Zyprexa Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

There may be a slightly increased risk of serious, possibly fatal side effects (such as stroke, heart failure, fast/irregular heartbeat, pneumonia) when this medication is used by older adults with dementia. This medication is not approved for the treatment of dementia-related behavior problems. Discuss the risks and benefits of this medication, as well as other effective and possibly safer treatments for dementia-related behavior problems, with the doctor.

If you are using olanzapine in combination with other medication to treat depression, also carefully read the drug information for the other medication.

Warnings:

There may be a slightly increased risk of serious, possibly fatal side effects (such as stroke, heart failure, fast/irregular heartbeat, pneumonia) when this medication is used by older adults with dementia. This medication is not approved for the treatment of dementia-related behavior problems. Discuss the risks and benefits of this medication, as well as other effective and possibly safer treatments for dementia-related behavior problems, with the doctor.

If you are using olanzapine in combination with other medication to treat depression, also carefully read the drug information for the other medication.

… Show More

Uses

Olanzapine is used to treat certain mental/mood conditions (such as schizophrenia, bipolar disorder). It may also be used in combination with other medication to treat depression. This medication can help to decrease hallucinations and help you to think more clearly and positively about yourself, feel less agitated, and take a more active part in everyday life.Olanzapine belongs to a class of drugs called atypical antipsychotics. It works by helping to restore the balance of certain natural substances in the brain.Talk to the doctor about the risks and benefits of treatment (especially when used by teenagers). See also Precautions section.

How to use Zyprexa

Read the Medication Guide provided by your pharmacist before you start taking olanzapine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor, usually once daily.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully.

Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor.

Tell your doctor if your condition lasts or gets worse.

Side Effects

Drowsiness, dizziness, lightheadedness, stomach upset, dry mouth, constipation, increased appetite, or weight gain may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: difficulty swallowing, shaking (tremor), slow heartbeat, fainting, mental/mood changes (such as confusion, restlessness), numbness/tingling of arms/legs, yellowing eyes/skin, severe stomach/abdominal pain, trouble urinating, interrupted breathing during sleep.

This drug may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

This drug may also cause significant weight gain and a rise in your blood cholesterol (or triglyceride) levels, especially in teenagers. These effects, along with diabetes, may increase your risk for developing heart disease. Discuss the risks and benefits of treatment with your doctor. (See also Notes section.)

Olanzapine may rarely cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any unusual/uncontrolled movements (especially of the face, lips, mouth, tongue, arms or legs).

This medication may increase a certain natural substance (prolactin) made by your body. For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor right away.

Get medical help right away if you have any very serious side effects, including: seizures.

This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, signs of kidney problems (such as change in the amount of urine).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www. fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking olanzapine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver problems, seizures, difficulty swallowing, low white blood cell count, dementia, difficulty urinating (for example, due to enlarged prostate), glaucoma (narrow angle), stomach/intestinal problems (such as blockage, chronic constipation, paralytic ileus), smoking, personal or family history of diabetes, heart disease, high cholesterol/triglyceride levels, breathing trouble during sleep (sleep apnea).

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.

Teenagers may be more sensitive to the side effects of this drug, especially weight gain, and also increased amounts of cholesterol, triglycerides, and prolactin. See also Side Effects section for more details.

Older adults may be more sensitive to the side effects of this drug, especially drowsiness, constipation, trouble urinating, confusion, dizziness, and lightheadedness. Drowsiness, confusion, dizziness, and lightheadedness can increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop symptoms including muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away.

Since untreated mental/mood problems (such as schizophrenia, bipolar disorder, depression) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Tell the doctor right away if your baby develops symptoms such as muscle stiffness or shakiness, unusual sleepiness, or difficulty feeding. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

A product that may interact with this drug is: metoclopramide.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Does Zyprexa interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness/dizziness, fast/irregular heartbeat, unusual/uncontrolled movements, seizures.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

Zyprexa 2.5 mg tablet

Color: whiteShape: roundImprint: LILLY 4112

This medicine is a white, round, film-coated, tablet imprinted with “LILLY 4112”.

Zyprexa 15 mg tablet

Color: blueShape: ellipticalImprint: LILLY 4415

This medicine is a white, round, film-coated, tablet imprinted with “LILLY 4112”.

Zyprexa 10 mg tablet

Color: whiteShape: roundImprint: LILLY 4117

This medicine is a white, round, film-coated, tablet imprinted with “LILLY 4112”.

Zyprexa 7.5 mg tablet

Color: whiteShape: roundImprint: LILLY 4116

This medicine is a white, round, film-coated, tablet imprinted with “LILLY 4112”.

Zyprexa 5 mg tablet

Color: whiteShape: roundImprint: LILLY 4115

This medicine is a white, round, film-coated, tablet imprinted with “LILLY 4112”.

Zyprexa 20 mg tablet

Color: pinkShape: ellipticalImprint: LILLY 4420

This medicine is a white, round, film-coated, tablet imprinted with “LILLY 4112”.

