Olanzapine (Intramuscular)

Olanzapine injection is used to treat agitation related to schizophrenia and bipolar mania. This medicine should not be used to treat behavioral issues in older adults with dementia or Alzheimer's disease.

Zyprexa® IntraMuscular injection must be given only by or under the direct supervision of a doctor.

Zyprexa® Relprevv™ is available only through a special restricted distribution program called the Zyprexa® Relprevv™ patient care program.

It is very important for your doctor to monitor your progress while you are using this medicine to ensure it is effective. Blood tests might be necessary to check for unwanted effects.

Olanzapine may cause some individuals to feel agitated, irritable, or behave unusually. It can also lead to suicidal thoughts and tendencies or make some people feel more depressed. If you or your caregiver notice any of these unwanted effects, inform your doctor immediately.

This medicine may lead to a condition called drug reaction with eosinophilia and systemic symptoms (DRESS). Contact your doctor right away if you develop a rash, red or swollen skin, fever, chills, cough, difficulty breathing, swollen glands, or unusual bleeding, bruising, or weakness after receiving this medicine.

This medicine may raise your cholesterol and fat levels in the blood. If this happens, your doctor may prescribe medications to lower your cholesterol and fat levels.

This medicine may cause weight gain. Your doctor may need to check your weight regularly during your treatment with this medicine.

This medicine may increase your blood sugar levels. Consult your doctor immediately if you experience increased thirst or urination. If you have diabetes, you may notice changes in your urine or blood sugar test results. If you have any questions, ask your doctor.

Contact your doctor right away if you experience difficulty breathing, a rapid heartbeat, a high fever, high or low blood pressure, excessive sweating, loss of bladder control, seizures, severe muscle stiffness, unusually pale skin, or extreme tiredness. These could indicate a serious condition known as neuroleptic malignant syndrome (NMS).

This medicine may cause tardive dyskinesia (a movement disorder). Inform your doctor immediately if you notice lip smacking or puckering, puffing of the cheeks, rapid or worm-like tongue movements, uncontrolled chewing, or involuntary movements of the arms and legs.

Olanzapine injection may cause drowsiness, difficulty thinking, trouble controlling body movements, or vision problems, which could lead to falls, fractures, or other injuries. Understand how this medicine affects you before driving, operating machines, or doing tasks that require alertness, coordination, or clear thinking and vision.

Dizziness, lightheadedness, or fainting may occur, especially when standing up from a lying or sitting position. Getting up slowly may help. If this issue continues or worsens, consult your doctor.

This medicine may cause post-injection delirium/sedation syndrome. Notify your doctor right away if you experience dizziness, drowsiness, sleepiness, seizures, or confusion regarding time, place, or person after receiving the injection.

This medicine can temporarily reduce the number of white blood cells in your blood, increasing the risk of infection. If possible, avoid contact with people who have infections. Contact your doctor immediately if you believe you are getting an infection or if you develop a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

This medicine may make it harder for your body to regulate its temperature. It could decrease your sweating. Your body may overheat if you do not sweat enough. If you become too hot, you might feel dizzy, weak, tired, or confused. You may also experience vomiting or an upset stomach. Avoid getting too hot while exercising and stay away from very hot places. Call your doctor if you become too hot and cannot cool down.

Avoid consuming alcohol while you are taking this medicine.

Do not take any other medicines unless you have discussed them with your doctor. This includes prescription or over-the-counter (OTC) medicines and herbal or vitamin supplements.

In deciding to use a medicine, the chances of using the drug must be weighed against the good it will do. This is a decision you and your doctor will make. For this drug, the following should be considered:

Allergies

Inform your physician if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Additionally inform your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of olanzapine injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of olanzapine injection in the elderly. Nevertheless, elderly patients are more likely to have dementia or age-related liver, kidney, or heart problems, which may require caution or an adjustment in the dose for patients receiving olanzapine injection.

Breast Feeding

There are no adequate studies in women for determining infant chance when using this drug during breastfeeding. Weigh the potential benefits against the potential chances prior to using this medicine while breastfeeding.

Interactions with Drugs

Although certain drugs should not be used together at all, in other cases two different medications may be used together even if an interaction might occur. In these cases, your clinician may want to change the dose, or other precautions may be necessary. When you are receiving this medication, it is especially essential that your healthcare professional know if you are taking any of the medications listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this drug with any of the following medications is not recommended. Your clinician may decide not to treat you with this medication or change some of the other medicines you take.

• Bepridil
• Bromopride
• Cisapride
• Dronedarone
• Levoketoconazole
• Levomethadyl
• Metoclopramide
• Pimozide
• Piperaquine
• Potassium Citrate
• Saquinavir
• Sparfloxacin
• Terfenadine
• Thioridazine
• Ziprasidone

Using this medicine with any of the following drugs is typically not advised, but may be required in some cases. If both drugs are prescribed together, your physician may change the dose or how often you use one or both of the medicines.

