COMMON BRAND NAME(S):
Zyprexa

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Uses: (1) Helps manage thinking problems and other difficulties seen in psychosis (schizophrenia and shizophreniform); (2) treats mania in bipolar disorder (often easing mania symptoms after only one week of treatment).

Other (unlabeled) generally accepted uses: (1) Works in anorexia; (2) eases anxiety in nursing home patients (Neuropsychiatric Inventory/Nursing Home Instrument or NPI/NH); (3) some data for helping patients with bipolar or mixed presentation who are resistant (refractory) to lithium or valproic acid; (4) eases marijuana (cannabis)-induced psychotic disorder.

How This Drug Works: This drug works as an antipsychotic by inhibiting the action of two primary nerve transmitters (dopamine and serotonin) in certain brain centers and acts to correct an imbalance of nerve impulse transmissions thought to be responsible for certain mental disorders. It also works at histamine, muscarinic, GABA, BZD, and adrenergic sites. The mechanism of action in bipolar disorder is not fully known at present.

Available Dosage Forms and Strengths

Tablets - 2.5 mg, 5 mg, 7.5 mg, 10 mg Tablets, orally-disintegrating (Zyprexa Zydis) - 5 mg, 10 mg, 15 mg, 20 mg

Recommended Dosage Ranges (Actual dose and schedule must be determined for each patient individually.)

Infants and Children: Dose not established, but use is increasing (see Bloch, Y in Sources).
18 to 60 Years of Age: Psychosis: Dosing is started with 5 to 10 mg daily. If the 5mg dose is used, the dose may be increased to a maximum of 10 mg as needed and tolerated. Dose changes should only be made after seven days at a new dose. Changes in dose are usually done in 5-mg steps.
Sudden (acute) mania: Starting doses of 10 to 15 mg once daily, increased as needed and tolerated in steps of 5 mg daily have been used. Treatment in mania has been up to 4 weeks.
Over 60 Years of Age: 5 mg of olanzapine is taken.

Conditions Requiring Dosing Adjustments

Liver Function: The drug is highly metabolized in the liver. The manufacturer says that even in patients with significantly impaired liver function (Childs Pugh A or B), only a lower (5 mg) initial starting dose should be given. It appears prudent to make any dose increases more slowly and closely follow the patient as well.
Kidney Function: Dosing changes are not thought to be needed.
Seizure Disorders: Seizures happened in 0.9% of patients during clinical trials of olanzapine. Olanzapine should be used with caution by seizure patients. Dose decreases are not defined at present.

Dosing Instructions: The tablet may be crushed and taken with food. It is best to take this medicine at the same time every day. The (Zydis) form is an orally disintegrating tablet and does not require water to take it. Make sure your hands are dry, peel back the foil on the blister pack (avoid pushing the tablet through the foil), and put the tablet into your mouth. This form easily falls apart in saliva and water is not needed. If you forget a dose: Take the missed dose as soon as you remember it, unless it's nearly time for your next dose-if that is the case, skip the missed dose and take the next dose right on schedule. DO NOT double doses. Talk with your doctor if you find yourself missing doses.

Please Note: The information contained on this page is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs or following any treatment or regimen. Only your doctor, nurse or pharmacist can provide you with advice on what is safe and effective for you.

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