Oleanz (Olanzapine)
Also sold as: Oleanz, Olanex, Zyprexa, Olexa
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
Tablet 2.5/5/7.5/10/15/20mg +2
Indications
- Schizophrenia
- Bipolar disorder (acute mania, maintenance)
- Treatment-resistant depression (with fluoxetine)
- Acute agitation (IM)
- Chemotherapy-induced N/V (off-label, low dose)
Adult Dosing
Schizophrenia/Bipolar
Start 5-10 mg OD; usual 10-20 mg/day
Acute agitation (IM)
5-10 mg IM, may repeat after 2h, max 30 mg/day
CINV (low dose)
2.5-5 mg OD as adjunct
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| No adjustment needed | No CrCl-based adjustment |
Hepatic Adjustment
Caution in hepatic impairment
Pregnancy & Lactation
Pregnancy: Category C
Risk of GDM, neonatal extrapyramidal symptoms
Lactation: Caution
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| CNS depressants | Additive sedation | Major |
| CYP1A2 inhibitors (fluvoxamine, ciprofloxacin) | Increased olanzapine levels | Moderate |
| Carbamazepine, smoking | Reduced olanzapine levels | Moderate |
| IM olanzapine + IM benzodiazepines | Avoid concurrent — hypotension/bradycardia/respiratory depression | Major |
DoctorScribe — AI Medical Scribe
Stop looking up Oleanz — just speak the prescription
"Oleanz as per dose, BD for 5 days." DoctorScribe writes the full prescription with brand, strength, frequency, and route — auto-applies pediatric weight-based dosing and renal adjustments. Try the live demo.
Side Effects
Common
- Significant weight gain (worst among antipsychotics)
- Sedation
- Dizziness
- Constipation
- Dry mouth
- Increased appetite
Serious / Discontinue If
- Metabolic syndrome (DM, dyslipidemia)
- Hyperglycemia, DKA
- NMS
- Tardive dyskinesia (less than typical antipsychotics)
- Increased mortality in elderly with dementia (FDA black box)
- Orthostatic hypotension
Contraindications
- Known QT prolongation, hypersensitivity, narrow-angle glaucoma
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Oleanz 5 | Sun Pharma | 10 tab ₹85 |
| Olanex 5 | Cipla | 10 tab ₹95 |
| Zyprexa 5 | Lilly | 10 tab ₹485 |
Monitoring Required
- Weight at every visit, BP, fasting glucose + HbA1c, lipid profile (baseline + every 6 months)
- EPS, signs of NMS
Patient Counseling Points
- Significant weight gain expected — diet/exercise plan essential
- Avoid in elderly with dementia (mortality risk)
- Report stiffness, fever, fast heart rate (NMS)
Stop Googling drug references mid-consultation
EasyClinic auto-flags Oleanz interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
References
- BNF
- Lexicomp
- Indian National Formulary
- Specialty society guidelines