Weltruza: A Monthly Olanzapine Shot, and Everything to Ask Before the First Dose

Weltruza is a new way to receive an old medicine. It delivers olanzapine, an antipsychotic used in the United States since 1996, as one shot under the skin of the belly each month. The delivery is new. The body-wide benefits and side effects, including weight gain, match olanzapine tablets, and the shot adds reactions where it is given.12

Weltruza (pronounced wel-troo-zah) is approved for adults with schizophrenia.1 The FDA signed its approval letter on October 8, 2026, and Teva announced the approval the next day.23 This guide explains how the shot works, what the main study found, what to watch for, and how to decide whether it fits your life. Your prescriber chooses your dose and plans any start, stop, or switch.

Get help right away. Call 911 if someone collapses, has a seizure, has trouble breathing, or cannot be woken up.4 After any Weltruza shot, call your prescriber right away or go to the nearest emergency room for much more sleepiness than usual, confusion, trouble walking or talking, stiff muscles or shaking, weakness, or passing out. High fever with stiff muscles and confusion also needs emergency care.1

Key takeaways

• Weltruza is olanzapine, given once a month by a healthcare professional as a shot under the skin of the belly. It is approved only for schizophrenia in adults.1
• If you have never taken olanzapine, you take it by mouth first to show you tolerate it. After that, no extra starting dose and no extra pills are needed.1
• Weight gain is the main side effect to plan for. In the 8-week study, 30% to 39% of people on Weltruza reported weight gain, compared with 9% on placebo.1
• Weltruza has no required three-hour wait after each shot, unlike the older olanzapine muscle shot. The label still says its risk of a rare overdose-like reaction called PDSS is unknown, and it asks clinicians to remind you of that risk at every shot.15
• Each dose keeps releasing medicine for weeks. Side effects do not stop the day you decide to stop, so any change needs a plan.1
• Before your first dose, confirm that your clinic can get the drug and that your coverage is settled. On October 13, 2026, Teva’s prescriber website still said “coming soon.”6

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What Weltruza is and who it is for

Schizophrenia can change how a person thinks, senses the world, and takes part in daily life. Some people hear or see things others do not, or hold strong beliefs that others do not share. Thoughts and speech can become hard to follow. Motivation, emotional expression, memory, and focus can also suffer.7

Treatment aims to ease these symptoms and help a person build the life they want. Medicine is one part of that. Therapy, family education and support, help with work or school, and coordinated care teams also matter.78

Weltruza’s approval covers adults with schizophrenia only. It is not known to be safe and effective in children.1 Olanzapine tablets are also used for bipolar I disorder, but that use does not carry over to this shot.19 If a clinician suggests another use, ask whether it is off-label, meaning outside the FDA approval, and what evidence supports it.

Weltruza carries a boxed warning, the FDA’s strongest label warning. Older adults with dementia-related psychosis who take antipsychotics have a higher risk of death. Weltruza is not approved for that condition.1

How the medicine and the shot work

What olanzapine does in the brain

Brain cells pass messages using chemical signals, including dopamine and serotonin. Olanzapine blocks some of the sites, called receptors, where these signals land. The label says no one knows exactly how it works, but blocking dopamine and serotonin type 2 receptors may explain its benefit.1

Olanzapine also blocks histamine, muscarinic, and alpha-1 receptors.1 The label links the alpha-1 effect to dizziness when standing up, and the muscarinic effect to constipation and dry mouth.1

Receptor effects offer clues. They cannot predict how you will feel. That is why benefit and side effects need to be checked together. Feeling calmer is a gain. Being too sleepy to work or care for yourself is a problem worth raising.

How one shot lasts a month

Weltruza starts as a liquid. Once it is injected, its carrier material forms a small solid deposit under the skin that releases olanzapine slowly.1 Picture a salt block left out in a pasture. It wears down a little at a time over weeks instead of dissolving all at once. The picture is simplified, but it shows why one shot can last a month.

Levels build with each monthly dose and level off after about the fourth dose.1 That does not mean you wait four months to feel any benefit. Blood levels and symptom relief are different measures.

The slow release has a tradeoff. The label reports a median half-life of about 46.5 days, compared with about 30 hours for olanzapine tablets.1 Half-life is the time it takes for the level in the blood to fall by half. With a tablet, a problem can change tomorrow’s plan. After a shot, medicine keeps entering the body for weeks. Report a side effect promptly instead of waiting for the next due date.

