Olanzapine

Manic episode: starting dose 15 mg as a single daily dose in monotherapy, or 10 mg daily in combination therapy. Preventing recurrence in bipolar disorder: starting dose 10 mg/day; patients already on olanzapine for a manic episode continue at the same dose. An increase above the recommended starting dose is advised only after appropriate clinical reassessment and should generally occur at intervals of not less than 24 hours. Olanzapine can be given without regard to meals. Gradual tapering should be considered when discontinuing. Elderly: a lower starting dose (5 mg/day) is not routinely indicated but should be considered for those 65 and over when clinical factors warrant. Renal and/or hepatic impairment: consider a lower starting dose of 5 mg; in moderate hepatic insufficiency (cirrhosis, Child-Pugh Class A or B) the starting dose should be 5 mg and only increased with caution. Smokers: starting dose and dose range need not be routinely altered, but smoking may induce olanzapine metabolism — monitor clinically and consider a dose increase if necessary. When more than one factor that may slow metabolism is present (female gender, geriatric age, non-smoking status), consider decreasing the starting dose and escalate conservatively. Orodispersible tablet: place in the mouth to disperse in saliva, or disperse in a full glass of water immediately before administration; it is bioequivalent to olanzapine tablets with the same dosage and frequency. Paediatric population: olanzapine is not recommended for use in children and adolescents below 18 years of age due to a lack of data on safety and efficacy; greater weight gain and lipid/prolactin alterations were reported in adolescents than in adults. eMC section 4.5 was not captured in this bundle — the interactions listed below are drawn from eMC sections 4.2/4.4 and the US label section 7; verify against UK SPC section 4.5.