Latuda vs. Zyprexa: Differences, similarities & side effects

In this article:

• Latuda vs. Zyprexa: Key differences
• Latuda vs. Zyprexa: Conditions treated
• Is Zyprexa better than Latuda?
• Latuda vs. Zyprexa: Insurance coverage and cost comparison
• Latuda vs. Zyprexa side effects
• Latuda and Zyprexa drug interactions
• Latuda and Zyprexa drug warnings
• Can you take Latuda and Zyprexa together?

In this article

• Latuda vs. Zyprexa: Key differences
• Latuda vs. Zyprexa: Conditions treated
• Is Zyprexa better than Latuda?
• Latuda vs. Zyprexa: Insurance coverage and cost comparison
• Latuda vs. Zyprexa side effects
• Latuda and Zyprexa drug interactions
• Latuda and Zyprexa drug warnings
• Can you take Latuda and Zyprexa together?

Latuda (lurasidone) and Zyprexa (olanzapine) are brand-name antipsychotic medications. Latuda is used for treating schizophrenia and bipolar depression. Zyprexa is used for managing schizophrenia and manic episodes of bipolar disorder. It can also be combined with antidepressants to treat depression or bipolar depression. Both medications work by affecting certain brain chemicals called dopamine and serotonin. However, Latuda and Zyprexa are not exactly the same. Continue reading to learn more about these medicines.

Latuda vs. Zyprexa: Key differences

Antipsychotic medications manage conditions related to psychosis, such as schizophrenia, bipolar disorder, and delirium. These medications are typically prescribed by psychiatrists, who specialize in diagnosing and treating mental health conditions. There are two main types of antipsychotics.

First-generation antipsychotics (typical antipsychotics), such as Haldol (haloperidol), were the earliest developed and are less commonly used today due to their more bothersome side effects compared to newer medications.

Second-generation antipsychotics (atypical antipsychotics) are now more commonly prescribed for psychosis. They tend to have fewer side effects than first-generation options. Latuda and Zyprexa are both atypical antipsychotics. Other examples include Abilify (aripiprazole), Caplyta (lumateperone), Clozaril (clozapine), Fanapt (iloperidone), Geodon (ziprasidone), Invega (paliperidone), Risperdal (risperidone), Rexulti (brexpiprazole), Saphris (asenapine), Seroquel (quetiapine), and Vraylar (cariprazine).

Although Zyprexa and Latuda are in the same drug class and come in both brand and generic versions, they have a few key differences, including their active ingredients and dosage forms. 

Compare Latuda vs. Zyprexa key differences
	Latuda	Zyprexa
Drug class	Second-generation antipsychotic; atypical antipsychotic	Second-generation antipsychotic; atypical antipsychotic
Brand/generic status	Brand and generic	Brand and generic
What is the generic name?	Lurasidone	Olanzapine
What form(s) does the drug come in?	Oral tablets: 20 mg, 40 mg, 60 mg, 80 mg, and 120 mg	Oral tablets (Zyprexa): 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, and 20 mg Orally disintegrating tablets (Zyprexa Zydis): 5 mg, 10 mg, 15 mg, and 20 mg Injection (Zyprexa Relprevv)
What is the standard dosage?	Varies by indication Schizophrenia: 40 to 160 mg by mouth once daily Bipolar depression: 20 to 120 mg by mouth once daily Should always be taken with at least 350 calories of food for optimal absorption	Varies by indication; a typical dose is 5 to 20 mg by mouth once daily Can be taken with or without food
How long is the typical treatment?	Long-term	Long-term
Who typically uses the medication?	Adults  Adolescents (for some uses)	Adults  Adolescents (for some uses)

Latuda vs. Zyprexa: Conditions treated

Latuda is approved by the Food and Drug Administration (FDA) to treat adult and adolescent patients (13–17 years old) with schizophrenia. It can also be used alone to treat bipolar depression associated with bipolar I disorder in adults and pediatric patients ages 10–17 years old. It can be used in combination with lithium or valproate in adults with bipolar depression. 

Zyprexa is FDA approved to treat schizophrenia in adults and adolescents 13–17 years old. It can be used to treat acute manic or mixed episodes associated with bipolar I disorder as well as maintenance treatment of bipolar I disorder in adults and adolescents 13 years and older. The table below outlines the FDA-approved uses for each medication.

Compare Latuda vs. Zyprexa conditions treated
Condition	Latuda	Zyprexa
Schizophrenia	Yes	Yes
Bipolar depression	Yes (associated with bipolar I disorder)	Yes (when used as a combination medicine called Symbyax that contains both olanzapine and fluoxetine)
Acute treatment of manic episodes or mixed episodes associated with bipolar I disorder	No	Yes (adults and adolescents), can be used alone or in combination with a mood stabilizer such as valproate or lithium
Maintenance treatment of bipolar I disorder	No	Yes
Add-on medication to antidepressants such as Prozac (fluoxetine) to treat depression	No	Yes (Symbyax)
Acute agitation associated with schizophrenia or bipolar I mania	No	Yes (injection only)

 

Is Zyprexa better than Latuda?

