Description

Simple

A medication used to treat a variety of psychiatric conditions such as bipolar disorder and schizophrenia, as well as agitation that is related to psychiatric conditions.

Clinical

An antipsychotic drug used in the management of schizophrenia, bipolar 1 disorder, and agitation associated with these disorders.

Overview

Olanzapine is a thienobenzodiazepine classified as an atypical or second-generation antipsychotic agent.[2] The second-generation antipsychotics were introduced in the 90s and quickly widespread due to the presumed higher efficacy, less extrapyramidal side effects and fewer drug-drug interactions.[5] Olanzapine presents a very close resemblance to [clozapine] and it only differs by two additional methyl groups and the absence of a chloride moiety.[10] It was obtained by the research of Eli Lilly and approved to be marketed in the US in 1996.[8]

Pharmacology

Indication

Olanzapine was initially used orally and intramuscularly for the chronic treatment of schizophrenia in patients over 13 years old and other psychiatric disorders such as bipolar I disorder including mixed or manic episodes.[ Read more

Pharmacodynamic

The effect of olanzapine in the D2 receptor is reported to produce the positive effects of this drug such as a decrease in hallucinations, delusions, disorganized speech, disorganized thought, and disorganized behavior. On the other hand, its effect on the serotonin 5HT2A receptor prevents the onset... Read more

Mechanism of action

The activity of olanzapine is achieved by the antagonism of multiple neuronal receptors including the dopamine receptor D1, D2, D3 and D4 in the brain, the serotonin receptors 5HT2A, 5HT2C, 5HT3 and 5HT6, the alpha-1 adrenergic receptor, the histamine receptor H1 and multiple muscarinic receptors.[ Read more

Absorption

Olanzapine presents a linear pharmacokinetic profile and, after daily administration, it reaches steady-state in about a week.[6] Under the administration of a normal dosage of olanzapine, the steady-s... Read more

Protein binding

Olanzapine is largely bound to plasma proteins and hence, about 93% of the administered dose is bound. The main proteins for binding are albumin and alpha-1 acid glycoprotein.[6]

Volume of distribution

The volume of distribution of olanzapine is reported to be of 1000 liters which indicate a large distribution throughout the body.[6]

Clearance

The mean clearance rate of olanzapine is of 29.4 L/hour however, some studies have reported an apparent clearance of 25 L/h.[ Read more

Half life

Olanzapine presents a half-life ranging between 21 to 54 hours with an average half-life of 30 hours.[6]

Route of elimination

Olanzapine is mainly eliminated through metabolism and hence, only 7% of the eliminated drug can be found as the unchanged form. It is mainly excreted in the urine which represents around 53% of the excreted dose followed by the feces that represent about 30%.[ Read more

Toxicity

The toxicity symptoms of olanzapine are known to include somnolence, mydriasis, blurred vision, respiratory depression, hypotension, extrapyramidal symptoms and anticholinergic effects. The overdosage effects in children are generally associated with more significant side effects.[ Read more

Adverse Effects

Contraindications

Information currently not available.

Food Interactions

  • Avoid alcohol.
  • Take with or without food. The absorption is unaffected by food.