Next

Save up to 80% on your prescriptions.

Available coupons

Save up to 80% on your prescription with WebMDRx

Drug Survey

Are you currently using Zyprexa?

This survey is being conducted by the WebMD marketing sciences department.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Zyprexa – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

Olanzapine belongs to group of medications known as antipsychotic agents. Olanzapine is used to treat schizophrenia and related mental disorders, as well as bipolar disorder.

Schizophrenia can cause symptoms such as hallucinations (e.g., hearing, seeing, or sensing things that are not there), delusions, unusual suspiciousness, and emotional withdrawal. People with this condition may also feel depressed, anxious, or tense.

Bipolar disorder can cause alternating periods of depression and mania (abnormally elevated or irritable mood) or “mixed episodes” where people have symptoms of both depression and mania. Olanzapine may be used, alone or in combination with other medications, to treat the manic or mixed episodes (but not the depression) of bipolar disorder.

Medications like olanzapine are thought to work by correcting the balance of neurotransmitters (chemicals that control the function of nerve pathways) in the brain.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

2.5 mg
Each white, round, film-coated tablet, marked in blue ink with “LILLY” and the tablet identification code “4112”, contains 2.5 mg (8 µmol) of olanzapine. Nonmedicinal ingredients: carnauba wax, crospovidone, FD&C Blue No. 2 Aluminum Lake, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, and titanium dioxide.

5 mg
Each white, round, film-coated tablet, marked in blue ink with “LILLY” and the tablet identification code “4115”, contains 5 mg (16 µmol) of olanzapine. Nonmedicinal ingredients: carnauba wax, crospovidone, FD&C Blue No. 2 Aluminum Lake, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, and titanium dioxide.

7.5 mg
Each white, round, film-coated tablet, marked in blue ink with “LILLY” and the tablet identification code “4116”, contains 7. 5 mg (24 µmol) of olanzapine. Nonmedicinal ingredients: carnauba wax, crospovidone, FD&C Blue No. 2 Aluminum Lake, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, and titanium dioxide.

10 mg
Each white, round, film-coated tablet, marked in blue ink with “LILLY” and the tablet identification code “4117”, contains 10 mg (32 µmol) of olanzapine. Nonmedicinal ingredients: carnauba wax, crospovidone, FD&C Blue No. 2 Aluminum Lake, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, and titanium dioxide.

15 mg
Each elliptical, film-coated, light blue tablet, marked with “LILLY” and the tablet identification code “4415”, contains 15 mg (48 µmol) of olanzapine. Nonmedicinal ingredients: carnauba wax, crospovidone, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, titanium dioxide, and triacetin.

20 mg
Each elliptical, film-coated, pink tablet, marked with “LILLY” and the tablet identification code “4420”, contains 20 mg (64 µmol) of olanzapine. Nonmedicinal ingredients: carnauba wax, crospovidone, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, synthetic red iron oxide, titanium dioxide, and triacetin.

How should I use this medication?

The usual starting dose of olanzapine injection for adults with schizophrenia or adults with bipolar disorder is 10 mg injected into the muscle. A lower dose (5 mg or 7.5 mg) may be given, and will be determined on an individual basis by your doctor. The injection is given by your doctor or trained health care professional.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a different dose than the ones listed here, do not change the way that you are using the medication without consulting your doctor.

For this medication to be effective, it is very important to use this medication exactly as prescribed by your doctor.

It is important that this medication be given exactly as recommended by your doctor. If you miss an appointment to receive olanzapine, contact your doctor as soon as possible to reschedule your appointment.

Store the medication at room temperature, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you are allergic to olanzapine or any ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• dizziness, especially when rising quickly from a lying or sitting position
• drowsiness
• dry mouth or eyes
• fatigue
• fluid retention
• increased appetite
• rash
• restlessness
• weakness
• weight gain

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• changes in your menstrual period (for women)
• enlarged breasts (in men)
• signs of a blood clot in the arm or leg (tenderness, pain, swelling, warmth, or redness in the arm or leg) or lungs (difficulty breathing, sharp chest pain that is worse when breathing in, coughing, coughing up blood, sweating, or passing out)
• signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
• signs of liver damage (abdominal pain, abdominal distention, fever, nausea or vomiting, yellowing of the skin or eyes)
• signs of muscle damage (e.g., unexplained muscle pain, tenderness or weakness, or brown or discoloured urine)
• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
• slow, irregular, or fast heartbeat
• symptoms of high blood sugar (e. g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of infection (cold or flu-like symptoms, fever, sore throat, as well as weakness or general feeling of discomfort)
• twitching of your muscles or unusual facial or tongue movements
• worsening constipation

Stop taking the medication and seek immediate medical attention if any of the following occur:

• painful erection or prolonged erection that lasts more than 4 hours
• seizure
• signs of an allergic reaction (shortness of breath or difficulty breathing; hives; swelling of the eyes, mouth, lips, or throat)
• signs of neuroleptic malignant syndrome (e.g., confusion, reduced consciousness, high fever, or muscle stiffness)
• signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
• signs of stroke (e. g., sudden or severe headache; sudden loss of coordination; vision changes; sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood clots: This medication may increase the chance of blood clot formation, causing reduction of blood flow to organs or the extremities.

