Zyprexa Dosage

Generic name: olanzapine (oral)
Brand names: ZyPREXA, ZyPREXA Zydis
Drug class: Atypical antipsychotics

Medically reviewed by  A Ras MD.

 Recommended Adult Dosing

Dosage forms:  TAB: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg; INJ: 5 mg per mL

Schizophrenia

[10 mg PO qd]
Start: 5-10 mg PO qd, may incr. 5 mg/day qwk; Max: 20 mg/day; Info: start 2.5-5 mg PO qd in non-smoker, elderly, debilitated or female pts or if hypotension risk; doses >10 mg/day rarely more effective; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

Bipolar I disorder, manic/mixed

[monotherapy]
Dose: 5-20 mg PO qd; Start: 10-15 mg PO qd, may adjust by 5 mg/day prn; Max: 20 mg/day; Info: for acute and maintenance tx; start 5 mg PO qd in non-smoker, elderly, debilitated or female pts or if hypotension risk; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC
[valproate or lithium adjunct]
Dose: 5-20 mg PO qd; Start: 10 mg PO qd, may adjust by 5 mg/day prn; Max: 20 mg/day; Info: for acute tx; start 5 mg PO qd in non-smoker, elderly, debilitated or female pts or if hypotension risk; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

Agitation, schizophrenia or bipolar I disorder-assoc.

[10 mg IM x1]
Max: 30 mg/day; Info: may repeat dose 2h after initial dose x1, then 4h after 2nd dose x1 prn; may give lower doses of 2.5-7.5 mg; consider 5 mg/dose in elderly and 2.5 mg/dose in non-smoker, debilitated or female pts or if hypotension risk; switch to PO ASAP; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

Bipolar I disorder, acute depressive

[5-12.5 mg PO qpm]
Start: 5 mg PO qpm; Max: 20 mg/day; Info: use w/ fluoxetine; may start 2.5 mg PO qpm in non-smoker, elderly or female pts or if hypotension risk; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

Major depressive disorder, acute tx-resistant

[5-20 mg PO qpm]
Start: 5 mg PO qpm; Max: 20 mg/day; Info: use w/ fluoxetine; may start 2.5 mg PO qpm in non-smoker, elderly or female pts or if hypotension risk; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

Nausea/vomiting prevention, chemo-related

[highly-emetogenic parenteral chemo]
Dose: 5-10 mg PO x1 on day 1, then 5-10 mg PO qd on days 2-4; Info: part of multi-drug regimen; consider lower doses in elderly/debilitated pts or if poorly tolerated
[moderately-emetogenic parenteral chemo]
Dose: 5-10 mg PO x1 on day 1, then 5-10 mg PO qd on days 2-3; Info: part of multi-drug regimen; consider lower doses in elderly/debilitated pts or if poorly tolerated

Refractory nausea/vomiting, chemo-related

[5-10 mg PO qd]
Info: for breakthrough emesis if not used on days 1-4 as part of prophylactic regimen; consider lower doses in elderly/debilitated pts or if poorly tolerated

Renal dosing

[no adjustment]
renal impairment: no adjustment
HD/PD: no adjustment; no supplement

Hepatic dosing

[not defined]
hepatic impairment: caution advised

SRC: NLM .