What the main study found

The main study, called SOLARIS, enrolled 675 adults aged 18 to 64 whose symptoms had recently worsened.10 Each person received one of three Weltruza doses or a placebo, a shot with no active drug, for 8 weeks.1011

Researchers measured symptoms with a scale called the PANSS, where lower scores mean milder symptoms. At 8 weeks, all three doses lowered scores more than placebo did, by about 10 to 11 points depending on the dose.10 Ratings of overall illness severity and of personal and social functioning also improved more than with placebo.10

A group average cannot tell you how much you will improve. Whether you can return to work, feel safe at home, or enjoy time with family are goals to set and track in your own care.

After 8 weeks, people could stay on Weltruza for up to 48 more weeks, knowing they were getting the active drug. People who had been on placebo were switched to one of the doses.10 Of the 423 people who started this longer phase, 135 finished it. Most who left withdrew on their own or stopped coming to visits. Thirty-three left because of side effects, and 7 left because the drug was not helping enough.10 Teva reported that symptoms stayed improved in people who continued.12 The longer phase had no placebo group, and so many people left that it cannot settle long-term questions.

No one died during the 8-week phase. Three people died during the long-term phase.10 Serious problems reported in that phase included two cases of diabetic ketoacidosis, a dangerous complication of very high blood sugar.10 Without a comparison group, the study cannot show whether the drug caused these events.

The study left out some groups. These included people 65 and older, people at significant risk of suicide or violence, people with moderate or severe substance use problems in the past 6 months, and people with very high blood sugar at screening.10 The results may not apply in the same way to everyone.

Teva paid for the study. Its main results are posted on public trial registries.1011 As of October 13, 2026, we could not find a peer-reviewed journal article reporting them.

A separate Teva-funded survey asked 70 trial participants and 35 trial staff members about their experience. Most were satisfied with the shot.13 Only people still in the trial were surveyed, so people who left because the shot did not suit them were not asked.14 We found no published trial comparing Weltruza head to head with another long-acting shot.

Is a monthly shot a good fit?

A monthly shot means fewer daily medicine tasks: no pills to remember, carry, or refill. Some people also find it cuts down on family arguments about reminders.15 The American Psychiatric Association (APA) suggests offering a long-acting shot when a person prefers one, as well as when pills have been missed.15 You do not have to prove you are “bad at taking pills” to ask about one. You also should not feel pushed into one because it is easier for someone else.

Your past experience with olanzapine tablets is useful here. If tablets helped and the side effects were manageable, a monthly form of the same drug may be worth discussing. If they caused major weight gain or heavy sleepiness, talk that through before choosing a form that stays in the body for weeks.

Questions worth bringing to the visit:

• What do I want treatment to help me do?
• What has helped or caused problems before?
• Can I get to a visit every month?
• How will we notice and handle side effects?
• What other choices fit my goals?
• What happens if I want to change the plan?

Before the first shot

If you have not taken olanzapine before, you take it by mouth first so your prescriber can confirm that you tolerate it.1 This matters because a shot cannot be taken back once it is given.

That trial of tablets is different from “oral overlap,” which means taking pills for a while after the first shot. Weltruza needs no overlap and no extra loading dose at the start.1

The label matches daily tablet doses to monthly shot doses:1

These are matched doses for two different delivery systems, so do not try to calculate your own. When switching from olanzapine tablets, the first shot is given the day after your last tablet, and you do not need to keep taking the tablets.1 Tell your team about any other medicine that contains olanzapine.1 If you take a different antipsychotic or a different dose, ask how the switch will be handled. Do not stop, add, or double tablets on your own.

The injection visit

A healthcare professional prepares and gives every dose under the skin of the belly. It is never given any other way, and it is not a home injection.1

Bring a current medicine list. Tell the team about new symptoms, side effects, recent illness, changes in smoking, and any chance of pregnancy. If needles make you nervous, say so before the shot.

Zyprexa Relprevv, the older olanzapine shot given into a muscle, requires at least three hours of observation after every dose.5 Weltruza has no required observation period.12 Your clinic can explain its own routine. If you feel unwell after a shot, tell staff before you leave. Symptoms that start later still matter.

About 3 in 10 people in the study had a reaction where the shot was given, such as a hard spot, pain, redness, itching, or swelling. About 1 in 12 had one after a placebo shot. Most reactions were mild or moderate.1 Report pain or skin changes that are severe, spreading, or not settling. Do not squeeze, drain, or try to remove a lump yourself.

Common side effects

The label lists the most common side effects as weight gain, sleepiness, headache, constipation, and injection-site reactions.1 In the 8-week study:1

Headache and constipation were close to placebo rates in this short study. These are group numbers, not a forecast for you. “Weight gain reported” counts people who reported it as a side effect. It does not mean everyone gained the same amount.

Other effects worth raising with your team:

Tell the team what a side effect stops you from doing. “I fall asleep at work” or “I cannot have a bowel movement” helps more than “I feel off.” Say when it started, how often it happens, and whether it is getting worse. Do not add a sleep aid, allergy pill, supplement, or leftover medicine without checking first.

