Olanzapine Extended-Release Injection

What is this medication?

OLANZAPINE (oh LAN za peen) treats schizophrenia. It works by balancing the levels of dopamine and serotonin in your brain, substances that help regulate mood, behaviors, and thoughts. It belongs to a group of medications called antipsychotics. Antipsychotic medications can be used to treat several kinds of mental health conditions.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Zyprexa Relprevv

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Blockage in your bowel
• Cigarette smoker
• Constipation
• Dementia
• Diabetes
• Difficulty swallowing
• Glaucoma
• Have trouble controlling your muscles
• Heart disease
• High cholesterol
• High levels of prolactin
• History of breast cancer
• History of irregular heartbeat
• History of stroke
• Liver disease
• Low blood counts, like low white cell, platelet, or red cell counts
• Low blood pressure
• Parkinson's disease
• Prostate disease
• Seizures
• Suicidal thoughts, plans or attempt; a previous suicide attempt by you or a family member
• Trouble passing urine
• An unusual or allergic reaction to olanzapine, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is for injection into a muscle by your care team. It will be given at regular intervals. Do not stop taking except on the advice of your care team.

A special MedGuide will be given to you before each treatment. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

Contact your care team as soon as possible if you miss an appointment for your injection.

What may interact with this medication?

Do not take this medication with any of the following:

• Dronedarone
• Cisapride
• Metoclopramide
• Pimozide
• Thioridazine

This medication may also interact with the following:

• Alcohol
• Antihistamines for allergy, cough, and cold
• Atropine
• Carbamazepine
• Certain medications for anxiety or sleep
• Certain medications for bladder problems like oxybutynin, tolterodine
• Certain medications for depression like amitriptyline, fluoxetine, sertraline
• Certain medications for stomach problems like dicyclomine, hyoscyamine
• Certain medications for travel sickness like scopolamine
• Fluvoxamine
• General anesthetics like halothane, isoflurane, methoxyflurane, propofol
• Levodopa or other medications for Parkinson's disease
• Medications for blood pressure
• Medications for seizures
• Medications that relax muscles for surgery
• Narcotic medications for pain
• Omeprazole
• Other medications that prolong the QT interval (an abnormal heart rhythm)
• Phenothiazines like chlorpromazine, prochlorperazine
• Rifampin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Your condition will be monitored carefully while you are receiving this medication. Tell your care team if your symptoms do not start to get better or if they get worse.

After your injection, you will need to stay at the clinic where you receive the injection for at least 3 hours so the care team can make sure you do not have symptoms of Post-injection Delirium Sedation Syndrome (PDSS). PDSS is a serious problem that can happen if the medication gets into your blood too fast. Some symptoms of PDSS include drowsiness, dizziness, feeling confused, having trouble talking or walking, seizures, having stiff or shaking muscles, feeling weak, being anxious or angry, passing out or fainting, and having blood pressure changes. When you leave the clinic, someone must be with you. If you have symptoms of PDSS after you leave the clinic or hospital, get medical help right away.

Do not drive or use heavy machinery for the rest of the day after receiving your injection. You may get dizzy or drowsy. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medication. Avoid alcoholic drinks.

This medication may cause serious skin reactions. They can happen weeks to months after starting the medication. Contact your care team right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips or lymph nodes in your neck or under your arms.

This medication may increase blood sugar. Ask your care team if changes in diet or medications are needed if you have diabetes.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water will help. Contact your care team if the problem does not go away or is severe.

This medication can cause problems with controlling your body temperature. It can lower the response of your body to cold temperatures. If possible, stay indoors during cold weather. If you must go outdoors, wear warm clothes. It can also lower the response of your body to heat. Do not overheat. Do not over-exercise. Stay out of the sun when possible. If you must be in the sun, wear cool clothing. Drink plenty of water. If you have trouble controlling your body temperature, call your care team right away.

If you smoke, tell your care team if you notice this medication is not working well for you. Talk to your care team if you are a smoker or if you decide to stop smoking.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
• High fever, stiff muscles, increased sweating, fast or irregular heartbeat, and confusion, which may be signs of neuroleptic malignant syndrome
• High prolactin level—unexpected breast tissue growth, discharge from the nipple, change in sex drive or performance, irregular menstrual cycle
• Infection—fever, chills, cough, or sore throat
• Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
• Pain or trouble swallowing
• Post-injection sedation syndrome—dizziness, drowsiness, slurred speech, confusion, agitation, feeling irritable or restless, trouble walking, loss of balance or coordination, unusual weakness or fatigue
• Rash, fever, and swollen lymph nodes
• Thoughts of suicide or self-harm, worsening mood, feelings of depression
• Uncontrolled and repetitive body movements, muscle stiffness or spasms, tremors or shaking, loss of balance or coordination, restlessness, shuffling walk, which may be signs of extrapyramidal symptoms (EPS)

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Diarrhea
• Dizziness
• Drowsiness
• Dry mouth
• Headache
• Nausea
• Weight gain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

This medication is given in a hospital or clinic and will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.