Zyprexa Relprevv

— THERAPEUTIC CATEGORIES —
  • Psychosis

Zyprexa Relprevv Generic Name & Formulations

General Description

Olanzapine extended-release 210mg/vial, 300mg/vial, 405mg/vial; pwd for susp; for IM inj after reconstitution.

Pharmacological Class

Atypical antipsychotic.

How Supplied

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

Manufacturer

Zyprexa Relprevv Indications

Indications

Schizophrenia. Do not dispense directly to patient; must enroll in Zyprexa Relprevv Patient Care Program (877) 772-9390.

Zyprexa Relprevv Dosage and Administration

Adult

Give by deep IM gluteal inj. Olanzapine-naïve: establish oral olanzapine tolerance prior to initiation. Target oral dose 10mg/day: inject 210mg every 2 weeks or 405mg every 4 weeks for first 8 weeks, then 150mg every 2 weeks or 300mg every 4 weeks as maintenance. Target oral dose 15mg/day: inject 300mg every 2 weeks for first 8 weeks, then 210mg every 2 weeks or 405mg every 4 weeks as maintenance dose. Target oral dose 20mg/day: inject 300mg every 2 weeks for first 8 weeks, then as maintenance dose. Debilitated, risk of hypotension, slow metabolizers, or sensitive to olanzapine: initially 150mg every 4 weeks; titrate with caution. Monitor patient post injection for at least 3 hours for overdose symptoms (post-injection delirium/sedation syndrome): see full labeling. Do not confuse with short-acting Zyprexa IM.

Children

<18yrs: not established.

Zyprexa Relprevv Contraindications

Not Applicable

Zyprexa Relprevv Boxed Warnings

Boxed Warning

Increased mortality in elderly patients with dementia-related psychosis.

Zyprexa Relprevv 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.

REMS

YES

Zyprexa Relprevv Pharmacokinetics

See Literature

Zyprexa Relprevv 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 Relprevv 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 Relprevv Clinical Trials

See Literature

Zyprexa Relprevv Note

Not Applicable

Zyprexa Relprevv Patient Counseling

See Literature