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Zyprexa Relprevv
olanzapine
Black Box Warnings .
Appropriate Use
restricted distribution program (Zyprexa Relprevv Patient Care Program) due to post-injection delirium/sedation syndrome risk; prescribers/healthcare facilities/pharmacies/pts must register
Post-Injection Delirium/Sedation Syndrome
s/sx consistent w/ olanzapine overdose reported, incl. sedation, coma, and delirium; observe pts for at least 3h after each injection in a registered healthcare facility w/ ready access to emergency response services
Dementia-Related Psychosis
not approved for dementia-related psychosis; incr. mortality risk in elderly dementia pts on conventional or atypical antipsychotics; most deaths due to cardiovascular or infectious events; extent to which incr. mortality attributed to antipsychotic vs. some pt characteristic(s) not clear
Adult Dosing .
Dosage forms: INJ: 150 mg per mL
Restricted Distribution in US
- [1-877-772-9390 or www.zyprexarelprevvprogram.com for more info]
schizophrenia
- [conversion from 10 mg/day PO]
- Dose: 210 mg IM q2wk or 405 mg IM q4wk x8wk, then 150 mg IM q2wk or 300 mg IM q4wk; Max: 300 mg q2wk or 405 mg q4wk; Info: start 150 mg IM q4wk in pts who are nonsmoking females 65 yo and older, debilitated, at risk for hypotension, or slow metabolizers; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC
- [conversion from 15 mg/day PO]
- Dose: 300 mg IM q2wk x8wk, then 210 mg IM q2wk or 405 mg IM q4wk; Max: 300 mg q2wk or 405 mg q4wk; Info: start 150 mg IM q4wk in pts who are nonsmoking females 65 yo and older, debilitated, at risk for hypotension, or slow metabolizers; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC
- [conversion from 20 mg/day PO]
- Dose: 300 mg IM q2wk; Max: 300 mg q2wk; Info: start 150 mg IM q4wk in pts who are nonsmoking females 65 yo and older, debilitated, at risk for hypotension, or slow metabolizers; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.