Two medicines, side by side
Ziprasidone vs olanzapine
Ziprasidone and olanzapine are both labeled for bipolar disorder and schizophrenia. Drugs@FDA records approvals of ziprasidone since 2001 and of olanzapine since 1996. Pharmacies paid $0.269 per ziprasidone HCl 20 mg capsule and $0.147 per olanzapine 20 mg tablet (NADAC, October 7, 2026). How each works, in its label's words: Ziprasidone, “The mechanism of action of ziprasidone in the treatment of the listed indications could be mediated through a combination of dopamine type 2 (D 2 ) and serotonin type 2 (5HT 2 ) antagonism.”; Olanzapine, “The mechanism of action of olanzapine, in the listed indications is unclear.”
Check it at the source: the ziprasidone FDA label on DailyMed (effective July 20, 2026); the olanzapine FDA label on DailyMed (effective March 5, 2026).
Highlights of the ziprasidone record
Ziprasidone (Geodon) · label of July 20, 2026
INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Ziprasidone capsules are not approved for the treatment of patients with dementia-related psychosis [see Warnings and Precautions ( 5.1 )]. WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsZiprasidone capsules are indicated for the treatment of schizophrenia, as monotherapy for the acute treatment of bipolar manic or mixed episodes, and as an adjunct to lithium or valproate for the maintenance treatment of bipolar disorder. […]
On the market
- Earliest approval on file
- February 5, 2001
- Generic labelers
- 23 labelers
- Pharmacy cost
- $0.269 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Highlights of the olanzapine record
Olanzapine (Zyprexa) · label of March 5, 2026
INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients.
Used for
From the label: indicationsOlanzapine is an atypical antipsychotic indicated: As oral formulation for the: · Treatment of schizophrenia. ( 1.1 ) · Adults: Efficacy was established in three clinical trials in patients with schizophrenia: two 6-week trials and one maintenance trial. ( 14.1 ) · Adolescents (ages 13-17): Efficacy was established in one 6-week trial in patients with schizophrenia ( 14.1 ). […]
On the market
- Earliest approval on file
- September 30, 1996
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.147 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 14
Source: FDA drug labels via openFDA (Ziprasidone label of July 20, 2026, Olanzapine label of March 5, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do ziprasidone and olanzapine differ on the record?
How each works, in its label's words: Ziprasidone, “The mechanism of action of ziprasidone in the treatment of the listed indications could be mediated through a combination of dopamine type 2 (D 2 ) and serotonin type 2 (5HT 2 ) antagonism.”; Olanzapine, “The mechanism of action of olanzapine, in the listed indications is unclear.”
Both are in FDA's class atypical antipsychotics.
Half-life, in each label's words: Ziprasidone, “Elimination of ziprasidone is mainly via hepatic metabolism with a mean terminal half-life of about 7 hours within the …”; Olanzapine, “Its half-life ranges from 21 to 54 hours (5th to 95th percentile; mean of 30 hr), and apparent plasma clearance ranges …”
Both labels carry a boxed warning; the records quote them.
Generics: ziprasidone since 2012; olanzapine since 2011 (Drugs@FDA).
| Ziprasidone | Olanzapine | |
|---|---|---|
| Labeled for | Bipolar disorder, Schizophrenia | Schizophrenia, Bipolar disorder, Depression |
| Pharmacologic class | Atypical Antipsychotic | Atypical Antipsychotic |
| How it works (label) | The mechanism of action of ziprasidone in the treatment of the listed indications could be mediated through a combination of dopamine type 2 (D 2 ) and serotonin type 2 (5HT 2 ) antagonism. | The mechanism of action of olanzapine, in the listed indications is unclear. However, the efficacy of olanzapine in schizophrenia could be mediated through a combination of dopamine and serotonin type 2 (5HT 2 ) antagonism. |
| Half-life (label) | Elimination of ziprasidone is mainly via hepatic metabolism with a mean terminal half-life of about 7 hours within the proposed clinical dose range. | Its half-life ranges from 21 to 54 hours (5th to 95th percentile; mean of 30 hr), and apparent plasma clearance ranges from 12 to 47 L/hr (5th to 95th percentile; mean of 25 L/hr). |
| Earliest approval on file (Drugs@FDA) | February 5, 2001 | September 30, 1996 |
| First generic approved | March 2, 2012 | October 24, 2011 |
| Generic labelers (NDC) | 23 labelers | 43 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.269 per capsule (Ziprasidone HCl 20 mg capsule) | $0.147 per tablet (Olanzapine 20 mg tablet) |
| 12-month price change | -13% | -5% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 1 | 14 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 6,148 | 107,881 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Ziprasidone label, drug interactionsRisk of serotonin syndrome with concomitant therapy with other serotonergic drugs such as SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, tryptophan, buspirone, amphetamines, and St. John’s Wort [see Contraindications ( 4.3 ), Warnings and Precautions ( 5.4 ), Adverse Reactions ( 6.2 )].
Source: FDA drug labels via openFDA
What next?
- Alternatives to ziprasidone
- every medicine labeled for the same conditions