Drug Index

Olanzapine

 
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Mechanism :

Olanzapine is an antagonist with moderate affinity binding for serotonin 5HT3 and muscarinic M1-5, respectively. Olanzapine binds weakly to GABAA, BZD, and beta-adrenergic receptors.


Indication :

• Schizophrenia

• Mania

• Bipolar depression

• Stuttering


Contraindications :

Contraindicated in patients with a known hypersensitivity to the product. May exacerbate, possibly precipitate, diabetes mellitus, low white blood cell count or liver dysfunction. Caution in galactosemia and phenylketonuria due to excipients.


Dosing :

Schizophrenia, Mania:

13-17 years: 2.5-5 mg/day orally, initially, adjust by increasing or decreasing by 2.5-5 mg. Target dose: 10 mg/day; Max dose: 20 mg/day.

Bipolar depression:

10-17 years: 2.5 mg orally in the evening and fluoxetine 20 mg orally, every evening initially, dosage adjustments if needed.

Stuttering:

<12 years: 1.25 mg orally at bedtime for one month, then 2.5 mg at bedtime.

>12 years: 2.5 mg orally, at bedtime for one month then 5 mg at bedtime.


Adverse Effect :

Commonly seen side effects include weight gain, hypertriglyceridemia, hypercholester-olemia, drowsiness. Less commonly seen are postural hypotension, xerostomia, insomnia, constipation, dyspepsia, hyperprolactinemia, hyperglycemia, accidental injury and peripheral edema. Blood dyscrasias, seizures, hyperglycemia, extra-pyramidal syndromes, neuroleptic malignant syndrome have been reported rarely.


Interaction :

Omeprazole and Rifampin: May cause an increase in olanzapine clearance.
Carbamazepine: Causes an increase in the clearance of olanzapine. This increase is likely due to the fact that carbamazepine is a potent inducer of CYP1A2 activity. Higher daily doses of carbamazepine may cause an even greater increase in olanzapine clearance.
Fluoxetine: Causes a small increase in the maximum concentration of olanzapine and a small decrease in olanzapine clearance.
Fluvoxamine: A CYP1A2 inhibitor, decreases the clearance of olanzapine.


08/06/2019 12:13:52 Olanzapine
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