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Zyprexa vs. Rexulti

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Olanzapine (Zyprexa) and brexpiprazole (Rexulti) are both atypical antipsychotics, but they have some key differences. Olanzapine is used to treat schizophrenia and bipolar disorder, and it can also be combined with fluoxetine (Prozac) to treat certain types of depression. Brexpiprazole, on the other hand, is approved for schizophrenia, as an add-on treatment for depression, and for dementia-related agitation from Alzheimer's disease. Olanzapine is available in both oral and injectable forms, while brexpiprazole is only available in an oral form. Olanzapine is more likely to cause weight gain, high cholesterol, and high blood sugar compared to brexpiprazole. Brexpiprazole is less likely to cause these side effects but can be more expensive since it's only available as a brand-name medication. Both medications can cause sleepiness and dizziness, but olanzapine is more commonly associated with sleep problems.

Olanzapine

(Zyprexa)

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Rexulti

(brexpiprazole)

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Summary for Zyprexa

Prescription only

Olanzapine (Zyprexa) is an atypical antipsychotic used treat schizophrenia or bipolar disorder. It can also treat depression, in combination with fluoxetine (Prozac), when other treatments haven't worked well. This medication is thought to work by balancing the levels of certain chemicals in the brain. Olanzapine (Zyprexa) is taken by mouth, typically once daily, by adults and children. Olanzapine (Zyprexa) is also available as an injection that's usually given in a hospital or clinic setting. Some of the more common side effects of olanzapine (Zyprexa) include sleep problems, dizziness, and weight gain.

Indications for Zyprexa

When taken with fluoxetine (Prozac):

  • Bipolar depression in adults and children age 10 years and older
  • Depression that hasn't responded well to other treatments

Pros and Cons for Zyprexa

Pros

  • Taken by mouth
  • Taken once daily
  • Might notice an improvement in your symptoms in as early as a week of starting olanzapine (Zyprexa)
  • Available as a lower-cost generic

Cons

  • Can cause anticholinergic side effects, such as constipation and dry mouth
  • Can affect your sleep
  • More likely to cause weight gain, high blood cholesterol, and high blood sugar levels compared to some other atypical antipsychotics

Common Side Effects for Zyprexa

  • Sleepiness (29%)
  • Trouble sleeping (12%)
  • Accidental injury (12%)
  • Dizziness (11%)
  • Weakness (10%)
  • Dry mouth (9%)
  • Constipation (9%)
  • Upset stomach (7%)
  • Runny nose (7%)

Warnings for Zyprexa

  • Higher risk of death in older people with dementia-related psychosis
  • Worsening depression, suicidal thoughts and behavior
  • Severe allergic skin reactions
  • Neuroleptic malignant syndrome
  • Weight gain, higher blood sugar, and higher cholesterol levels
  • Difficulty controlling body movements
  • Changes in blood pressure and higher risk of falls
  • Risk of infection (from low white blood cell count)
  • Seizures
  • High prolactin levels
  • Difficulty concentrating and extreme sleepiness
  • Anticholinergic side effects

Summary for Rexulti

Prescription only

Rexulti (brexpiprazole) is an atypical antipsychotic used to treat depression and schizophrenia. It can also help manage dementia-related agitation from Alzheimer's disease. The medication works by balancing chemicals in your brain to regulate your mood. Rexulti (brexpiprazole) comes as a tablet you take by mouth, usually once a day. Common side effects include weight gain, sleepiness, and dizziness. Although generic versions have been approved, they aren't yet available in pharmacies.

Indications for Rexulti

Pros and Cons for Rexulti

Pros

  • Only need to take once a day
  • Less likely to cause weight gain compared to older antipsychotics
  • Available in many strengths

Cons

  • Can take a couple of months to fully work
  • Interacts with many medications
  • Not known if safe in pregnancy

Common Side Effects for Rexulti

Depression

  • Fidgeting (9%)
  • Weight gain (7%)
  • Headache (7%)
  • Sleepiness (5%)

Schizophrenia

  • Fidgeting (6%)

Dementia-related agitation

  • Headache (8%)

Warnings for Rexulti

  • Higher risk of death in older adults with dementia-related psychosis
  • Suicidal thoughts and behaviors
  • Neuroleptic malignant syndrome (NMS)
  • Uncontrolled body movements (tardive dyskinesia)
  • High blood sugar, high cholesterol, and weight gain
  • Impulse control problems
  • Low white blood cell count
  • Falls and fainting
  • Seizures
  • Trouble controlling body temperature
  • Difficulty swallowing
  • Problems with thinking and movement

Prices with our coupons for Zyprexa vs. Rexulti

Price Card Drug Icon
Olanzapine30 tablets / 5mg
$12.46$182.43
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Rexulti30 tablets / 1mg
$1,506.81$1,866.99
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