If you have a history of clotting you may be at increased risk of experiencing blood clot-related problems such as heart attack, stroke, or clots in the deep veins of your leg. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision, or difficulty speaking, contact your doctor immediately.

Body temperature: This medication, like other antipsychotic medications, can disrupt the body’s ability to control body temperature. If you exercise vigorously, are exposed to extreme heat, are dehydrated, or are taking anticholinergic medications (e.g., benztropine, oxybutynin) you are more at risk. Contact your doctor as soon as possible if you feel very hot and are unable to cool down while taking this medication.

Cholesterol: Olanzapine can cause increased blood cholesterol levels. If you are at risk of developing high cholesterol or you have high cholesterol levels before starting olanzapine, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Olanzapine may impair the mental and physical abilities required for driving a car or operating machinery. Avoid drinking alcohol while taking this medication, as it may produce extreme drowsiness.

Glaucoma: This medication may cause the symptoms of glaucoma (increased pressure in the eye) to develop or become worse. If you have glaucoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking this medication.

High blood sugar: Olanzapine, in rare instances, may cause an increase in blood sugar levels. Your doctor will monitor you if you have diabetes or are at risk of developing diabetes. If you experience weakness, increased thirst, increased urination, and increased appetite while taking this medication, contact your doctor.

Hypersensitivity reactions: A severe allergic reaction called hypersensitivity syndrome has occurred for some people with the use of olanzapine. This reaction involves a number of organs in the body and may be fatal if not treated quickly. Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.

Liver disease: Olanzapine can affect liver function and cause liver problems. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low blood pressure: Olanzapine may cause low blood pressure, especially when moving from a lying or sitting position to a standing position. If you have heart disease, cerebrovascular disease, or conditions that increase the risk of developing low blood pressure (e.g., dehydration, treatment with blood pressure medications) you should be monitored by your doctor.

Neuroleptic malignant syndrome (NMS): Olanzapine, like other antipsychotic medications, can cause a potentially fatal syndrome known as neuroleptic malignant syndrome (NMS). If you notice the symptoms of NMS such as high fever, confusion or loss of consciousness, racing or irregular heartbeat, muscle stiffness, or sweating, get immediate medical attention.

Phenylketonuria: People with phenylketonuria (an inherited disorder where the enzyme needed to break down phenylalanine is lacking) should take the regular tablet forms of olanzapine and not the oral dissolving tablets (ODT). The ODT form of olanzapine contains aspartame, which is a source of phenylalanine.

Prolonged erection: In rare cases, use of this medication by some men may cause them to develop priapism (a prolonged and painful erection). If you have an erection that lasts for more than 4 hours, contact your doctor.

Seizures: Olanzapine may increase the risk of seizures, especially if you have had seizures in the past. If you are at risk of seizures and take this medication, you should be closely monitored by your doctor.

Suicidal or self-harm behaviour: People taking this medication may want to hurt themselves or others. These symptoms may occur within several weeks after starting this medication. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.

Tardive dyskinesia (TD): TD, a syndrome consisting of potentially irreversible, involuntary, repetitive movements of the face and tongue muscles, may develop in people who take certain antipsychotic medications including olanzapine.

Although TD appears most commonly in seniors, especially women, it is impossible to predict who will develop TD. The risk of developing TD increases with higher doses and long-term treatment. If your experience muscle twitching or abnormal movements of the face or tongue, contact your doctor as soon as possible.

Urinary problems: This medication can cause urinary retention. If you have a history of urinary retention or benign prostatic hypertrophy, or other prostate problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Weight gain: With long-term treatment, weight gain (averaging 5. 4 kg) has occurred in people who take this medication. Weight gain tends to level off after 6 to 8 months of treatment.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Babies born to mothers that took this medication in the last 3 months of pregnancy may experience withdrawal symptoms after they are born, including breathing problems, difficulty feeding, or irritability. If you have been taking this medication during pregnancy, make sure that everyone involved in caring for you and your baby are aware.

Breast-feeding: This medication passes into breast milk. Women taking this medication should not breast-feed.

Children: The safety and effectiveness of using this medication have not been established for children under the age of 18.

Seniors: There may be a higher risk of strokes, heart attacks, and deaths associated with the use of olanzapine by seniors with dementia. Seek medical attention immediately if you notice the signs and symptoms of a stroke (e.g., sudden weakness or numbness, speech problems, vision problems, dizziness, confusion, sudden severe headache) or a heart attack (e.g., discomfort or pain in the chest, back, neck, jaw, arms; sweating; shortness of breath; nausea; lightheadedness) or infection (e.g., pneumonia). Olanzapine should not be used in seniors with dementia.

