Drug information of Olanzapine

Olanzapine

Drug group:

Olanzapine is an antipsychotic medication that affects chemicals in the brain. Olanzapine is used to treat the symptoms of psychotic conditions such as schizophrenia and bipolar disorder (manic depression) in adults and children who are at least 13 years old. Olanzapine is sometimes used together with other antipsychotic medications or antidepressants.

Mechanism of effect

The mechanism of action of olanzapine, as with other drugs having efficacy in schizophrenia, is unknown. However, it has been proposed that this drug's efficacy in schizophrenia is mediated through a combination of dopamine and serotonin type 2 (5HT2) antagonism. The mechanism of action of olanzapine in the treatment of acute manic or mixed episodes associated with bipolar I disorder is unknown.

Pharmacodynamic

Olanzapine is an antagonist with moderate affinity binding for serotonin 5HT3 (Ki=57 nM) and muscarinic M1-5 (Ki=73, 96, 132, 32, and 48 nM, respectively).

Pharmacokinetics

Olanzapine is well absorbed and reaches peak concentrations in approximately 6 hours following an oral dose. It is eliminated extensively by first pass metabolism, with approximately 40% of the dose metabolized before reaching the systemic circulation. Food does not affect the rate or extent of olanzapine absorption.

Dosage

Usual Adult Dose for Bipolar Disorder Monotherapy: Initial dose: 10 or 15 mg orally once a day Dose adjustments: If indicated, dose adjustments should occur at intervals of at least 24 hours in 5 mg increments/decrements Maintenance dose: 5 to 20 mg orally once a day Maximum dose: 20 mg orally once a day Usual Adult Dose for Schizophrenia Initial dose: 5 to 10 mg orally once a day Target dose: 10 mg orally once a day within the first several days; further dose adjustments, if needed, should occur at intervals of not less than 1 week in 5 mg increments/decrements Maximum dose: 20 mg orally once a day Usual Pediatric Dose for Schizophrenia Age 13 years or older: Initial dose: 2.5 to 5 mg orally once a day Target dose: 10 mg orally once a day; further dose adjustments, if needed, should occur at intervals of not less than 1 week in 2.5 to 5 mg increments/decrements. Maximum dose: 20 mg orally once a day

Alerts

1-INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. 2-The possibility of a suicide attempt is inherent in schizophrenia and in bipolar I disorder, and close supervision of high-risk patients should accompany drug therapy 3-A potentially fatal symptom complex sometimes referred to as Neuroleptic Malignant Syndrome (NMS) has been reported in association with administration of antipsychotic drugs, including olanzapine.

Points of recommendation

1-Patients starting treatment with olanzapine should undergo fasting blood glucose testing at the beginning of treatment and periodically during treatment. 2-Take without regard to meals.

Pregnancy level

C


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