OLANZAPINE

Second generation antipsychotic

Dosage Forms

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Tablet

10 mg

Uses

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  • Schizophrenia
  • Mania (monotherapy or combination therapy)
  • Prevention of recurrence of bipolar disorder

Dose and Duration

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Monotherapy for mania

Adult and child over 12 years: by mouth, 15 mg once daily adjusted according to response to usual dose range of 5–20 mg once daily

In renal and hepatic impairment: initially 5 mg daily

Other uses

Adult: by mouth, 10 mg once daily adjusted according to response to usual dose range of 5–20 mg once daily (max 20 mg daily)

Child 12–18 years: initially, 5–10 mg once daily

In renal and hepatic impairment: initially 5 mg daily

Contraindications

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  • Hypersensitivity to olanzapine
  • Known risk of narrow-angle glaucoma

Side Effects

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  • Eosinophilia, neutropenia, leucopoenia
  • Elevated lipid and glucose levels, glucosuria
  • Increased appetite, weight gain
  • Agitation, restlessness, somnolence
  • Parkinsonism, impaired voluntary movement
  • Orthostatic hypotension
  • Constipation and dry mouth
  • Transient elevation in hepatic aminotransferases
  • Rash
  • Joint pain
  • Erectile dysfunction, decreased libido
  • Physical weakness, fatigue
  • Oedema, pyrexia
  • Elevated plasma prolactin levels
  • Neuroleptic malignant syndrome

Interactions

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  • Fluvoxamine (increased concentration of olanzapine)
  • Valproate (increased risk of side effects)
  • Parenteral benzodiazepines (increased risk of hypotension, bradycardia and respiratory depression when co-administered with IM olanzapine)

Pregnancy

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  • Can be used

Breast-feeding

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  • Do not use

⚠️ Caution

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  • Only use olanzapine in pregnancy if benefit outweighs risk. Risk of neonatal lethargy, tremor and hypertonia when used in 3ʳᵈ trimester
  • May exacerbate ketoacidosis in diabetic patients