【药品名称 英文名：Olanzapine(Zyprexa) 正式名: 奥氮平[Olanzapine] 商品名: 再普乐[ZYPREXA] 【药理作用】 奥氮平是一种抗精神病药，对多种受体系统具有药理作用。动物试验表明，奥氮平对5-HT、多巴胺D、α-肾上腺素、组胺H等多种受体有亲和力。动物行为研究表明，奥氮平具有5-HT、多巴胺和胆碱能拮抗作用，与其受体结合情况相符。奥氮平的体外和体内5-HT2受体亲和力大于其与多巴胺D2受体的亲和力。电生理研究表明，奥氮平选择性地减少间脑边缘系统（A10）多巴胺能神经元的放电，而对纹状体（A9）的运动功能通路影响很小。奥氮平在低于产生僵住反应的剂量水平时能减少条件性回避反应。与其它抗精神病药不同，奥氮平在抗焦虑测试中能增加反应。对照临床试验结果表明，奥氮平能显著改善阴性及阳性症状。 【适应症】 奥氮平用于治疗精神分裂症。 初始治疗有效的患者，奥氮平在维持治疗期间能够保持其临床效果。 奥氮平用于治疗中、重度躁狂发作。 对奥氮平治疗有效的躁狂发作患者，奥氮平可用于预防双相情感障碍的复发。 【用法用量】 精神分裂症： 奥氮平的建议起始剂量为10mg/天，每日一次，与进食无关。 在精神分裂症的治疗过程中，可以根据患者的临床状态调整日剂量为5－20mg/天。建议经过适当的临床评估后，剂量可增加至10mg/天的常规剂量以上，加药间隔不少于24小时。停用奥氮平时应逐渐减少剂量。 躁狂发作： 单独用药时起始剂量为每日15mg，合并治疗时每日10mg。 预防双相情感障碍复发： 推荐起始剂量为10mg/日。对于使用奥氮平治疗躁狂发作的患者，预防复发的持续剂量同前。对于新发躁狂、混合发作或抑郁发作，应继续奥氮平治疗（需要时剂量适当调整），同时根据临床情况合并辅助药物治疗情感症状。 在精神分裂症、躁狂发作和双相情感障碍的预防治疗过程中，可根据个体临床状况不同，在5－20mg/日的范围内相应调整每日剂量。建议仅在适当的临床再评估后方可使用超过推荐剂量的药物，且加药间隔不少于24小时。停用奥氮平时应逐渐减少剂量。 任何疑问，请遵医嘱！ 【禁忌症】 本品禁用于已知对奥氮平过敏的患者。 本品慎用于有下列情况的患者： 1.有癫痫史或有癫痫相关疾病者； 2.任何原因所致的白细胞和/或中性粒细胞降低者； 3.有药物所致骨髓抑制/毒性反应史者； 4.伴发疾病、放疗或化疗所致的骨髓抑制； 5.嗜酸性粒细胞过多性疾病或骨髓及外骨髓增生性疾病； 6.前列腺增生、麻痹性肠梗阻和窄角性青光眼患者。 【不良反应】 临床试验中与奥氮平使用有关的主要不良反应是嗜睡和体重增加。在有痴呆的老年患者中，与奥氮平治疗有关的死亡率和脑血管不良事件比安慰剂高。少数患者在治疗中出现血糖和甘油三脂水平升高。奥氮平对血浆催乳素浓度影响甚微，因而无男性乳房增大、泌乳和女性月经紊乱、闭经等临床表现。偶见不良反应包括头晕，静坐不能，口干，便秘，外周水肿，直立性低血压及肝转氨酶－过性升高。 【注意事项】 奥氮平可引起嗜睡，从事危险作业时应谨慎。若和酒精同服，可使奥氮平的镇静作用增强。患者长期服用抗精神病药（包括奥氮平），如果出现迟发性运动障碍的体征或症状，应减药或停药。若出现神经阻滞剂恶性综合症（NMS）的临床表现（如：高热肌强直精神状态改变及植物神经紊乱等），应立即停用所有抗精神病药，包括奥氮平。 【原产地英文商品名】ZYPREXA RELPREVV 210mg/vial 【原产地英文药品名】OLANZAPINE PAMOATE 【中文参考商品译名】 注：以下产品是不同规格和不同的价格，购买时请以电话咨询为准 ·再普乐 RELPREVV 210毫克/瓶 ·再普乐 RELPREVV 300毫克/瓶 ·再普乐 RELPREVV 405毫克/瓶 ·再普乐片剂 15毫克/片 30片/瓶 ·再普乐片剂 10毫克/片 30片/瓶 ·再普乐片剂 5毫克/片 30片/瓶 ·再普乐片剂 7.5毫克/片 30片/瓶 ·再普乐片剂 2.5毫克/片 30片/瓶 ·再普乐片剂 20毫克/片 30片/瓶 ·再普乐 ZYDIS 10毫克/片 30片/瓶 ·再普乐 ZYDIS 15毫克/片 30片/瓶 ·再普乐 ZYDIS 20毫克/片 30片/瓶 ·再普乐 ZYDIS 5毫克/片 30片/瓶 【中文参考药品译名】奥氮平 PAMOATE 【生产厂家中文参考译名】礼来 【生产厂家英文名】LILLY ZYPREXA (olanzapine) Tablet for Oral use ZYPREXA ZYDIS (olanzapine) Tablet, Orally Disintegrating for Oral use ZYPREXA IntraMuscular (olanzapine) Injection, Powder, For Solution for Intramuscular use What is Zyprexa? Zyprexa (olanzapine) is an atypical antipsychotic medication. Exactly how it works is not known. It is thought to work by changing the actions of certain chemicals in the brain. Zyprexa is used to treat the symptoms of psychotic conditions such as schizophrenia and bipolar disorder (manic depression) in adults and children who are at least 13 years old. Zyprexa is sometimes used together with other antipsychotic medications or antidepressants. Zyprexa may also be used for other purposes not listed in this medication guide. ------------------------------------------------------- Important information about Zyprexa Zyprexa is not for use in psychotic conditions related to dementia. Zyprexa may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions. You may gain weight or have high cholesterol and triglycerides (types of fat) while taking this medicine, especially if you are a teenager. Your blood may need to be tested often. Visit your doctor regularly. Zyprexa can cause high blood sugar (hyperglycemia). If you are diabetic, check your blood sugar levels on a regular basis while you are taking Zyprexa. Zyprexa may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Avoid drinking alcohol while taking Zyprexa. Avoid becoming overheated or dehydrated. Drink plenty of fluids, especially in hot weather and during exercise. It is easier to become dangerously overheated and dehydrated while you are taking Zyprexa. ------------------------------------------------------- Before taking Zyprexa Zyprexa is not for use in psychotic conditions related to dementia. Zyprexa may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions. You should not take Zyprexa if you are allergic to it. If you have any of these other conditions, your doctor may need to adjust the dose of Zyprexa or order special tests: liver disease; heart disease, high or low blood pressure; a history of low white blood cell (WBC) counts; high cholesterol or triglycerides; a history of heart failure, heart attack, or stroke; a history of breast cancer; seizures or epilepsy; diabetes; an enlarged prostate or difficulty urinating; bowel problems; or narrow-angle glaucoma. FDA pregnancy category C. It is not known whether Zyprexa will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Olanzapine can pass into breast milk and may harm a nursing baby. You should not breast-feed while using Zyprexa. See also: Pregnancy and breastfeeding warnings in more detail The Zyprexa orally disintegrating tablet (Zyprexa Zydis) may contain phenylalanine. Talk to your doctor before using this form of olanzapine if you have phenylketonuria (PKU). ------------------------------------------------------- How should I take Zyprexa? Take Zyprexa exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Zyprexa can be taken with or without food. Zyprexa is usually taken once a day. This medicine may be only part of a complete program of treatment that also includes counseling and other psychological support programs. Follow your doctor's instructions. Call your doctor if your symptoms do not improve, or if they get worse while using Zyprexa. Do not stop taking Zyprexa suddenly without first talking to your doctor, even if you feel fine. You may have serious side effects if you stop taking Zyprexa suddenly. To take olanzapine orally disintegrating tablets (Zyprexa Zydis): Keep the tablet in its blister pack until you are ready to take it. