Medication Information:
Olanzapine (Generic) - Zyprexa (Brand)

Classification: Atypical antipsychotic; mood stabilizer.
Common Usage: Oral olanzapine has FDA approved indications for the treatment of schizophrenia and for the short-term treatment of acute mania or mixed episodes associated with bipolar disorder in adults, both as a monotherapy and in combination with lithium or valproate.  Olanzapine is also indicated for the maintenance treatment of bipolar disorder. An injectable formulation is indicated for the treatment of agitation associated with schizophrenia and bipolar I mania.

Major Side Effects: The most common side effects experienced by patients taking olanzapine include somnolence, sedation, increased appetite and weight gain, dry mouth, dizziness, constipation, stomach upset and restlessness.  Also, extrapyramidal effects, such as tremor and muscle stiffness, have been reported by patients taking olanzapine; the risk for these side effects increases with dose. Some patients on olanzapine have had an increase in levels of the hormone prolactin (hyperprolactinemia), which may be associated with breast tenderness or discharge.

The following serious conditions have been associated with atypical antipsychotic medications, including olanzapine:

• Hyperglycemia and diabetes mellitus - Patients taking atypical antipsychotics should be monitored for symptoms of high blood sugar (hyperglycemia) during treatment. Patients with an established diagnosis of diabetes mellitus should be monitored regularly for worsening of glucose control.
• Cerebrovascular adverse events - These include strokes and transient ischemic attacks (TIAs). Olanzapine has been associated with such adverse events in elderly patients with dementia. Olanzapine is not presently approved for the treatment of patients with dementia-related psychosis.
• Tardive dyskinesia (TD) - This syndrome involves abnormal involuntary movements of the mouth, tongue, or extremities that may be irreversible. It is infrequent with olanzapine but has been reported usually after prolonged treatment.
• Neuroleptic malignant syndrome (NMS) - Symptoms of this potentially fatal but treatable condition include excessive activity, muscle rigidity, altered mental status, fever and marked changes in heart rate and blood pressure. It has occurred rarely during olanzapine treatment.

This is not a complete list of all known or potential adverse effects.  Notify your prescriber or pharmacist of any symptoms that have started since you began taking this medication, changing its dose, or adding or changing other medication or diet.  Take care when performing any task (for example, driving or operating machinery) that requires your attention until you have experience with this drug and are confident you can perform the task safely.

Interactions with Other Medications: Drug interactions of olanzapine in combination with other drugs have not been extensively evaluated in systematic studies. It is always important to use caution when taking olanzapine with other psychotropic drugs, including alcohol. Carbamazepine (Tegretol), omeprazole (Prolosec) and rifampin (Rifadin), may reduce the amount of olanzapine in your body. Fluvoxamine (Luvox) may substantially increase the amount of olanzapine in your body. Fluoxetine (Prozac, Sarafem) may also cause some increase in the amount of olanzapine in your body.

This is not a complete list of all known or potential drug interactions.  To help prevent problems, always make sure your pharmacist and all prescribers know all the medications you are taking.  This includes over-the-counter drugs and any dietary or herbal supplements or medications.

Common Dosages:  For adults with schizophrenia, olanzapine should be taken once a day, starting at 5 to 10 mg/day and reaching 10 mg/day within several days. The dosage may be increased above 10 mg/day after clinical assessment; the safety of doses above 20 mg/day has not been determined.

For adults with bipolar disorder taking olanzapine as monotherapy, olanzapine can be taken once a day, starting at 10 to 15 mg/day. The dosage may be increased or decreased by 5 mg/day at intervals not less than 24 hours; the safety of doses above 20 mg/day has not been determined.

For adults with bipolar disorder taking olanzapine in conjunction with lithium or valproate, olanzapine should be started at 10 mg/day. Doses of 5 to 20 mg/day may be effective; the safety of doses above 20 mg/day has not been determined.

For controlling agitation, the recommended dose of injectable (intramuscular) olanzapine is 10 mg. The safety of total daily doses greater than 30 mg has not been evaluated; maximal dosing of intramuscular olanzapine may be associated with orthostatic hypotension.

Identification: Olanzapine is available as Zyprexa 2.5-, 5-, 7.5-, 10-,  15-, and 20-mg tablets. The 2.5-, 5-, 7.5- and 10- mg tablets are white, round and imprinted in blue ink with "LILLY" and the tablet number. (The 2.5-mg tablets marked "4112"; the 5-mg tablets are marked "4115"; the 7.5-mg tablets are marked "4116"; and the 10-mg tablets are marked "4117".) The 15-mg tablets are elliptical, blue and debossed with "LILLY" and "4415". The 20-mg tablets are elliptical, pink and debossed with "LILLY" and "4420".

Olanzapine is also available as Zyprexa Zydis orally disintegrating tablets in 5-, 10-, 15-, and 20-mg tablets. The tablets are round, yellow and debossed with the tablet strength.

Intramuscular olanzapine is available in vials of 10 mg (needs to be reconstituted with 2 ml of sterile water to a concentration of 5-mg/ml).

Storage: Store this medication at normal room temperature (59° F to 86° F) in a tightly closed, light- and moisture-resistant container.  If you have difficulty opening child-resistant containers, your pharmacist can provide a container that is easier to open.  Keep the medication out of direct sunlight and avoid storing it in a warm or humid area - such as the bathroom or kitchen - to prevent deterioration.  To prevent accidental poisoning, keep all medications out of the reach of children.  Do not take an expired medication.  Do not transfer medication from one container to another.  Carefully discard discontinued medication where children cannot find it.

A SERVICE OF…. Manisses Communications Group, Inc.

Note: These guidelines are for general information only. For more specific information, consult your physician or pharmacist.