Movement and hormone effects

Some antipsychotic side effects involve movement. Akathisia is an inner restlessness, often with fidgeting, pacing, or trouble sitting still.15 It can be mistaken for agitation from the illness itself, so describe what you feel and what others see.15 Stiffness, shaking, and muscle spasms can also occur.15

Tardive dyskinesia is uncontrolled movement, often of the face or tongue. It may not go away even after the medicine stops, and it can even start after stopping.1 Tell your prescriber about any movement you cannot control. Regular movement checks can catch changes you might not notice.15

Olanzapine can raise prolactin, a hormone. Signs can include missed periods, milk leaking from the breasts, breast growth in men, problems with erections, and lower fertility in women.1 These deserve a direct conversation.

Weight, blood sugar, and cholesterol

Olanzapine can raise appetite, weight, blood sugar, and blood fats. The label says Weltruza’s effects on weight and lab values matched what is expected with long-term olanzapine.1 Among 137 people treated for at least 48 weeks, Teva reported an average gain of about 5.6 kg (about 12 pounds). That figure is company data.12

Start with a baseline: your weight and blood tests before the first dose.115 Tell the team about diabetes, high cholesterol, past weight change on medicine, and your family’s health history. If you have diabetes, keep following your diabetes plan and ask how often to check your sugar.1

Weight gain on olanzapine is a known drug effect. It says nothing about effort. More hunger and tiredness make habits harder. A useful plan fits your budget, food access, energy, and home life. Small steps you can repeat work better than extreme diets, and a dietitian or primary care clinician can help. Ask early: “If my weight starts to rise, what is our next step?” The answer may be closer tracking, a medicine change, or treatment for weight or blood sugar.

Medicines that may help

Metformin, a diabetes medicine, is sometimes used to limit antipsychotic weight gain. A 2024 expert guideline recommends starting metformin together with olanzapine, though the certainty of the evidence is low.16 Metformin is FDA-approved for type 2 diabetes, so this use is off-label.17 Your clinician needs to review your kidney function and other health factors first.

Semaglutide, a GLP-1 medicine, was tested in the HISTORI trial. Adults with schizophrenia, prediabetes, and obesity who were taking antipsychotics lost about 9 kg (20 pounds) more and had lower blood sugar on semaglutide than on placebo over 30 weeks. Stomach and bowel side effects were more common.18 That trial did not test Weltruza. Do not start a weight-loss medicine on your own.

Blood sugar warning signs

Tell your care team if you feel very thirsty, need to urinate more than usual, feel very hungry, feel weak or tired, or feel sick to your stomach.1 High blood sugar can appear even in people who do not already have diabetes.9 Confusion or breath that smells fruity can signal a dangerous level and needs urgent care, because extremely high blood sugar can lead to coma or death.19

PDSS: the question the label leaves open

PDSS stands for post-injection delirium/sedation syndrome. It happens when too much olanzapine reaches the blood too quickly, causing symptoms like an overdose.1 It has occurred with Zyprexa Relprevv in fewer than 1 in 1,000 injections and in about 2 in 100 patients treated for up to 46 months. Most cases came within 3 hours of the shot, but some came later.1

No PDSS cases were reported in Weltruza’s studies before approval. The label still says the risk is currently unknown.1 That is why the label tells clinicians to remind you about it each time you get a shot.1 It is also why the FDA asked Teva to send in every reported case quickly for the first 5 years after approval.3

Warning signs after any dose include:1

• feeling more sleepy than usual
• dizziness
• confusion or disorientation
• trouble walking or talking
• stiff muscles or shakiness
• weakness
• feeling grouchy, angry, anxious, or nervous
• a rise in blood pressure
• seizures or passing out

Call your prescriber right away or go to the nearest emergency room.1 Call 911 for a seizure, collapse, trouble breathing, or a person who cannot be woken up.4 Tell the emergency team the drug name and the date of the last shot. Do not try to sort out at home whether it is PDSS, another drug effect, a stroke, or something else.

Other serious warnings

High fever, stiff muscles, and confusion. These can signal neuroleptic malignant syndrome (NMS), along with changes in pulse or blood pressure and heavy sweating. Go to the nearest emergency room or call your prescriber right away.1

Rash with fever or swelling. A rare allergic reaction called DRESS can harm the skin, liver, kidneys, lungs, or heart, and it can be fatal. Warning signs include fever, rash, blistering or peeling skin, swelling of the face or glands, yellow skin or eyes, dark urine or changes in urination, chest pain, and cough or trouble breathing. Call your prescriber right away.1 Trouble breathing or fast swelling of the face or throat needs 911.

