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ZYPREXA
Mood disorders
Psychosis
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Drug Name:

ZYPREXA Rx

Generic Name and Formulations:
Olanzapine 2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg; tabs.

Company:
Lilly, Eli and Company



Therapeutic Use:

Indications for ZYPREXA:

Bipolar disorder: as monotherapy or with lithium or valproate for short-term use in acute mixed or manic episodes, or for maintenance. In combination with fluoxetine: depressive episodes associated with bipolar disorder, or treatment resistant depression (TRD; see literature).

Adult Dose for ZYPREXA:

Bipolar disorder: 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. Bipolar depression: initially olanzapine 5mg + fluoxetine 20mg once daily in the PM; range olanzapine 5–12.5mg + fluoxetine 20–50mg. TRD: initially olanzapine 5mg + fluoxetine 20mg once daily in the PM; range: olanzapine 5–20mg + fluoxetine 20–50mg. Risk of hypotension, hepatic impairment, slow metabolizers, or sensitive to olanzapine: initially olanzapine 2.5–5mg + fluoxetine 20mg; increase cautiously. Dose adjustments: see literature. Zydis: Dissolve in mouth and swallow with or without fluids.

Children's Dose for ZYPREXA:

<13yrs: not recommended. 13–17yrs: Bipolar disorder: Monotherapy: initially 2.5–5mg once daily; increase to target dose of 10mg/day, adjust by 2.5–5mg if needed; max 20mg/day. Maintenance: continue at lowest dose to maintain remission: see literature.

See Also:

ZYPREXA INTRAMUSCULAR

ZYPREXA ZYDIS

Pharmacological Class:

Thienobenzodiazepine.

Rems:

YES

Contraindications:

Combination therapies: see other drug monographs.

Warnings/Precautions:

Relprevv: post-injection delirum/sedation syndrome: monitor after each injection. Elderly (not for dementia-related psychosis; may increase risk of death). Cardio- or cerebrovascular disease. Diabetes. Monitor for hyperglycemia, hyperlipidemia; do fasting blood glucose and lipids testing at beginning, and during therapy. Monitor for weight gain. Hypovolemia. Dehydration. History of seizures. Conditions that affect metabolism or hemodynamic responses. Hepatic impairment (monitor ALT/AST). GI or GU obstruction. Narrow angle glaucoma. History of paralytic ileus or breast cancer. Pre-existing low WBCs or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; discontinue if WBCs decline. Exposure to extreme heat. Reevaluate periodically. Dysphagia. Suicidal ideation (monitor). Write ℞ for smallest practical amount. Debilitated. Labor & delivery. Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy (Cat.C). Nursing mothers: not recommended.

Interactions:

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:

Somnolence, sedation, dizziness, constipation, weight gain, personality disorder, akathisia, asthenia, rhinitis, postural hypotension, tachycardia, headache, fever, abdominal pain, diarrhea, vomiting, dry mouth, cough, nasopharyngitis, nervousness, joint pain, peripheral edema, hyperglycemia, tardive dyskinesia, worsening of parkinsonian symptoms, neuroleptic malignant syndrome (monitor), hyperprolactinemia, increased ALT; leukopenia, neutropenia, agranulocytosis; others.

How Supplied:

Tabs—30, 1000; Zydis—30; Vial—1

ZYPREXA

  • 5mg tablets (Qty:30)
  • appx. price $384.00
GoodRx

Indications for ZYPREXA:

Schizophrenia.

Adult Dose for ZYPREXA:

Initially 5–10mg once daily; increase to 10mg once daily within several days, adjust by 5mg/day at intervals of 1 week; max 20mg/day. Maintenance: usual range 10–20mg/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.

Children's Dose for ZYPREXA:

<13yrs: not recommended. 13–17yrs: initially 2.5–5mg once daily; increase to target dose of 10mg/day, adjust by 2.5–5mg if needed; max 20mg/day. Maintenance: continue at lowest dose to maintain remission: see literature.

See Also:

ZYPREXA INTRAMUSCULAR

ZYPREXA RELPREVV

ZYPREXA ZYDIS

Pharmacological Class:

Thienobenzodiazepine.

Rems:

YES

Warnings/Precautions:

Relprevv: post-injection delirum/sedation syndrome: monitor after each injection. Elderly (not for dementia-related psychosis; may increase risk of death). Cardio- or cerebrovascular disease. Diabetes. Monitor for hyperglycemia, hyperlipidemia; do fasting blood glucose and lipids testing at beginning, and during therapy. Monitor for weight gain. Hypovolemia. Dehydration. History of seizures. Conditions that affect metabolism or hemodynamic responses. Hepatic impairment (monitor ALT/AST). GI or GU obstruction. Narrow angle glaucoma. History of paralytic ileus or breast cancer. Pre-existing low WBCs or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; discontinue if WBCs decline. Exposure to extreme heat. Reevaluate periodically. Dysphagia. Suicidal ideation (monitor). Write ℞ for smallest practical amount. Debilitated. Labor & delivery. Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy (Cat.C). Nursing mothers: not recommended.

Interactions:

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:

Somnolence, sedation, dizziness, constipation, weight gain, personality disorder, akathisia, asthenia, rhinitis, postural hypotension, tachycardia, headache, fever, abdominal pain, diarrhea, vomiting, dry mouth, cough, nasopharyngitis, nervousness, joint pain, peripheral edema, hyperglycemia, tardive dyskinesia, worsening of parkinsonian symptoms, neuroleptic malignant syndrome (monitor), hyperprolactinemia, increased ALT; leukopenia, neutropenia, agranulocytosis; others.

How Supplied:

Tabs—30, 1000; Zydis—30; Vial—1

ZYPREXA

  • 5mg tablets (Qty:30)
  • appx. price $384.00
GoodRx

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