What other drugs could interact with this medication?

There may be an interaction between olanzapine and any of the following:

• aclidinium
• alcohol
• aliskiren
• alpha-agonists (e.g., clonidine, methyldopa)
• alpha-blockers (e.g., alfuzosin, doxazosin, tamsulosin)
• angiotensin converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
• amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
• anaesthetics
• antiarrhythmics (e.g., amiodarone, dronedarone, flecainide, mexiletine, procainamide, quinidine)
• antihistamines (e. g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
• anti-Parkinson’s medications (e.g., amantadine, apomorphine, bromocriptine, levodopa, pramipexole, ropinirole)
• antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, quetiapine, risperidone)
• antiseizure medications (e.g., carbamazepine, clobazam, levetiracetam, phenobarbital, phenytoin, primidone, topiramate, valproic acid, zonisamide)
• atropine
• azelastine
• barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
• belladonna
• benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
• benztropine
• beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
• botulinum toxin
• brimonidine
• bupropion
• buspirone
• calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
• cannabis
• chloral hydrate
• chloroquine
• darifenacin
• deferasirox
• diabetes medications (e. g., canagliflozin, chlorpropamide, glyburide, insulin, metformin, rosiglitazone)
• disopyramide
• diuretics (water pills; e.g., furosemide, hydrochlorothiazide, indapamide, triamterene)
• domperidone
• donepezil
• eluxadoline
• entacapone
• flavoxate
• fluconazole
• galantamine
• glucagon
• glycopyrrolate
• guanfacine
• ipratropium
• ketotifen
• leflunomide
• leuprolide
• lithium
• macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
• methadone
• methoxsalen
• methylphenidate
• metoclopramide
• mifepristone
• mirabegron
• mirtazapine
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, rasagiline, selegiline, tranylcypromine)
• muscle relaxants (e.g., baclofen, cyclobenzaprine, methocarbamol, orphenadrine, tizanidine)
• nabilone
• narcotic pain relievers (e. g., codeine, fentanyl, morphine, oxycodone)
• nitroglycerin
• oxybutynin
• pentamidine
• potassium supplements
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, levofloxacin, norfloxacin, ofloxacin)
• rifampin
• ritonavir
• rivastigmine
• romidepsin
• St. John’s wort
• saquinavir
• scopolamine
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
• serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
• serotonin-norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
• solifenacin
• sotalol
• suvorexant
• tapentadol
• teriflunomide
• tetrabenazine
• tiotropium
• tolterodine
• tramadol
• trazodone
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
• tyrosine kinase inhibitors (e. g., dasatinib, imatinib, nilotinib, sunitinib, vemurafenib)
• tryptophan
• umeclidinium
• valerian
• voriconazole
• zolpidem
• zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2023. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Zyprexa

Zyprexa. Oral tablets Directory of drugs. Tomsk

//= $single_post[“name_eng”] ?>
//= $single_post[“name_eng”] ?>

Packaging

Oral tablets

Pharmacological action

Being a ligand of serotonin (2A/2C, 3, 6), dopamine (D1-D5), m-cholinergic (m1-m5), histamine h2- and alpha1-adrenergic receptors, selectively affects limbic system.

Indications for use

Acute form of schizophrenia and other psychoses, accompanied by pronounced positive (delusions, hallucinations, thought disorders, hostility, suspicion) and / or negative (blunted affect, emotional and social isolation, poverty of speech activity) symptoms. Secondary affective symptoms in schizophrenia and comorbidities.

Release form

film-coated tablets 5 mg; blister 7, box (box) 4;

film-coated tablets 7.5 mg; blister 7, box (box) 4;

film-coated tablets 10 mg; blister 7, box (box) 4;

film-coated tablets 2.5 mg; blister 7, box (box) 4;

film-coated tablets 7.5 mg; blister 7, box (box) 8;

film-coated tablets 10 mg; blister 7, box (box) 2;

film-coated tablets 5 mg; blister 7, box (box) 2;

film-coated tablets 10 mg; blister 7, box (box) 1;

film-coated tablets 10 mg; blister 7, box (box) 8;

film-coated tablets 2.5 mg; blister 7, box (box) 1;

film-coated tablets 2.5 mg; blister 7, box (box) 2;

film-coated tablets 2.5 mg; blister 7, box (box) 8;

film-coated tablets 5 mg; blister 7, box (box) 1;

film-coated tablets 5 mg; blister 7, box (box) 8;

film-coated tablets 7.5 mg; blister 7, box (box) 1;

film-coated tablets 7.5 mg; blister 7, box (box) 2;

film-coated tablets 5 mg; blister 7, box (box) 4;

film-coated tablets 10 mg; blister 7, box (box) 4;

film-coated tablets 5 mg; blister 7, box (box) 4;

film-coated tablets 2. 5 mg; blister 7, box (box) 4;

film-coated tablets 5 mg; blister 7, box (box) 4;

film-coated tablets 7.5 mg; blister 7, box (box) 4;

film-coated tablets 10 mg; blister 7, box (box) 4;

Compound

1 coated tablet contains olanzapine 5; 7.5 or 10 mg; in a blister 7 pcs., in a box of 4 blisters.

