Zyprexa

Before taking this medicine

The label lists no contraindications for Zyprexa (olanzapine) when used alone. This does not mean it is suitable for everyone. When used with fluoxetine, lithium or valproate, the contraindications and warnings for the combination or the other medicine must also be checked. Older adults with dementia-related psychosis have an increased risk of death and stroke or transient ischaemic attack. Caution is needed in people with heart or blood vessel disease, conditions that make blood pressure drops more likely, a history of seizures, urinary retention, an enlarged prostate, constipation or a bowel condition such as paralytic ileus. Caution is also needed with other medicines that have anticholinergic effects. Olanzapine can cause high blood sugar, sometimes severe, changes in blood fats and weight gain. Blood sugar and blood fats should be checked before and periodically during treatment, and weight should be monitored regularly. People with a history of significantly low white blood cell counts or medicine-related reductions in these cells need frequent blood count checks during the first few months. Serious reactions include neuroleptic malignant syndrome and DRESS, a severe drug reaction. These require stopping treatment and medical assessment. Involuntary movements known as tardive dyskinesia may also require treatment to be stopped. Olanzapine can impair judgement, thinking and movement, so caution is needed when operating machinery. People at high risk of suicide need close supervision. Exposure during the third trimester of pregnancy may cause movement-related or withdrawal symptoms in newborns. Safety and effectiveness have not been established in children under 13 years, or in children under 10 years when olanzapine is combined with fluoxetine.