Olanzapine information from DrugsUpdate
L - Contraindicated in lactation
Olanzapine (trade names Zyprexa, Zyprexa Zydis, Zalasta, Zolafren, Olzapin, Rexapin or in combination with fluoxetine Symbyax) is an atypical antipsychotic, approved by the FDA for the treatment of schizophrenia and bipolar disorder. The olanzapine formulations are manufactured and marketed by the pharmaceutical company Eli Lilly and Company, whose patent for olanzapine proper expires in 2011
Olanzapine is an atypical antipsychotic with affinity for serotonin 5-HT2A/2C, dopamine, muscarinic M1-M5, histamine H1 and adrenergic α1 receptors.
Well absorbed from the GI tract (oral); peak plasma concentrations after 5-8 hr (oral) or 15-45 min (IM).
Extensively hepatic by direct glucuronidation and oxidation.
Urine (as metabolites), faeces; 30-38 hr (elimination half-life).
Postural hypotension; constipation; dizziness; wt gain; agitation; insomnia; akathisia; tremor; personality disorders; oedema; somnolence; increased appetite; antimuscarinic effects; speech difficulty; exacerbation of Parkinson's disease; hallucinations; asthenia; increased body temperature; bradycardia; hyperprolactinaemia; QT prolongation (uncommon); asymptomatic elevations of hepatic transaminases.
Potentially Fatal: Exacerbation of preexisting diabetes sometimes leading to ketoacidosis. Neuroleptic malignant syndrome.
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death compared with those taking placebo. Although the causes of death were varied, most of the deaths appeared to be either CV (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature. Olanzapine is not approved for treatment of dementia-related psychosis.
Assess LFTs periodically; monitor blood glucose for hyperglycemia, and assess patient for symptoms of hyperglycemia (eg, polydipsia, polyuria, polyphagia), especially in diabetic patients. In patients receiving treatment for extended time, periodically reevaluate the long-term usefulness of continued therapy. Monitor baseline and follow-up lipid levels. Regularly monitor patient's weight.
Symptoms: Tachycardia, agitation/aggressiveness, dysarthria, extrapyrimidal symptoms, sedation/coma. Induction of emesis is not recommended, gastric lavage and admin of activated charcoal may be effective. Monitor closely and treat symptomatically
Impaired renal, hepatic, cardiovascular function; prostatic hypertrophy; paralytic ileus; DM; parkinsonism; pregnancy. History of blood dyscrasias, myelosuppression, seizures; dementia; dyslipidaemia. IM: Hypotension, bradyarrhythmia, hypoventilation; monitor BP carefully.
Olanzapine may antagonise the effects of levodopa and dopamine agonists. Drugs that induce CYP1A2 or glucuronyl transferase enzymes e.g. omeprazole and rifampicin, may increase olanzapine clearance. Inhibitors of CYP1A2 may potentially inhibit olanzapine elimination. Carbamazepine may increase the clearance of olanzapine. Concomitant admin of activated charcoal reduced the oral bioavailability of olanzapine by 50-60%. Caution should be taken when olanzapine is administered with centrally acting drugs and alcohol.
Adult: Initially, 5-10 mg daily adjusted in steps of 5 mg, according to response. Usual range: 5-20 mg daily. Doses >10 mg should be given only after clinical reassessment. Max: 20 mg daily.
Renal impairment: Initiate at lower dose (5 mg) and increase cautiously.
Hepatic impairment: Initiate at lower dose (5 mg) and increase cautiously.
Acute mixed or manic episodes in bipolar disorder
Adult: Initially, 10 or 15 mg daily as monotherapy or 10 mg daily when used as part of combination therapy. Adjust dose in steps of 5 mg; usual range: 5-20 mg daily. For prevention of recurrence: Start with 10 mg daily.
Renal impairment: Initiate at lower dose (5 mg) and increase cautiously
Hepatic impairment: Initiate at lower dose (5 mg) and increase cautiously
Rapid control of agitation and disturbed behaviour in schizophrenia or mania
Adult: Initially, 5-10 mg followed by 5-10 mg as required 2 hr later. Max: 3 inj per 24-hr period; max (including oral olanzapine): 20 mg/day. May give injections for up to 3 days but should transfer to oral therapy as soon as possible.
Hepatic impairment: Dose adjustments may be needed.
May be taken with or without food
List of Contraindications
Caution when used during pregnancy.
Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Contraindicated in lactatio
Safety and efficacy not established
Consider a lower starting dose
Angle-closure glaucoma; lactation. IM: History of CVS disease, heart surgery.
Store at 15-30°C.
Store at 15-30°C.
Olanzapine brands in India