Zyprexa Intramuscular Generic Name & Formulations
Legal Class
Rx
General Description
Olanzapine 10mg/vial; IM inj after reconstitution.
Pharmacological Class
Atypical antipsychotic.
See Also
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
Legal Class
Rx
General Description
Olanzapine 10mg/vial; IM inj after reconstitution.
Pharmacological Class
Atypical antipsychotic.
See Also
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