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

SKU: DP13779 Category: