Olanzapine for schizophrenia, bipolar disorder, mania and agitation

This leaflet is about the use of olanzapine for schizophrenia, bipolar disorder, mania and agitation.

Information Standard quality markThis leaflet has been written specifically about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Do not stop giving olanzapine suddenly, as your child is likely to get withdrawal symptoms.

Name of drug

Olanzapine
Brand names: Zyprexa®, Zyprexa Velotab®

Why is it important for my child to take this medicine?

This medicine will reduce your child’s symptoms and help their mood and behaviour to be more stable.

What is olanzapine available as?

  • Tablets: 2.5 mg (white), 5 mg (white), 7.5 mg (white), 10 mg (white), 15 mg (light blue), 20 mg (pink); these contain small amounts of lactose
  • Velotabs: 5 mg, 10 mg, 15 mg, 20 mg (all yellow); these contain small amounts of aspartame and mannitol

When should I give olanzapine?

Olanzapine is usually given once each day, usually in the evening. Try to give it at about the same time each day.

How much should I give?

Your doctor will work out the amount of olanzapine (the dose) that is right for your child. The dose will be shown on the medicine label.
Your child will probably be started on a low dose. Your doctor may then increase the dose if they think this will help.

It is important that you follow your doctor’s instructions about how much to give.

How should I give it?

TabletsTablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablet. You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey or jam.

Make sure your child swallows it straight away, without chewing.

Velotabs

  • Hold the blister strip at the edges. Tear gently along the perforations to separate one blister cell from the rest.
  • Carefully peel off the backing, then gently push the tablet out.
  • Put the tablet in your child’s mouth. It will dissolve and can then be swallowed.
  • You can put the tablet in a glass of water, fruit juice, milk or coffee. Stir it well.
  • With some drinks, the mixture may change colour and possibly become cloudy. Your child should drink it all, straight away.

When should the medicine start working?

This depends on what your child is being treated for. If your child gets hallucinations (seeing or hearing things that are not there), these should start to get better after a week or so. It may take longer than this for delusions (believing something to be real that is not) to stop. It may take 6–8 weeks before your child’s mood and behaviour seem more normal. It is important that you continue to give olanzapine during this time. Contact your doctor if you are worried.

What if my child is sick (vomits)?

  • If your child is sick less than 30 minutes after having a dose of olanzapine, give them the same dose again.
  • If your child is sick more than 30 minutes after having a dose of olanzapine, you do not need to give them another dose. Wait until the next normal dose.

What if I forget to give it?

If you remember before your child goes to bed, give them the missed dose. You do not need to wake them up, however. You can give the missed dose in the morning, as long as this is at least 6 hours before the next dose is due. If olanzapine makes your child sleepy, it may be better not to give the missed dose in the morning.

Never give a double dose of olanzapine.

What if I give too much?

It can be dangerous to give too much olanzapine.

If you think you may have given your child too much olanzapine, contact your doctor or NHS Direct (0845 4647 in England and Wales; 08454 24 24 24) or take your child to hospital.
Take the medicine container or packet with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.

Are there any possible side-effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).
Side-effects that you must do something about

Contact your doctor straight away if your child has any of the following:

  • muscle spasms (stiffening of the muscles), twitching in the face and body, or uncontrolled movements of the tongue or jaw, or they seem restless and cannot control their movements
  • fever, sore throat, rash or mouth ulcers

Other side-effects you need to know about

  • Your child may feel sleepy or sluggish (drowsy) for a few hours after giving a dose. It is therefore best to give olanzapine to your child at bedtime.
  • If your teenager drives, they need to be aware that their reaction times may be slower while taking olanzapine and that they may feel drowsy.

Your child may get the following side-effects. If they are still a problem after 2 weeks, contact your doctor for advice.

  • They may feel sleepy, tired or weak.
  • They may get constipated (have difficulty doing a poo). Make sure they eat food that contains fibre (e.g. bran, wholemeal bread, rice, pasta, fruit and vegetables) and that they drink plenty of fluid.
  • They may feel light-headed or dizzy when they stand up, or may faint. This is because olanzapine may lower the blood pressure. They should stand up slowly, and should lie down for a while if they feel dizzy. If this becomes a problem, contact your doctor.
  • They may have more of an appetite. To make sure that they don’t put on weight, avoid foods that are in high in calories (cakes, biscuits, sweets, crisps) and make sure they have regular physical activity.
  • They may have a dry mouth. Eating citrus fruits (e.g. oranges) and taking sips of water may help.
  • Your child’s skin will be more sensitive to sunlight and they are more likely to get sun burn. When outdoors, they should keep their skin covered, use high-factor sun screen and wear a hat, especially in the summer.

Can other medicines be given at the same time as olanzapine?

  • You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
  • Olanzapine should not be taken with some common drugs that you get on prescription. Tell your doctor and pharmacist about any other medicines your child is taking before giving olanzapine.
  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Is there anything else I need to know about this medicine?

Do not suddenly stop giving your child olanzapine, as they may get withdrawal symptoms (difficulty sleeping, tremor, anxiety, nausea, vomiting).

Generally, olanzapine should not be taken during pregnancy, particularly during the last 3 months. If your daughter thinks she might be pregnant, she should contact her doctor straight away. She should continue to take olanzapine until she has seen her doctor.

Teenagers who drink alcohol need to be aware that the effects of alcohol are stronger when taking olanzapine and that they need to be extra careful.

General advice about medicines

  • Try to give medicines at about the same times each day, to help you remember.
  • Only give this to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

If you think someone else may have taken the medicine by accident, contact your doctor for advice.

  • Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
  • Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where I should keep this medicine?

  • Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
  • Keep the medicine in the container it came in.
  • Make sure that children cannot see or reach the medicine.

Who to contact for more information

Your child’s doctor or pharmacist will be able to give you more information about olanzapine and about other medicines used to treat your child’s condition.


You can also get useful information from:


Publication Date

8/12/2011

Copyright Disclaimer

Version 1.2, March 2011 (November 2011). © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: March 2013.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.