Drug Index


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.
<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.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Initial dose 5 mg daily and titrate as necessary
10-20Initial dose 5 mg daily and titrate as necessary
<10Initial dose 5 mg daily and titrate as necessary

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in GFR<10 mL/min
HDNot dialysed. Dose as in GFR<10 mL/min
HDF/High fluxUnknown dialysability. Dose as in GFR<10 mL/min
CAV/VVHDUnknown dialysability. Dose as in GFR=10–20 mL/min

Hepatic Dose :

4-6years: 0.65mg daily.
6-12y: 1.25mg-2.5mg daily, increasing weekly based on response.
Adolescent: 1.25-2.5mg daily, increasing weekly based on response target dose 5 mg/day.
12/19/2023 01:34:09 Olanzapine
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