Olanzapine

(Zyprexa, Oliza)

Olanzapine Use

Antipsychotic/antimanic. Schizophrenia and related psychoses: Adults, 5-10 mg/day initially, with a target dose of 10 mg/day within several days. Make further adjustments, if indicated, at intervals of not less than 1 week. Olanzapine dose increments/decrements of 5 mg/day are recommended. Safety/efficacy of doses>20 mg/day not established. Maintenance therapy: Use the lowest Olanzapine dose needed to maintain remission. Reassess patients periodically to determine the need for maintenance treatment.

Bipolar mania: Initially, 15 mg Olanzapine once daily in monotherapy or 10 mg daily in combination therapy (e.g., with lithium or divalproex sodium). Olanzapine dosage range: 5-20 mg/day. Adjust dosage in response to clinical assessment.

Elderly or debilitated patients: Start with 5 mg/day and, if indicated, increase dosage with caution.

Hepatic and/or renal impairment: Start with 5 mg/day and titrate slowly to initial target dose. If indicated, increase dosage with caution.

The Zydis tablet begins to dissolve in the mouth within seconds, allowing it to be swallowed with or without liquid. Alternatively, the tablet can be mixed with 125 mL of water, milk, coffee, orange or apple juice and the contents promptly consumed.

Olanzapine Precautions

Neuroleptic malignant syndrome, tardive dyskinesia. Hypotension and syncope, especially in initiation of treatment. History of seizures. Hepatic, renal, cardiovascular disease. Lactation(breast-feeding is not recommended) and pregnancy. Hyperglycemia. Hyperprolactinemia. Suicide. Safety/efficacy in children < 18 years not established. Disruption of body temperature regulation. Antiemetic effect. If symptoms of infection occur, consider WBC count and differential count.

Olanzapine Side effects

Dizziness, somnolence, dry mouth, dyspepsia, constipation, ALT (SGPT) increased, personality disorder, increased appetite, weight gain, akathisia, asthenia, tremor, postural hypotension. Rare cases of Priapism and leukopenia.

Olanzapine Interactions

Olanzapine may enhance the effects of alcohol, centrally-acting drugs, antihypertensive agents; may antagonize the effects of levodopa and dopamine agonists. Decreased levels of Olanzapine with carbamazepine, omeprazole. Inhibitors of Olanzapin's metabolism: fluvoxamine, ciprofloxacin, ketoconazole. Concomitant smoking may increase Olanzapin's metabolism.

Olanzapine Patient tips

Caution re somnolence (NB driving); hypotension/syncope, especially on starting Olanzapine.

Olanzapine Supplied

2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg Olanzapine tablets (contain lactose); 5 mg, 10 mg, 15 mg orally disintegrating (Zydis) tablets (contain phenylalanine); i.m. injection, 10 mg single use vials.

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