Olanxol 10mg Danapha tablets treat schizophrenia (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Olanzapine

Ingredient

Composition information	Content
Olanzapine	10mg

Uses

indication

Treatment of schizophrenia, bipolar disorder:

Execction or mixture, fast cycle, agitation due to schizophrenia or bipolar disease.

Pharmacology

olanzapin is an existing anti -psychotic drug (the second generation) and is a substance of dibenzodiazepin. The drug has many other pharmacological properties different from the typical anti -psychotic drugs such as less causing foreign syndrome, less prolactin secretion, less dysplasia when treated for prolonged treatment and effectively on both positive, negative and inhibited manifestations of the schizophrenia.

Olanzapin's anti -psychotic effects have complex mechanisms. This mechanism is associated with the antagonism of the drug in Serotonin Type 2, Type 3, Type 6 and Dopamine receptors in the central nervous system. Olanzapin has the effect of inhibiting and reducing response to receptors 5 - HT2A, related to the anti -revolt effect of the drug. Olanzapin also stabilizes the temperament due to a part of the d2 receptor inhibitors of dopamine.

olanzapin also has antagonistic effects on muscarin receptors. The anti -cholinergic effect on the one hand explains the reduction of the risk of outsider syndrome, on the other hand, it is related to some other unwanted effects. Olanzapin also has the H1 receptor antagonistic effect of histamine and Alpha - 1 Adrenergic receptor. This effect is related to the ability to cause chicken sleep, hypotension posture when using the drug.

Pharmacokinetics

absorption

olanzapin is well absorbed by oral, reaching the top concentration of plasma fluctuating about 5 to 8 hours after drinking. Food does not affect the absorption. Due to the metabolism of step 1 in the liver, oral bioavailability reaches 60%. The concentration of drugs in plasma reaches a stable state after 7-10 days of repeated dose. The concentration of drugs in plasma changes between individuals, depending on age, gender and smoking.

Distribution

olanzapin is distributed quickly and much to the tissues, including the central nervous system. About 93% olanzapin binds to plasma proteins, mainly with albumin and α1 acid - glycoprotein. The distribution of olanzapin is about 1000 liters. Olanzapin and glucuronic conjugate metabolites through the placenta and excretion into breast milk.

Metabolism

The drug is metabolized mainly in the liver with direct glucuronicization and indirect oxidation through Cytochrom P450 - CYP1A2, a small part through Cytochrom P450 - CYP2D6. The two main metabolites are 10 - N - glucuronid and 4 ' - N - Demethyl olanzapin without the activity of olanzapin.

Elimination

Semi -selling time in plasma from 21 hours to 54 hours and increased to about 1.5 times in the elderly. Olanzapin's clearance increased by about 40% in smokers compared to non -smokers and decreased by about 30% in women compared to men. About 57% and 30% of the drug are excreted in the urine and feces, mainly in the form of metabolites. A small part (7%) in the original form. Pharmacokinetics does not change much in patients with renal failure.

Before taking Olanxol 10mg Danapha tablets treat schizophrenia (10 blisters x 10 tablets)

How to use

olanxol is a drink that is used by drinking, regardless of meals.

Dosage

Use an additional form of preparation with 5 mg, 15 mg content to suit each specified.

Adults

schizophrenia:

The starting dose is 5 to 10 mg/day, the target dose of 10 mg/day, the recommendation of adjusting the dose up to 10 mg/day is made by no less than 1 week apart. However, it is recommended to use over 10 mg/day only after clinical reassessment.

Single therapy: dose from 10 - 15 mg/day. The 5 mg dose adjustment is made from less than 24 hours apart if necessary so that the dose is within 5 - 20 mg/day. If there is a response that can be treated continues with the same dose to prevent recurrence.

Multi therapy: Dosage recommended 10 mg/day.

Prevention of recurrence in the previous Hung Cam patient responded to olanzapin: The recommended starting dose is 10 mg/day.

Prevent relapse of depression: The recommended dose starts 10 mg/day.

Children

The efficiency and safety of olanzapin in children under 18 years of age has not been established, but the drug has been used effectively in schizophrenia at this age.

Elderly

Do not use, often using low starting dose is 5 mg but it should be considered for patients over 65 years old when accompanied by unfavorable clinical factors.

Patients with kidney failure and/or liver failure

Should consider using a low starting dose is 5 mg. In the case of average liver failure (cirrhosis type A or B Child - PUGH), the starting dose of 5 mg and carefully when increasing the dose.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms

Doses over 200 mg may be fatal. Symptoms usually appear within 1-2 hours, the maximum effect within 4-6 hours after taking the drug includes: agitation, tachycardia, cholinergic resistance, pupils, pupils, pupils, muscle spasms, salivation increases, consciousness from sedation to coma. Sometimes cardiac arrest appears, tachycardia, malignant neuropular syndrome, respiratory inhibition, epilepsy, hypertension or hypotension (including vertical posture lowering).

Treatment

Acute poisoning:

Mainly treat symptoms, support care, maintenance of intravenous pathway accompanied by tightening cardiovascular function and survival signs. Gastrointestinal wash with activated carbon accompanied by sorbitol to eliminate and prevent absorption. Maintain support ventilation and oxygen therapy. Control arrhythmia by appropriate treatments. Extending the QRS interval on the electrocardiogram can be adjusted by transmitting bicarbonate solution. Acute tower syndrome can be treated with anti -cholinergic drugs (diphenhydramin, atropin). No specific antidote. Dialysis and peritoneal fertilizer plays a very limited role in the treatment of olanzapin acute poisoning. Be careful with this risk.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

Common, ADR> 1/100

Nervous system: Drowsiness, Dream, Dizziness, Mobility Disorder, Parkinson.

Metabolism and nutrition: weight gain, prolactin increase, hypercholesterol, hyperglycemia and hyper triglycerides, urinary glucose, increased appetite.

Blood and lymphatic system: Eosin hypernagus, leukopenia, neutropenia.

Cardiovascular system: Hypotension posture.

Digestive system: constipation, dry mouth.

liver system - bile: increase enzyme transaminase.

Skin and subcutaneous tissue: Red Red.

Musculoskeletal and connective tissue system: joint pain.

Reproductive system: erectile dysfunction in men, decreased libido in men and women, hyperkemia blood prolactin.

general disorder: weakness, fatigue, edema, fever.

Uncommon, 1/1000

The immune system: Hypersensitivity to the drug.

metabolism and nutrition: Exacerbation of diabetes sometimes combined with keton acidosis and coma (there have been cases leading to death).

Nervous system: Convulsions in many cases have a history of epilepsy or risk factors for convulsions, late movement disorders, forgetful or forgetting, tongue disorders.

respiratory - chest: nosebleeds.

Cardiovascular system: slow heart rate, extending the QT, thrombosis including pulmonary embolism and deep vein thrombosis.

Digestive system: bloating.

Skin and subcutaneous tissue: sensitive to light, hair loss.

Kidney and urinary: Urine uncontrolled, urinary retention.

Reproductive system: amenorrhea, breast enlargement, female mammary glands in men.

Rare, ADR

Blood and lymphatic system: thrombocytopenia.

Metabolism and nutrition: lower body heat.

Nervous system: Malignant neuroleptic syndrome, Drug stop syndrome.

Cardiovascular system: Seven ventricular tachycardia.

Digestive system: pancreatitis.

Hepatitis: Hepatitis.

Mechanical and joint system: Mechanical pattern.

Reproductive system: erect.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Olanxol drugs are contraindicated in the following cases:

History of hypersensitivity to any ingredients of the drug.

Lactating women.

Patients are at risk of closed angle glaucoma.

Be cautious when using

Parkinson's disease: It is not recommended to use olanzapin in the treatment of mental disorders related to Dopamine owner in Parkinson's patient.

Malignant neuropular syndrome: is a life that threatens life related to the use of anti -psychotic drugs. The clinical manifestations of this syndrome are high fever, stiffness, mental change, imbalance of autonomous nervous system (vascular or blood pressure abnormalities, tachycardia, sweating and arrhythmia), accompanied by signs such as increased creatinine phosphokinase, myoglobin urine (mechanical prize) and acute renal failure. If there are signs of this syndrome, the anti -psychotic drug must be stopped.

Hyperborn and diabetes: Hyperglycemia and/or worse than diabetes, sometimes associated with keton acidosis or coma has been reported rare, including several deaths. The drug can cause weight gain, should monitor blood glucose and weight regularly.

Lipid disorders: The drug can cause blood lipid disorders, so regular testing of blood lipid concentration during treatment.