Pharmacodynamics

Being a ligand of serotonin (2A / 2C, 3, 6), dopamine (D1-D5), m-cholinergic (m1-m5), histamine h2- and alpha1-adrenergic receptors, selectively affects the limbic system.

Pharmacokinetics

Well absorbed, Cmax in plasma after 5-8 hours Metabolized in the liver (via conjugation and oxidative pathways) to inactive metabolites. The main metabolite, 10-N-glucuronide, does not pass through the BBB. The average T1 / 2 varies (depending on age and sex) within 21-54 hours.

Use during pregnancy

If prescribing during pregnancy is necessary, the intended benefit to the mother should be carefully weighed against the risk to the fetus. During lactation, nursing mothers should stop breastfeeding.

Contraindications for use

Hypersensitivity.

Side effects

Frequent (more than 10%) – drowsiness, weight gain; rare (less than 10%) – dizziness, dry mouth, constipation, peripheral edema, orthostatic hypotension, akathisia, dystonia, eosinophilia (asymptomatic), a slight and temporary increase in prolactin levels (gynecomastia, lactorrhoea), liver transaminase activity.

Method of administration and dosage

Inside, regardless of food intake. The initial dose is from 10 mg / day, once. Then the daily dose may vary – from 5 to 20 mg / day, depending on the clinical condition.

Overdose

Symptoms: nausea, slurred speech, drowsiness. Mydriasis, respiratory depression, hypotension, extrapyramidal disorders were noted in animal experiments.

Treatment: There is no specific antidote. Treatment is symptomatic, with the obligatory use of activated charcoal, ensuring good lung ventilation and oxygen saturation; in case of collapse – intravenous administration of norepinephrine (but not adrenomimetics with beta-stimulating activity – adrenaline, dopamine, etc. ).

Interaction with other drugs

Weakens the effects of levodopa and dopamine agonists. Activated charcoal reduces bioavailability by 50-60% when taken orally. Smoking and carbamazepine speed up metabolism. There was no obvious interaction with antacids, cimetidine, imipramine, warfarin, diazepam, lithium, theophylline, biperiden.

Precautions

Use with caution in patients with prostatic hypertrophy, angle-closure glaucoma, paralytic ileus, history of seizures, liver or kidney disease; in patients with altered hematological parameters; and also in combination with other drugs that depress the central nervous system (including with alcohol). It is not recommended to drive potentially dangerous mechanisms (vehicles, etc.) during treatment.

Storage conditions

List B.: In a dry, dark place, at a temperature of 15–30 °C.

Shelf life

36 months.

ZIPREXA: instruction, price, analogues | Lilly S.A.

org/SiteNavigationElement”>
• Pharmacological properties
• Indications for ZIPREX
• Application of ZIPREX
• Contraindications
• Side effects
• Special instructions
• Interactions
• Overdose
• Storage conditions
• Diagnosis
• Recommended alternatives
• Trade names

olanzapine is an antipsychotic agent (neuroleptic) with a wide pharmacological spectrum of action due to its effect on a number of receptor systems. The affinity of olanzapine to serotonin 5-HT _{2 А/С} -, 5-HT ₃ -, 5-HT ₆ -, dopamine D ₁ -, D ₂ – D ₃ -, D ₄ -, D ₅ -, muscarinic M ₁ -, M ₅ -, α ₁ – adrenergic and histamine H ₁ – receptors. In the course of experiments to study the effect of olanzapine on the behavior of animals, the presence of olanzapine antagonism in relation to both serotonin 5-HT, _{and dopamine and cholinergic receptors was revealed. Under conditions of in vitro and in vivo , olanzapine has a more pronounced affinity and activity for serotonin 5-HT 2 receptors compared to dopamine D 2 receptors. According to electrophysiological studies, olanzapine selectively reduces the excitability of mesolimbic (A10) dopaminergic neurons, and at the same time has a slight effect on the striatal (A9) nerve pathways involved in the regulation of motor functions. Olanzapine inhibits the conditioned protective reflex, which indicates its antipsychotic activity at lower doses than at doses that cause catalepsy (a disorder that reflects an adverse effect on motor function).}

Two placebo-controlled and two of three comparative controlled trials involving 2900 patients with schizophrenia showed that olanzapine provides a statistically significant reduction in both productive and negative disorders.

Pharmacokinetics. After oral administration, olanzapine is well absorbed and its maximum plasma concentration is reached after 5-8 hours. Absorption of olanzapine is independent of food intake.

