OLANZAPINE CITRATE

Indications & Dose:

Schizophrenia | Combination therapy for mania

 BY MOUTH Adult: 10 mg daily, adjusted according to response, usual dose 5–20 mg daily, doses greater than 10mg daily only after reassessment, when one or more factors present that might result in slower metabolism (e.g. female gender, elderly, non-smoker) consider lower initial dose and more gradual dose increase; maximum 20 mg per day Preventing recurrence in bipolar disorder

BY MOUTH Adult: 10 mg daily, adjusted according to response, usual dose 5–20 mg daily, doses greater than 10mg daily only after reassessment, when one or more factors present that might result in slower metabolism (e.g. female gender, elderly, nonsmoker) consider lower initial dose and more gradual dose increase; maximum 20 mg per day Monotherapy for mania

BY MOUTH

Adult: 15 mg daily, adjusted according to response, usual dose 5–20 mg daily, doses greater than 15mg daily only after reassessment, when one or more factors present that might result in slower metabolism (e.g. female gender, elderly, non-smoker) consider lower initial dose and more gradual dose increase; maximum 20 mg per day Control of agitation and disturbed behaviour in schizophrenia or mania

 BY INTRAMUSCULAR INJECTION

Adult: Initially 5–10 mg for 1 dose; usual dose 10 mg for 1 dose, followed by 5–10 mg after 2 hours if required, maximum 3 injections daily for 3 days; maximum daily combined oral and parenteral dose 20 mg, when one or more factors present that might result in slower metabolism (e.g. female gender, elderly, non-smoker) consider lower initial dose and more gradual dose increase Elderly: Initially 2.5–5 mg, followed by 2.5–5 mg after 2 hours if required, maximum 3 injections daily for 3 days; maximum daily combined oral and parenteral dose 20 mg, when one or more factors present that might result in slower metabolism (e.g. female gender, elderly, non-smoker) consider lower initial dose and more gradual dose increase 

Contraindications:

Side Effects:

Cautions:

Precautions:

hepatic function impairment; children < 18 yr; history of myocardial infarction, heart failure, cardiac conduction abnormalities; cerebrovascular disease; seizure disorders; patients at risk for aspiration pneumonia; prostatic hypertrophy, narrow-angle glaucoma, history of paralytic ileus 

Interaction:

Drugs Carbamazepine: Decreased olanzapine concentrations Levodopa: Antagonism of the effects of levodopa due to dopamine receptor blockade 

Warnings:

Adverse Effects:

Lactations:

 Excretion into human breast milk unknown; excreted in the milk of treated rats 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Agitation, akathisia, amnesia. anxiety, articulation impairment, dizziness, euphoria, headache, hostility, hypertonia, insomnia, nervousness, sommolence, stuttering, tardive dyskinesia, tremor

CV: Chest pain, edema; hypotension, postural hypotension, tachycardia

EENT: Amblyopia, blepharitis, pharyngitis, rhinitis

GI: Abdominal pain, constipation, dry mouth, increased appetite, transaminase elevations

GU: Premenstrual syndrome

METAB: Weight gain

MS: Back pain, joint pain, twitching S

KIN: Rash MISC: Fever, neuroleptic malignant syndrome 

Patient And Carer Advice: