Monograph Details
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Central Nervous System
> Mood disorders
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ZYPREXA |
| Manufacturer |
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Lilly, Eli and Company |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Thienobenzodiazepine. |
| Generic Name |
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Olanzapine 2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg; tabs. |
| Also |
• ZYPREXA INTRAMUSCULAR
• ZYPREXA ZYDIS
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| Indications |
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Bipolar disorder: as monotherapy or with lithium or valproate for short-term use in acute mixed or manic episodes, or for maintenance. |
| Children |
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Not recommended. |
| Adults |
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Monotherapy: initially 10–15mg once daily; may increase by 5mg/day. Concomitant lithium or valproate: initially 10mg once daily. For both: max 20mg/day. Maintenance: usual range 5–20mg/day. Debilitated, risk of hypotension, slow metabolizers, or sensitive to olanzapine: initially 5mg once daily; increase cautiously. Zydis: Dissolve in mouth and swallow with or without fluids. |
| Precautions |
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Diabetes risk factors (obtain baseline fasting blood sugar). Monitor for hyperglycemia. Cardio- or cerebrovascular disease. Hypovolemia. Dehydration. Seizures. Hepatic impairment (monitor ALT/AST). GI or GU obstruction. Narrow angle glaucoma. History of paralytic ileus or breast cancer. Exposure to extreme heat. Reevaluate periodically. Dysphagia. Suicidal ideation. Write Rx for smallest practical amount. Elderly (esp. with dementia). Debilitated. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
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Orthostatic hypotension with antihypertensives, alcohol, benzodiazepines, others. Avoid alcohol. Caution with other CNS drugs, drugs that lower seizure threshold, anticholinergics, and with hepatotoxic agents. May antagonize levodopa, dopamine agonists. May be antagonized by rifampin, omeprazole, carbamazepine, others that induce CYP1A2 or glucuronyl transferase. May be potentiated by fluvoxamine, others that inhibit CYP1A2. Smokers may have increased metabolism. |
| Adverse Reactions |
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Somnolence, dry mouth, dizziness, asthenia, constipation, weight gain, dyspepsia, abnormal gait, increased appetite, tremor, fever, back or chest pain, postural hypotension, tachycardia, hypertension, peripheral edema, hyperglycemia, tardive dyskinesia, worsening of parkinsonian symptoms, neuroleptic malignant syndrome, hyperprolactinemia, increased ALT; others. |
| How Supplied |
Tabs—30, 60, 1000
Zydis—30
Vial—1 |
| Additional Resources |
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• Related Prescribing Note |
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