In clinical studies with doses ranging from 1 to 20 mg, plasma concentrations of olanzapine have been shown to be linear and dose proportional.

Olanzapine is metabolized in the liver as a result of conjugation and oxidation processes. The main circulating metabolite is 10-N-glucuronide, which does not cross the BBB. Cytochrome P450 isoenzymes CYP 1A2 and CYP 2D6 are involved in the formation of N-desmethyl and 2-hydroxymethyl metabolites of olanzapine. Both metabolites in the in vivo studies of had significantly less pharmacological activity than olanzapine. The main pharmacological activity of the drug is due to the parent substance – olanzapine.

After oral administration, the mean half-life of olanzapine in healthy patients is 33 hours (range 21 to 54 hours for 5 and 95%), and the mean plasma clearance of olanzapine is 26 l/h (range 12 to 47 l/h for 5 and 95%). The pharmacokinetics of olanzapine varies depending on gender, age and whether the patient smokes.

The indicated data are summarized in the table:

Thus, smoking, sex and age may affect the clearance of olanzapine and its half-life. The degree of influence of these factors is less pronounced than the interindividual differences of these indicators.

In patients with mild renal impairment and apparently healthy individuals, there is no significant difference between the average values ​​of the half-life and clearance of the drug. About 57% of olanzapine is excreted in the urine, mainly in the form of metabolites. In smokers with mild hepatic impairment, olanzapine clearance is lower than in non-smokers without hepatic impairment.

At plasma concentrations of 7 to 1000 ng/mL, about 93% of olanzapine binds to plasma proteins. Olanzapine mainly binds to albumin and α ₁ -acid glycoprotein.

No differences in the pharmacokinetics of olanzapine due to race have been established.

The CYP 2D6 isoform of cytochrome P450 does not affect the metabolism of olanzapine.

olanzapine is indicated for the treatment of exacerbations and as maintenance therapy for schizophrenia and other psychoses with marked positive (delusions, hallucinations, thought disturbances, hostility and suspicion) and/or negative symptoms (eg, flattened affect, emotional and social isolation, paucity of speech). Olanzapine also reduces the secondary affective symptoms commonly associated with schizophrenia and related disorders. Olanzapine is effective in maintaining clinical improvement with long-term therapy in patients who respond to initial therapy.

Olanzapine alone or in combination with lithium or valproate is indicated for the treatment of acute manic or mixed episodes in bipolar disorder, with or without psychotic features, and rapid cyclicity. Olanzapine is indicated to reduce the severity of manic, mixed, or depressive episodes in bipolar disorder and to prolong the interictal period.

Olanzapine in combination with fluoxetine is indicated for the treatment of depressive episodes occurring in bipolar disorders.

Schizophrenia and related disorders: The recommended starting dose of olanzapine is 10 mg once daily with or without food, since food does not affect the absorption of the drug. The dose range for olanzapine is 5–20 mg daily. The daily dose should be determined based on an assessment of clinical status. Increasing the recommended starting dose above 10 mg is possible only after a clinical examination.

Acute mania in bipolar disorder: The recommended starting dose of olanzapine as monotherapy is 15 mg per day or 10 mg per day in combination with lithium or valproate. This dose is prescribed regardless of food intake, since food intake does not affect the absorption of the drug. The dose range for olanzapine is 5–20 mg daily. The daily dose should be determined based on an assessment of clinical status. An increase in the recommended starting dose is possible only after a clinical examination and should be carried out sequentially at intervals of at least 24 hours.

Maintenance therapy for bipolar disorder: Patients treated with olanzapine for the treatment of acute mania should continue maintenance therapy for bipolar disorder at the same dose. For patients in remission, the recommended starting dose of olanzapine is 10 mg daily. The subsequent daily dose is determined based on the clinical status in the range of 5-20 mg per day. Olanzapine is prescribed regardless of food intake, since it does not affect the absorption of the drug.

Bipolar depression: olanzapine in combination with fluoxetine is given once daily with or without food, usually starting with olanzapine 5 mg and fluoxetine 20 mg. The efficacy of olanzapine as an antidepressant has been demonstrated in the dose range of 6–12 mg (mean modal daily dose 7.4 mg) and fluoxetine 25–50 mg (mean modal daily dose 39.3 mg) in two clinical studies. Dose adjustment, if necessary, can be carried out for each agent separately (olanzapine, fluoxetine).

General data on oral use in selected populations: at a reduced initial daily dose to 2.5-5 mg, the drug can be prescribed to elderly patients or in the presence of other clinical factors. An initial dose of 5 mg is recommended in patients with severe renal or moderate hepatic insufficiency, as well as in patients with a combination of factors (female gender, older age, smoking) that may reduce the metabolism of olanzapine.

The effect of olanzapine in patients under 18 years of age has not been studied.

hypersensitivity to the drug.