Dizziness and falls. Weltruza can lower blood pressure when you stand, make you sleepy, and slow your thinking and movement, which can lead to falls and broken bones.1 Stand up slowly and report dizziness. Fainting or a fall injury needs prompt care.

Severe constipation or trouble urinating. Olanzapine can slow the bowel and bladder, and the risk rises with other medicines that do the same.1 Severe belly pain, a swollen belly with vomiting, or being unable to pass urine needs urgent care. Tell the team about past bowel blockage or prostate problems before treatment.1

Trouble swallowing. Food or liquid can go into the lungs.1 Report coughing or choking while eating.

Low white blood cells. These cells fight infection. If you have had low counts before, expect blood tests during the first few months.1 Report fever or other signs of infection.

Seizures and overheating. Tell the team about any seizure history. Olanzapine can also make it harder for the body to cool down.1

A list of risks does not mean each one will happen to you. The goal is to know which changes need a call and which need emergency care.

Other medicines, alcohol, and smoking

Bring a full list of prescriptions, over-the-counter products, vitamins, and supplements. Do not start or stop a medicine without talking to your prescriber first.1

Some medicines change how fast the body clears olanzapine. The label names carbamazepine and rifampin as medicines that can lower olanzapine levels, and fluvoxamine as one that can raise them. Several of these interactions involve a liver enzyme called CYP1A2.1 Olanzapine can also strengthen blood pressure medicines and weaken levodopa and similar Parkinson’s medicines.1 Medicines that cause constipation or dry mouth add to those effects.1 Ask your pharmacist to check each new medicine.

Avoid alcohol. The Medication Guide says it raises the risk of dizziness, sleepiness, and other side effects.1 Tell your team honestly about cannabis or other drug use so they can tell medicine effects apart from changes in the illness.

Smoking changes drug levels

Tobacco smoke speeds up the liver’s breakdown of olanzapine. Smokers clear Weltruza 22.5% faster, though the label found no meaningful difference in benefit or side effects between smokers and nonsmokers.1 A change in smoking is a different matter. When someone stops or cuts back, levels can start rising within about three days, and the full shift can take two to four weeks. Starting again can lower levels.1920

The effect comes from chemicals in tobacco smoke, not from nicotine. Nicotine patches, gum, and vapes do not cause it, so switching to them counts as stopping smoking for this purpose. A hospital stay where you cannot smoke has the same effect.19 Tell your prescriber about any change. Quitting is good for your health; plan it so medicine effects can be watched, and never adjust a dose yourself. Our Quit Kit covers the options for quitting.

Pregnancy, breastfeeding, and other health conditions

Talk about pregnancy plans before starting if you can. If you become pregnant, contact your prescriber and your pregnancy clinician, and do not make a sudden change on your own. They will weigh the risks of the medicine against the risks of untreated illness.

Receiving Weltruza in the third trimester can cause newborn problems such as abnormal muscle movements, agitation, stiffness or floppiness, tremors, sleepiness, and breathing or feeding trouble.1 Make sure the delivery and newborn teams know the date of the last shot. The National Pregnancy Registry for Atypical Antipsychotics (1-866-961-2388) collects outcomes to help future patients.1

Olanzapine passes into breast milk. If you breastfeed, watch for a baby who is very sleepy, irritable, feeding poorly, or has tremors or unusual movements.121 Most breastfeeding data come from olanzapine tablets, with only one published report involving a long-acting olanzapine shot.21 Make a feeding plan with your prescriber and your baby’s clinician. Our guide to staying well through pregnancy and the postpartum weeks goes deeper.

Weltruza’s studies did not include anyone 65 or older.1 Older adults may need extra care because of falls, other medicines, and other illnesses.

Before starting, tell your clinician about diabetes or high blood sugar, high cholesterol, low or high blood pressure, heart problems or stroke, low white blood cell counts, seizures, urinary or prostate problems, constipation or bowel blockage, breast cancer, or dehydration.1 Weltruza was not studied in people with kidney or liver problems.1 The label lists no conditions that rule it out completely, but that does not mean it suits everyone.1

Health checks during treatment

An injection visit is a chance to review the whole plan. The checks below follow the APA guideline for any antipsychotic. They are not a special Weltruza schedule, and your team may check more often.15

Other tests depend on your health. These may include a blood count if you have had low counts, a prolactin test for hormone symptoms, or a heart tracing (ECG) if you have heart risks.115

Ask who orders your labs and who reviews them. A test helps only when someone acts on it. A simple log of shot dates, concerns, and goals is enough. You do not need to hunt for problems every day.

Daily life and family support

Driving, work, travel, and heat

Do not drive or use dangerous machinery until you know how Weltruza affects you.1 Having no required waiting period does not mean you are safe to drive right after a shot. If you feel sleepy, dizzy, or slowed, arrange a ride. If your work or childcare needs quick reactions, talk about alertness before the first dose.

