Olanstad 10

Rx

Indications:

Management of schizophrenia and for the treatment of moderate to severe mania associated with bipolar disorder.

Dosage:

Adults:

Schizophrenia: Start with 5 – 10 mg daily and the daily dosage should be adjusted in steps of 5 mg at intervals of not less than one week up to 10 mg daily.

Manic episode:

• The treatment of acute manic episodes: 10 mg or 15 mg daily (in monotherapy) or 10 mg (in combination therapy). The daily dosage may be adjunct of 5 mg/day if necessary, to a dose of between 5 to 20 mg daily. If a response is achieved, continue at the same dosage to prevent recurrence.
• Prevention of recurrence in patients whose manic episodes have responded previously to olanzapine: Start with 10 mg daily.

Moderate hepatic or renal impairment: A starting dose of 5 mg daily, only increased with caution.

When more than one factor is present which might result in slower metabolism (female, geriatric age, non-smoking): Consideration should be given to decreasing the starting dose and dose escalation should be conservative.

Children and adolescents < 18 years old: Olanzapine is not recommended for use.

Elderly >= 65 years old when clinical factors warrant: A lower starting dose (5 mg/day) should be considered.

Usage:

Olanstad 10 is administered orally without regard to meals.

• Known hypersensitivity to any ingredients in the formulation.
• Patients with known risk for narrow – angle glaucoma.

• Very common: Weight gain; somnolence; orthostatic hypotension; elevated plasma prolactin levels.
• Common: eosinophilia, leukopenia, neutropenia; elevated cholesterol levels, elevated glucose levels, elevated triglyceride levels, glucosuria, increased appetite; dizziness, akathisia, parkinsonism, dyskinesia; mild, transient anticholinergic effects including constipation and dry mouth; transient, asymptomatic elevations of hepatic aminotransferases (ALT, AST), especially in early treatment; rash; arthralgia; erectile dysfunction in males, decreased libido in males and females; asthenia, fatigue, oedema, pyrexia; increased alkaline phosphatase, high creatine phosphokinase, high gamma glutamyltransferase, high uric acid.

Olanstad 10 is not recommended for use in patients:

• Rare hereditary problems of galactose intolerance, total lactase deficiency or glucose – galactose malabsorption.
• Dementia-related psychosis and/or behavioural disturbances patients.
• Parkinson’s disease.
• Develops signs/symptoms indicative of neuroleptic malignant syndrome (NMS); presents with unexplained high fever: Discontinue the drug.
• Tardive dyskinesia: A dose reduction or discontinuation.

Caution is advised when prescribing Olanstad 10 for patients:

• Prostatic hypertrophy, or paralytic ileus and related conditions.
• Combination with other centrally acting medicines and alcohol.
• Diabetes mellitus/dyslipidemic or patients with risk factors.
• Low leucocyte and/or neutrophil counts; receiving medicines known to cause neutropenia; history of drug-induced bone marrow depression/toxicity; bone marrow depression caused by concomitant illness, radiation therapy or chemotherapy; hypereosinophilic or myeloproliferative disease.
• Have a history of seizures or are subject to factors which may lower the seizure threshold.
• Hepatic impairment; pre-existing conditions associated with limited hepatic functional reserve; being treated with potentially hepatotoxic drugs.
• Experiencing conditions which may contribute to an elevation in core body temperature.
• At risk for aspiration pneumonia.
• Elderly; in patients with congenital long QT syndrome; congestive heart failure; heart hypertrophy; hypokalaemia or hypomagnesaemia.

Risk of sudden cardiac death.

Olanstad 10 should be used in pregnancy only if the benefit justifies the risk. Patients should be advised not to breast-feed an infant.

Patients should be aware of how they react to drug before driving or operating machinery.