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When considering the use of olanzapine (Zyprexa), it is crucial to be well-informed about the potential risks and safety precautions associated with this medication. Below are key points to keep in mind:

• Increased Risk for Older Adults with Dementia: Olanzapine is not recommended for individuals aged 65 and older with dementia-related psychosis due to a higher risk of death. If dementia is present, discuss alternative treatments with your healthcare provider.

• Mental Health Concerns: This medication may exacerbate depression or lead to suicidal thoughts, particularly in those under 24 or with a history of mental health conditions. Immediate medical attention is advised if such symptoms occur.

• Allergic Reactions: Rare but severe skin reactions, such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), may occur. Discontinue use and seek medical help if you experience rash, blisters, or facial swelling.

• Neuroleptic Malignant Syndrome: A rare, life-threatening condition with symptoms like fever, muscle stiffness, and confusion. If these occur, stop taking the medication and contact your healthcare provider immediately.

• Metabolic Changes: Olanzapine can increase blood sugar, cholesterol, and weight. Regular monitoring of blood tests, a balanced diet, and exercise are recommended to manage these effects.

• Uncontrolled Movements: Prolonged use may lead to involuntary movements. Report any such symptoms to your healthcare professional promptly.

• Blood Pressure and Fall Risk: The medication may cause dizziness or falls due to low blood pressure. Rise slowly from sitting or lying positions and consult your doctor if falls occur.

• Infection Risk: Olanzapine can reduce white blood cell count, increasing infection risk. Regular blood tests are necessary to monitor levels, and any signs of infection should be reported immediately.

• Seizure Risk: Inform your healthcare provider if you have a history of seizures before starting olanzapine.

• Hormonal Effects: High prolactin levels associated with this medication may cause fertility issues or menstrual irregularities. Monitoring by your doctor may be needed.

• Drowsiness and Concentration Issues: Olanzapine can cause significant drowsiness and impair concentration, especially if taken with other sedatives or alcohol. Avoid driving or engaging in activities requiring alertness until you know how the medication affects you.

• Anticholinergic Effects: Potential side effects include difficulty urinating and constipation, especially if combined with other anticholinergic drugs. Discuss potential interactions with your healthcare team.

For any concerns or if adverse effects occur, contact your healthcare provider for guidance. Always discuss the risks and benefits of olanzapine with your doctor before starting treatment.

Common side effects:

• Drowsiness
• Dizziness
• Lightheadedness
• Stomach upset
• Dry mouth
• Constipation
• Increased appetite
• Weight gain

Less common but important to monitor:

• Increased cholesterol levels
• Increased blood sugar levels
• Numbness or tingling in the arms or legs
• Yellowing of the skin or eyes
• Severe stomach pain
• Trouble urinating
• Interrupted breathing during sleep
• Increase in prolactin levels

Serious side effects:

• Difficulty swallowing
• Shaking or tremors
• Slow heartbeat
• Fainting
• Mental or mood changes (confusion or restlessness)
• Diabetes
• Tardive dyskinesia
• Serious allergic reactions
• Neuroleptic malignant syndrome

Interactions with high risk of serious adverse effects and should be avoided:

• Metoclopramide
• Bepridil
• Cisapride
• Dronedarone
• Levomethadyl
• Mesoridazine
• Pimozide
• Piperaquine
• Saquinavir
• Sparfloxacin
• Terfenadine
• Thioridazine
• Ziprasidone

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Alprazolam
• Codeine
• Hydrocodone
• Amiodarone
• Clozapine
• Escitalopram
• Fentanyl
• Fluoxetine
• Lithium
• Methadone
• Moxifloxacin
• Ondansetron
• Quetiapine
• Sertraline
• Sotalol
• Tramadol
• Trazodone

Interactions with low risk that usually do not require a change in therapy:

• Ciprofloxacin
• Haloperidol
• Valproic Acid