Clinical Pharmacology Details


OLANZAPINE CITRATE


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Indications & Dose:

Schizophrenia Combination therapy for mania



Adult: 10 mg daily, adjusted according to response, usual dose 5–20 mg daily, doses greater than 10mg daily only after reassessment, when one or more factors present that might result in slower metabolism (e.g. female gender, elderly, non-smoker) consider lower initial dose and more gradual dose increase; maximum 20 mg per day


Preventing recurrence in bipolar disorder 



Adult: 10 mg daily, adjusted according to response, usual dose 5–20 mg daily, doses greater than 10mg daily only after reassessment, when one or more factors present that might result in slower metabolism (e.g. female gender, elderly, nonsmoker) consider lower initial dose and more gradual dose increase; maximum 20 mg per day


Monotherapy for mania



Adult: 15 mg daily, adjusted according to response, usual dose 5–20 mg daily, doses greater than 15mg daily only after reassessment, when one or more factors present that might result in slower metabolism (e.g. female gender, elderly, non-smoker) consider lower initial dose and more gradual dose increase; maximum 20 mg per day


Control of agitation and disturbed behaviour in schizophrenia or mania 



Adult: Initially 5–10 mg for 1 dose; usual dose 10 mg for 1 dose, followed by 5–10 mg after 2 hours if required, maximum 3 injections daily for 3 days; maximum daily combined oral and parenteral dose 20 mg, when one or more factors present that might result in slower metabolism (e.g. female gender, elderly, non-smoker) consider lower initial dose and more gradual dose increase
Elderly: Initially 2.5–5 mg, followed by 2.5–5 mg after 2 hours if required, maximum 3 injections daily for 3 days; maximum daily combined oral and parenteral dose 20 mg, when one or more factors present that might result in slower metabolism (e.g. female gender, elderly, non-smoker) consider lower initial dose and more gradual dose increase

Contraindications:

Side Effects:

Cautions:

Precautions:

hepatic function impairment; children < 18 yr; history of myocardial infarction, heart failure, cardiac conduction abnormalities; cerebrovascular disease; seizure disorders; patients at risk for aspiration pneumonia; prostatic hypertrophy, narrow-angle glaucoma, history of paralytic ileus

Interaction:

Drugs
Carbamazepine: Decreased olanzapine concentrations
Levodopa: Antagonism of the effects of levodopa due to dopamine receptor blockade

Warnings:

Adverse Effects:

Lactations:

 Excretion into human breast milk unknown; excreted in the milk of treated rats

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Agitation, akathisia, amnesia. anxiety, articulation impairment, dizziness, euphoria, headache, hostility, hypertonia, insomnia, nervousness, sommolence, stuttering, tardive dyskinesia, tremor
CV: Chest pain, edema; hypotension, postural hypotension, tachycardia
EENT: Amblyopia, blepharitis, pharyngitis, rhinitis
GI: Abdominal pain, constipation, dry mouth, increased appetite, transaminase elevations
GU: Premenstrual syndrome
METAB: Weight gain
MS: Back pain, joint pain, twitching
SKIN: Rash


MISC: Fever neuroleptic malignant syndrome

Patient And Carer Advice: