Drug Action
Olanzapine is a dopamine D1, D2, D4, 5-HT2, histamine- 1-, and muscarinic-receptor antagonist.
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Individual generic drug information
Extracted information for Olanzapine only.
Olanzapine is a dopamine D1, D2, D4, 5-HT2, histamine- 1-, and muscarinic-receptor antagonist.
Source page 438
Schizophrenia | Combination therapy for mania ▶BY MOUTH ▶Adult: 10 mg daily, adjusted according to response, usual dose 5–20 mg daily, doses greater than 10 mg 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 10 mg 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 Monotherapy for mania ▶BY MOUTH ▶Adult: 15 mg daily, adjusted according to response, usual dose 5–20 mg daily, doses greater than 15 mg 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
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▶With intramuscular use Acute myocardial infarction. bradycardia. recent heart surgery. severe hypotension. sick sinus syndrome. unstable angina
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Bone-marrow depression. hypereosinophilic disorders. low leucocyte count. low neutrophil count. myeloproliferative disease. paralytic ileus CAUTIONS, FURTHER INFORMATION ▶CNS and respiratory depression ▶With intramuscular use Blood pressure, pulse and respiratory rate should be monitored for at least 4 hours after intramuscular injection, particularly in those also receiving a benzodiazepine or another antipsychotic (leave at least one hour between administration of olanzapine intramuscular injection and parenteral benzodiazepines).
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▶With intramuscular use When prescribing, dispensing, or administering, check that this injection is the correct preparation—this preparation is usually used in hospital for the rapid control of an acute episode and should not be confused with depot preparations which are usually used in the community or clinics for maintenance treatment. Available from specialist importing companies.
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Extracted information for Olanzapine only.
→Appendix 1: olanzapine
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GENERAL SIDE-EFFECTS ▶Common or very common Anticholinergic syndrome. appetite increased. arthralgia. asthenia. eosinophilia. fever. glycosuria. oedema. sexual dysfunction ▶Uncommon Abdominal distension. alopecia. breast enlargement. diabetes mellitus. dysarthria. epistaxis. memory loss. photosensitivity reaction. urinary disorders ▶Rare or very rare Hepatic disorders. hypothermia. pancreatitis. rhabdomyolysis. thrombocytopenia SPECIFIC SIDE-EFFECTS ▶Common or very common ▶With intramuscular use Dyslipidaemia ▶With oral use Hypersomnia ▶Uncommon ▶With intramuscular use Hypoventilation ▶With oral use Diabetic coma. ketoacidosis. oculogyration ▶Rare or very rare ▶With intramuscular use Withdrawal syndrome ▶Frequency not known ▶With intramuscular use Cardiovascular event. erythema. fall . gait abnormal. hallucinations. pneumonia
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Use only if potential benefit outweighs risk; neonatal lethargy, tremor, and hypertonia reported when used in third trimester.
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Avoid—present in milk.
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Manufacturer advises caution. Dose adjustments Manufacturer advises consider initial dose of 5 mg daily and cautious titration.
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Dose adjustments Consider initial dose of 5 mg daily.
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▶Blood lipids and weight should be measured at baseline, at 3 months (weight should be measured at frequent intervals during the first 3 months), and then yearly with antipsychotic drugs. Patients taking olanzapine require Nervous system more frequent monitoring of these parameters: every 3 months for the first year, then yearly. ▶Fasting blood glucose should be measured at baseline, at 4–6 months, and then yearly. Patients taking olanzapine should have fasting blood glucose tested at baseline, after one months’ treatment, then every 4–6 months.
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Extracted information for Olanzapine only.
Olanzapine orodispersible tablet may be placed on the tongue and allowed to dissolve, or dispersed in water, orange juice, apple juice, milk, or coffee.
Source page 439
There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Tablet CAUTIONARY AND ADVISORY LABELS 2 ▶Olanzapine (Non-proprietary) Olanzapine 2.5 mg Olanzapine 2.5mg tablets | 28 tablet P £21.85 DT = £1.36 Olanzapine 5 mg Olanzapine 5mg tablets | 28 tablet P £43.70 DT = £1.55 Olanzapine 7.5 mg Olanzapine 7.5mg tablets | 28 tablet P £62.27 DT = £1.97 | 56 tablet P £3.96–£131.10 Olanzapine 10 mg Olanzapine 10mg tablets | 28 tablet P £87.40 DT = £1.53 Olanzapine 15 mg Olanzapine 15mg tablets | 28 tablet P £119.18 DT = £1.95 Olanzapine 20 mg Olanzapine 20mg tablets | 28 tablet P £158.90 DT = £2.28 ▶Zalasta (Consilient Health Ltd) Olanzapine 2.5 mg Zalasta 2.5mg tablets | 28 tablet P £18.57 DT = £1.36 Olanzapine 5 mg Zalasta 5mg tablets | 28 tablet P £37.14 DT = £1.55 Olanzapine 7.5 mg Zalasta 7.5mg tablets | 56 tablet P £111.43 Olanzapine 10 mg Zalasta 10mg tablets | 28 tablet P £74.29 DT = £1.53 Olanzapine 15 mg Zalasta 15mg tablets | 28 tablet P £101.30 DT = £1.95 Olanzapine 20 mg Zalasta 20mg tablets | 28 tablet P £135.06 DT = £2.28 ▶Zyprexa (Eli Lilly and Company Ltd) Olanzapine 2.5 mg Zyprexa 2.5mg tablets | 28 tablet P £21.85 DT = £1.36 Olanzapine 5 mg Zyprexa 5mg tablets | 28 tablet P £43.70 DT = £1.55 Olanzapine 7.5 mg Zyprexa 7.5mg tablets | 56 tablet P £131.10 Olanzapine 10 mg Zyprexa 10mg tablets | 28 tablet P £87.40 DT = £1.53 Olanzapine 15 mg Zyprexa 15mg tablets | 28 tablet P £119.18 DT = £1.95 Olanzapine 20 mg Zyprexa 20mg tablets | 28 tablet P £158.90 DT = £2.28 Oral lyophilisate ▶Zyprexa (Eli Lilly and Company Ltd) Olanzapine 5 mg Zyprexa 5mg Velotabs sugar-free | 28 tablet P £48.07 DT = £48.07 Olanzapine 10 mg Zyprexa 10mg Velotabs sugar-free | 28 tablet P £87.40 DT = £87.40 Olanzapine 15 mg Zyprexa 15mg Velotabs sugar-free | 28 tablet P £131.10 DT = £131.10 Olanzapine 20 mg Zyprexa 20mg Velotabs sugar-free | 28 tablet P £174.79 DT = £174.79 Orodispersible tablet CAUTIONARY AND ADVISORY LABELS 2 Nervous system EXCIPIENTS: May contain Aspartame ▶Olanzapine (Non-proprietary) Olanzapine 5 mg Olanzapine 5mg orodispersible tablets sugar free sugar-free | 28 tablet P £6.86–£40.85 DT = £6.86 Olanzapine 5mg orodispersible tablets | 28 tablet P £30.00 DT = £29.35 Olanzapine 10 mg Olanzapine 10mg orodispersible tablets | 28 tablet P £50.00 DT = £49.00 Olanzapine 10mg orodispersible tablets sugar free sugar-free | 28 tablet P £11.50–£74.29 DT = £11.50 Olanzapine 15 mg Olanzapine 15mg orodispersible tablets sugar free sugar-free | 28 tablet P £11.65–£66.76 DT = £11.65 Olanzapine 15mg orodispersible tablets | 28 tablet P £48.82 DT = £48.82 Olanzapine 20 mg Olanzapine 20mg orodispersible tablets sugar free sugar-free | 28 tablet P £18.93–£96.14 DT = £18.93 Olanzapine 20mg orodispersible tablets | 28 tablet P £80.00 DT = £78.93 ▶Zalasta (Consilient Health Ltd) Olanzapine 5 mg Zalasta 5mg orodispersible tablets sugar-free | 28 tablet P £40.85 DT = £6.86 Olanzapine 10 mg Zalasta 10mg orodispersible tablets sugar-free | 28 tablet P £74.20 DT = £11.50 Olanzapine 15 mg Zalasta 15mg orodispersible tablets sugar-free | 28 tablet P £111.43 DT = £11.65 Olanzapine 20 mg Zalasta 20mg orodispersible tablets sugar-free | 28 tablet P £148.57 DT = £18.93 eiiii F 401
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Extracted information for Olanzapine only.
Patients or carers should be given advice on how to administer orodispersible tablets.
Source page 439
Filter the extracted dose blocks for this individual drug.
First line only; read the complete Indications and dose section above.
10 mg daily, adjusted according to response,
This is a first-line fragment. Read the full Indications and Dose section above.
Candidate age grouping · source page 438
First line only; read the complete Indications and dose section above.
10 mg daily, adjusted according to response,
This is a first-line fragment. Read the full Indications and Dose section above.
Candidate age grouping · source page 438
First line only; read the complete Indications and dose section above.
15 mg daily, adjusted according to response,
This is a first-line fragment. Read the full Indications and Dose section above.
Candidate age grouping · source page 438
First line only; read the complete Indications and dose section above.
Initially 5–10 mg for 1 dose; usual dose 10 mg
This is a first-line fragment. Read the full Indications and Dose section above.
Candidate age grouping · source page 439
First line only; read the complete Indications and dose section above.
Initially 2.5–5 mg, followed by 2.5–5 mg after
This is a first-line fragment. Read the full Indications and Dose section above.
Candidate age grouping · source page 439