Select therapeutic use:

Mood disorders:

Indications for ZYPREXA INTRAMUSCULAR:

Agitation due to bipolar I mania.

Adult Dosage:

Give by deep IM inj. Usual range: 2.5mg–10mg/dose. Elderly: 5mg. Debilitated, risk of hypotension, or sensitive to olanzapine: 2.5mg. All: up to max 3 doses/day (2–4 hrs apart); switch to oral form when appropriate. Severe orthostatic hypotension: additional dose not recommended.

Children Dosage:

Not recommended.

ZYPREXA INTRAMUSCULAR Contraindications:

Combination therapies: see other drug monographs.

Boxed Warning:

Increased mortality in elderly patients with dementia-related psychosis.

ZYPREXA INTRAMUSCULAR Warnings/Precautions:

Elderly with dementia-related psychosis (not approved use); increased risk of death or cerebrovascular events (eg, stroke, TIA). Cardio- or cerebrovascular disease. Discontinue if neuroleptic malignant syndrome occurs or if DRESS is suspected; consider discontinuation if tardive dyskinesia occurs. Diabetes. Monitor for hyperglycemia, hyperlipidemia; do fasting blood glucose and lipids testing at beginning, and during therapy. Monitor for weight gain. Hypovolemia. Dehydration. History of seizures. Conditions that affect metabolism or hemodynamic responses. Narrow angle glaucoma. Urinary retention. Significant prostatic hypertrophy. Constipation. History of paralytic ileus or related conditions. Breast cancer. Pre-existing low WBCs or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; discontinue if WBCs decline. Perform fall risk assessments when initiating and recurrently on long-term therapy. Exposure to extreme heat. Dysphagia. Suicidal ideation (monitor). Reevaluate periodically. Write ℞ for smallest practical amount. Debilitated. Hepatic impairment (monitor ALT/AST). Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy. Nursing mothers: monitor infants.

ZYPREXA INTRAMUSCULAR Classification:

Thienobenzodiazepine.

ZYPREXA INTRAMUSCULAR Interactions:

Orthostatic hypotension with antihypertensives, alcohol (caution), diazepam. Caution with other CNS drugs, anticholinergics, hepatotoxic agents. Concomitant IV benzodiazepine: not recommended with IM olanzapine. May antagonize levodopa, dopamine agonists. May be antagonized by rifampin, omeprazole, carbamazepine, others that induce CYP1A2 or glucuronyl transferase. May be potentiated by fluvoxamine, others that inhibit CYP1A2. Smokers may have increased clearance.

Adverse Reactions:

Somnolence, sedation, dizziness, constipation, weight gain, increased appetite, personality disorder, akathisia, asthenia, postural hypotension, headache, abdominal pain, dry mouth, fatigue, tremor, extremity/back pain, nausea, diarrhea, vomiting, cough, nasopharyngitis; neutropenia, hyperprolactinemia, elevated liver enzymes, EPS.

Drug Elimination:

Renal, fecal.

How Supplied:

Tabs—30; Zydis—30; Vial—1

Psychosis:

Indications for ZYPREXA INTRAMUSCULAR:

Agitation due to schizophrenia.

Adult Dosage:

Give by deep IM inj. Usual range: 2.5mg–10mg/dose. Elderly: 5mg. Debilitated, risk of hypotension, or sensitive to olanzapine: 2.5mg. All: up to max 3 doses/day (2–4 hrs apart); switch to oral form when appropriate. Severe orthostatic hypotension: additional dose not recommended.

Children Dosage:

Not recommended.

Boxed Warning:

Increased mortality in elderly patients with dementia-related psychosis.

ZYPREXA INTRAMUSCULAR Warnings/Precautions:

Relprevv: post-injection delirum/sedation syndrome: monitor after each injection. Elderly with dementia-related psychosis (not approved use); increased risk of death or cerebrovascular events (eg, stroke, TIA). Cardio- or cerebrovascular disease. Discontinue if neuroleptic malignant syndrome occurs or if DRESS is suspected; consider discontinuation if tardive dyskinesia occurs. Diabetes. Monitor for hyperglycemia, hyperlipidemia; do fasting blood glucose and lipids testing at beginning, and during therapy. Monitor for weight gain. Hypovolemia. Dehydration. History of seizures. Conditions that affect metabolism or hemodynamic responses. Narrow angle glaucoma. Urinary retention. Significant prostatic hypertrophy. Constipation. History of paralytic ileus or related conditions. Breast cancer. Pre-existing low WBCs or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; discontinue if WBCs decline. Perform fall risk assessments when initiating and recurrently on long-term therapy. Exposure to extreme heat. Dysphagia. Suicidal ideation (monitor). Reevaluate periodically. Write ℞ for smallest practical amount. Debilitated. Hepatic impairment (monitor ALT/AST). Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy. Nursing mothers: monitor infants.

ZYPREXA INTRAMUSCULAR Classification:

Thienobenzodiazepine.

ZYPREXA INTRAMUSCULAR Interactions:

Orthostatic hypotension with antihypertensives, alcohol (caution), diazepam. Caution with other CNS drugs, anticholinergics, hepatotoxic agents. Concomitant IV benzodiazepine: not recommended with IM olanzapine. May antagonize levodopa, dopamine agonists. May be antagonized by rifampin, omeprazole, carbamazepine, others that induce CYP1A2 or glucuronyl transferase. May be potentiated by fluvoxamine, others that inhibit CYP1A2. Smokers may have increased clearance.

Adverse Reactions:

Somnolence, sedation, dizziness, constipation, weight gain, increased appetite, personality disorder, akathisia, asthenia, postural hypotension, headache, abdominal pain, dry mouth, fatigue, tremor, extremity/back pain, nausea, diarrhea, vomiting, cough, nasopharyngitis; neutropenia, hyperprolactinemia, elevated liver enzymes, EPS.

Drug Elimination:

Renal, fecal.

How Supplied:

Tabs—30; Zydis—30; Vial—1; Relprevv (kit)—1 (w. diluent + supplies)