Parenteral Manual

OLANZapine

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Zyprexa®
Classification: 
Antipsychotic
Original Date: 
August 2005
Revised Date: 
September 2013
Indications: 
  • Rapid control of agitation in patients with schizophrenia and related psychotic disorders
Reconstitution and Stability: 
  • Reconstitute 10 mg vials with 2.1 mL of Sterile Water for Injection  for a concentration of 5 mg/mL
  • Reconstituted solution must be used within 1 hour of preparation, kept at room temperature
Compatibility: 

- Solutions Compatible: Sterile Water for Injection

- Additive/buretrol Compatible: no information

- Y-site Compatible: no information

- Incompatible: diazepam, haloperidol, lorazepam

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM YES, inject slowly, deep into muscle
IV Direct NO
IV Intermittent Infusion NO
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

  • Safety and efficacy have not been studied

Adult:

  • Initial: 10 mg IM.  Lower doses of 5 mg or 7.5 mg may be appropriate
  • Repeated doses: 5-10 mg IM 2 hours after the first injection and a third dose 4 hours after the second dose
  • Maximum: 20 mg/day (including olanzapine given orally); with no more than 3 injections in 24 hours

ADJUSTMENT FOR RENAL/HEPATIC IMPAIRMENT:

  • An initial dose of 5 mg IM should be given
Potential hazards of parenteral administration: 
  • Neuroleptic Malignant syndrome (hyperpyrexia, muscle rigidity, altered mental status, autonomic instability)
  • Somnolence, dizziness, weight gain
  • Orthostatic hypotension, syncope associated with bradycardia (infrequent)
  • Extrapyramidal symptoms are more likely with high doses
  • Hyperglycemia
  • Patients should be closely observed for 2-4 hours following injection for hypotension, bradyarrhythmia, and hypoventilation
Notes: 
  • Parenteral administration may be used for up to a maximum of 3 days
  • Should switch patient to oral therapy as soon as possible if ongoing therapy is required
  • Concomitant use of parenteral benzodiazepine is no recommended with IM OLANZapine

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