Plan travel around your shot dates, and ask the clinic for help if a date needs to move. Carry a medicine list and the date of your last shot. Tell any surgeon or dentist that you receive olanzapine.9

Avoid getting too hot or dehydrated. In hot weather, stay in a cool place, stay out of the sun, skip heavy clothing, drink plenty of water, and do not overexercise.1 If a doctor has limited your fluids for another condition, ask how to balance the two. Call your doctor right away if you are very ill with signs of dehydration, such as sweating too much or not at all, a dry mouth, feeling very hot or thirsty, or being unable to urinate.1

How family can help

Start by asking what help the person wants: a ride, a reminder they agree to, or help writing down questions. Be specific about who does what and when.

Listen to both sides of the experience. A family may be relieved that distress has eased while the person is bothered by tiredness or weight gain. Both matter, and both belong in the visit, with the person’s permission.

Agree ahead of time on changes that should prompt a call, such as much less sleep, rising distress, new movements, falls, or heavy sleepiness. Describe what you see without deciding the cause.

Ask how the person wants information shared. Leave room for private questions about sex, fertility, or substance use. Family education and coordinated care help with daily challenges, and support with housing, work, school, and substance use matters too. A monthly shot does not replace those parts of care.78 Our essay on living with antipsychotic injections covers family support in more detail.

For a mental health crisis, call or text 988.7 For a poisoning question or a possible extra dose, call Poison Control at 1-800-222-1222.22 Call 911 first for severe symptoms.4

Other treatment choices

Choosing Weltruza means choosing both a drug and a way of giving it. A new delivery method can ease the daily task, but it will not fix a side effect that comes from olanzapine itself. A different drug brings a different set of tradeoffs.

Each product has its own doses, warnings, and approved uses. This table is not a switching plan.1592324

Other options include paliperidone shots and tablets that work in different ways. Cobenfy, for example, acts on cholinergic receptors instead of dopamine receptors.25 It has its own side effects and conditions that rule it out, such as urinary retention and some liver problems.26 See our full comparison of long-acting injections and our Cobenfy guide.

If symptoms continue despite adequate treatment, the team should recheck the diagnosis, whether the medicine is being received as planned, other illnesses, and substance use. The APA recommends clozapine for treatment-resistant schizophrenia.15 Switching to a long-acting form does not replace that review.

No single shot is safest or most effective for everyone. Ask which option matches your past response and your goals.

Cost, access, and missed doses

Confirm access before the first dose

FDA approval and an appointment-ready supply are separate questions. Teva said Weltruza would be available in the coming weeks, and its prescriber website still said “coming soon” on October 13, 2026.26 Ask whether your clinic can get it now.

No single price applies to everyone. Cost depends on your plan, the clinic, and whether the drug is billed through your pharmacy benefit or your medical benefit. Ask about the charge for the drug, the injection, the visit, and lab work.

Teva’s support program helps with insurance questions, prior authorization (an insurer’s approval before it agrees to pay), and appeals.6 Teva’s savings program is for people with commercial insurance only. People with Medicare, Medicaid (Medi-Cal in California), VA, TRICARE, or other government coverage cannot use it, and neither can people who are uninsured or paying cash. It has annual limits, and the current terms run through December 31, 2026. It also ends if your commercial plan does not cover Weltruza or denies prior authorization, and it does not pay for office visits or injection fees.27

Being left out of the savings program does not mean your plan will refuse to cover the drug. Ask your clinic and your plan to check. In Medi-Cal, antipsychotic medicines, including shots given in a clinic, are paid by the state’s Medi-Cal program rather than by managed care plans such as IEHP.2829 Newly approved drugs can take extra time before clinics can bill for them.28 Ask your clinic how Medi-Cal will handle Weltruza.

Ask who orders the drug, whether a specialty pharmacy is involved, and what happens if approval is delayed. Settle the plan for the second dose before the first one is given.

If you miss a shot

Call the clinic right away to reschedule.1 The label allows a dose up to one week before or after the monthly due date. If more than five weeks pass since the last shot, the next dose is given as soon as possible, and later dates are reset from that day.1 Let the team manage the timing, and tell them about any symptom changes or new medicines. Do not use leftover tablets to “catch up.”

Stopping or switching

You can raise stopping or changing treatment at any visit. Say why: side effects, cost, or too little benefit. The reason shapes a safer plan.

A long-acting dose fades over weeks. It does not end the day you decide to stop.1 Your prescriber has to account for that when starting another medicine, and no single switch schedule fits everyone.

Olanzapine is not a controlled substance. The label also says dependence and tolerance have not been well studied in people.1 Symptoms returning after a change and withdrawal-like effects are different problems, and both need a clinician’s review. Stopping still needs a plan.

