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ZYPREXA INTRAMUSCULAR
Mood disorders
Psychosis
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Drug Name:

ZYPREXA INTRAMUSCULAR Rx

Generic Name and Formulations:
Olanzapine 10mg/vial; IM inj after reconstitution.

Company:
Lilly, Eli and Company

Therapeutic Use:

Indications for ZYPREXA INTRAMUSCULAR:

Agitation due to bipolar I mania.

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.

Contraindications:

Combination therapies: see other drug monographs.

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. Hepatic impairment (monitor ALT/AST). Prostatic hypertrophy. Narrow angle glaucoma. History of paralytic ileus or 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. Labor & delivery. Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy (Cat.C). Nursing mothers: not recommended.

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.

See Also:

ZYPREXA

ZYPREXA ZYDIS

Pharmacological Class:

Thienobenzodiazepine.

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.

How Supplied:

Tabs—30; Zydis—30; Vial—1

Indications for ZYPREXA INTRAMUSCULAR:

Agitation due to schizophrenia.

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.

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. Hepatic impairment (monitor ALT/AST). Prostatic hypertrophy. Narrow angle glaucoma. History of paralytic ileus or 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. Labor & delivery. Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy (Cat.C). Nursing mothers: not recommended.

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.

See Also:

ZYPREXA

ZYPREXA ZYDIS

ZYPREXA RELPREVV

Pharmacological Class:

Thienobenzodiazepine.

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.

How Supplied:

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

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