of, and periodically during, treatment
-
Hyperglycemia and diabetes mellitus
- Consider risks and benefits when prescribing olanzapine to patients with diabetes mellitus, or borderline increased blood glucose level (fasting 100-126 mg/dL, nonfasting 140-200 mg/dL); monitor regularly for worsening of glucose control; hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported in patients treated with atypical antipsychotics including olanzapine
Neuroleptic malignant syndrome
- NMS have been reported in association with atypical antipsychotic administration (eg, olanzapine)
- Symptoms includes hyperpyrexia, muscle rigidity; altered mental status and evidence of autonomic instability
- Management of NMS should include immediate discontinuation of antipsychotic drugs and other drugs not essential to concurrent therapy; intensive symptomatic treatment and medical monitoring; and treatment of any concomitant serious medical problems for which specific treatments are available
- If a patient requires antipsychotic drug treatment after recovery from NMS, the potential reintroduction of drug therapy should be carefully considered and monitored
Pregnancy & Lactation
Pregnancy category: C
Neonates exposed to antipsychotic drugs during 3rd trimester of pregnancy are at risk for EPS or withdrawal symptoms after delivery; these complications vary in severity, with some being self-limited and others requiring ICU support and prolonged hospitalization
Lactation: Drug enters breast milk; not recommended
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
May act through combination of dopamine and serotonin type 2 receptor site antagonism
Absorption
Peak plasma time: 6 hr (PO); 15-45 min (short-acting IM); 7 days (extended-release IM)
Distribution
Protein bound: 93%
Vd: 1000 L
Metabolism
Extensively metabolized through direct glucuronidation and CYP450 oxidation
Metabolites: Inactive
Elimination
Half-life: 21-54 hr (immediate release); 30 days (extended release)
Excretion: Urine (57%), feces (30%)
Administration
Oral administration
May take with or without food
Oral disintegrating tablets
- After opening sachet, peel back foil on blister; do not push tablet through foil
- Immediately upon opening the blister, using dry hands, remove tablet and place entire tablet in the mouth
- Tablet disintegration occurs rapidly in saliva so it can be easily swallowed with or without liquid
IM Administration
Short-acting and extended-release IM preparations are not interchangeable
Short-acting: Dissolve in 2.1 mL SWI to yield 5 mg/mL solution; inject deep and slow within 1 hr of reconstitution
Extended-release: Reconstitute with supplied diluent (210-mg vial in 1.3 mL; 300-mg vial in 1.8 mL; 405-mg vial in 2.3 mL); inject deep in gluteal muscle
Do not use lorazepam injection for reconstitution, and do not mix with haloperidol or diazepam in syringe
Storage
tablets and oral disintegrating tablets
- Store at room temperature, 68-77°F (20-25°C)
- Protect from light and moisture
IM, short-acting
- Before reconstitution: Store at room temperature, 68-77°F (20-25°C)
- Reconstituted vial: Store at room temperature, 68-77°F (20-25°C) for up to 1 hr if necessary
- Discard any unused portion of reconstituted vial
- Protect from light, do not freeze.
IM, extended-release
- Before reconstitution: Store at room temperature not to exceed 30°C (86°F)
- Suspended solution: Store at room temperature for up to 24 hr if necessary
- Immediately agitate prior to product withdrawal; administer immediately once suspension is withdrawn into syringe
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
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Zyprexa Zydis oral - | 20 mg tablet | ![]() | |
Zyprexa Zydis oral - | 15 mg tablet | ![]() | |
Zyprexa Zydis oral - | 15 mg tablet | ![]() | |
Zyprexa Zydis oral - | 10 mg tablet | ![]() | |
Zyprexa Zydis oral - | 5 mg tablet | ![]() | |
Zyprexa Zydis oral - | 20 mg tablet | ![]() | |
Zyprexa oral - | 2.5 mg tablet | ![]() | |
Zyprexa oral - | 15 mg tablet | ![]() | |
Zyprexa oral - | 10 mg tablet | ![]() | |
Zyprexa oral - | 7.5 mg tablet | ![]() | |
Zyprexa oral - | 5 mg tablet | ![]() | |
Zyprexa oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 7.5 mg tablet | ![]() | |
olanzapine oral - | 7.5 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 2.5 mg tablet | ![]() | |
olanzapine oral - | 2.5 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 2.5 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 7.5 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 7.5 mg tablet | ![]() | |
olanzapine oral - | 2.5 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 7.5 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 2.5 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 7.5 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 2.5 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 7.5 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 7.5 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 2.5 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 7.5 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 2.5 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 20 mg tablet | ![]() | |
olanzapine oral - | 15 mg tablet | ![]() | |
olanzapine oral - | 10 mg tablet | ![]() | |
olanzapine oral - | 5 mg tablet | ![]() | |
olanzapine intramuscular - | 10 mg vial | ![]() | |
olanzapine intramuscular - | 10 mg vial | ![]() | |
Zyprexa intramuscular - | 10 mg vial | ![]() |
Copyright © 2010 First DataBank, Inc.
