Zyprexa Relprevv (olanzapine) is an atypical antipsychotic. It's a long-acting injection used to treat schizophrenia in adults. This medication is injected into the muscle, typically every 2 to 4 weeks, by a healthcare provider in a clinic setting. Some of the more common side effects of this medication include weight gain, nausea, and making you more sleepy.
Zyprexa Relprevv (olanzapine) is an atypical antipsychotic. It's thought to work by balancing out the levels of chemicals (dopamine and serotonin) in the brain to help control thoughts and behaviors.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Bloating or swelling of the face, arms, hands, lower legs, or feet
blurred vision
change in vision
change in walking and balance
clumsiness or unsteadiness
difficulty with speaking
difficulty with swallowing
impaired vision
inability to sit still
loss of balance control
mask-like face
muscle trembling, jerking, or stiffness
need to keep moving
rapid weight gain
restlessness
shakiness in the legs, arms, hands, or feet
shuffling walk
slowed movements
slurred speech
stiffness of the arms and legs
tic-like (jerky) movements of the head, face, mouth, and neck
tingling of the hands or feet
trembling or shaking of the fingers, hands, or feet
twisting movements of the body
uncontrolled movements, especially of the face, neck, and back
unusual weight gain or loss
Less common
Bladder pain
bloody or cloudy urine
bruising
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
difficult or labored breathing
difficult, burning, or painful urination
dizziness
excessive muscle tone
frequent urge to urinate
headache
inability to move the eyes
increased blinking or spasms of the eyelid
itching of the vagina or genital area
lack of coordination
large, flat, blue, or purplish patches in the skin
loss of bladder control
loss of memory
lower back or side pain
muscle tension or tightness
nervousness
pain, redness, and swelling at the injection site
pounding in the ears
problems with memory
rhythmic movement of the muscles
slow, fast, pounding, or irregular heartbeat or pulse
speaking is less clear than usual
sticking out the tongue
thick, white vaginal discharge with no odor or with a mild odor
tightness in the chest
trouble with breathing, speaking, or swallowing
twitching
uncontrolled twisting movements of the neck, trunk, arms, or legs
unusual or incomplete body or facial movements
weakness of the arms and legs
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Acid or sour stomach
back pain
belching
change in personality
difficulty having a bowel movement (stool)
discouragement
feeling sad or empty
increased appetite
increased cough
indigestion
lack of appetite
lack or loss of strength
loss of interest or pleasure
stomach discomfort, upset, or pain
thirst
trouble sleeping
trouble with concentrating
watering of the mouth
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Given once every 2 to 4 weeks, depending on the dose
Good choice for people who don't want to take medications by mouth
Must be given as an injection into the buttocks muscle by a healthcare provider
Need to be monitored for at least 3 hours after each injection for severe sleepiness
Make sure to mark your appointments in your calendar to see your provider and receive your Zyprexa Relprevv (olanzapine) doses so you don't miss any of your doses.
You'll need to stay at the clinic where you receive Zyprexa Relprevv (olanzapine) for about 3 hours after each injection. This is so you can be monitored for extreme sleepiness or confusion (delirium) after the injection and get medical attention if needed.
Make arrangements to have someone drive you home after the Zyprexa Relprevv (olanzapine) injection. You shouldn't drive or do anything that requires focus or concentration on the days you receive the medication because of the risk of sleepiness and dizziness.
Zyprexa Relprevv (olanzapine) interacts with a lot of commonly prescribed medications. For example, Zyprexa Relprevv (olanzapine) can affect blood pressure, so your provider might need to adjust the dose of blood pressure medications if you're taking any.
Avoid alcohol while taking Zyprexa Relprevv (olanzapine) because it can worsen side effects (e.g., drowsiness, dizziness, low blood pressure) as well as worsen your schizophrenic symptoms.
Zyprexa Relprevv (olanzapine) can raise your blood sugar levels. If you have diabetes, ask your provider if you need to check your blood sugar more often while taking Zyprexa Relprevv (olanzapine).
Zyprexa Relprevv (olanzapine) can raise cholesterol (fat) levels in your blood and can cause weight gain. It's important that you eat a healthy and balanced diet low in fat and sugar and maintain a regular exercise routine while taking Zyprexa Relprevv (olanzapine).
