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ZypAdhera ® (olanzapine pamoate monohydrate)
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ZypAdhera® (olanzapine pamoate): Switching from Oral Olanzapine
Patients should be treated initially with oral olanzapine before administering olanzapine pamoate, to establish tolerability and response. The first olanzapine pamoate dose for all patients is identified based on target oral olanzapine dose.
Posology
In order to identify the first olanzapine pamoate dose for all patients, the scheme in Recommended dose scheme between oral olanzapine and olanzapine pamoate should be considered.1
Target oral olanzapine dose |
Recommended starting dose of olanzapine pamoate |
Maintenance dose after 2 month of olanzapine pamoate treatment |
10 mg/day |
210 mg/2 weeks |
150 mg/2 weeks |
15 mg/day |
300 mg/2 weeks |
210 mg/2 weeks |
20 mg/day |
300 mg/2 weeks |
300 mg/2 weeks |
- Some specific patient populations may require lower starting doses and cautious dose escalation.2 For full information please refer to summary of product characteristics.
Dose adjustment
Olanzapine LAI provides therapeutic levels of systemic olanzapine from the very first injection. However, approximately 3 months are needed to re-establish steady state.2
Patients should be monitored carefully for signs of relapse during the first one to two months of treatment.1
During antipsychotic treatment, improvement in the patient's clinical condition may take several days to some weeks. Patients should be closely monitored during this period.1
During treatment, dose may subsequently be adjusted on the basis of individual clinical status. After clinical reassessment, dose may be adjusted within the range 150 mg to 300 mg every 2 weeks or 300 to 405 mg every 4 weeks (Recommended dose scheme between oral olanzapine and olanzapine pamoate).1
- Some specific patient populations may require lower starting doses and cautious dose escalation.2 For full information please refer to summary of product characteristics.
Oral supplementation
If oral olanzapine supplementation is clinically indicated, then the combined total dose of olanzapine from both formulations should not exceed the corresponding maximum oral olanzapine dose of 20 mg/day.1
Important notes
Olanzapine LAI is intended for deep gluteal intramuscular injection only.2
ZypAdhera 210 mg, 300 mg, and 405 mg, powder and solvent for prolonged release suspension for injection must not be confused with olanzapine 10 mg powder for solution for injection.1
References
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.
Date of Last Review: 28 April 2022