Olanzapine

GENERIC NAME: olanzapine

DRUG CLASS AND MECHANISM
Olanzapine is a drug that is used to treat schizophrenia and acute manic episodes associated with bipolar I disorder. Olanzapine belongs to a drug class known as atypical antipsychotics. Other members of this class include clozapine (Clozaril), risperidone (Risperdal), aripiprazole (Abilify) and ziprasidone (Geodon). The exact mechanism of action of olanzapine is not known. It may work by blocking receptors for several neurotransmitters (chemicals that nerves use to communicate with each other) in the brain. It binds to alpha-1, dopamine, histamine H-1, muscarinic, and serotonin type 2 (5-HT2) receptors. Olanzapine was approved by the FDA in 1996.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS
Tablets: 2.5, 5, 7.5, 10, 15, 20 mg. Tablets (orally disintegrating): 5, 10, 15, 20 mg. Injection (immediate release): 10 mg vial. Suspension for Injection (extended release): 210, 300, and 405 mg (powder).

DRUG INTERACTIONS
Carbamazepine (Tegretol) can reduce blood concentrations of olanzapine, possibly necessitating higher doses of olanzapine. Other drugs that may also reduce blood levels of olanzapine are omeprazole (Prilosec) and rifampin. Smoking may reduce blood concentrations of olanzapine. Ciprofloxacin (Cipro), diltiazem (Cardizem, Dilacor, Tiazac), erythromycin, and fluvoxamine (Luvox) may have the opposite effect, that is, they may increase blood levels of olanzapine, and the dose of olanzapine may need to be reduced. Olanzapine can cause orthostatic hypotension, a drop in blood pressure upon standing up that may cause dizziness or even fainting. Taking olanzapine with either diazepam (Valium), other related benzodiazepines or alcohol can exaggerate the orthostatic hypotension caused by olanzapine.

USES
This medication is used to treat certain mental/mood conditions (schizophrenia, bipolar mania). It works by helping to restore the balance of certain natural chemicals in the brain (neurotransmitters). Some of the benefits of continued use of this medication include feeling less nervous, better concentration, and reduced episodes of hallucinations. However, olanzapine has not been shown to be safe or effective in the elderly for the treatment of delusions/hallucinations (psychosis) due to dementia.

HOW TO USE
Take as directed, usually once a day by mouth with or without food. Stand up slowly, especially when starting this medication, to avoid dizziness. The dosage is based on your medical condition and response to therapy. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time each day.

SIDE EFFECTS
Dizziness, stomach pain, dry mouth, constipation, weight gain, drowsiness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. To minimize dizziness or fainting, stand up slowly when arising from a seated or lying position; especially when you first start using this medication. Tell your doctor immediately if any of these serious side effects occur: fast heartbeat, ankle/leg swelling, agitation, confusion, restlessness, weakness, difficulty speaking, numbness or tingling of hands or feet, trouble walking (abnormal gait), painful menstrual periods, pink urine, tremor. Tell your doctor immediately if any of these unlikely but serious side effects occur: chest pain, yellowing of the eyes or skin, one-sided weakness, sudden vision changes, headache, painful urination, other eye problems, seizures, difficulty swallowing. This drug may infrequently make your blood sugar level rise, which can cause or worsen diabetes. High blood sugar can rarely cause serious (sometimes fatal) conditions such as diabetic coma. Tell your doctor immediately if you develop symptoms of high blood sugar, such as unusual increased thirst and urination. If you already have diabetes, be sure to check your blood sugars regularly. This drug may also cause significant weight gain and a rise in your blood cholesterol (or triglyceride) levels. 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.) This medication may rarely cause a serious condition called neuroleptic malignant syndrome (NMS). Tell you doctor immediately if you develop the following: fever, muscle stiffness, severe confusion, sweating, fast or irregular heartbeat. Olanzapine may rarely cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor immediately if you develop any unusual/uncontrolled movements (especially of the face or tongue). In rare instances, this medication may increase your blood level of a certain hormone (prolactin). For females, this rare increase in prolactin levels may result in unwanted breast milk, the menstrual period stopping, 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 immediately. For males, in the very unlikely event you have a painful, prolonged erection (lasting more than 4 hours), stop using this drug and seek immediate medical attention or permanent problems could occur. A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

PRESCRIBED FOR
Olanzapine is used for treating schizophrenia and acute mixed or manic episodes associated with bipolar disorder. It also is used as maintenance therapy for bipolar disorder and treating agitation due to schizophrenia or bipolar disorder. Olanzapine also is used in combination with fluoxetine (Prozac) for treatment of resistant depression and treatment of depression associated with bipolar disorder.

DOSING
The usual oral dose of olanzapine for treating schizophrenia is 10-20 mg once daily. Therapy is initiated with 5-10 mg/day, and the dose may be increased by 5 mg a day at weekly intervals. The maximum dose is 20 mg daily. The recommended dose of extended release injection is 150-405 mg every 2 or 4 weeks.

Treatment of bipolar disorder usually is initiated with oral doses of 10-15 mg once daily. The dose may be increased by 5 mg daily at 24 hour intervals. The maximum dose is 20 mg daily.

The usual dose for treating agitation due to schizophrenia or bipolar disorder is 10 mg administered by intramuscular injection (immediate release). Additional 10 mg doses may be administered, but the efficacy of total doses greater than 30 mg daily have not been adequately evaluated.

The recommended treatment for resistant depression is 5-20 mg of olanzapine combined with 20-50 mg of fluoxetine once daily in the evening while the recommended treatment for depression associated with bipolar disorder is 5-12.5 mg olanzapine combined with 20-50 mg fluoxetine once daily in the evening.

OVERDOSE
If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: severe drowsiness, slurred speech, slowed breathing, or seizures.

MISSED DOSE
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE
Store at room temperature between 68 and 77 degrees F (20-25 degrees C) away from moisture and light. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets.

Note : This product information is intended only for residents of the India. Taj Pharmaceuticals Limited, medicines help to treat and prevent a range of conditions—from the most common to the most challenging—for people around the world.