Interactions

Type in a drug name to check for interaction with Olanzapine
Type a drug name in the box above to get started
  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
(R)-warfarin
The metabolism of (R)-warfarin can be decreased when combined with Olanzapine.
(S)-Warfarin
The metabolism of (S)-Warfarin can be decreased when combined with Olanzapine.
1-(2-Phenylethyl)-4-phenyl-4-acetoxypiperidine
The metabolism of Olanzapine can be decreased when combined with 1-(2-Phenylethyl)-4-phenyl-4-acetoxypiperidine.
1,10-Phenanthroline
The therapeutic efficacy of Olanzapine can be decreased when used in combination with 1,10-Phenanthroline.
2,4-thiazolidinedione
The therapeutic efficacy of 2,4-thiazolidinedione can be decreased when used in combination with Olanzapine.
2,5-Dimethoxy-4-ethylamphetamine
The therapeutic efficacy of Olanzapine can be decreased when used in combination with 2,5-Dimethoxy-4-ethylamphetamine.
2,5-Dimethoxy-4-ethylthioamphetamine
The therapeutic efficacy of Olanzapine can be decreased when used in combination with 2,5-Dimethoxy-4-ethylthioamphetamine.
3,5-Dinitrocatechol
The therapeutic efficacy of 3,5-Dinitrocatechol can be decreased when used in combination with Olanzapine.
4-Bromo-2,5-dimethoxyamphetamine
The therapeutic efficacy of Olanzapine can be decreased when used in combination with 4-Bromo-2,5-dimethoxyamphetamine.
4-Bromo-2,5-dimethoxyphenethylamine
The therapeutic efficacy of 4-Bromo-2,5-dimethoxyphenethylamine can be decreased when used in combination with Olanzapine.
4-hydroxycoumarin
The risk or severity of adverse effects can be increased when Olanzapine is combined with 4-hydroxycoumarin.
4-Methoxyamphetamine
The risk or severity of adverse effects can be increased when Olanzapine is combined with 4-Methoxyamphetamine.
5-methoxy-N,N-dimethyltryptamine
The risk or severity of adverse effects can be increased when Olanzapine is combined with 5-methoxy-N,N-dimethyltryptamine.
6-O-benzylguanine
The metabolism of 6-O-benzylguanine can be decreased when combined with Olanzapine.
7-Nitroindazole
The risk or severity of adverse effects can be increased when Olanzapine is combined with 7-Nitroindazole.
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline
The risk or severity of adverse effects can be increased when Olanzapine is combined with 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline.
8-azaguanine
The metabolism of 8-azaguanine can be decreased when combined with Olanzapine.
8-chlorotheophylline
The metabolism of 8-chlorotheophylline can be decreased when combined with Olanzapine.
9-Deazaguanine
The metabolism of 9-Deazaguanine can be decreased when combined with Olanzapine.
9-Methylguanine
The metabolism of 9-Methylguanine can be decreased when combined with Olanzapine.
13 References
  1. 1 . Chelkeba L, Gidey K, Mamo A, Yohannes B, Matso T, Melaku T: Olanzapine for chemotherapy-induced nausea and vomiting: systematic review and meta-analysis. Pharm Pract (Granada). 2017 Jan-Mar;15(1):877. doi: 10.18549/PharmPract.2017.01.877. Epub 2017 Mar 15.PubMed: 28503222
  2. 2 . Martel ML, Klein LR, Rivard RL, Cole JB: A Large Retrospective Cohort of Patients Receiving Intravenous Olanzapine in the Emergency Department. Acad Emerg Med. 2016 Jan;23(1):29-35. doi: 10.1111/acem.12842. Epub 2015 Dec 31.PubMed: 26720055
  3. 3 . Yang T, Liu Q, Lu M, Ma L, Zhou Y, Cui Y: Efficacy of olanzapine for the prophylaxis of chemotherapy-induced nausea and vomiting: a meta-analysis. Br J Clin Pharmacol. 2017 Jul;83(7):1369-1379. doi: 10.1111/bcp.13242. Epub 2017 Mar 23.PubMed: 28112422
  4. 4 . Brunner E, Falk DM, Jones M, Dey DK, Shatapathy CC: Olanzapine in pregnancy and breastfeeding: a review of data from global safety surveillance. BMC Pharmacol Toxicol. 2013 Aug 1;14:38. doi: 10.1186/2050-6511-14-38.PubMed: 23902726
  5. 5 . Malhotra K, Vu P, Wang DH, Lai H, Faziola LR: Olanzapine-Induced Neutropenia. Ment Illn. 2015 Jun 23;7(1):5871. doi: 10.4081/mi.2015.5871. eCollection 2015 Feb 24.PubMed: 26266027
  6. 6 . Thomas K, Saadabadi A: Olanzapine .PubMed: 30422498
  7. 7 . Chue P, Singer P: A review of olanzapine-associated toxicity and fatality in overdose. J Psychiatry Neurosci. 2003 Jul;28(4):253-61.PubMed: 12921220
  8. 8 . Green W. (2001). Child & adolescent clinical psychopharmacology (3rd ed.). Lippincott Williams & Wilkins.
  9. 9 . Ng C., Lin K., Singh B. and Chiu E. (2008). Ethno-psychopharmacology. Cambridge University Press.
  10. 10 . Schatzberg A. and Nemeroff C. (2017). The american psychiatric association publishing textbook of psychopharmacology (5th ed.). American Psychiatric Association Publishing.
  11. 11 . Canadian Mental Health Association Link
  12. 12 . NIH Link
  13. 13 . Mylan-Olanzapine. Product monograph Link