Loss of granulocytes: Use carefully for patients with low number of leukocytes and/or neutrophils due to any cause. Neutral leukemia has been reported to be common when using olanzapin in combination with valproat and in patients with acidic leukemia or bone marrow hyperetopers.

Stop drugs: Very rare acute symptoms such as sweating, insomnia, tremor, anxiety, vomiting or vomiting when stopping olanzapin suddenly.

Increased QT interval: It is necessary to be cautious when prescribing olanzapin along with the known drugs that work to extend the QT range, especially in the elderly, patients with congenital QT syndrome, congenital heart failure, heart hypertrophy, hypotension and hypoglycemia.

Vascular thrombosis: Very rare. Patients with schizophrenia often have risk factors for venous thrombosis, such as motionless patients, so they are identified and prophylactic evaluation.

Late dysplasia: The risk of late dysplasia increases when long -term use. Therefore, if there are signs or symptoms of dysplasia, the dose reduction should be considered.

Seism: rarely occur, be careful to use for patients with a history of convulsions or risk factors that lower the seizure threshold.

Hemodynamic effects: Olanzapin can cause vertical hypotension accompanied by dizziness, tachycardia and in several patients, olanzapin can be unconscious, especially during the starting dose period, may be due to the effect of receptor antagonist properties α1 - adrenergic.

Suddenly due to heart disease: The risk of sudden death in patients using olanzapin is approximately twice in patients who do not use anti -psychotic drugs.

Increased enzyme transaminase: Be cautious in patients with signs and symptoms of liver failure, the previous patient has a limit on liver function and patients who are treating drugs that canxicate the liver. Periodic evaluation of Transaminase enzyme in patients with severe liver failure.

Air conditioning: olanzapin may lose the ability to lower the body's body temperature. Be careful to use for patients who are in a state that can increase body temperature as if they are trying to exertion, hot infection, using anti -cholinergic drugs or dehydration.

Difficulty swallowing: olanzapin may lose the esophageal and respiratory movement. Pneumonia - Respiratory is a common cause of raging and death in patients with Alzheimer disease, cautiously taking olanzapin as well as anti -psychotic drugs for these patients.

suicide: The ability to commit suicide inherent in schizophrenia and bipolar disorder. It is advisable to closely monitor patients at high risk of suicide and drug treatment.

Awareness and exercise impairment: olanzapin increases mortality and the risk of harmful to brain vessels in elderly patients with dementia.

Lactose -containing drugs, patients with rare genetic problems such as galactose tolerance, lactase deficiency, or malposure - Galactose should not be used.

The ability to drive and operate machinery

The drug can cause drowsiness. Therefore, it is necessary to advise patients not to drive and operate machinery.

Pregnancy

Do not recommend the use of olanzapin for pregnant women or intend to get pregnant, should only use drugs when benefits bring more danger to the fetus.

The period of breastfeeding

olanzapin is exported to breast milk that can cause central nerve inhibiting effects in breastfed babies. Therefore, it is necessary to avoid using olanzapin for breastfeeding women or not breastfeeding when required to treat the mother.

Interactive drug

The possibility of other drugs affecting olanzapin

olanzapin metabolized through cytochrom P450 isoenzyme CYP1A2, CYP2D6. The use of inhibitors, induction or actions as a substrate of the above isenzyme may affect plasma olinzapin levels.

Simultaneous use of olanzapin with diazepam or alcohol may increase the risk of hypotension.

Concentrated with activated carbon will reduce the bioavailability of oral olanzapin from 50% to 60%.

Olanzapin's metabolism may be touched by smoking (olanzapin clearance is 33% lower and 21% longer than non -smokers than smokers) or Carbamazepine treatment (44% clearance and 20% decrease in the sale time).

Fluvoxamine inhibits CYP1A2 thus inhibiting the metabolism of olanzapin significantly.

Do not take olanzapin with Parkinson's medications in Parkinson patients and dementia.

Olanzapin's ability affects other drugs

olanzapin increases the effects on the nervous system of central neurotransmitter, including alcohol.

Concomitance use olanzapin with hypotension drugs can lead to excessive hypotension.

olanzapin may oppose the action of dopamine drivers.

Neutral leukemia may be more common when olanzapin is used with Valproat.

There is a risk in theory of extending the QT range when using olanzapin in combination with other drugs that have been known.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

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