• Abametapir
• Acepromazine
• Adagrasib
• Alfentanil
• Alfuzosin
• Alprazolam
• Amantadine
• Amiodarone
• Amisulpride
• Amitriptyline
• Amobarbital
• Anagrelide
• Anileridine
• Apalutamide
• Apomorphine
• Apomorphine Hydrochloride
• Aripiprazole
• Aripiprazole Lauroxil
• Arsenic Trioxide
• Asenapine
• Astemizole
• Atazanavir
• Azithromycin
• Baclofen
• Bedaquiline
• Benperidol
• Benzhydrocodone
• Bromazepam
• Bromocriptine Mesylate
• Buprenorphine
• Bupropion
• Buserelin
• Buspirone
• Butabarbital
• Butorphanol
• Cabergoline
• Calcium Oxybate
• Cannabidiol
• Cannabis
• Capmatinib
• Carbamazepine
• Carbinoxamine
• Carisoprodol
• Carphenazine
• Ceritinib
• Cetirizine
• Chloral Hydrate
• Chlordiazepoxide
• Chloroquine
• Chlorpromazine
• Chlorzoxazone
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clobazam
• Clofazimine
• Clomipramine
• Clonazepam
• Clorazepate
• Clothiapine
• Clozapine
• Cobicistat
• Codeine
• Crizotinib
• Cyclobenzaprine
• Dabrafenib
• Daridorexant
• Dasatinib
• Degarelix
• Delamanid
• Desipramine
• Deslorelin
• Deutetrabenazine
• Dexmedetomidine
• Diacetylmorphine
• Diazepam
• Dichloralphenazone
• Difenoxin
• Dihydrocodeine
• Diphenhydramine
• Diphenoxylate
• Disopyramide
• Dofetilide
• Dolasetron
• Domperidone
• Donepezil
• Doxepin
• Doxylamine
• Droperidol
• Ebastine
• Efavirenz
• Encorafenib
• Enflurane
• Enoxacin
• Entrectinib
• Enzalutamide
• Eribulin
• Erythromycin
• Escitalopram
• Esketamine
• Estazolam
• Eszopiclone
• Ethchlorvynol
• Ethopropazine
• Ethylmorphine
• Etrasimod
• Famotidine
• Felbamate
• Fenoldopam Mesylate
• Fentanyl
• Fexinidazole
• Fingolimod
• Flecainide
• Flibanserin
• Fluconazole
• Flunitrazepam
• Fluoxetine
• Fluphenazine
• Flurazepam
• Fluspirilene
• Fluvoxamine
• Formoterol
• Foscarnet
• Fosphenytoin
• Fospropofol
• Fostemsavir
• Gabapentin
• Gabapentin Enacarbil
• Galantamine
• Gatifloxacin
• Gemifloxacin
• Gepirone
• Glasdegib
• Glucagon
• Glycopyrrolate
• Glycopyrronium Tosylate
• Gonadorelin
• Goserelin
• Granisetron
• Halazepam
• Halofantrine
• Haloperidol
• Halothane
• Hexobarbital
• Histrelin
• Hydrocodone
• Hydromorphone
• Hydroquinidine
• Hydroxychloroquine
• Hydroxyzine
• Ibutilide
• Iloperidone
• Imipramine
• Inotuzumab Ozogamicin
• Isoflurane
• Itraconazole
• Ivabradine
• Ivosidenib
• Ketamine
• Ketazolam
• Ketobemidone
• Ketoconazole
• Lacosamide
• Lapatinib
• Lefamulin
• Lemborexant
• Lenvatinib
• Leuprolide
• Levocetirizine
• Levodopa
• Levofloxacin
• Levorphanol
• Lithium
• Lofexidine
• Lorazepam
• Loxapine
• Lumacaftor
• Lumefantrine
• Macimorelin
• Magnesium Oxybate
• Meclizine
• Mefloquine
• Melperone
• Meperidine
• Mephobarbital
• Meprobamate
• Meptazinol
• Mesoridazine
• Metaxalone
• Methacholine
• Methadone
• Methdilazine
• Methocarbamol
• Methohexital
• Methotrimeprazine
• Methylene Blue
• Metronidazole
• Midazolam
• Mifepristone
• Mirtazapine
• Mitotane
• Mizolastine
• Mobocertinib
• Molindone
• Moricizine
• Morphine
• Morphine Sulfate Liposome
• Moxifloxacin
• Nafarelin
• Nalbuphine
• Nelfinavir
• Nicomorphine
• Nilotinib
• Nitrazepam
• Nitrous Oxide
• Norfloxacin
• Octreotide
• Ofloxacin
• Omeprazole
• Ondansetron
• Opium
• Opium Alkaloids
• Orphenadrine
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Oxazepam
• Oxycodone
• Oxymorphone
• Ozanimod
• Pacritinib
• Paliperidone
• Panobinostat
• Papaveretum
• Papaverine
• Paregoric
• Paroxetine
• Pasireotide
• Pazopanib
• Pentamidine
• Pentazocine
• Pentobarbital
• Perampanel
• Perazine
• Periciazine
• Perphenazine
• Phenobarbital
• Phenytoin
• Pimavanserin
• Pipamperone
• Piperacetazine
• Pipotiazine
• Piritramide
• Pitolisant
• Pixantrone
• Ponesimod
• Posaconazole
• Potassium Oxybate
• Pramipexole Dihydrochloride
• Prazepam
• Pregabalin
• Primidone
• Probucol
• Procainamide
• Prochlorperazine
• Promazine
• Promethazine
• Propafenone
• Propofol
• Protriptyline
• Quazepam
• Quetiapine
• Quinidine
• Quinine
• Quizartinib
• Ramelteon
• Ranolazine
• Relugolix
• Remifentanil
• Remimazolam
• Remoxipride
• Revefenacin
• Ribociclib
• Rifampin
• Risperidone
• Ritonavir
• Ropeginterferon Alfa-2b-njft
• Ropinirole Hydrochloride
• Rotigotine
• Scopolamine
• Secobarbital
• Secretin Human
• Selpercatinib
• Sertindole
• Sertraline
• Sevoflurane
• Siponimod
• Sodium Oxybate
• Sodium Phosphate
• Sodium Phosphate, Dibasic
• Sodium Phosphate, Monobasic
• Solifenacin
• Sorafenib
• Sotalol
• St John's Wort
• Sufentanil
• Sulpiride
• Sultopride
• Sunitinib
• Suvorexant
• Tacrolimus
• Tamoxifen
• Tapentadol
• Telaprevir
• Telavancin
• Telithromycin
• Temazepam
• Tetrabenazine
• Thiethylperazine
• Thiopental
• Thiopropazate
• Tilidine
• Tiotropium
• Tizanidine
• Tolonium Chloride
• Tolterodine
• Topiramate
• Toremifene
• Tramadol
• Trazodone
• Triazolam
• Triclabendazole
• Trifluoperazine
• Trifluperidol
• Triflupromazine
• Trimeprazine
• Trimipramine
• Triptorelin
• Vandetanib
• Vardenafil
• Vemurafenib
• Venlafaxine
• Vilanterol
• Vinflunine
• Voclosporin
• Voriconazole
• Vorinostat
• Zaleplon
• Zolpidem
• Zopiclone
• Zotepine
• Zuclopenthixol
• Zuranolone

