On this page
- Atypical antipsychotic
- Acute and chronic psychosis and acute manic episode, in the event of intolerance or treatment failure with other antipsychotics (preferably use haloperidol for these indications)
Forms and strengths
- 2.5 mg, 5 mg and 10 mg tablets
- Adult: 10 mg once daily. Increase up to 15 mg daily if necessary (max. 20 mg daily).
- Reduce the dose by half in older patients (max. 10 mg daily).
- Acute psychosis: at least 3 months
- Chronic psychosis: at least one year
- Manic episode: 8 weeks after remission of symptoms
Discontinue treatment gradually (over 4 weeks). If signs of relapse occur, increase the dose then decrease it more gradually.
Contra-indications, adverse effects, precautions
- Do not administer to patients with cardiac disorders (heart failure, recent myocardial infarction, conduction disorders, bradycardia, etc.), dementia (e.g. Alzheimer's disease), Parkinson's disease, history of neuroleptic malignant syndrome and closed-angle glaucoma.
- Administer with caution and carefully monitor use in older patients and patients with hypokalaemia, hypotension, prostate disorders, renal or hepatic impairment, history of seizures.
- May cause: orthostatic hypotension, drowsiness, extrapyramidal symptoms, hyperprolactinaemia, weight gain, hyperlipidaemia, hyperglycaemia, anticholinergic effects (constipation, dry mouth), headache, insomnia, dizziness, sexual dysfunction; neuroleptic malignant syndrome (unexplained hyperthermia with neuromuscular disorders), rare but requiring immediate treatment discontinuation.
- In the event of extrapyramidal symptoms, combine with biperiden or trihexyphenidyl.
- Avoid or monitor combination with:
- central nervous system depressants (opioid analgesics, sedatives, H1 antihistamines, etc.);
- ciprofloxacin (increased plasma concentrations of olanzapine);
- carbamazepine, rifampicin, phenobarbital, phenytoin, ritonavir (decreased plasma concentrations of olanzapine);
- antihypertensive drugs (risk of hypotension); drugs that prolong the QT interval (amiodarone, chloroquine, erythromycin, fluconazole, mefloquine, pentamidine, quinine, etc.).
- Avoid alcohol during treatment.
- Pregnancy: re-evaluate whether the treatment is still necessary; if it is continued, use the lowest effective dose. Observe the neonate the first few days (risk of agitation, tremors, hypertonia/hypotonia, respiratory difficulties, sleeping disorders, etc.) if the mother was under treatment in the 3rd trimester. If treatment starts during pregnancy, preferably use haloperidol.
- Breast-feeding: if absolutely necessary, do not exceed 10 mg daily.
- Olanzapine is not included in the WHO list of essential medicines.