There is not a lot of data comparing the two drugs directly. In one study comparing Latuda and Zyprexa, both medicines significantly improved symptoms in patients with schizophrenia during a six-week period. In a six-month extension study, Latuda maintained these improvements and showed benefits like sustained symptom control, reduced weight gain, and better cholesterol levels compared to Zyprexa. Switching from Zyprexa to Latuda led to further improvements in weight and cholesterol levels, though there was a slight increase in a movement disorder called akathisia. 

A meta-analysis published in 2019 reviewed 32 oral antipsychotics, including Latuda and Zyprexa, to compare the efficacy and side effects. Latuda was found to have a minimal effect on heart rhythm, suggesting a lower risk for this cardiac side effect. Zyprexa was associated with an average weight gain of about 7 pounds, indicating a higher likelihood of weight-related issues. Latuda, on the other hand, was linked to less weight gain. Both medications were effective in reducing symptoms of schizophrenia compared to placebo (inactive medicine).

A more recent meta-analysis published in 2024 evaluated the efficacy and tolerability of five FDA-approved atypical antipsychotics for acute bipolar depression. Among the five drugs studied, all were more effective than placebo in improving depressive symptoms. Both Latuda and Zyprexa were effective, but Zyprexa was associated with significant weight gain and increases in total cholesterol and triglycerides. In contrast, Latuda was associated with less weight gain and fewer metabolic side effects. 

Because treatment is individualized to each patient based on many individual factors, it is important to discuss the best treatment options for your condition with your healthcare provider.

Latuda vs. Zyprexa: Insurance coverage and cost comparison

Most commercial health insurance plans and Medicare prescription plans, such as Medicare Part D and Medicare Advantage plans, typically cover Latuda and Zyprexa. However, the copays and out-of-pocket expenses can differ depending on your plan. Choosing brand-name medications might result in higher costs or limited coverage compared with generic drugs. For the most accurate pricing information, contact your insurance provider.

Without insurance or discounts, the cost of a one-month supply of brand-name Latuda is approximately $1,863. Using a SingleCare coupon for generic lurasidone can reduce this cost to as low as $22. 

Without insurance, a one-month supply of brand-name Zyprexa costs about $573, but a SingleCare coupon for generic olanzapine can lower the price to as little as $10. Drug prices fluctuate and vary by pharmacy, so these prices are just estimates.

Compare Latuda vs. Zyprexa cost & coverage
	Latuda	Zyprexa
Typically covered by insurance?	Yes (generic)	Yes (generic)
Typically covered by Medicare Part D?	Yes (generic)	Yes (generic)
Quantity	30, 20 mg tablets	30, 5 mg tablets
SingleCare cost*	$22 (generic)	$10 (generic)

*Drug prices fluctuate and vary by pharmacy.

Latuda vs. Zyprexa side effects

Extrapyramidal symptoms (EPS) refer to a range of movement disorders often associated with antipsychotic medications. These symptoms can occur in several ways, including:

• Dystonia: This is characterized by involuntary muscle contractions leading to abnormal postures and repetitive movements. Dystonia can impact various body parts, such as the back, pelvis, stomach, neck, jaw, eyes, face, and tongue.
• Akathisia: This condition involves a persistent feeling of restlessness and an uncontrollable urge to move. Individuals with akathisia might frequently shift their weight or fidget.
• Parkinsonism: Symptoms resemble those of Parkinson’s disease and include tremors, muscle stiffness, a slow and shuffling walk, a hunched posture, balance issues, and difficulty rising from a seated position.
• Tardive dyskinesia: This disorder involves involuntary movements primarily affecting the face and tongue, including grimacing, lip smacking, and excessive blinking.

Common side effects of Latuda include nausea, vomiting, drowsiness, and EPS, such as tremors or rigidity. Latuda can also lead to increased prolactin levels, which may cause men to experience swollen breast tissue or erectile dysfunction. In women, elevated prolactin levels might lead to breast milk secretion, even in those not breastfeeding, and can affect menstrual cycles.

For adults, common side effects of Zyprexa include decreased energy, dry mouth, increased appetite, sleepiness, shaking, constipation, dizziness, restlessness, and behavioral changes. In pediatric patients (ages 13–17), additional side effects include headaches, stomach pain, limb pain, and increased tiredness. Pediatric patients may experience more pronounced sleepiness and higher increases in prolactin levels and liver enzymes compared to adults.

