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Zyprexa Fact Sheet

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Medication Name (brand): 
Zyprexa
Medication Name (clinical): 
olanzapine
Manufacturer: 

Eli Lilly; patent expiration 2011.

Indications: 
  • Schizophrenia, both short-term and maintenance treatment.

  • Bipolar disorder, including manic or mixed episodes, and maintenance monotherapy. Approval specifically includes both monotherapy and combination treatment with lithium or Depakote.
  • IM formulation indicated for treatment of agitation associated with schizophrenia and bipolar mania.
  • Off-label use for a variety of disorders, including treatment-resistant depression, anxiety disorders, PTSD, general impulsivity/agitation, and insomnia.

Mechanism: 

D2 and 5HT 2 receptor antagonist.

Dosing: 
  • Supplied as:

  • Oral tablets at 2.5 mg, 5 mg, 10 mg, 15 mg, and 20 mg
  • Orally disintegrating “Zyprexa Zydis” tablets in 5 mg, 10 mg, 15 mg and 20 mg
  • Intramuscular injectible Zyprexa in 10 mg vials
  • Start most patients at 5-10 mg QD, may need to increase up to 30 mg per day or more.
  • Recommended IM dose for treatment of acute agitation is 10 mg.

Side Effects: 
  • BLACK BOX WARNING: All atypicals may increase mortality in elderly patients by 1.7 times greater than placebo.

  • Most common are somnolence, dry mouth, constipation, and weight gain.
  • Weight gain: Substantial; 10-30 pounds weight gain is common.
  • EPS: Akithisia and parkinsonism in 10-20% of patients, depending on dosing.
  • Glucose/Lipids: Associated with new onset diabetes and hyperlipidemia; worse in this regard than all atypicals except for clozapine.
  • EKG: No concerns.
  • Prolactin level: Transient increase only.
  • Pregnancy Category C.

Drug-drug Interactions: 
  • Does not affect hepatic enzymes and thus does not affect metabolism of other drugs.

  • However, the metabolism of Zyprexa is affected in the following ways:
  • Smoking and Tegretol increase clearance by 40%-50%, decreasing effective dose.
  • Luvox decreases clearance by 50-70%, increasing blood levels of Zyprexa.
  • Half-life 1-2 days, greater in elderly patients.

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