Generic Name: Olanzapine
Brand Name: Zyprexa
Formulation: Oral tablet
Quantity: 7 tablets
Strength: 5 mg per tablet

Mechanism of Action (MOA):

• Olanzapine is an atypical antipsychotic that works by modulating the activity of various neurotransmitters in the brain, primarily dopamine and serotonin.
• It acts as an antagonist at D2 (dopamine) and 5-HT2 (serotonin) receptors, which helps reduce psychotic symptoms and stabilize mood in conditions like schizophrenia and bipolar disorder.
• Additionally, olanzapine has effects on other receptors such as histamine, adrenergic, and muscarinic receptors, contributing to its therapeutic effects.

Indications:

1. Schizophrenia:
   • For the acute treatment and maintenance of schizophrenia in adults.
2. Bipolar Disorder:
   • For the acute treatment of mania in bipolar disorder (used alone or in combination with other mood stabilizers).
   • Can be used for maintenance therapy in bipolar disorder to prevent further manic or depressive episodes.

Dosage:

• Schizophrenia:
  • Initial dose: 5 mg to 10 mg once daily.
  • Maintenance dose: Typically between 10 mg and 20 mg per day, adjusted based on patient response.
• Bipolar Disorder:
  • Acute mania: 10 mg once daily (can be adjusted based on clinical response).
  • Maintenance therapy: Can be reduced to a dose of 5 mg to 10 mg once daily after stabilization.
• Geriatric or Hepatic Impairment:
  • Initial doses may be reduced to 5 mg per day to avoid excessive sedation or side effects.

Side Effects:

• Common Side Effects:
  • Sedation, dizziness, drowsiness, dry mouth, constipation, weight gain, increased appetite.
• Serious Side Effects:
  • Neuroleptic Malignant Syndrome (NMS) – a potentially fatal condition involving fever, muscle rigidity, altered mental status, and autonomic dysfunction.
  • Tardive dyskinesia – involuntary movements, particularly of the face and tongue.
  • Hyperglycemia and diabetes (monitor blood sugar levels regularly).
  • Hyperlipidemia (elevated cholesterol and triglycerides).
  • Orthostatic hypotension (low blood pressure when standing up).
  • Severe weight gain and metabolic changes.

Precautions:

• Metabolic Monitoring: Monitor for signs of weight gain, hyperglycemia, lipid abnormalities (e.g., high cholesterol), especially in long-term use.
• Elderly Patients: Use cautiously in elderly patients with dementia-related psychosis due to an increased risk of stroke and mortality.
• CNS Effects: Caution when used with other CNS depressants (e.g., alcohol, benzodiazepines) due to the sedative effects.
• Liver Function: Dose reduction may be required in patients with liver impairment.
• Pregnancy Category: Category C (may cause harm to the fetus, use only if the potential benefit justifies the potential risk).

Contraindications (CI):

1. Hypersensitivity: Contraindicated in patients who have a known allergy or hypersensitivity to olanzapine.
2. Comatose States: Not recommended for use in patients who are in a coma or have severe CNS depression.
3. Severe Hepatic Impairment: Contraindicated in patients with severe liver dysfunction.

Pharmacist Related Data