Indication & Dosage |
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| Oral |
| SCHIZOPHRENIA |
| Adult:
Initially, 5-10 mg daily adjusted in steps of 5 mg, according to response. Usual range: 5-20 mg daily. Doses >10 mg should be given only after clinical reassessment. |
| Max Dosage: 20 mg daily. |
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| Oral |
| ACUTE MIXED OR MANIC EPISODES IN BIPOLAR DISORDER |
| Adult:
Initially, 10 or 15 mg daily as monotherapy or 10 mg daily when used as part of combination therapy. Adjust dose in steps of 5 mg; usual range: 5-20 mg daily. For prevention of recurrence: Start with 10 mg daily. |
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| Intramuscular |
| CONTROL OF AGITATION AND DISTURBED BEHAVIOUR IN SCHIZOPHRENIA OR MANIA |
| Adult:
Initially, 5-10 mg followed by 5-10 mg as required 2 hr later. Max: 3 inj per 24-hr period; max (including oral olanzapine): 20 mg/day. May give injections for up to 3 days but should transfer to oral therapy as soon as possible. |
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| Administration |
May be taken with or without food. |
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| Precautions |
Impaired renal, hepatic, cardiovascular function; prostatic hypertrophy; paralytic ileus; DM; parkinsonism; pregnancy. History of blood dyscrasias, myelosuppression, seizures; dementia; dyslipidaemia. IM: Hypotension, bradyarrythmia, hypoventilation; monitor BP carefully. |
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Potentially Life-threatening
Adverse Drug Reactions |
Postural hypotension; constipation; dizziness; wt gain; agitation; insomnia; akathisia; tremor; personality disorders; oedema; somnolence; increased apetite; antimuscarinic effects; speech difficulty; exacerbation of Parkinson's disease; hallucinations; asthenia; increased body temperature; bradycardia; hyperprolactinaemia; QT prolongation (uncommon); asymptomatic elevations of hepatic transaminases. |
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| Adverse Drug Reactions |
Exacerbation of preexisting diabetes sometimes leading to ketoacidosis. NMS. |
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| Interactions |
Olanzapine may antagonize the effects of levodopa and dopamine agonists. Drugs that induce CYP1A2 or glucuronyl transferase enzymes eg, omeprazole and rifampicin, may increase in olanzapine clearance. Inhibitors of CYP1A2 may potentially inhibit olanzapine elimination. Carbamazepine may increase the clearance of olanzapine. Concomitant admin of activated charcoal reduced the oral bioavailability of olanzapine by 50-60%. Caution should be taken when olanzapine is administered with centrally acting drugs and alcohol. |
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