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet. Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet. Zyprexa can cause high blood sugar (hyperglycemia). If you are diabetic, check your blood sugar levels on a regular basis while you are taking Zyprexa. You may gain weight or have high cholesterol and triglycerides (types of fat) while taking this medicine, especially if you are a teenager. Your blood may need to be tested often. Visit your doctor regularly. If you are taking a combination of drugs, use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Store at room temperature away from moisture, heat, and light. See also: Zyprexa dosage in more detail ------------------------------------------------------- What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. ------------------------------------------------------- What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include drowsiness, agitation, aggression, slurred speech, confusion, increased heart rate, jerky or uncontrolled muscle movements, trouble breathing, or fainting. ------------------------------------------------------- What should I avoid while taking Zyprexa? Zyprexa may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Drinking alcohol can increase sleepiness caused by Zyprexa. Avoid becoming overheated or dehydrated. Drink plenty of fluids, especially in hot weather and during exercise. It is easier to become dangerously overheated and dehydrated while you are taking Zyprexa. ------------------------------------------------------- Zyprexa side effects Get emergency medical help if you have any of these signs of an allergic reaction to Zyprexa: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Zyprexa and call your doctor at once if you have any of these serious side effects: very stiff (rigid) muscles, high fever, tremors, sweating, confusion, fast or uneven heartbeats, slow heart rate, feeling like you might pass out; twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs; trouble speaking or swallowing; dry mouth, thirst, feeling very hot (with or without sweating), urinating less than usual or not at all; high blood sugar (increased thirst, loss of appetite, fruity breath odor, increased urination, drowsiness, dry skin, nausea, and vomiting); sudden numbness or weakness, confusion, or problems with vision, speech, or balance; fever, chills, body aches, flu symptoms, sores in your mouth and throat; swelling in your hands or feet; changes in personality, unusual thoughts or behavior, hallucinations, or thoughts about hurting yourself; or upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes). Less serious Zyprexa side effects may include: weight gain (more likely in teenagers), increased appetite; headache, dizziness, drowsiness, feeling tired or restless; memory problems; stomach pain, constipation, loss of bladder control; back pain, pain in your arms or legs; numbness or tingly feeling; breast swelling or discharge (in women or men); or missed menstrual periods. This is not a complete list of Zyprexa side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. See also: Zyprexa side effects (in more detail) ------------------------------------------------------- What other drugs will affect Zyprexa? Before using Zyprexa, tell your doctor if you regularly use other medicines that can make you sleepy or slow your breathing (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to the side effects of Zyprexa. Tell your doctor about all other medicines you use, especially: heart or blood pressure medication; carbamazepine (Tegretol); diazepam (Valium); fluoxetine and olanzapine (Symbyax); fluvoxamine (Luvox); omeprazole (Prilosec); rifampin (Rifater, Rifadin, Rifamate); or a medication to treat Parkinson's disease including levodopa (Sinemet, Larodopa, Atamet), selegiline (Eldepryl, Emsam), pramipexole (Mirapex), ropinirole (Requip), and others. This list is not complete and other drugs may interact with Zyprexa. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. ------------------------------------------------------- Where can I get more information? Your pharmacist can provide more information about Zyprexa. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.