Zyprexa Relprevv (olanzapine) can cause a drop in blood pressure when moving positions, such as from sitting to standing. This is more common when starting treatment and when your dose changes. Make sure to get up slowly and try to hold onto something for stability. If you end up falling or hitting your head, seek medical help right away.
Although rare, Zyprexa Relprevv (olanzapine) can cause difficulty swallowing, which can raise the risk for choking. Make sure to take small bites of food and eat slowly to lower your risk for choking.
Drink water to stay hydrated, especially if you're out in the sun or exercising. Be careful if you're traveling to a place that is very hot. This is because Zyprexa Relprevv (olanzapine) might make it hard for your body to maintain a normal body temperature.
Zyprexa Relprevv (olanzapine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Though rare, there has been reports of people experiencing extreme sleepiness (sedation), coma, and confusion (delirium) after getting Zyprexa Relprevv (olanzapine). This is called post-injection delirium/sedation syndrome and it can be life-threatening. Because of this risk, you, your provider, the clinic where you get treatment, and the pharmacy that delivers Zyprexa Relprevv (olanzapine) to your clinic, must all be enrolled in a special program called the Zyprexa Relprevv Patient Care Program. After your injection, you'll be monitored for at least 3 hours at the clinic for symptoms. If needed, you'll be able to get medical attention right away.
When your provider thinks its safe for you to leave the clinic, a caregiver must go with you. You can't go home by yourself because there's still a possible risk of being extremely sleepy. Don't drive or do anything that requires a lot of focus or attention for the rest of the day. Get medical help right away if you experience symptoms, such as sleepiness, confusion, anxiety, uncontrollable movements, slurred speech, dizziness, weakness, high blood pressure, and seizures.
Risk factors: Age 65 years and older with dementia and psychosis
Older adults who also have dementia sometimes have some of the symptoms of schizophrenia, like hallucinations and delusions. This is called dementia-related psychosis, and it shouldn't be treated with Zyprexa Relprevv (olanzapine). Older people with dementia-related psychosis have a high risk of death if they take medications like Zyprexa Relprevv (olanzapine). Because of this risk, Zyprexa Relprevv (olanzapine) shouldn't be used in people 65 years and older with dementia-related psychosis. Let your provider know if you or your loved one has dementia before starting Zyprexa Relprevv (olanzapine).
Having schizophrenia can put people at risk for self-harm or suicidal thoughts. If you or anyone around you notice that you have suicidal thoughts or behavior, get medical help right away.
Although rare, Zyprexa Relprevv (olanzapine) can cause serious skin reactions, such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). If you notice changes in your skin (e.g., rash, blisters, swollen lymph nodes, skin reddening, skin peeling) or experience swelling in your face or trouble breathing, get medical attention right away.
Taking antipsychotic medications like Zyprexa Relprevv (olanzapine) can cause a rare, but life-threatening condition called neuroleptic malignant syndrome (NMS). Symptoms include fever, sweating, stiff muscles, confusion, not aware of your surroundings, and fast or irregular heartbeat. If you experience any of these symptoms while taking Zyprexa Relprevv (olanzapine), get medical attention as soon as possible. Your provider will likely have you stop taking Zyprexa Relprevv (olanzapine) and switch you to something else.
Risk factors: History of diabetes | History of high cholesterol
Zyprexa Relprevv (olanzapine) can raise your blood sugar levels. Rarely, it can reach dangerous levels resulting in coma or death. Let your provider know if you have symptoms of high blood sugar, such as feeling very hungry or thirsty, urinating more often, stomach pain, weakness, or fruity-smelling breath.
Zyprexa Relprevv (olanzapine) can also cause high cholesterol levels and weight gain. Your provider might check your weight and order blood tests regularly to make sure your blood sugar, cholesterol, and weight aren't too high.
Zyprexa Relprevv (olanzapine) can cause uncontrolled and possibly permanent muscle movements in the tongue, face, mouth, lips, neck, hands, arms, legs, and feet (tardive dyskinesia). To lower your risk of tardive dyskinesia, your provider will have you take the lowest dose that treats your symptoms. Get medical help right away if you notice any unusual movements you can't control. This side effect can sometimes occur even after you stop the medication.
