(Legend)

Generic Name

• Olanzapine
  T½ = 21–54 h
  Protein binding = 93%
  Pregnancy category C [Zyprexa Relprevv Extended release IM; up to 4 wk]

Trade Name

• Zyprexa
• Zyprexa Zydis
• Zyprexa Intramuscular & Relprevv

Dose Range/Adult Daily Dose

• Range: 5–20 mg/d
  Schizophrenia: Start: 5–10 mg po/d (not to exceed 20 mg/d)
  Bipolar: Start: 10–15 mg/d po (not to exceed 20 mg/d); IM (acute agitation): 5–10 mg, may repeat in 2 h/4 h

Use/Common Side Effects (CSE)

• Use: Schizophrenia, psychotic disorders; Bipolar: Acute mania; mixed episodes; long-term maintenance
  CSE: Agitation, dizziness, sedation, orthostatic hypotension, constipation, weight gain, NMS, SEIZURES
  NEW (2016): Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).

Geriatric & Dose Considerations

• Dosage reduction may be needed; reduce dosage for debilitated or non-smoking females ≥65: start at 5 mg/d po.
  Caution w CV, CVA, BPH, hepatic disease. ↑mortality in elderly with dementia-related psychosis

Classification

• Antipsychotic [Atypical]

Assessment Cautions

• Monitor for diabetes (serum glucose, BMI), akathisia, EPS, NMS; perform CBCs, LFTs, eye exams. Monitor BP, pulse, respiratory rate, ECG; SERIOUS [rash, fever, lymph nodes] DRESS (seek medical help); must enroll in Zyprexa Relprevv Patient Care Program.