Patient Handout
olanzapine oral
OLANZAPINE DISINTEGRATING TABLET - ORAL
(oh-LAN-za-peen)
COMMON BRAND NAME(S): Zyprexa
WARNING: 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.If you are using olanzapine in combination with other medication to treat depression, also carefully read the drug information for the other medication.
USES: Olanzapine is used to treat certain mental/mood conditions (such as schizophrenia, bipolar disorder). It may also be used in combination with other medication to treat depression. This medication can help to decrease hallucinations and help you to think more clearly and positively about yourself, feel less agitated, and take a more active part in everyday life.Olanzapine belongs to a class of drugs called atypical antipsychotics. It works by helping to restore the balance of certain natural substances in the brain.Talk to the doctor about the risks and benefits of treatment (especially when used in teenagers). See also Precautions section.
HOW TO USE: Read the Medication Guide provided by your pharmacist before you start taking olanzapine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually once daily.This medication comes in a blister or a bottle. Do not remove the tablet from the packaging until you are ready to take it. Make sure your hands are dry before handling the tablet. If your tablet comes in a blister, peel back the foil to carefully remove the tablet. Do not push the tablet through the foil because doing so can damage the tablet. Place the tablet in your mouth right away and allow it to dissolve. After the tablet has melted, it can be swallowed with or without liquid.The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor.Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: Drowsiness, dizziness, lightheadedness, stomach upset, dry mouth, constipation, increased appetite, or weight gain may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: difficulty swallowing, shaking (tremor), slow heartbeat, fainting, mental/mood changes (such as confusion, restlessness), numbness/tingling of arms/legs, yellowing eyes/skin, severe stomach/abdominal pain, trouble urinating, interrupted breathing during sleep.This drug may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.This drug may also cause significant weight gain and a rise in your blood cholesterol (or triglyceride) levels, especially in teenagers. These effects, along with diabetes, may increase your risk for developing heart disease. Discuss the risks and benefits of treatment with your doctor. (See also Notes section.)Olanzapine may rarely cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any unusual/uncontrolled movements (especially of the face, lips, mouth, tongue, arms or legs).This medication may increase a certain natural substance (prolactin) made by your body. For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor right away.Get medical help right away if you have any very serious side effects, including: seizures.This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, signs of kidney problems (such as change in the amount of urine).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking olanzapine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver problems, seizures, difficulty swallowing, low white blood cell count, dementia, difficulty urinating (for example, due to enlarged prostate), glaucoma (narrow angle), stomach/intestinal problems (such as blockage, chronic constipation, paralytic ileus), smoking, personal or family history of diabetes, heart disease, high cholesterol/triglyceride levels, breathing trouble during sleep (sleep apnea).This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to limit/avoid aspartame (or phenylalanine) in your diet, ask your doctor or pharmacist about using this medication safely.This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.Teenagers may be more sensitive to the side effects of this drug, especially weight gain, and also increased amounts of cholesterol, triglycerides, and prolactin. See also Side Effects section for more details.Older adults may be more sensitive to the side effects of this drug, especially drowsiness, constipation, trouble urinating, confusion, dizziness, and lightheadedness. Drowsiness, confusion, dizziness, and lightheadedness can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop symptoms including muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away.Since untreated mental/mood problems (such as schizophrenia, bipolar disorder, depression) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.This drug passes into breast milk and may have undesirable effects on a nursing infant. Tell the doctor right away if your baby develops symptoms such as muscle stiffness or shakiness, unusual sleepiness, or difficulty feeding. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: metoclopramide.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness/dizziness, fast/irregular heartbeat, unusual/uncontrolled movements, seizures.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as blood sugar, weight, blood pressure, blood cholesterol/triglyceride levels, liver function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised December 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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- Compare formulary status to other drugs in the same class.
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