OLANZAPINE
(Zyprexa, Zyprexa Zydis)Standard Prescription
olanzapine__mg PO__(frequency)
olanzapine ODT__mg PO__(frequency)
olanzapine__mg IM Q__H prn___; max__doses/__hrs
olanzapine ODT__mg PO__(frequency)
olanzapine__mg IM Q__H prn___; max__doses/__hrs
Dosages
Adolescents/Adults:
Initial: 2.5 - 5 mg PO once daily.
IM dosing for acute agitation:
(not stocked at BCCH)
Initial: 2.5-10 mg IM
Subsequent: up to 10 mg IM/dose. Maximum: 3 x 10 mg doses, 2-4 hrs apart (monitor for orthostatic hypotension prior to each dose)
Prevention or treatment of chemotherapy-induced nausea and vomiting
Children >= 5 years: 0.14 mg/kg/dose once daily
Adolescents/adults: 5-10 mg/dose PO daily
Start prior to chemotherapy and continue up to 3 days after completion of chemotherapy.
Initial: 2.5 - 5 mg PO once daily.
Usual daily dose: 5-20 mg PO once daily.
Maximum dose: 20 mg/24 hr.
IM dosing for acute agitation:
(not stocked at BCCH)
Initial: 2.5-10 mg IM
Subsequent: up to 10 mg IM/dose. Maximum: 3 x 10 mg doses, 2-4 hrs apart (monitor for orthostatic hypotension prior to each dose)
Prevention or treatment of chemotherapy-induced nausea and vomiting
Children >= 5 years: 0.14 mg/kg/dose once daily
Adolescents/adults: 5-10 mg/dose PO daily
Start prior to chemotherapy and continue up to 3 days after completion of chemotherapy.
Mechanism of Action
Atypical antipsychotic
Forms Supplied
tablet: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg
(not stocked at BCCH: 20 mg)
oral dissolving tablet (ODT): 5 mg (not stocked at BCCH: 10 mg, 15 mg)
ODT tablets (Zydis) dissolve quickly on the tongue. Useful in patients who can't swallow tablets or who "cheek" meds.
injection: 10 mg/vial (not stocked at BCCH)
(not stocked at BCCH: 20 mg)
oral dissolving tablet (ODT): 5 mg (not stocked at BCCH: 10 mg, 15 mg)
ODT tablets (Zydis) dissolve quickly on the tongue. Useful in patients who can't swallow tablets or who "cheek" meds.
injection: 10 mg/vial (not stocked at BCCH)
Comments
A second generation antipsychotic (SGA)
Effective in treatment of psychosis, schizophrenia, bipolar disorder, agitation.
Also used for the treatment of anorexia nervosa, augmentation therapy for obsessive compulsive disorder.
Adverse effects include somnolence, anticholinergic effects, increased appetite, increased ALT, postural hypotension, lowered seizure threshold, akathisia.
Olanzapine is a CYP 1A2 substrate. Serum level can potentially be affected by strong 1A2 inhibitors/ inducers, including cigarette smoking. Dose adjustment may be required if smoking status changes.
DO NOT combine IM olanzapine within 1 hr of parenteral benzodiazepine use: may result in respiratory depression and death. Peak olanzapine level is 5-fold higher after IM administration than with same dose given orally.
Risk of metabolic abnormalities (including weight gain (most of all SGAs), hyperglycemia and lipid abnormalities). Must do baseline & periodic assessment of height, weight, waist circumference, blood pressure, fasting glucose & lipid profile. Refer to www.camesaguideline.org for more information.
Effective in treatment of psychosis, schizophrenia, bipolar disorder, agitation.
Also used for the treatment of anorexia nervosa, augmentation therapy for obsessive compulsive disorder.
Adverse effects include somnolence, anticholinergic effects, increased appetite, increased ALT, postural hypotension, lowered seizure threshold, akathisia.
Olanzapine is a CYP 1A2 substrate. Serum level can potentially be affected by strong 1A2 inhibitors/ inducers, including cigarette smoking. Dose adjustment may be required if smoking status changes.
DO NOT combine IM olanzapine within 1 hr of parenteral benzodiazepine use: may result in respiratory depression and death. Peak olanzapine level is 5-fold higher after IM administration than with same dose given orally.
Risk of metabolic abnormalities (including weight gain (most of all SGAs), hyperglycemia and lipid abnormalities). Must do baseline & periodic assessment of height, weight, waist circumference, blood pressure, fasting glucose & lipid profile. Refer to www.camesaguideline.org for more information.
References
4, 83, 186, 187, 349, 449 489, 490
Last Edited
2021-08-03 01:10:24