Olanzapine Prescription Guide: Dosage, Safety Tips, and Bleeding Risk

If you or someone you care for needs an antipsychotic, olanzapine often shows up on the list. It’s used for schizophrenia, bipolar disorder, and sometimes off‑label for severe anxiety. Getting the right dose and watching for problems can make a big difference in how well it works and how safe it feels.

How to Start Olanzapine

Doctors usually begin with a low dose – 5 mg once a day for most adults. Some patients need a bit more, so they may go up to 10 mg after a week if they tolerate it well. For people with liver issues or older adults, the starting dose might be 2.5 mg to keep side effects low.

Take the pill at the same time every day, preferably in the evening because it can make you sleepy. If you miss a dose, just take it as soon as you remember unless it’s almost time for the next one – then skip the missed one and keep the regular schedule.

Because olanzapine can raise blood sugar and cholesterol, doctors often check blood work before starting and then every few months. If you have diabetes or a history of heart problems, let the prescriber know right away.

Managing Side Effects and Bleeding Risk

Common side effects include weight gain, drowsiness, and dry mouth. Drinking plenty of water, eating a balanced diet, and moving a bit each day can help keep weight in check. If you feel too sleepy, talk to your doctor – they might shift the dose to bedtime or lower it a bit.

Olanzapine can also cause low blood pressure when you stand up fast. To avoid dizziness, stand up slowly and consider wearing compression socks if you notice frequent light‑headedness.

One less‑talked‑about issue is bleeding risk. Olanzapine isn’t a blood thinner, but it can interact with drugs that affect clotting, like NSAIDs or certain antidepressants. If you’re taking any of those, the prescriber might use the CRUSADE Bleeding Score to see how likely you are to bleed. A higher score means they’ll watch you more closely or adjust meds.

Always tell your healthcare team about over‑the‑counter meds, supplements, or herbal products you use. Even something as simple as fish oil can affect bleeding, especially when combined with olanzapine and a blood‑thinning drug.

If you notice unusual bruising, nosebleeds, or blood in the stool, call your doctor right away. Early detection lets the team change the treatment plan before anything serious happens.

Remember that each person reacts differently. The key is open communication with your prescriber, regular lab checks, and paying attention to how you feel day to day. With the right dose and careful monitoring, olanzapine can be an effective part of managing mental health while keeping safety front and center.