Zyprexa vs. Latuda
See how Zyprexa and Latuda compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Both drugs treat schizophrenia, but only Zyprexa is approved for acute mania and agitation, while only Latuda is approved for bipolar depression as its own standalone treatment.
Zyprexa causes substantially more weight gain and metabolic change than Latuda based on head-to-head trial data, which matters most for patients with metabolic risk factors.
Zyprexa comes in more forms, including a long-acting monthly injection, while Latuda is oral-only and must be taken with a substantial meal to absorb properly.
Zyprexa vs. Latuda Drug Summary
Zyprexa
Zyprexa (olanzapine) is an atypical antipsychotic used for schizophrenia and bipolar I disorder, covering mania, long-term maintenance, and acute agitation. It comes as a tablet, an orally disintegrating tablet, a short-acting injection, or a long-acting monthly injection (Relprevv). Combined with fluoxetine, it is also used for certain bipolar and treatment-resistant depression.
Latuda
Latuda (lurasidone) is an atypical antipsychotic used for schizophrenia and for depressive episodes tied to bipolar I disorder, alone or added to lithium or valproate. It is taken once daily by mouth with a substantial meal, usually without any initial dose titration. It is not approved for the manic phase of bipolar disorder.
Zyprexa vs. Latuda Side Effects
Zyprexa
Latuda
Zyprexa vs. Latuda Dosage
Zyprexa
Latuda
| STAGE | DOSE | WHEN |
| Starting dose | 5-10 mg once daily | At the start |
| Maximum dose | 2.5-10 mg per IM dose | If needed |
| Dose changes | 4 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 40 mg once daily | At the start |
| Maximum dose | 40-80 mg once daily | If needed |
| Dose changes | 4 increases | As tolerated |
Zyprexa
| STAGE | DOSE | WHEN |
| Starting dose | 5-10 mg once daily | At the start |
| Maximum dose | 2.5-10 mg per IM dose | If needed |
| Dose changes | 4 increases | As tolerated |
Latuda
| STAGE | DOSE | WHEN |
| Starting dose | 40 mg once daily | At the start |
| Maximum dose | 40-80 mg once daily | If needed |
| Dose changes | 4 increases | As tolerated |
Zyprexa vs. Latuda Indications
Zyprexa
Zyprexa is FDA-approved for schizophrenia and for bipolar I disorder, covering acute mania, long-term maintenance, and short-acting injections for agitation. Combined with fluoxetine, it is also approved for bipolar and treatment-resistant depression. It is not approved for dementia-related psychosis in older adults.
Schizophrenia in adults and adolescents (13-17)
Bipolar I mania, alone or with lithium or valproate
Long-term maintenance of bipolar I disorder
Acute agitation from schizophrenia or bipolar mania
Latuda
Latuda is FDA-approved for schizophrenia and for major depressive episodes tied to bipolar I disorder, alone or added to lithium or valproate. It is not approved for the manic phase of bipolar disorder or for acute agitation. Like Zyprexa, it carries a boxed warning against use in older adults with dementia-related psychosis.
Schizophrenia in adults and adolescents (13-17)
Bipolar I depression monotherapy in adults
Bipolar I depression monotherapy in ages 10-17
Bipolar I depression with lithium or valproate (adults)
Zyprexa vs. Latuda Pros and Cons
Zyprexa
Zyprexa has the broadest bipolar indication of the two, covering mania, maintenance, and acute agitation, along with a long-acting monthly injection option. It has been on the market since 1996 with an established generic, but its metabolic side effect profile is more pronounced than Latuda's.
Pros
Approved for acute mania and short-term agitation, not just depression
Available as a long-acting monthly injection (Relprevv) for maintenance
Long real-world track record, on the market since 1996
Typically costs less out-of-pocket, roughly $440 to $900 per month without insurance, before savings programs
Cons
Causes substantially more weight gain and metabolic change than Latuda in trial data
Not approved for bipolar depression on its own, only combined with fluoxetine
Long-acting injection requires a 3-hour monitored observation after each dose
Somnolence is very common, reported in roughly half of patients in trials
Latuda
Latuda's main clinical edge is a lower burden of weight gain and metabolic change, backed by head-to-head trial data against olanzapine. It only covers schizophrenia and bipolar depression, so it cannot replace Zyprexa for mania or acute agitation.
Pros
Causes far less weight gain and metabolic change than olanzapine in trial data
No initial dose titration needed for most patients to reach an effective dose
Approved for bipolar depression on its own, including ages 10 and up
Linked to smaller changes in blood sugar and cholesterol than olanzapine in trials
Cons
Not approved for acute mania or agitation, unlike Zyprexa
No injectable form exists for patients who cannot take oral medication
Must be taken with a substantial meal (at least 350 calories) to absorb well
Costs significantly more than Zyprexa, roughly $1,100 to $1,900 per month without insurance, before savings programs
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