olanzapine (Zyprexa, Zydis)

Olanzapine is a drug that is used to treatschizophreniaand acutemanicepisodes associated withbipolar I disorder.

Olanzapine belongs to a drug class known as atypical antipsychotics. Other members of this class includeclozapine(Clozaril),risperidone(Risperdal),aripiprazole(Abilify) andziprasidone(Geodon). The exact mechanism of action of olanzapine is not known. It may work by blocking receptors for several neurotransmitters (chemicals that nerves use to communicate with each other) in the brain. It binds to alpha-1,dopamine, histamine H-1, muscarinic, and serotonin type 2 (5-HT2) receptors. Olanzapine was approved by the FDA in 1996.

What brand names are available for olanzapine?

Zyprexa, Zyprexa Zydis, Zyprexa Relprevv

Is olanzapine available as a generic drug?

Yes

Do I need a prescription for olanzapine?

Yes

WARNING

• Elderly patients withdementiarelated psychosis treated with antipsychotics are at an increased risk of death.
• When using olanzapine andfluoxetinein combination, also refer to the boxed warning section of the package insert for Symbyax.

Common side effects

Common side effects seen with olanzapine are:

• an inability to sit still (akathisia),
• constipation,
• dizziness,
• drowsiness,
• insomnia,
• dry mouth,
• orthostatic hypotension,
• tremor, and
• weight gain.

Several disorders of movement also may occur with olanzapine, for example, extrapyramidal effects (sudden, often jerky, involuntary motions of the head, neck, arms, body, or eyes).Tardive dyskinesia(involuntary movements of the mouth, tongue, jaw, or eyelids) also may occur in 1 in 100 patients receiving olanzapine. Some cases can be irreversible. The likelihood of developingtardivedyskinesiaincreases with prolonged treatment.

There may be an increased risk of elevated bloodsugarlevels anddiabeteswith olanzapine as well as the other antipsychotic medications in its class. Patients should be tested during treatment for elevated bloodsugar. Additionally, persons with risk factors fordiabetes, includingobesityor a family history ofdiabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.

Patients may develop severe sedation,coma, and ordeliriumafter an injection of extended release olanzapine. Patients must be examined for 3 hours after receiving an injection.

Olanzapine may increaseprolactinlevels. Increased prolactin levels may manifest as abnormalmenstruation, sexual dysfunction, and breast enlargement.

The usual oral dose of olanzapine for treatingschizophreniais 10-20 mg once daily. Therapy is initiated with 5-10 mg/day, and the dose may be increased by 5 mg a day at weekly intervals. The maximum dose is 20 mg daily. The recommended dose of extended release injection is 150-405 mg every 2 or 4 weeks.

Treatment ofbipolar disorderusually is initiated with oral doses of 10-15 mg once daily. The dose may be increased by 5 mg daily at 24 hour intervals. The maximum dose is 20 mg daily.

The usual dose for treating agitation due toschizophreniaorbipolar disorderis 10 mg administered by intramuscular injection (immediate release). Additional 10 mg doses may be administered, but the efficacy of total doses greater than 30 mg daily have not been adequately evaluated.

The recommended treatment for resistantdepressionis 5-20 mg of olanzapine combined with 20-50 mg of fluoxetine once daily in the evening while the recommended treatment fordepression与bipolar disorderis 5-12.5 mg olanzapine combined with 20-50 mg fluoxetine once daily in the evening.

Carbamazepine(Tegretol) can reduce blood concentrations of olanzapine, possibly necessitating higher doses of olanzapine. Otherdrugsthat may also reduce blood levels of olanzapine areomeprazole(Prilosec) and rifampin.

Smokingmay reduce blood concentrations of olanzapine.

Ciprofloxacin(Cipro),diltiazem(Cardizem, Dilacor,Tiazac),erythromycin, andfluvoxamine(Luvox) may have the opposite effect, that is, they may increase blood levels of olanzapine, and the dose of olanzapine may need to be reduced.

Olanzapine can cause orthostatichypotension, a drop in官网地址bwinupon standing up that may causedizzinessor evenfainting. Taking olanzapine with eitherdiazepam(Valium), other relatedbenzodiazepinesoralcoholcan exaggerate the orthostatichypotensioncaused by olanzapine.

There are no adequate studies of olanzapine inpregnantwomen. Olanzapine should only be administered to pregnant women if the benefits justify the unknown risks.

Olanzapine is excreted intobreast milk. Therefore, it is recommended that olanzapine not be used bynursingmothers.

What preparations of olanzapine are available?

Tablets: 2.5, 5, 7.5, 10, 15, 20 mg. Tablets (orally disintegrating): 5, 10, 15, 20 mg. Injection (immediate release): 10 mg vial. Suspension for Injection (extended release): 210, 300, and 405 mg (powder).

How should I keep olanzapine stored?

Tablets should be kept at room temperature, 20 C - 25 C (68 F - 77 F). Suspension is stored at room temperature not to exceed 30 C (86 F).