Olanzapine (US brand name Zyprexa® and generic) is a second-generation (atypical) antipsychotic. Here is basic information about this medication.
FDA-approved indications
1. As an oral formulation:
a. Schizophrenia in adults and adolescents
b. Manic or mixed episodes associated with bipolar I disorder in adults and adolescents (ages 13-17 )
c. Manic or mixed episodes associated with bipolar I disorder in adults (as an adjunct to valproate or lithium)
2. As an intramuscular injection:
Acute agitation associated with schizophrenia and bipolar I mania in adults
3. Olanzapine in combination with fluoxetine:
a. Depressive episodes associated with bipolar I disorder in adults
b. Depressive episodes associated with bipolar I disorder in children and adolescents (ages 10-17)
c. Treatment-resistant depression in adults
Note: Olanzapine is not approved for the treatment of dementia-related psychosis in the elderly due to increased risk of death and cerebrovascular accidents.
Dosage
1. Schizophrenia (adults)
Start at 5–10 mg orally once daily orally
Target: 10 mg/day within several days
2. Schizophrenia (adolescents)
Start at 2.5–5 mg orally once daily
Target: 10 mg/day
3. Bipolar I disorder (manic or mixed episodes) in adults
Start at 10 or 15 mg orally once daily
4. Bipolar I disorder (manic or mixed episodes) in adolescents
Start at 2.5–5 mg orally once daily
Target: 10 mg/day
5. Bipolar I disorder (manic or mixed episodes) with lithium or valproate in adults
Start at 10 mg orally once daily
6. Agitation associated with schizophrenia and bipolar I mania in adults
10 mg Intramuscular (IM) injection (5 mg or 7.5 mg when clinically warranted).
Assess for orthostatic hypotension prior to subsequent dosing (max. 3 doses 2-4 hrs apart)
7. Depressive episodes associated with bipolar I disorder in adults (in combination with fluoxetine)
Start at 5 mg of oral olanzapine and 20 mg of fluoxetine orally once daily
8. Depressive episodes associated with bipolar I disorder in children and adolescents (in combination with fluoxetine)
Start at 2.5 mg of oral olanzapine and 20 mg of fluoxetine orally once daily
9. Treatment resistant depression in adults (in combination with fluoxetine)
Start at 5 mg of oral olanzapine and 20 mg of fluoxetine orally once daily
General Instructions (from Prescribing Information)
1. Lower starting dose is recommended in debilitated or pharmacodynamically sensitive patients or patients with predisposition to hypotensive reactions, or with potential for slowed metabolism.
2. Olanzapine may be given without regard to meals.
Olanzapine and Fluoxetine in combination
1. Dosage adjustments, if indicated, should be made with the individual components according to efficacy and tolerability.
2. Olanzapine monotherapy is not indicated for the treatment of depressive episodes associated with bipolar I disorder or treatment resistant depression.
3. Safety of co-administration of doses above 18 mg olanzapine with 75 mg fluoxetine has not been evaluated.
4. 50 mg fluoxetine has not been evaluated in children and adolescents ages 10 to 17.
Dosage forms and strengths
Tablets (Zyprexa® and generic): 2.5, 5, 7.5, 10, 15, 20 mg
Orally disintegrating tablets (Zyprexa Zydis® and generic): 5, 10, 15, 20 mg
Intramuscular injection (Zyprexa® and generic): 10 mg vial
Please refer to Prescribing Information (see link below) for a complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
Related Pages
Second-generation (atypical) antipsychotics—General articles
Second-generation (“atypical”) antipsychotics (List)
Second-generation antipsychotics: Dose equivalents
Dose adjustment for second-generation antipsychotics based on drug interactions
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References
Olanzapine Prescribing Information. Available at this link.
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