How long to stay on treatment depends on your illness, history, response, risk of relapse, and wishes. When you feel well, use the next visit to talk about what is working. Skipping visits without a plan puts that progress at risk.

Frequently asked questions

Is Weltruza the same as Zyprexa Relprevv?

Both contain olanzapine, but they are different products. Relprevv is a muscle shot given every 2 or 4 weeks, with a required watch of at least 3 hours afterward. Weltruza is a monthly shot under the skin with no required watch period.15

Do I have to stay at the clinic after a Weltruza shot?

The label sets no required observation period.1 Ask about your clinic’s routine, and tell staff before leaving if you feel unwell. Because the PDSS risk is unknown, learn the warning signs.1

Do I need to take olanzapine pills before starting Weltruza?

Only if you have not taken olanzapine before. In that case you take tablets first to confirm you tolerate them. You do not need pills after the first shot.1

Does Weltruza cause weight gain?

It can. In the 8-week study, 30% to 39% of people on Weltruza reported weight gain, compared with 9% on placebo.1 Plan weight checks and blood tests from the start.

How long does Weltruza stay in your body?

Each dose releases medicine for weeks. The label reports a median half-life of about 46.5 days, so levels fall slowly after the last shot.1

What happens if I miss a Weltruza injection?

Call the clinic right away. The label allows a dose within one week of the due date. If more than five weeks have passed, the next dose is given as soon as possible and the schedule restarts from there.1

Can I drink alcohol on Weltruza?

Avoid it. Alcohol raises the risk of dizziness, sleepiness, and other side effects.1

Is Weltruza covered by Medi-Cal or Medicare?

Coverage depends on your plan and was still being set up in October 2026. In Medi-Cal, antipsychotics are paid by the state program rather than by plans such as IEHP, and new drugs can take time to become billable.28 Teva’s savings program excludes Medi-Cal, Medicare, and other government plans, but your coverage may still pay for the drug. Ask your clinic to check.27

Can someone with bipolar disorder get Weltruza?

Weltruza is approved only for schizophrenia in adults.1 Some other long-acting shots, including Uzedy and Abilify Maintena, are approved for bipolar I maintenance.2324

What should I ask before deciding?

Ask about the expected benefit, your biggest risks, the health checks you will need, access and cost, other options, and what happens if you want to change the plan.

How this essay was checked

Every factual claim was checked on October 13, 2026 against the Weltruza prescribing information and Medication Guide, the FDA approval letter, the SOLARIS trial registry records, the comparator labels, and the cited guidelines and public health sources. Trial numbers come from the label and the registry, not from press coverage. Where a figure comes only from Teva, the text says so. Product availability and coverage change quickly, so confirm them with your clinic.

Related reading on NP FADY

• Long-Acting Antipsychotics: How They Work and Who They Help covers the starting point for how long-acting shots work and who they help.
• Antipsychotic Injections: Comparing Your Treatment Options covers every long-acting antipsychotic side by side, with starts and schedules.
• Living With Antipsychotic Injections: Safety and Family Support covers the visit, health checks, missed doses, and how families can help.
• Cobenfy for Schizophrenia: A New Pathway and Its Tradeoffs covers a daily option that works on a different brain system.
• Combining GLP-1s With Mood Stabilizers and Antipsychotics covers what is known about using GLP-1 medicines alongside antipsychotics.
• Quit Kit: Every Way Out of Nicotine, Ranked by Evidence covers quitting options, and why your prescriber should know before you quit.
• Staying Well Through Pregnancy and the Postpartum Weeks covers medicine decisions around pregnancy and breastfeeding.
• What to Tell Your Psychiatrist at the First Visit covers how to prepare for an appointment so it covers what matters to you.

References

1. WELTRUZA (olanzapine) for extended-release injectable suspension: Prescribing Information and Medication Guide. Teva Neuroscience. Revised October 2026. https://www.weltruza.com/globalassets/weltruza/prescribing-information.pdf Accessed 2026-10-13.

2. Teva announces U.S. Food and Drug Administration (FDA) approval of WELTRUZA (olanzapine) for extended-release injectable suspension, as the first and only once-monthly subcutaneous injectable olanzapine for adults with schizophrenia. Teva Pharmaceuticals. October 9, 2026. https://www.tevausa.com/news-and-media/press-releases/teva-announces-u.s.-food-and-drug-administration-fda-approval-of-weltruza-olanzapine-for-extended-re/ Accessed 2026-10-13.

3. NDA 219007 approval letter, WELTRUZA. US Food and Drug Administration. Signed October 8, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2026/219007Orig1s000ltr.pdf Accessed 2026-10-13.

4. Poison Control home page (when to call 911). National Capital Poison Center, webPOISONCONTROL. https://www.poison.org/ Accessed 2026-10-13.

5. ZYPREXA RELPREVV (olanzapine pamoate) Prescribing Information. FDA labeling. Revised May 2026. https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/022173s043lbl022173s040lbl.pdf Accessed 2026-10-13.

6. WELTRUZA resources for healthcare professionals (site banner and Teva support resources). Teva Pharmaceuticals. https://www.weltruzahcp.com/resources Accessed 2026-10-13.

7. Schizophrenia. National Institute of Mental Health. NIH Publication No. 24-MH-8082, revised 2024. https://www.nimh.nih.gov/health/publications/schizophrenia Accessed 2026-10-13.

8. Recovery After an Initial Schizophrenia Episode (RAISE). National Institute of Mental Health. https://www.nimh.nih.gov/research/research-funded-by-nimh/research-initiatives/recovery-after-an-initial-schizophrenia-episode-raise Accessed 2026-10-13.

9. Olanzapine. MedlinePlus Drug Information, US National Library of Medicine. Last revised May 15, 2026. https://medlineplus.gov/druginfo/meds/a601213.html Accessed 2026-10-13.

10. A randomized, double-blind, placebo-controlled study with an open-label, long-term safety phase to evaluate the efficacy and safety of TV-44749 in adults with schizophrenia (SOLARIS), NCT05693935. ClinicalTrials.gov. Results first posted January 9, 2026. https://clinicaltrials.gov/study/NCT05693935 Accessed 2026-10-13.

11. SOLARIS trial results, EudraCT 2022-001865-11. EU Clinical Trials Register. Results first published February 8, 2026. https://www.clinicaltrialsregister.eu/ctr-search/trial/2022-001865-11/results Accessed 2026-10-13.

12. New long-term safety data from the completed phase 3 SOLARIS trial support the potential of olanzapine LAI (TEV-‘749) as the first long-acting olanzapine treatment option for schizophrenia with no PDSS observed. Teva Pharmaceuticals. September 20, 2025. https://www.tevapharm.com/news-and-media/latest-news/new-long-term-safety-data-from-the-completed-phase-3-solaris-trial-support-the-potential-of-olanzapine-la/ Accessed 2026-10-13.

13. Cutler AJ, Gonzalez A, Suett M, et al. Patient and healthcare professional attitudes and trial experiences with a subcutaneous long-acting injectable olanzapine (TV-44749) for schizophrenia treatment. Adv Ther. Published online September 15, 2026. doi:10.1007/s12325-026-03697-y. https://doi.org/10.1007/s12325-026-03697-y Accessed 2026-10-13.

14. New data strengthens Teva’s schizophrenia portfolio, including phase 3 SOLARIS trial survey results demonstrating patient and healthcare professional satisfaction with TEV-‘749 (olanzapine). Teva Pharmaceuticals. March 31, 2025. https://www.tevapharm.com/news-and-media/latest-news/new-data-strengthens-tevas-schizophrenia-portfolio-including-phase-3-solaris-trial-survey-results-demon/ Accessed 2026-10-13.

15. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia, Third Edition. American Psychiatric Association. 2020 (book edition 2021). https://www.med.unc.edu/psych/epi-nc/wp-content/uploads/sites/720/2024/01/APA-2020-guidelines-1.pdf Accessed 2026-10-13.

16. Carolan A, Hynes-Ryan C, Agarwal SM, et al. Metformin for the prevention of antipsychotic-induced weight gain: guideline development and consensus validation. Schizophr Bull. 2025;51(5):1193-1205. doi:10.1093/schbul/sbae205. https://academic.oup.com/schizophreniabulletin/article/51/5/1193/7919241 Accessed 2026-10-13.

17. GLUMETZA (metformin hydrochloride) extended-release tablets Prescribing Information. FDA labeling. Revised August 2026. https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/021748s031lbl.pdf Accessed 2026-10-13.

18. Ganeshalingam AA, Uhrenholt N, Arnfred S, et al. Semaglutide treatment of antipsychotic-treated patients with schizophrenia, prediabetes, and obesity: the HISTORI randomized clinical trial. JAMA Psychiatry. 2025;82(11):1065-1074. doi:10.1001/jamapsychiatry.2025.2332. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2838205 Accessed 2026-10-13.

19. Considering drug interactions with smoking. NHS Specialist Pharmacy Service. Published October 31, 2023; updated November 8, 2023. https://www.sps.nhs.uk/articles/considering-drug-interactions-with-smoking/ Accessed 2026-10-13.

20. Managing specific interactions with smoking: olanzapine. NHS Specialist Pharmacy Service. Published October 31, 2023. https://www.sps.nhs.uk/articles/managing-specific-interactions-with-smoking/ Accessed 2026-10-13.

