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Zyprexa (Olanzapine)

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Zyprexa is the brand name of the drug Olanzapine. It is a prescription antipsychotic medication that helps in improving the thoughts, moods, and actions of people with psychotic conditions like Bipolar disorders or Schizophrenia.

The drug comes in tablets and injectables. The tablets are either round or oblong, with colors ranging from white, pink, or blue. It is used as a monotherapy or as an adjuvant to ameliorate several types of mental health abnormalities and psychotic disorders.

Zyprexa works by balancing the levels of dopamine and serotonin in your brain. These chemicals are essential mood dispositions and behavioral tendencies in humans.

Precautions to Note Before Using Zyprexa

Patients should adhere to the following precautions:

  • Do not take the drug if you have allergies to its active ingredients or thienobenzodiazepine derivates. It is important to tell your doctor if you have any history of:

    • Stroke,

    • Hypercholesterolemia or hypertriglyceridemia,

    • Cardiomyopathy,

    • Seizure,

    • Liver diseases,

    • Alzheimer's disease,

    • Hypotension,

    • Breast cancer,

    • Glaucoma (narrow-angle),

    • Diabetes Mellitus.

  • The drug is not appropriate for treating dementia-related mental disorders in aged people (those above 65 years of age) as it may increase the risk of death in this population.

  • Breastfeeding mothers should be cautious as Zyprexa can be excreted into breast milk, causing irritability, tremors, severe drowsiness, and other discomforts in nursing babies.

  • Pregnant women in their 3rd trimester should inform their doctor before taking Zyprexa for professional advice to prevent injuries to their babies.

Adverse Effects of Zyprexa

There are several adverse reactions that have been reported in people taking the drug. Below is an abridged list of the side effects of the drug:

  • Strokes,

  • Having suicidal thoughts,

  • Hypotension,

  • Feeling of dizziness,

  • Hyperprolactinemia,

  • Skin rashes,

  • Itchy sensations,

  • Headaches,

  • Weight gain,

  • Difficulty in passing urine,

  • Difficulty in swallowing,

  • Irregularities in the menstrual cycle,

  • Irregular heartbeats.

Dosage and Indications

The dosage to be taken is dependent on the medical condition (mental disorder) that is to be treated. The drug can be taken with food or without food.


In adults, a 10 mg dose per day for a period of one week is recommended. This dose can be further adjusted to a dose of 15 mg per day as treatment continues. It should, however, not exceed a dose of 20 mg per day.

In teenagers (13-17) years of age, an initial 2.5 - 5 mg per day in the first week is recommended. The daily maximum dose should not exceed 10 mg per day. A 2.5 to 5mg decrease or increase can be made when dosage modification is necessary. In elderly people or those with hypotension, a starting dose of 5mg is approved.

Bipolar Disorder

When using the drug as a monotherapy for bipolar disorders, you can start with 10 to 15 mg per day. Daily dosages of adjustments of plus or minus 5mg can be done when required while monitoring the patient as treatment progresses. A three to four weeks treatment with Zyprexa is known to be effective as a monotherapy for Maniac episodes. A 10 mg dose taken once daily is effective as an adjuvant therapy with Valproate.

In adolescents (13 -17 years), 2.5 - 5 mg per day can be administered as a starting dose while targeting an ideal quantity of not more than 10 mg per day is recommended and effective for manic episodes in bipolar disorder. It is not medically advisable to give doses that are greater than 20 mg in a 24-hour period because there is no clinical evidence to ascertain that the drug is safe and effective at higher doses.


Zyprexa interacts with over 600 medications, more than 15 pathological conditions, and four alcohol/ food products. Some of the drugs with which it interacts are:

  • Zoloft

  • Ability

  • Gabapentin

  • Prozac

  • Cymbalta

  • Klonopin

  • Seroquel (Quetiapine)

  • Lamictal

  • Trazodone

  • Ativan

  • Acarbose

  • Acetohexamide

  • Abarelix

  • Acebutolol

  • Azithromycin

  • Arsenic trioxide

  • Brexanolone

  • Bromocriptine

  • Cannabidiol

  • Cabergoline

  • Carbamazepine

  • Cimetidine

  • Clarithromycin

  • Diazepam

  • Entacapone

  • Ethanol

  • Methyldopa

  • Metronidazole

  • Moxifloxacin

  • Nifedipine

  • Norfloxacin

  • Nitroprusside

  • Ofloxacin

  • Omeprazole

  • Orphenadrine

  • Pentamidine

  • Papaverine

  • Pergolide

  • Phenobarbital

  • Probenecid

  • Procyclidine

  • Procainamide

  • Promethazine

  • Quinine

  • Ramipril

  • Sparfloxacin

  • Tramadol

  • Vasopressin

  • Valerian

  • Voriconazole

  • Valsartan

  • Ziprasidone

It interacts with the following pathological conditions:

  • Dementia,

  • Conditions that cause Alanine aminotransferases (ALT),

  • Elevations,

  • Anticholinergic effects,

  • Seizures,

  • Aspirations,

  • Hyperprolactinemia ( increase in plasma prolactin levels),

  • Tardive dyskinesia,

  • PKU (phenylketonuria),

  • Diabetes Mellitus,

  • Acute alcohol intoxication (toxicity),

  • Hematological abnormalities,

  • Hypotension ( low blood pressure),

  • Central nervous system depression,

  • Dyslipidemias,

  • Parkinson's disease,

  • Liver diseases.

Overdose/Missed dose

If you miss a dose of Zyprexa, try to take it as soon as you can remember. However, if the time you remember to take it coincides with your next dose, do skip the missed dose to avoid incidences of overdose. Do well to inform your doctor about the incidence of missed doses.

In cases of overdose or accidental poisoning, contact 911 or the poison control center in your district or seek emergency medical attention.


Zyprexa should be stored away from direct sunlight, heat, and moisture. It should be stored at room temperature in a place that is away from the reach of children and pets.