Zyprexa refers to psychotropic drugs.
Release form and composition
Zyprexa is available in the form of tablets, dispersible tablets and lyophilisate for preparing a solution for i / m administration.
Zyprexa tablets are placed in 7 pcs. in a blister card, sold in cardboard packs, which contain 1, 2, 4 or 8 blisters.
Lyophilisate for the preparation of the solution is available in vials placed in packs of cardboard.
The active ingredient of Zyprexa is olanzapine. The tablets contain 2.5 mg, 5 mg, 7.5 mg or 10 mg of olanzapine and excipients: hydroxypropylcellulose (hyprolose), lactose monohydrate, microcrystalline cellulose, crospovidone, magnesium stearate.
The composition of the lyophilisate for preparing a solution for the / m introduction includes olanzapine, 10 mg, and excipients: lactose monohydrate, 50 mg, and tartaric acid, 3.5 mg.
Indications for use
Zyprexa tablets are used for the following diseases:
- Schizophrenia. Therapy of exacerbations, long-term anti-relapse and supportive treatment of schizophrenia and other psychotic disorders with severe negative (impoverishment of speech, reduction of social activity, emotional flatness) and / or productive (automatism, hallucinations, delusions) symptoms and associated affective disorders;
- Bipolar affective disorder. Zyprexa as monotherapy or simultaneously with valproate or lithium is prescribed in the treatment of acute manic or mixed episodes in bipolar affective disorder without / with a fast change of phases and without / with psychotic manifestations. The drug is used to prevent relapse in patients with bipolar disorder, in which olanzapine had an effect in the therapy of the manic phase.
Ziprex tablets in combination with fluoxetine are used to treat depressive conditions that are associated with bipolar disorder.
Zyprexa's lyophilisate for preparation of the solution for i / m administration is prescribed, if necessary, for rapid relief of psychomotor agitation (agitation) in patients with schizophrenia, dementia, and bipolar affective disorders.
Contraindications to the use of Zyprexa is an individual hypersensitivity to the components of the drug.
It is necessary to prescribe the drug with caution in the presence of such diseases:
- Prostate hypertrophy with severe symptoms;
- Oppression of bone marrow hematopoiesis;
- Intestinal obstruction of a paralytic nature;
- Myeloproliferative pathology;
- Angle-closure glaucoma;
- Tendency to convulsive seizures.
Dosing and Administration
Dosage and duration of treatment depends on the disease.
Zyprexa tablets are prescribed as follows:
- Schizophrenia and psychotic disorders similar to her. The initial dose is 10 mg / day. Further therapeutic dosing is 5-20 mg / day. Dosage more than 10 mg / day. should be justified. These doses are applied after clinical monitoring of the patient's condition;
- Mania of acute nature in bipolar disorder. The initial dose is 15 mg / day. Further therapeutic dose of 5-20 mg / day. Dosage is more than 15 mg / day. should be justified. It is used after clinical monitoring of the patient’s condition, while the dose is increased at intervals of a day or more;
- Patients with pathologies of the kidneys. The initial dose is 5 mg / day., Then the individual dosage is applied;
- Elderly patients. The initial dosage is 2.5-5 mg / day., Further therapeutic dosage is prescribed individually, usually 2.5-5 mg / day.
Zyprexa lyophilisate for preparation of the solution for i / m administration is applied according to the following scheme:
- Agitation in schizophrenia and bipolar affective disorder. The initial dose of 10-30 / 10 once. If necessary, a second injection is made after 120 minutes, and a third injection, 240 minutes after the second. Further therapeutic dosing is 5–20 mg / day;
- Agitation for dementia. A single initial dose of 2.5 mg / day. The recommended further therapeutic dose is 5 mg / day. But in any case, the total daily dose should not exceed 12.5 mg / day.
Zyprexa lyophilisate solution should not be administered intravenously or subcutaneously.
To prepare the solution for i / m administration, the contents of the vial are dissolved in sterile water for injection (2.1 ml). The resulting solution should be yellow, transparent. Before the introduction, you need to make sure that there is no mechanical impurities in the solution.
When using the drug in different doses, a different volume of solution is used for intramuscular injections: Zipreks 2.5 mg - 0.5 ml, Zipreks 5 mg - 1 ml, Zipreks 7.5 mg - 1.5 ml, Zyprex 10 mg - all the contents of the bottle.
The prepared solution for i / m administration must be used within one hour, the unused residue is poured.
Zyprexa is dissolved only with sterile water for injection. The drug should not be mixed in the same syringe with diazepam (precipitation occurs) or haloperidol (the effect of Zyprex decreases with time). Zyprexa should not be dissolved in lorazepam solution, since this procedure lengthens the time of dissolution.
The use of Zyprexa can cause such side effects:
- Drowsiness, asthenia, orthostatic hypotension;
- Dizziness, convulsions, photophobia;
- Hyperprolactinemia, gynecomastia;
- Acatasia, leukopenia, thrombocytopenia, ketoacidosis, eosinophilia, hyperglycemia, priapism, galactorrhea, activation of liver enzymes;
- Increased appetite, weight gain, peripheral edema, gait disturbance;
- Diabetic coma;
- Dryness of the oral mucosa;
- Skin rashes;
- Hepatitis, constipation.
When a planned or coming pregnancy while taking Zyprexa, you must consult a doctor. The use of this drug in pregnant women is justified only in the case when its possible benefit to the mother outweighs the possible risk to the fetus.
Since olanzapine passes into breast milk, breastfeeding should be discarded during its use.
Clinical symptoms of neuroleptic malignant syndrome or high body temperature require the abolition of Zyprexa.
With prolonged Zipreksoy therapy may develop tardive dyskinesia. If the first symptoms of this pathology appear, reduce the dose or discontinue the drug. After it is canceled, it is possible to increase or manifest symptoms of tardive dyskinesia.
Zyprex should be used with caution in patients with a history of seizures, or exposed to factors that reduce the threshold of convulsive readiness.
Precautions should be prescribed Zyprexa simultaneously with other drugs affecting the central nervous system, as well as with ethanol.
The efficacy and safety of this drug in the age group under 18 years old has not been studied.
Since Zyprexa often causes drowsiness, when taking it, patients should be careful when operating mechanical means, including transport.
Zyprexa analogues include: Zipreksa Zidis, Zalasta, Zalasta Koo-tab, Olanzapin.
Terms and conditions of storage
Zyprexa tablets and lyophilisate are stored in a dry place at 15ºС-30ºС, avoiding direct sunlight. The shelf life of the tablets is three years. Zyprexa lyophilisate should be stored for two years. The solution of the lyophilisate can not be stored for more than an hour, as well as freeze.