Olanzapine (US brand name Zyprexa® and generic) is a second-generation (atypical) antipsychotic. Here is basic information about this medication.

FDA-approved indications

1. As oral formulation for:

a. Schizophrenia in adults and adolescents

b. Manic or mixed episodes associated with bipolar I disorder in adults and adolescents (ages 13-17 )

c. Manic or mixed episodes associated with bipolar I disorder in adults (as an adjunct to valproate or lithium)

2. As Intramuscular injection for:

Acute agitation associated with schizophrenia and bipolar I mania in adults

3. Olanzapine in combination with fluoxetine for:

a. Depressive episodes associated with bipolar I disorder in adults

b. Depressive episodes associated with bipolar I disorder in children and adolescents (ages 10-17)

c. Treatment-resistant depression in adults

Note: Olanzapine is not approved for the treatment of dementia-related psychosis in elderly due to increased risk of death and cerebrovascular accidents.

Dosage

1. Schizophrenia (adults)

Start at 5–10 mg orally once daily orally

Target: 10 mg/day within several days

2. Schizophrenia (adolescents)

Start at 2.5–5 mg orally once daily

Target: 10 mg/day

3. Bipolar I disorder (manic or mixed episodes) in adults

Start at 10 or 15 mg orally once daily

4. Bipolar I disorder (manic or mixed episodes) in adolescents

Start at 2.5–5 mg orally once daily

Target: 10 mg/day

5. Bipolar I disorder (manic or mixed episodes) with lithium or valproate in adults

Start at 10 mg orally once daily

6. Agitation associated with schizophrenia and bipolar I mania in adults

10 mg Intramuscular (IM) injection (5 mg or 7.5 mg when clinically warranted).

Assess for orthostatic hypotension prior to subsequent dosing (max. 3 doses 2-4 hrs apart)

7. Depressive episodes associated with bipolar I disorder in adults (in combination with fluoxetine)

Start at 5 mg of oral olanzapine and 20 mg of fluoxetine orally once daily

8. Depressive episodes associated with bipolar I disorder in children and adolescents (in combination with fluoxetine)

Start at 2.5 mg of oral olanzapine and 20 mg of fluoxetine orally once daily

9. Treatment resistant depression in adults (in combination with fluoxetine)

Start at 5 mg of oral olanzapine and 20 mg of fluoxetine orally once daily

General Instructions (from Prescribing Information)

1. Lower starting dose is recommended in debilitated or pharmacodynamically sensitive patients or patients with predisposition to hypotensive reactions, or with potential for slowed metabolism.

2. Olanzapine may be given without regard to meals.

Olanzapine and Fluoxetine in combination

1. Dosage adjustments, if indicated, should be made with the individual components according to efficacy and tolerability.

2. Olanzapine monotherapy is not indicated for the treatment of depressive episodes associated with bipolar I disorder or treatment resistant depression.

3. Safety of co-administration of doses above 18 mg olanzapine with 75 mg fluoxetine has not been evaluated.

4. 50 mg fluoxetine has not been evaluated in children and adolescents ages 10 to 17.

Please refer to Prescribing Information (see link below) for complete discussion of dosage, administration, warnings and precautions, contraindications, etc.

Dosage forms and strengths

Tablets (Zyprexa® and generic): 2.5, 5, 7.5, 10, 15, 20 mg

Orally disintegrating tablets (Zyprexa Zydis® and generic): 5, 10, 15, 20 mg

Intramuscular injection (Zyprexa® and generic): 10 mg vial