Zyprexa Intramuscular

— THERAPEUTIC CATEGORIES —
  • Mood disorders
  • Psychosis

Zyprexa Intramuscular Generic Name & Formulations

General Description

Olanzapine 10mg/vial; IM inj after reconstitution.

Pharmacological Class

Atypical antipsychotic.

How Supplied

Tabs—30; Zydis—30; Vial—1

Manufacturer

Zyprexa Intramuscular Indications

Indications

Agitation due to bipolar I mania.

Zyprexa Intramuscular Dosage and Administration

Adult

Give by deep IM inj. Usual range: 2.5mg–10mg/dose. Elderly: 5mg. Debilitated, risk of hypotension, or sensitive to olanzapine: 2.5mg. All: up to max 3 doses/day (2–4 hrs apart); switch to oral form when appropriate. Severe orthostatic hypotension: additional dose not recommended.

Children

Not recommended.

Zyprexa Intramuscular Contraindications

Contraindications

Combination therapies: see other drug monographs.

Zyprexa Intramuscular Boxed Warnings

Boxed Warning

Increased mortality in elderly patients with dementia-related psychosis.

Zyprexa Intramuscular Warnings/Precautions

Warnings/Precautions

Elderly with dementia-related psychosis (not approved use); increased risk of death or cerebrovascular events (eg, stroke, TIA). Cardio- or cerebrovascular disease. Discontinue if neuroleptic malignant syndrome occurs or if DRESS is suspected; consider discontinuation if tardive dyskinesia occurs. Diabetes. Monitor for hyperglycemia, hyperlipidemia; do fasting blood glucose and lipids testing at beginning, and during therapy. Monitor for weight gain. Hypovolemia. Dehydration. History of seizures. Conditions that affect metabolism or hemodynamic responses. Narrow angle glaucoma. Urinary retention. Significant prostatic hypertrophy. Constipation. History of paralytic ileus or related conditions. Breast cancer. Pre-existing low WBCs or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; discontinue if WBCs decline. Perform fall risk assessments when initiating and recurrently on long-term therapy. Exposure to extreme heat. Dysphagia. Suicidal ideation (monitor). Reevaluate periodically. Write ℞ for smallest practical amount. Debilitated. Hepatic impairment (monitor ALT/AST). Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy. Nursing mothers: monitor infants.

Zyprexa Intramuscular Pharmacokinetics

See Literature

Zyprexa Intramuscular Interactions

Interactions

Orthostatic hypotension with antihypertensives, alcohol (caution), diazepam. Caution with other CNS drugs, anticholinergics, hepatotoxic agents. Concomitant IV benzodiazepine: not recommended with IM olanzapine. May antagonize levodopa, dopamine agonists. May be antagonized by rifampin, omeprazole, carbamazepine, others that induce CYP1A2 or glucuronyl transferase. May be potentiated by fluvoxamine, others that inhibit CYP1A2. Smokers may have increased clearance.

Zyprexa Intramuscular Adverse Reactions

Adverse Reactions

Somnolence, sedation, dizziness, constipation, weight gain, increased appetite, personality disorder, akathisia, asthenia, postural hypotension, headache, abdominal pain, dry mouth, fatigue, tremor, extremity/back pain, nausea, diarrhea, vomiting, cough, nasopharyngitis; neutropenia, hyperprolactinemia, elevated liver enzymes, EPS.

Zyprexa Intramuscular Clinical Trials

See Literature

Zyprexa Intramuscular Note

Not Applicable

Zyprexa Intramuscular Patient Counseling

See Literature

Zyprexa Intramuscular Generic Name & Formulations

General Description

Olanzapine 10mg/vial; IM inj after reconstitution.

Pharmacological Class

Atypical antipsychotic.

How Supplied

Tabs—30; Zydis—30; Vial—1; Relprevv (kit)—1 (w. diluent + supplies)

Manufacturer

Zyprexa Intramuscular Indications

Indications

Agitation due to schizophrenia.

Zyprexa Intramuscular Dosage and Administration

Adult

Give by deep IM inj. Usual range: 2.5mg–10mg/dose. Elderly: 5mg. Debilitated, risk of hypotension, or sensitive to olanzapine: 2.5mg. All: up to max 3 doses/day (2–4 hrs apart); switch to oral form when appropriate. Severe orthostatic hypotension: additional dose not recommended.

Children

Not recommended.

Zyprexa Intramuscular Contraindications

Not Applicable

Zyprexa Intramuscular Boxed Warnings

Boxed Warning

Increased mortality in elderly patients with dementia-related psychosis.

Zyprexa Intramuscular Warnings/Precautions

Warnings/Precautions

Relprevv: post-injection delirum/sedation syndrome: monitor after each injection. Elderly with dementia-related psychosis (not approved use); increased risk of death or cerebrovascular events (eg, stroke, TIA). Cardio- or cerebrovascular disease. Discontinue if neuroleptic malignant syndrome occurs or if DRESS is suspected; consider discontinuation if tardive dyskinesia occurs. Diabetes. Monitor for hyperglycemia, hyperlipidemia; do fasting blood glucose and lipids testing at beginning, and during therapy. Monitor for weight gain. Hypovolemia. Dehydration. History of seizures. Conditions that affect metabolism or hemodynamic responses. Narrow angle glaucoma. Urinary retention. Significant prostatic hypertrophy. Constipation. History of paralytic ileus or related conditions. Breast cancer. Pre-existing low WBCs or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; discontinue if WBCs decline. Perform fall risk assessments when initiating and recurrently on long-term therapy. Exposure to extreme heat. Dysphagia. Suicidal ideation (monitor). Reevaluate periodically. Write ℞ for smallest practical amount. Debilitated. Hepatic impairment (monitor ALT/AST). Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy. Nursing mothers: monitor infants.

Zyprexa Intramuscular Pharmacokinetics

See Literature

Zyprexa Intramuscular Interactions

Interactions

Orthostatic hypotension with antihypertensives, alcohol (caution), diazepam. Caution with other CNS drugs, anticholinergics, hepatotoxic agents. Concomitant IV benzodiazepine: not recommended with IM olanzapine. May antagonize levodopa, dopamine agonists. May be antagonized by rifampin, omeprazole, carbamazepine, others that induce CYP1A2 or glucuronyl transferase. May be potentiated by fluvoxamine, others that inhibit CYP1A2. Smokers may have increased clearance.

Zyprexa Intramuscular Adverse Reactions

Adverse Reactions

Somnolence, sedation, dizziness, constipation, weight gain, increased appetite, personality disorder, akathisia, asthenia, postural hypotension, headache, abdominal pain, dry mouth, fatigue, tremor, extremity/back pain, nausea, diarrhea, vomiting, cough, nasopharyngitis; neutropenia, hyperprolactinemia, elevated liver enzymes, EPS.

Zyprexa Intramuscular Clinical Trials

See Literature

Zyprexa Intramuscular Note

Not Applicable

Zyprexa Intramuscular Patient Counseling

See Literature