Brand names: Zyprexa
Zyprexa helps manage symptoms of schizophrenia, the manic phase of bipolar disorder, and other psychotic disorders. It is thought to work by opposing the action of serotonin and dopamine, two of the brain's major chemical messengers. The drug is available as Zyprexa tablets and Zyprexa Zydis, which dissolves rapidly with or without liquid.
At the start of Zyprexa therapy, the drug can cause extreme low blood pressure, increased heart rate, dizziness, and, in rare cases, a tendency to faint when first standing up. These problems are more likely if you are dehydrated, have heart disease, or take blood pressure medicine. To avoid such problems, your doctor may start with a low dose of Zyprexa and increase the dosage gradually.
Zyprexa should be taken once a day with or without food. To use Zyprexa Zydis, open the sachet, peel back the foil on the blister pack, remove the tablet, and place the entire tablet in the mouth. Do not push the tablet through the foil. The medication can be taken with or without water; the saliva in your mouth will cause the tablet to dissolve.
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Zyprexa.
If Zyprexa gives you an allergic reaction, you cannot take the drug.
Certain antipsychotic drugs, including Zyprexa, are associated with an increased risk of developing high blood sugar, which on rare occasions has led to coma or death. See your doctor right away if you develop signs of high blood sugar, including dry mouth, unusual thirst, increased urination, and tiredness. If you have diabetes or have a high risk of developing it, see your doctor regularly for blood sugar testing.
Use Zyprexa with caution if you have any of the following conditions: Parkinson's disease, trouble swallowing, narrow angle glaucoma (high pressure in the eye), an enlarged prostate, heart irregularities, heart disease, heart failure, liver disease, or a history of heart attack, seizures, or intestinal blockage.
Zyprexa should not be used to treat elderly patients who have dementia because the drug could increase the risk of stroke. In addition, antipsychotic drug treatment has been associated with swallowing and breathing problems in older people and those with Alzheimer's disease.
Drugs such as Zyprexa sometimes cause a condition called Neuroleptic Malignant Syndrome (NMS). Symptoms include high fever, muscle rigidity, irregular pulse or blood pressure, rapid heartbeat, excessive sweating, and changes in heart rhythm. If these symptoms appear, contact your doctor right away. You'll have to discontinue using Zyprexa while the condition is under treatment.
There is also a risk of developing tardive dyskinesia, a condition marked by slow, rhythmical, involuntary movements. This problem is more likely to surface in older adults, especially elderly women. When it does, use of Zyprexa is usually stopped.
Animal studies suggest that Zyprexa may increase the risk of breast cancer, although human studies have not confirmed such a risk. If you have a history of breast cancer, see your doctor regularly for checkups.
People at high risk of suicide attempts should be prescribed the lowest dose possible to reduce the risk of intentional overdose.
Zyprexa sometimes causes drowsiness and can impair your judgment, thinking, and motor skills. Use caution while driving and don't operate dangerous machinery until you know how the drug affects you.
Medicines such as Zyprexa can interfere with regulation of the body's temperature. Do not get overheated or become dehydrated while taking Zyprexa. Avoid extreme heat and drink plenty of fluids.
Zyprexa can cause low blood pressure upon standing, resulting in dizziness, rapid heartbeat, and fainting, especially at the start of therapy. Let the doctor know if you develop this problem; your dosage can be adjusted to reduce the symptoms.
If you have phenylketonuria and must avoid the amino acid phenylalanine, you should not take Zyprexa Zydis, which contains this substance.
The safety and effectiveness of Zyprexa have not been studied in children.
Avoid alcohol while taking Zyprexa. The combination can cause a sudden drop in blood pressure.
If Zyprexa is taken with certain other drugs, the effects of either can be increased, decreased, or altered. Ask your doctor before taking any prescription or over-the-counter drugs. It is especially important to check before combining Zyprexa with the following:Blood pressure medicationsBenzodiazepinesCarbamazepineDiazepamDrugs that boost the effect of dopamine, such as Parkinson's medicationsFluvoxamineLevodopaOmeprazoleRifampin
If you are pregnant or plan to become pregnant, inform your doctor immediately. Zyprexa should be used during pregnancy only if absolutely necessary. The drug may appear in breast milk; do not breastfeed while on Zyprexa therapy.
The usual starting dose is 5 to 10 milligrams once a day. If you start at the lower dose, after a few days the doctor will increase it to 10. After that, the dosage will be increased no more than once a week, 5 milligrams at a time, up to a maximum of 20 milligrams a day.
Those most likely to start at 5 milligrams are people who are weak, people prone to low blood pressure, and nonsmoking women over 65 (because they tend to have a slow metabolism).
Manic Episodes in Bipolar Disorder
The usual starting dose is 10 to 15 milligrams once a day. If needed, the dose can be increased every 24 hours by 5 milligrams a day, up to a maximum daily dose of 20 milligrams. After the person is stabilized, the doctor may continue maintenance therapy at a dosage range of 5 to 20 milligrams a day. If Zyprexa is being combined with lithium or valproate, the usual starting dose is 10 milligrams once a day.
An overdose of Zyprexa is usually not life-threatening, but fatalities have been reported. If you suspect an overdose, seek medical attention immediately.
Overdoses of Zyprexa have also led to breathing difficulties, changes in blood pressure, excessive perspiration, fever, muscle rigidity, cardiac arrest, coma, and convulsions.