In clinical trials the most common (≥10 % ) side effects associated with olanzapine were drowsiness and weight gain. An increase in plasma prolactin concentration was noted in 34% of patients taking olanzapine, but this increase was moderately pronounced and transient (the final value did not exceed the upper limits of the norm and was statistically insignificantly different from that when using placebo), and clinical manifestations of hyperprolactinemia (for example, gynecomastia, galactorrhea, enlargement of the mammary glands) were rarely noted. In most patients, normalization of prolactin levels occurred without discontinuation of the drug.

Common (<10% but ≥1%) side effects associated with olanzapine included dizziness, asthenia, akathisia, increased appetite, peripheral edema, orthostatic hypotension, dry mouth, and constipation. Occasionally, a transient asymptomatic increase in the activity of hepatic transaminases (ALAT and AST) and eosinophils was detected. In clinical studies of patients with baseline plasma glucose ≤140 mg/dL, isolated cases of glucose levels both ≥200 mg/dL (probable diabetes mellitus) and ≥160 mg/dL but <200 mg/dL (probable) were noted. hyperglycemia).

Rarely (<1% and ≥0.01%) noted side effects such as photosensitivity, bradycardia.

Very rare (<0.1% but ≥0.01%) Possible hepatitis, leukopenia, seizures, skin rash; extremely rare (<0.01%) – allergic reactions, withdrawal syndrome, venous thromboembolism, jaundice, pancreatitis, thrombocytopenia, diabetic ketoacidosis, diabetic coma, hyperglycemia, hypercholesterolemia, hypertriglyceridemia, rhabdomyolysis, priapism, increased alkaline phosphatase and bilirubin.

Adverse effects in selected populations

In clinical trials, patients with drug-induced (dopamine agonist) psychosis associated with Parkinson’s disease experienced significantly more symptomatic improvement compared with placebo. Hallucinations were also reported very frequently compared to placebo.

During clinical trials, the most common (≥10%) adverse events associated with the use of olanzapine in elderly patients with dementia-associated psychosis were gait disturbance and falling; Common (<10% but ≥1%) Urinary incontinence and pneumonia.

Very common (≥10%) side effects in patients with bipolar disorder receiving olanzapine in combination with lithium or valproate were weight gain, dry mouth, increased appetite and tremor, common (10% but ≥ 1%) also had speech disorders.

Warning!

Neuroleptic Malignant Syndrome (NMS)

NZS, a potentially fatal syndrome complex, has been described with antipsychotics, including olanzapine. The clinical manifestations of NMS are hyperpyrexia, muscle rigidity, loss of consciousness, and symptoms of cardiovascular instability (irregular pulse or blood pressure, tachycardia, increased sweating, and cardiac arrhythmia). Additional signs may include increased CPK activity, myoglobinuria (rhabdomyolysis), and acute renal failure. The clinical manifestations of NSD, as well as the presence of high fever without other clinical manifestations of NSD, require the immediate withdrawal of all antipsychotics, including olanzapine.

Tardive dyskinesia

Due to the high risk of developing tardive dyskinesia with long-term use of antipsychotic drugs, an agreed dose reduction or complete withdrawal of the drug should be made if the patient develops signs or symptoms of tardive dyskinesia.

Over time, these symptoms may worsen the patient’s condition or even appear after treatment is stopped.

The efficacy and safety of olanzapine in elderly patients with dementia-related psychosis has not been established. Risk factors that cause an increase in mortality in the patient population receiving therapy with olanzapine are age ≥80 years, concomitant use of sedatives, benzodiazepines, or the presence of concomitant pulmonary disease (for example, pneumonia with or without aspiration).

Warning!

Liver function tests. Transient asymptomatic elevations in liver transaminases (AlAT and AST) have occasionally been reported with olanzapine, especially at the start of treatment. In rare cases, the development of hepatitis, very rare cases of cholestatic or mixed liver damage have been reported. In the case of an increase in the activity of AlAT and / or AsAT during treatment, it is necessary to monitor the patient’s condition and consider the feasibility of reducing the dose of the drug.

Hyperglycemia and diabetes mellitus : note the high prevalence of diabetes mellitus among patients with schizophrenia. As with other antipsychotic drugs, hyperglycemia, diabetes mellitus, worsening of pre-existing diabetes mellitus, ketoacidosis, and diabetic coma are very rare. A causal relationship between the use of antipsychotic drugs and the listed conditions has not been established. Appropriate clinical monitoring is recommended in patients with diabetes mellitus and in patients with risk factors for developing diabetes mellitus.

Seizures

Olanzapine should be used with caution in patients with a history of seizures or susceptible to factors that lower the seizure threshold. Rare cases of seizures have been reported in these patients during treatment with olanzapine.

Anticholinergic activity

Clinical studies have shown a low incidence of anticholinergic manifestations. However, clinical experience with olanzapine in patients with comorbidities is limited, so caution is advised when prescribing the drug to patients with clinically significant prostatic hypertrophy, paralytic ileus, and angle-closure glaucoma.

