ZYPREXA OLANZAPINE 5MG TABLETS 28S
KSh5,187.00
Indications and dosage
1. Schizophrenia
PO
- 5-10 mg/day initially; if necessary, may be titrated upward in increments of 5 mg/day at intervals >1 week
- Maintenance: 10-20 mg/day; not to exceed 20 mg/day
2. Bipolar Mania
Indicated for acute/maintenance treatment of manic or mixed episodes associated with bipolar 1 disorder; may be used adjunctively to valproate or lithium in the treatment of manic or mixed episodes associated with bipolar disorder
Monotherapy: 10-15 mg/day PO initially; may be titrated upward in increments of 5 mg/day at intervals >24 hr
Adjunct to lithium or valproate: 10 mg/day PO initially
Maintenance: 5-20 mg/day PO; not to exceed 20 mg/day
3. Bipolar Depression
Indicated for depressive episodes associated with bipolar I disorder in combination with fluoxetine
5 mg PO in evening; adjusted to range of 5-12.5 mg/day
4. Chemotherapy Associated Nausea or Vomiting (Off-label)
Off-label use for prevention of chemotherapy associated nausea or vomiting in combination with 5-HT3 antagonist and dexamethasone (N Engl J Med 2016;375[2]:134-42)
Breakthrough nausea and vomiting: 5-10 mg PO qDay for 3 days, when not used for acute and delayed emesis prevention
Acute and delayed emesis prevention
- Off-label use for prevention of chemotherapy associated nausea or vomiting in combination with 5-HT3 antagonist and dexamethasone
- In combination with dexamethasone and a 5-HT3 antagonist (eg, palonosetron, aprepitant)
- High emetic risk IV chemotherapy: 10 mg PO the day of chemotherapy (day 1), followed by 10 mg PO qDay (days 2-4)
- Moderate emetic risk IV chemotherapy: 10 mg PO the day of chemotherapy (day 1), followed by 10 mg PO qDay (days 2-3)
???? PEDIATRICS
1. Bipolar I Disorder (Manic or Mixed Episodes)
<13 years: Safety and efficacy not established
13-17 years: 2.5-5 mg/day PO initially; target dosage, 10 mg/day; adjust by increments/decrements of 2.5-5 mg; dosage range, 2.5-20 mg/day
2. Schizophrenia
<13 years: Safety and efficacy not established
13-17 years: 2.5-5 mg/day PO initially; target dosage, 10 mg/day; adjust by increments/decrements of 2.5-5 mg; dosage range, 2.5-20 mg/day
3. Bipolar Depression
Indicated for depressive episodes associated with bipolar I disorder in combination with fluoxetine
<10 years: Safety and efficacy not established
10-17 years: 2.5 mg PO qPM and fluoxetine 20 mg PO qPM initially; dosage adjustments, if indicated, should be made to individual components according to efficacy and tolerability
Safety of coadministered doses greater than olanzapine 12 mg with fluoxetine 50 mg have not been in pediatric clinical studies
4. Stuttering (Off-label)
?12 years: 1.25 mg PO at bedtime for 4 weeks, then 2.5 mg at bedtime
GERIATRIC
Not approved for dementia-related psychosis, because of increased risk of cardiovascular or infection-related mortality
Consider lower starting dosage
1. Schizophrenia
2.5-5 mg/day PO initially
IM (extended-release): 150 mg every 4 weeks in patients who are debilitated or predisposed to hypotensive episodes; not studied in patients with renal or hepatic impairment; requires deep IM administration (muscle mass in elderly may be sufficient)
2. Schizophrenia or Bipolar-Related Agitation
IM (short-acting): 5 mg; consider 2.5 mg if patient is predisposed to hypotensive reactions.
INTERACTIONS
Click on here for interactions.
ADVERSE EFFECTS
Adverse Effects
>10%
Orthostatic hypotension (?20%)
Weight gain, dose dependent (5-40%)
Hypertriglyceridemia (?39%)
Hypercholesterolemia (?39%)
Somnolence, dose dependent (6-39%)
Extrapyramidal symptoms (EPS), dose dependent (15-32%)
Xerostomia (9-22%)
Weakness (2-20%)
Dizziness (4-18%)
Accidental injury (12%)
Insomnia (12%)
Elevated alanine aminotransferase (ALT) level (5-12%)
Constipation (9-11%)
Dyspepsia (7-11%)
Hyperprolactinemia (30%)
Hyperglycemia (12.8%)
1-10%
Hypotension (2%)
Postural hypotension (1%)
Tremor (1%)
Asthenia (2%)
Akathisia reactions (2%)
Parkinsonism reactions (4%)
<1%
Syncope
Sudden cardiac death
Hyperglycemia
Diabetic coma with ketoacidosis
Diabetic ketoacidosis
Acute hemorrhagic pancreatitis
Venous thromboembolism
Immune hypersensitivity reaction
Cerebrovascular disease
Seizure, status epilepticus
Suicidal intent
Pulmonary embolism
Death
Neuroleptic malignant syndrome (NMS)
Tardive dyskinesia