Elderly patients with dementia-related psychosis
Elderly patients who have dementia-related psychosis
and who are undergoing treatment with antipsychotic drugs are at an increased risk when using this medicine. Such patients are at an increased risk of side-effect
such as stroke
, temporary disruption in the supply of blood to a part of the brain (transient ischemic attack) and fatal conditions. The use of this medicine is not recommended in such patients.
Suicidal ideation and thoughts
The possibility to attempt suicide
is seen frequently in patients who have schizophrenia
and bipolar-I disorder. Close supervision of patients at high risk should be done along with drug therapy. Prescription for Olanzapine should be written for the smallest quantity which is consistent with good patient management, so as to reduce the risk of overdose.
Rare, life-threatening and unusual reaction to antipsychotic drugs (neuroleptic malignant syndrome, NMS)
Patients who are on treatment with antipsychotic drugs are at an increased risk when using this medicine. Such patients may experience an increased risk of elevated body temperature, muscle rigidity, altered mental status, irregular pulse or blood pressure, sweating (diaphoresis), increased or decreased heartbeat, increased enzyme levels (creatinine
phosphokinase), the presence of myoglobin in the urine (myoglobinuria
) and kidney damage. Careful medical monitoring, as well as treatment according to symptoms, is required in such patients.
High blood sugar levels (hyperglycemia)
Patients undergoing therapy with Olanzapine are at an increased risk of high blood sugar levels. Such patients may develop symptoms such as the feeling of extreme thirstiness (polydipsia
), abnormally large production of urine, excessive eating with increased appetite (polyphagia
), and weakness. Patients who develop these symptoms while undergoing treatment with atypical antipsychotics should undergo fasting blood glucose testing to monitor the worsening of glucose control.
High levels of lipids in the blood (hyperlipidemia)
Undesirable changes in lipid
levels have been observed in patients who are on treatment with Olanzapine. Such patients should undergo monitoring of lipid levels in the blood.
The patients who are on treatment with Olanzapine are at an increased risk to experience weight gain. Patients who are on treatment with Olanzapine should undergo regular monitoring of body weight.
Involuntary body movements (tardive dyskinesia)
Elderly patients, especially elderly women are at an increased risk when using this medicine. Such patients may develop involuntary body movements when using this medicine. If any of these symptoms appear, discontinue the use of this medicine.
Low blood pressure while standing up from sitting or lying posture
Patients with known history of heart problems and those who are on treatment with other drugs are at an increased risk when using this medicine. Such patients may experience symptoms such as dizziness
, increased or decreased heartbeat and fainting
. Take necessary precautions while using this medicine in such patients.
Patients with history of drug induced leukopenia/neutropenia
Patients who are on treatment with antipsychotic drugs, who have low white blood cell count and patients who have a history of blood disorders are at an increased risk when using this medicine. Such patients should be monitored adequately for the presence of any infection or fever
. Discontinue the use of Olanzapine in patients suffering from severe neutropenia
Difficulty in swallowing (dysphagia)
Patients using Olanzapine are at an increased risk of developing dysphagia
and a condition where food, liquids, saliva or vomit is breathed into the airways (aspiration) and dysphagia
Patients who are on treatment with antipsychotic drugs including Olanzapine and patients who have a history of seizures
are at an increased risk when using this medicine. Olanzapine should be used with caution in patients who have a history of seizures or conditions that lower the susceptibility of patients to seizures (seizure threshold) such as Alzheimer’s dementia
Abnormal functioning of the brain
The patients who are on treatment with Olanzapine are at an increased risk to experience sleepiness along with problems in thinking, memory
, and movement functions. Olanzapine should be used with caution due to its effects on memory and movement functions, and therefore the use of machinery and automobiles should be done cautiously.
Body temperature regulation
Patients using Olanzapine may experience disrupted ability of the body to reduce body temperature during heavy exercise
, exposure to extreme heat, receiving medicine in combination with anticholinergic activity, and dehydration
. Appropriate care is advised when Olanzapine is prescribed to patients who may experience increased body temperature.
Patients with existing illness
Patients with enlarged prostate gland (prostatic hypertrophy), eye disorder (narrow-angle glaucoma
), blockage of intestine due to paralysis
of intestinal muscles (history of paralytic ileus
), and elderly patients with dementia-related psychosis
are at an increased risk when using this medicine. Such patients may experience symptoms such as falls
, sleepiness, accumulation of the fluid in the body, abnormal gait, unintentional passage of urine (urinary incontinence), drowsiness, increased weight, lack of energy, fever
, lung infection (pneumonia
), dry mouth and visual hallucinations
. The use of Olanzapine is not recommended for the treatment of patients with dementia-related psychosis.
Increased levels of prolactin hormone (hyperprolactinemia)
Patients who are on treatment with Olanzapine may experience an increased risk of elevated prolactin levels. Hyperprolactinemia
may lead to reduced reproductive function in both males and females patients which further results in decreased bone density.