Dopaminergic antagonism

Olanzapine in vitro exhibits dopaminergic receptor antagonism and could theoretically interfere with the effects of levodopa and dopamine agonists, as well as other antipsychotics.

General effect on the central nervous system

Given the predominant effect of olanzapine on the central nervous system, care must be taken when prescribing it in combination with other centrally acting drugs and avoiding the simultaneous use of alcohol.

Pregnancy and lactation

Experience with olanzapine during pregnancy is limited and should only be used when the expected benefit to the mother far outweighs the potential risk to the fetus.

Isolated cases of tremor, hypertension, drowsiness and insomnia have been reported in infants whose mothers took olanzapine during the last trimester of pregnancy.

In a study of healthy breastfeeding women, olanzapine was found in breast milk. Patients are advised to stop breastfeeding if they are taking olanzapine.

Influence on the ability to drive vehicles and work with potentially dangerous mechanisms

Since olanzapine can cause drowsiness and dizziness, patients should avoid potentially hazardous activities during the period of drug treatment.

The metabolism of olanzapine may be affected by inhibitors or inducers of cytochrome P450 isoforms, especially CYP 1A2. Smoking or concomitant use of carbamazepine increases the clearance of olanzapine. Smoking and treatment with carbamazepine stimulate CYP1A2 activity. Inhibitors of CYP 1A2 activity may reduce the clearance of olanzapine. Olanzapine is a weak inhibitor of CYP 1A2 activity; it does not alter the pharmacokinetics of theophylline, which is predominantly metabolized by CYP 1A2.

Clinical studies have shown that the use of olanzapine during therapy with the following drugs is not accompanied by inhibition of the metabolism of such drugs: imipramine or its metabolite desipramine (CYP 2D6, CYP 3A, CYP 1A2), warfarin (CYP 2C19), theophylline (CYP 1A2), diazepam (CYP 3A4, CYP 2C19). There was no interaction of olanzapine with simultaneous administration with lithium salts or biperiden.

When equilibrium concentration was reached, olanzapine did not affect the pharmacokinetics of ethanol. However, when ethanol is co-administered with olanzapine, additional pharmacological effects such as increased sedation may occur.

A single dose of cimetidine or aluminum/magnesium antacids did not affect the oral bioavailability of olanzapine. The additional administration of activated charcoal reduced the oral bioavailability of olanzapine by 50–60%.

Fluoxetine (60 mg per dose or 60 mg daily for 8 days) results in an average increase in the maximum concentration of olanzapine by 16% and a mean decrease in the clearance of olanzapine by 16%. The influence of these factors is insignificant compared to the overall individual variability, so dosing adjustments are usually not required.

Fluvoxamine, a CYP 1A2 inhibitor, reduces the clearance of olanzapine. This results in an average increase in fluvoxamine C _max : 54% among non-smokers in women and 77% among smokers in men. The mean increase in AUC of olanzapine is 52% and 108%, respectively. Patients taking fluvoxamine should reduce the dose of olanzapine.

In vitro experiments with human liver microsomes showed that olanzapine has a slight ability to inhibit the process of glucuronization of valproic acid (the main route of its metabolism). In addition, a slight effect of valproate on the metabolism of olanzapine was found in vitro . Daily additional administration of in vivo 10 mg of olanzapine for 2 weeks did not affect the steady-state plasma concentration of valproate. Therefore, the combined use of valproate and olanzapine does not require additional regulation of the dose of valproate.

With a single intramuscular injection of olanzapine at a dose of 5 mg 1 hour before the administration of 2 mg of lorazepam, the pharmacokinetics of these drugs did not change. However, the introduction of such a combination of drugs was accompanied by an increase in drowsiness, which is typical with the introduction of each drug separately.

Olanzapine has antagonistic activity against α ₁ -adrenergic receptors. The drug should be administered with caution to patients taking antihypertensive drugs. Since olanzapine is metabolized by CYP 1A2, substances that can stimulate or inhibit this isoenzyme may affect the pharmacokinetics of olanzapine.

Symptoms: Very common (≥10%) symptoms of olanzapine overdose are tachycardia, agitation/aggressiveness, dysarthria, various extrapyramidal disorders and disturbances of consciousness of varying severity (from sedation to coma). Other clinically significant effects of olanzapine overdose included delirium, convulsions, coma, the possibility of NSD, respiratory depression, aspiration, hypertension or hypotension, arrhythmias (<2% of cases) and cardiopulmonary shock. The minimum dose for acute overdose with a fatal outcome was 450 mg, the maximum dose for overdose with a favorable outcome was 1500 mg.

Treatment: no specific antidote. It is not recommended to prescribe drugs that cause vomiting. Shown gastric lavage, the appointment of activated charcoal (its intake reduces the bioavailability of olanzapine when taken orally by 50-60%). Symptomatic treatment is recommended in accordance with the clinical condition and control of the functions of vital organs, including the elimination of arterial hypotension, circulatory collapse and support for respiratory function.