Zyprexa is also linked to Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), a potentially life-threatening condition. Symptoms of DRESS include rash, fever, and swollen glands, requiring emergency medical care.

Although less common, serious adverse effects may occur with both medications. Individuals experiencing signs of an allergic reaction, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat, should seek emergency medical attention right away. 

For more information about common side effects, see the table below. Note that side effect frequency may vary with dosage. This is not a complete list, and other side effects may occur. For more information, consult your healthcare provider or pharmacist.

Compare Latuda vs. Zyprexa side effects
	Latuda		Zyprexa
Side effect	Applicable?	Frequency	Applicable?	Frequency
Insomnia	Yes	7%–11%	Yes	12%
EPS	Yes	6%–22%	Yes	10%–32%
Nausea	Yes	7%–13%	Yes	2%–9%
Vomiting	Yes	6%–9%	Yes	4%
Drowsiness or sedation	Yes	8%–26%	Yes	Varies; up to 52% in people who also took lithium or valproate
Dizziness	Yes	4%–6%	Yes	7%–18%
Dry mouth	Yes	4%–6%	Yes	6%
Headache	No	N/A	Yes	17%
Increased appetite	Yes	3%	Yes	3%–24%

Source: Latuda (DailyMed), Zyprexa (DailyMed)

Latuda and Zyprexa drug interactions

Before starting treatment with Latuda or Zyprexa, tell your healthcare provider about all of the medications you are taking, including prescription drugs, over-the-counter (OTC) medications, vitamins, and dietary supplements. Some drug combinations with Latuda or Zyprexa may need to be avoided or dosages may need to be adjusted. It is also important to avoid alcohol while on these medications. For personalized advice on drug interactions and their effects, consult your prescribing healthcare provider.

Compare Latuda vs. Zyprexa drug interactions
Drug	Drug class	Latuda	Zyprexa
Clarithromycin  Ketoconazole Ritonavir Voriconazole	Strong CYP3A4 inhibitors	Yes	No
Diltiazem  Erythromycin  Verapamil	Moderate CYP3A4 inhibitors	Yes	Yes
Carbamazepine Phenytoin  Rifampin  St. John’s wort	Strong CYP3A4 inducers	Yes	Yes
Bosentan  Modafinil  Nafcillin	Moderate CYP3A4 inducers	Yes	No
Fluvoxamine	SSRI antidepressant	Yes	Yes
Benztropine Diphenhydramine	Anticholinergic drugs	Yes	Yes
Atenolol  Lisinopril  Valsartan	Medications that lower blood pressure	Yes	Yes
Alcohol Anxiety medicines Muscle relaxants Opioid pain medicines  Seizure medicines Sleeping medicines	Drugs that cause central nervous system (CNS) depression	Yes	Yes

 

Latuda and Zyprexa drug warnings

Before taking Latuda or Zyprexa, tell your healthcare provider about your medical history and medical conditions, including if you are pregnant, planning to become pregnant, or breastfeeding.

Latuda and Zyprexa both have a black box warning about an increased risk of death in older adults with dementia-related psychosis as well as an increased risk of suicidal thoughts and behaviors—especially in children and young adults. Patients of all ages on Latuda or Zyprexa should be closely monitored for any mood changes or suicidal thoughts.

Additional warnings for Latuda and Zyprexa include:

• Neuroleptic Malignant Syndrome (NMS) is a rare but severe condition that can be fatal and is associated with antipsychotic medications like Zyprexa and Latuda. Symptoms may include severe muscle stiffness, high fever, delirium, and kidney failure. Immediate medical attention is required if these symptoms occur.
• Tardive dyskinesia (TD) is a type of extrapyramidal symptom (EPS) associated with these medications. It involves repetitive, involuntary movements, such as grimacing, blinking, and lip-smacking. 
• Metabolic changes, such as weight gain, diabetes, and elevated cholesterol levels can occur. 
• There’s a risk of decreases in white blood cells, which may require discontinuation of the medication.
• There’s a risk of orthostatic hypotension, which is a drop in blood pressure when standing that can lead to fainting. Avoid alcohol and refrain from driving or operating machinery until you know how the medication affects you.
• Both medications may increase sensitivity to high temperatures. Stay hydrated and avoid overheating, especially during physical activity and in hot environments.

Can you take Latuda and Zyprexa together?

Combining Latuda and Zyprexa is generally not recommended. Routine use of multiple antipsychotic medications is discouraged due to limited evidence supporting their combined efficacy and safety, as well as increased risks for drug interactions and medication errors. Exceptions may be considered in certain scenarios, such as if a patient has not responded to several single therapies, or if there is a plan to eventually transition to a single medicine. Consult your healthcare provider for medical advice regarding your treatment.