Tips for searching:
• You have to select a product and type at least 2 words to activate the search
• Use only words that are specific to the information you are looking for
• Avoid typing questions or sentences
Please do not use this field to report adverse events or product complaints. Adverse events and product complaints should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellow card in the Google play or Apple app store. Adverse events and product complaints should also be reported to Lilly: please call Lilly UK on 01256 315 000.
ZypAdhera ® (olanzapine pamoate monohydrate)
This information is intended for UK registered healthcare professionals only as a scientific exchange in response to your search for information. For current prescribing information for all Lilly products, including Summaries of Product Characteristics, Patient Information Leaflets and Instructions for Use, please visit: www.medicines.org.uk (England, Scotland, Wales) or www.emcmedicines.com/en-GB/northernireland/ (Northern Ireland).
ZypAdhera® (olanzapine pamoate): Avoiding Needle Clogs and Issues
Always attach a fresh safety needle to the syringe prior to injection. Additional information on handling needle issues is provided below.
One carton contains1
- one vial of powder and
- one vial of solvent,
- one Hypodermic 3 ml syringe with pre-attached 19-gauge, 38 mm safety needle,
- one 19-gauge, 38 mm Hypodermic safety needle and
- two 19-gauge, 50 mm Hypodermic safety needles.
The needles are provided for safety and convenience purposes.2
Needle Clogs During Administration of Olanzapine Pamoate
Always change the needle to a fresh needle immediately before administration of the dose.2
If there is resistance encountered during the injection, attempt to finish the injection by slightly repositioning the needle.2
If the needle clogs and the injection cannot be finished, please
- first try pulling back on the plunger to clear the needle and attempt to finish the injection, and
- if the needle is still clogged, remove the needle from the patient and replace the needle with a fresh needle and attempt to deliver the remainder of the dose.2
If the injection still does not complete, it is considered a complete dose; do not attempt to make up a fresh vial and calculate the difference.2
Important Information about Bent or Damaged Needles
Bent or damaged needles can result in breakage or damage to the tissue or accidental needle puncture.2
If the needle is bent or damaged, do not attempt to straighten the needle or engage the Needle-Pro device. The Needle-Pro device may not properly contain a bent needle and/or the needle could puncture the needle protection device, which may result in a needle stick with a contaminated needle.2
Mishandling of the needle protection device may cause needles, especially short or small-gauge needles, to bend, whereby they protrude from the needle protector sheath, which may result in a contaminated needle stick.2
Avoidance of Stopper Fragmentation During Reconstitution
The primary contributor of particulate matter in vial presentations originates from the rubber closure.3 Therefore, particles observed after reconstitution might originate from puncturing the stopper with the needle. Many elements can influence the production of stopper fragments during reconstitution (see ).4
Blunt needle tips have a much greater tendency to produce fragments than sharp tips.
Needles larger than 21-gauge tend to promote fragmentation.
Force of puncture
Lower needle insertion forces reduce the tendency to produce fragments.
Angle of puncture
Needle insertion at a 45° angle to the plane of the stopper reduces the likelihood of fragments.
Using a spike on a stopper design that was not intended to receive a spike will produce fragments.
To avoid stopper fragmentation during reconstitution of olanzapine pamoate,
- insert the needle at a 45° angle, instead of vertically 90° angle to the plane of the stopper
- apply a steady force when puncturing the membrane but avoid a rapid, forceful puncture or a twisting motion, and
- carefully inspect the needle prior to use for any damage to the tip including blunting.2
1ZypAdhera [summary of product characteristics]. Eli Lilly Nederland B.V., The Netherlands.
2Data on file, Eli Lilly and Company and/or one of its subsidiaries.
3Dempsey G, Webber GS. Hazards of particle injection. Pharm J. 1983;231:63-64.
4Causes of coring and fragmentation in the field. West Pharma. Published June 23, 2014. Accessed October 4, 2023. https://www.westpharma.com/blog/2014/June/Causes-of-Coring-and-Fragmentation-in-the-Field
5Causes of coring and fragmentation in the field. West Pharma. Published June 23, 2014. Accessed January 29, 2018. https://www.westpharma.com/blog/2014/June/Causes-of-Coring-and-Fragmentation-in-the-Field
LAI = Long Acting Injection
Date of Last Review: 20 November 2023