Uses of Olanap: - Schizophrenia - Mania Schizophrenia, Bipolar disorder, Agitation, Mania Angle-closure glaucoma; lactation. IM: History of CVS disease, heart surgery.

Atypical neuroleptic drugs

Olanzapine is an antipsychotic agent and has affinities for serotonin 5HT2A/2C, 5HT3, 5HT6; dopamine D1, D2, D3, D4, D5; cholinergic muscarinic receptors M1-M5; α1 adrenergic; and histamine H1 receptors. 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. Olanzapine is well absorbed after oral administration, reaching peak plasma concentrations within 5 to 8 hours. The absorption is not affected by food. Olanzapine is not mutagenic or clastogenic as well as not carcinogenic.

How to use Olanzapine: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Olanzapine may be taken with or without food, but it is better to take it at a fixed time. Administration: May be taken with or without food. Adult Dose: Oral Schizophrenia Adult: 5-10 mg/day initially; if necessary, may be titrated upward in increments of 5 mg/day at intervals >1 week Maintenance: 10-20 mg/day; not to exceed 20 mg/day Bipolar Mania Used as monotherapy or in combination with lithium or valproate Monotherapy: 10-15 mg/day PO initially Adjunct to lithium or valproate: 10 mg/day PO initially Maintenance: 5-20 mg/day PO; not to exceed 20 mg/day Depression in bipolar disorder Use in combination with fluoxetine 5 mg in evening; adjusted to range of 5-12.5 mg/day; may be increased up to 20 mg/day in resistant depression Hepatic impairment: Initial: 5 mg daily. Child Dose: Oral Bipolar I Disorder (Manic or Mixed Episodes) <13 years: Safety and efficacy not established 13-17 years: 2.5-5 mg/day PO initially; target dosage, 10 mg/day; adjust by increments/decrements of 2.5-5 mg; dosage range, 2.5-20 mg/day Schizophrenia <13 years: Safety and efficacy not established 13-17 years: 2.5-5 mg/day PO initially; target dosage, 10 mg/day; adjust by increments/decrements of 2.5-5 mg; dosage range, 2.5-20 mg/day Renal Dose: Renal impairment: Initial: 5 mg daily.

Olanzapine may antagonise the effects of levodopa and dopamine agonists. Drugs that induce CYP1A2 or glucuronyl transferase enzymes e.g. omeprazole and rifampicin, may increase olanzapine clearance. Inhibitors of CYP1A2 may potentially inhibit olanzapine elimination. Carbamazepine may increase the clearance of olanzapine. Concomitant admin of activated charcoal reduced the oral bioavailability of olanzapine by 50-60%. Caution should be taken when olanzapine is administered with centrally acting drugs and alcohol.

Angle-closure glaucoma; lactation. IM: History of CVS disease, heart surgery.

Common - Dizziness - Sleepiness - Orthostatic hypotension (sudden lowering of blood pressure on standing) - Dryness in mouth - Weight gain - Increased prolactin level in blood - Constipation - Muscle stiffness - Restlessness - Tremor >10% Orthostatic hypotension (>20%),Weight gain, dose dependent (5-40%),Hypertriglyceridemia (<39%),Hypercholesterolemia (<39%),Somnolence, dose dependent (6-39%),Extrapyramidal symptoms (EPS), dose dependent (15-32%),Xerostomia (9-22%),Weakness (2-20%),Dizziness (4-18%),Accidental injury (12%),Insomnia (12%),Elevated alanine aminotransferase (ALT) level (5-12%),Constipation (9-11%),Dyspepsia (7-11%),Hyperprolactinemia (30%),Hyperglycemia (12.8%) 1-10% Hypotension (2%),Postural hypotension (1%),Tremor (1%),Asthenia (2%),Akathisia reactions (2%),Parkinsonism reactions (4%) <1% Syncope,Sudden cardiac death,Hyperglycemia,Diabetic coma with ketoacidosis,Diabetic ketoacidosis,Acute hemorrhagic pancreatitis,Venous thromboembolism,Immune hypersensitivity reaction,Cerebrovascular disease,Seizure, status epilepticus,Suicidal intent,Pulmonary embolism,Death,Neuroleptic malignant syndrome (NMS),Tardive dyskinesia Potentially Fatal: Exacerbation of preexisting diabetes sometimes leading to ketoacidosis. Neuroleptic malignant syndrome.

Olanzapine should be used in pregnancy only if the potential benefits justify the potential risk to the foetus. So, patients should be advised to notify their physician if they become pregnant or intend to become pregnant during treatment with Olanzapine. There is no report to show teratogenecity. Patients should not breast feed if they are taking Olanzapine.

Precaution: Patient w/ cerebrovascular disease or conditions predisposing to hypotension, benign prostatic hyperplasia, paralytic ileus, DM, Parkinson's disease, history of blood dyscrasias, bone marrow depression, hypereosinophilic disorders, myeloproliferative disease, history of seizures or conditions that lower the seizure threshold. IM: Acute MI, unstable angina, severe hypotension or bradycardia, sick sinus syndrome, recent heart surgery. Elderly w/ dementia-related psychosis. Hepatic and renal impairment. Pregnancy and lactation. Patient Counselling This drug may cause somnolence and dizziness, if affected, avoid driving and operating machinery. Avoid cigarette smoking. Monitoring Parameters Monitor BP, pulse and resp rate for at least 4 hr after IM inj. Clinical monitoring for hyperglycaemia, plasma lipids and wt. Lactation: Drug enters breast milk; not recommended

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Atypical neuroleptic drugs

Olanzapine is an atypical antipsychotic with affinity for serotonin 5-HT2A/2C, dopamine, muscarinic M1-M5, histamine H1 and adrenergic alpha1 receptors.

Olanzapine should be used in pregnancy only if the potential benefits justify the potential risk to the foetus. So, patients should be advised to notify their physician if they become pregnant or intend to become pregnant during treatment with Olanzapine. There is no report to show teratogenecity. Patients should not breast feed if they are taking Olanzapine.