Zyprexa (Olanzapine)

1. What is Zyprexa?
2. Indications for use
3. Dosing and administration
4. Contraindications for use
5. Side effects
6. Interactions with other drugs

What is Zyprexa?

Zyprexa is antipsychotic preparation or neuroleptic agent. The active constituent of this preparation is olanzapine. The pharmaceutical aids are lactose monohydrate, hydroxypropyl cellulose, crospovidone, microcrystalline cellulose and magnesium stearate. This is antipsychotic preparation with the wide pharmacological spectrum of influence on raw of receptor systems. This preparation is used for the treatment of schizophrenia. It should be taken according to the instruction for use. You’d better consult a doctor before taking this remedy.

Indications for use

Zyprexa is indicated for:

• the treatment of schizophrenia;
• maintaining clinical improvement in the continuing treatment of patients who have had an initial response to treatment;
• the treatment of a moderate and severe manic phase;
• prevention of relapse in patients with bipolar disorder, in whom olanzapine was effective in treating the manic phase.

Dosing and administration

The drug is taken orally, regardless of food intake, at a dose of 5-20 mg/day.

• In schizophrenia in adults, the recommended initial dose is 10 mg/day;
• In acute mania associated with bipolar disorders, adults need to take 15 mg once a day as monotherapy or 10 mg once a day in combination with lithium or valproic acid (maintenance therapy at the same dose);
• In depression associated with bipolar disorders, adults need to take 5 mg 1 time/day in combination with 20 mg fluoxetine (if necessary, the dose may be changed).

Elderly patients, patients with risk factors (including severe CRF or moderate-level hepatic insufficiency), with a combination of risk factors (female, elderly, non-smokers) may need a reduction in the initial dose to 5 mg/day.

Contraindications for use

• hypersensitivity to components of the drug;
• patients under 18 years of age;
• deficiency of lactase;
• lactose intolerance;
• glucose-galactose malabsorption

Side effects

Zyprexa may cause the following adverse reactions:

• tachycardia;
• irritation;
• dysarthria;
• extrapyramidal disorders;
• impairment of consciousness;
• delirium;
• convulsions;
• neuroleptic malignant syndrome;
• respiratory depression;
• aspiration;
• arterial hypertension or hypotension;
• cardiac arrhythmia;
• cardiopulmonary arrest.

All these symptoms sound very horrible that’s why you need to be attentive while taking this drug.

Interactions with other drugs

• Inducers or inhibitors of the CYP 1A2 isoenzyme may alter the metabolism of Zyprexa;
• The clearance of olanzapine is increased in smoking patients and with the simultaneous use of carbamazepine (the activity of CYP1A2 increases);
• Ethanol did not affect the pharmacokinetics of Zyprexa in an equilibrium state, however, ethanol administration in conjunction with olanzapine may be accompanied by an increase in the pharmacological effects of olanzapine (sedation);
• Activated charcoal reduces the bioavailability of olanzapine to 50-60%;
• Fluoxetine (60 mg once or 60 mg daily for 8 days) increases Cmax of olanzapine by 16% and reduces clearance by 16%, which is not clinically important (olanzapine dosage adjustment is not required);
• Fluvoxamine (CYP 1A2 inhibitor) reduces the clearance of olanzapine, increases the Cmax of olanzapine in non-smokers by 54% and 77% for men who smoke, the AUC by 52% and 108%, respectively (a reduction in the dose of olanzapine);
• Zyprexa slightly suppresses the formation of valproic acid glucuronide (the main pathway of metabolism). Valproic acid slightly affects the metabolism of olanzapine. The clinically significant pharmacokinetic interaction between Zyprexa and valproic acid is unlikely.