21. Olanzapine. Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development. Last revision April 15, 2026. https://www.ncbi.nlm.nih.gov/books/NBK501056/ Accessed 2026-10-13.

22. What You Can Do. Poison Help, Health Resources and Services Administration. https://poisonhelp.hrsa.gov/what-you-can-do Accessed 2026-10-13.

23. UZEDY (risperidone) extended-release injectable suspension Prescribing Information. Teva Neuroscience. Revised October 2025. https://www.uzedy.com/globalassets/uzedy/prescribing-information.pdf Accessed 2026-10-13.

24. ABILIFY MAINTENA (aripiprazole) extended-release injectable suspension Prescribing Information. Otsuka. Revised February 2026. https://www.otsuka-us.com/media/static/Abilify-M-PI.pdf Accessed 2026-10-13.

25. FDA approves drug with new mechanism of action for treatment of schizophrenia. US Food and Drug Administration. September 26, 2024. https://www.fda.gov/news-events/press-announcements/fda-approves-drug-new-mechanism-action-treatment-schizophrenia Accessed 2026-10-13.

26. COBENFY (xanomeline and trospium chloride) Prescribing Information. FDA labeling. Original approval, September 2024. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/216158s000lbl.pdf Accessed 2026-10-13.

27. Terms and conditions for the Savings Program for WELTRUZA. Teva Pharmaceuticals. Valid for doses dispensed October 8, 2026 through December 31, 2026. https://www.weltruzatandc.com/globalassets/weltruza/savings-offer-weltruza-terms-and-conditions.pdf Accessed 2026-10-13.

28. Provider bulletin: reminder, billing for drug classes carved out to Department of Health Care Services fee-for-service (Inland Empire, Los Angeles, Sacramento, San Diego). Molina Healthcare of California. August 1, 2024. https://medicare.centralhealthplan.com/-/media/Molina/PublicWebsite/PDF/Providers/ca/Medicaid/Provider-Bulletin-08-01-2024-Reminder-Billing-for-Drug-Classes-Carved-out-to-Department-of-Health-Care-Services-Fee-For-Service-IE-LA-SAC-SD.ashx Accessed 2026-10-13.

29. Changes to the pharmacy reimbursable physician administered drugs, effective May 1, 2025. Medi-Cal Rx, California Department of Health Care Services. https://medi-calrx.dhcs.ca.gov/cms/medicalrx/static-assets/documents/provider/publications/2025.05_A_Changes_to_PADs.pdf Accessed 2026-10-13.

This essay is for education only. It is not medical advice and does not replace care from your own clinician. Evidence checked October 13, 2026. Drug availability, insurance coverage, and labeling can change after that date.

If you or someone you know is in crisis

• Call 911 or go to your nearest emergency room for any life-threatening emergency.
• 988 Suicide & Crisis Lifeline — call or text 988, or chat at 988lifeline.org, available 24/7, free and confidential. En español: marque 988 y oprima 2, o envíe AYUDA al 988. Deaf or hard of hearing: 988 videophone (ASL) or TTY 711 then 988. Veterans: 988 and press 1, or text 838255.
• Crisis Text Line — text HOME to 741741.
• The Trevor Project (crisis support for LGBTQ+ young people) — call 1-866-488-7386, or text START to 678-678.
• National Sexual Assault Hotline (RAINN) — call 1-800-656-HOPE (4673) or text HOPE to 64673; free, confidential, 24/7. Online chat at RAINN.org/hotline.
• National Domestic Violence Hotline — call 1-800-799-SAFE (7233) or text START to 88788; 24/7, help in 200+ languages. Online chat at TheHotline.org. If your phone or computer may be monitored, calling from a safer device is an option.
• Riverside County — Inland SoCal Crisis Helpline 951-686-HELP (4357), 24/7 (Inland SoCal United Way / 211+, in partnership with RUHS-BH); Community Access, Referral, Evaluation and Support (CARES) Line 800-499-3008, 24/7.
• San Bernardino County — Access Unit (Behavioral Health Helpline) 888-743-1478, 24/7; Mobile Crisis/CCRT 800-398-0018 (24/7, all ages) or text 909-420-0560. Arrowhead Regional Medical Center (ARMC) has a dedicated walk-in adolescent psychiatric ER (ages 13–17).
• Children under 13 — call 911 for immediate danger, contact your county's mobile crisis team (they respond to all ages), or go to the nearest pediatric emergency room.
• California Peer-Run Warm Line (non-crisis — someone to talk to) — call or text 1-855-600-WARM (9276); daytime and evening hours, not a 24/7 line.
• NP Fady (non-emergency) — for routine scheduling or questions, call (909) 707-6261. This line is not monitored for emergencies.