asenapine vs olanzapine
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
Side-by-side comparison of asenapine and olanzapine. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Saphris
Zyprexa
Asenapine (Saphris) is an antipsychotic medicine. It is used to treat bipolar I disorder in adults and children ages 10-17.
Olanzapine is a medicine used to treat certain mental disorders. It helps to balance chemicals in the brain to improve mood and behavior.
Asenapine is used to treat bipolar I disorder. In children ages 10 to 17, it can treat manic or mixed episodes on its own. In adults, it can be used with lithium or valproate to treat these episodes.
Olanzapine is used to treat schizophrenia in adults and teens (13-17). It also treats manic or mixed episodes of bipolar I disorder in adults and teens (13-17). In adults, it can be used with other medicines to treat bipolar depression.
Asenapine affects certain chemicals in the brain. These chemicals are called neurotransmitters. By changing the balance of these chemicals, asenapine can help reduce symptoms of bipolar disorder.
Olanzapine is an atypical antipsychotic. It works by affecting the levels of certain chemicals in your brain. These chemicals include dopamine and serotonin, which can help improve mood, thinking, and behavior.
- • Sleepiness
- • Numbness in the mouth
- • Dizziness
- • Changes in taste
- • Nausea
- • Dizziness
- • Weight gain
- • Increased appetite
- • Dry mouth
- • Constipation
- Drug Interaction 78
- Toxicity To Various Agents 64
- Completed Suicide 61
- Myocarditis 53
- Sedation 39
- Weight Increased 6,722
- Diabetes Mellitus 5,388
- Drug Interaction 4,048
- Toxicity To Various Agents 3,966
- Somnolence 3,839
Asenapine may increase the risk of death in elderly patients who have psychosis related to dementia. Asenapine is not approved to treat this condition.
Olanzapine can increase the risk of death in older adults with dementia-related psychosis. Olanzapine is not approved to treat this condition. When using olanzapine with fluoxetine, read the Symbyax label for more warnings.
Tell your doctor if you are pregnant or plan to become pregnant. Babies born to mothers who use antipsychotics in the last 3 months of pregnancy may have withdrawal symptoms after birth. There is a pregnancy registry, call 1-866-961-2388.
If you take olanzapine during the third trimester of pregnancy, your baby may have withdrawal symptoms after birth. There is a pregnancy registry to monitor outcomes in women who take atypical antipsychotics during pregnancy. Talk to your doctor.
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How to Read This asenapine vs olanzapine Comparison
asenapine is classified in the Atypical Antipsychotic drug class, while olanzapine sits within the Atypical Antipsychotic class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, asenapine has 295 submissions while olanzapine has 23,963. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for asenapine or olanzapine.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.