Maximum Recommended Dose of Zyprexa (Olanzapine)

Dosing Guidelines by Indication

The American family physician recommends a target dose range of 10-20 mg/day for adults with schizophrenia or bipolar disorder 1

For elderly or debilitated patients, lower starting doses of 2.5-5 mg are recommended, with gradual titration, according to the American family physician and Annals of Oncology 1, 2
The maximum dose remains 20 mg/day for elderly or debilitated patients, but lower doses are often effective, as stated by the American family physician 1
For patients with Alzheimer's disease or dementia, an initial dose of 2.5 mg once daily at bedtime is recommended, with a maximum dose of 10 mg/day, usually given twice daily in divided doses, according to the American family physician 1

The American College of Emergency Physicians notes that QTc prolongation occurs at maximum recommended doses of olanzapine, though it has the least effect among atypical antipsychotics studied, in patients with schizophrenia or bipolar I disorder 3, 4

The American Geriatrics Society recommends starting with lower doses of 2.5-5 mg with gradual titration for elderly or debilitated patients, with a maximum dose of 20 mg/day 5
Weight gain and metabolic effects increase with higher doses, particularly above 20 mg/day, as noted by the American Diabetes Association 5

The American Heart Association notes that QTc prolongation can occur at maximum recommended doses, though olanzapine has the least effect among atypical antipsychotics studied 5