Risk factors: Low blood pressure | Taking medications that lower blood pressure | History of medical conditions that can lower blood pressure | High Zyprexa Relprevv (olanzapine) doses
Zyprexa Relprevv (olanzapine) can make you tired, lower your blood pressure, or cause you to lose your balance, which can lead to falls. When standing from a sitting or lying position, make sure to get up slowly and hold onto something. If you experience a fall while taking Zyprexa Relprevv (olanzapine), contact your provider.
Risk factors: History of low blood cell counts
Though rare, Zyprexa Relprevv (olanzapine) can lower your white blood cell counts (WBCs) and put you at risk for developing infections. You'll need to get blood tests done regularly during the first few months of taking Zyprexa Relprevv (olanzapine) so your provider can make sure your WBCs are in a safe range. If your WBC count drops too low, you'll likely need to stop taking Zyprexa Relprevv (olanzapine). If you develop any signs of infection, such as fever, tiredness, chills, cough, or trouble breathing, and they don't go away, contact your provider right away.
Risk factors: History of seizures | Health conditions that make it easier to get seizures
Zyprexa Relprevv (olanzapine) can potentially cause seizures. Before starting this medication, let your provider know if you have a history of seizures or have a medical condition that puts you at risk for getting seizures.
Antipsychotics like Zyprexa Relprevv (olanzapine) can raise the levels of prolactin in your body. High prolactin can lead to fertility problems, enlarged male breasts, sexual dysfunction, absence or irregular menstrual periods, and weak bones. Your provider will likely measure your prolactin levels during treatment to make sure they aren't too high.
Risk factors: Taking high doses of Zyprexa Relprevv (olanzapine) | Age 65 years or older | Drinking alcohol | Taking other medications that can cause sleepiness
Zyprexa Relprevv (olanzapine) can cause extreme sleepiness and lower your ability to think, react, and focus. Your risk is higher if you're also taking other medications that can cause drowsiness, such as benzodiazepines, anxiety medications, muscle relaxants, and sleep medications. Make sure you know how this medication affects you before driving a car or doing activities that require your concentration. Talk to your healthcare provider right away if you feel too sleepy from taking Zyprexa Relprevv (olanzapine).
Zyprexa Relprevv (olanzapine) can cause anticholinergic problems, such as constipation, dry mouth, and fast heart rate. The risk for these side effects is higher if you're also taking other anticholinergic medications.
You don't necessarily need to stop Zyprexa Relprevv (olanzapine) if you have these symptoms. But if you've certain medical conditions, such as difficulty urinating, enlarged prostate, constipation, or a history of bowel blockage, this medication can make those conditions worse. Let your provider know if these side effects make it difficult for you to go about your daily life, you might need to switch to a different medication.
Zyprexa Relprevv (olanzapine) is given as an injection into the buttock muscle by a healthcare provider.
Your provider will calculate your dose of Zyprexa Relprevv (olanzapine) based on what dose of oral olanzapine (Zyprexa) you were previously taking.
Treatment during the first 2 months: The typical dose is 210 mg or 300 mg injected every 2 weeks, or 405 mg every month.
Treatment after month 2: The typical dose is 150 mg, 210 mg, or 300 mg injected every 2 weeks. Or, 300 mg or 405 mg every month.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Schizophrenia in adults
Bipolar 1 disorder in adults
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Dayabandara, M., et al. (2017). Antipsychotic-associated weight gain: Management strategies and impact on treatment adherence. Neuropsychiatric Disease and Treatment.
Detke, H. C., et al. (2010). Post-injection delirium/sedation syndrome in patients with schizophrenia treated with olanzapine long-acting injection, I: Analysis of cases. BMC Psychiatry.
Eli Lilly and Company. (2023). Zyprexa Relprevv- olanzapine pamoate kit [package insert]. DailyMed.
Heres, S., et al. (2014). Pharmacokinetics of olanzapine long-acting injection: The clinical perspective. International Clinical Psychopharmacology.
MedlinePlus. (2023). Delirium.
You and Your Hormones. (2023). Prolactin. Society for Endocrinology.
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