Using this medication with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best therapy for you. If both drugs are prescribed together, your clinician may change the dose or how often you use one or both of the medications.

• Amprenavir
• Betel Nut
• Fosamprenavir
• Valproic Acid

Interactions with Food/Tobacco/Alcohol

Certain medications should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain drugs may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medication with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your physician may change the dose or how frequently you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Ethanol
• Tobacco

Other Medical Problems

The presence of other medical issues may affect the use of this medication. Make sure you inform your doctor if you have any other medical issues, especially:

• Blood vessel disease or circulation issues or
• Dehydration or
• Heart attack or stroke, history of or
• Heart disease or
• Heart failure or
• Heart rhythm problems or
• Hypotension (low blood pressure) or
• Hypovolemia (low blood volume)—May cause side effects to become worse.

• Breast cancer, prolactin-dependent or
• Glaucoma, narrow-angle or
• Hyperlipidemia (high cholesterol or fat in the blood) or
• Hyperprolactinemia (high prolactin in the blood) or
• Liver disease or
• Paralytic ileus (serious intestinal problem), or history of or
• Prostatic hypertrophy (enlarged prostate), or history of or
• Seizures, history of or
• Urinary retention (issues with passing urine), or history of—Use with caution. This drug may make these conditions worse.

• Diabetes or
• Hyperglycemia (high blood sugar)—This medication may raise your blood sugar levels.

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
• drooling
• 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
• chest pain
• 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
• fever
• heartburn
• increased appetite
• increased cough
• indigestion
• lack of appetite
• lack or loss of strength
• loss of interest or pleasure
• runny nose
• sneezing
• stomach discomfort, upset, or pain
• stuffy nose
• thirst
• trouble sleeping
• trouble with concentrating
• watering of the mouth
• weight gain

Less common

• Body aches or pain
• chills
• cold sweats
• congestion
• cough
• dry skin
• dryness or soreness of the throat
• false or unusual sense of well-being
• heavy menstrual bleeding
• hoarseness
• joint pain
• lack of feeling or emotion
• leg cramps
• pain in the arms or legs
• sweating
• tender, swollen glands in the neck
• uncaring feelings
• voice change
• vomiting

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.

In the U.S.

• ZyPREXA IntraMuscular
• ZyPREXA Relprevv

Available Dosage Forms:

• Powder for Solution
• Powder for Suspension, Extended Release

Therapeutic Class: Antipsychotic

Chemical Class: Thienobenzodiazepine

A nurse or other trained health professional will give you this medicine in a clinic, community health center, or hospital. This medicine is given as a shot into a muscle.

Your doctor may give you a few doses of this medicine until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Tell your doctor if you smoke tobacco. You might need a different amount of this medicine if you smoke.

• What drugs cause tardive dyskinesia?