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Zyprexa Relprevv , Zypr-0006-Uspi-20170123 Zypr

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Zyprexa Relprevv , Zypr-0006-Uspi-20170123 Zypr HIGHLIGHTS OF PRESCRIBING INFORMATION • Neuroleptic Malignant Syndrome: Manage with immediate discontinuation and close monitoring. (5.5) These highlights do not include all the information needed to use ZYPREXA RELPREVV safely and effectively. • Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Discontinue if DRESS is suspected. (5.6) See full prescribing information for ZYPREXA RELPREVV. • Metabolic Changes: Atypical antipsychotic drugs have been associated with metabolic changes including hyperglycemia, dyslipidemia, and weight gain. (5.7) ZYPREXA RELPREVV (olanzapine) For Extended Release Injectable Suspension • Hyperglycemia and Diabetes Mellitus: In some cases extreme and associated with ketoacidosis or Initial U.S. Approval: 1996 hyperosmolar coma or death, has been reported in patients taking olanzapine. Patients taking olanzapine should be monitored for symptoms of hyperglycemia and undergo fasting blood glucose testing at the WARNING: POST-INJECTION DELIRIUM/SEDATION SYNDROME AND INCREASED beginning of, and periodically during, treatment. (5.7) MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS • Dyslipidemia: Undesirable alterations in lipids have been observed. Appropriate clinical monitoring is See full prescribing information for complete boxed warning. recommended, including fasting blood lipid testing at the beginning of, and periodically during, treatment. (5.7) • Potential consequences of weight gain should be considered. Patients should receive regular • Patients are at risk for severe sedation (including coma) and/or delirium after each injection and must Weight Gain: monitoring of weight. (5.7) be observed for at least 3 hours in a registered facility with ready access to emergency response • Discontinue if clinically appropriate. (5.8) services. Because of this risk, ZYPREXA RELPREVV is available only through a restricted distribution Tardive Dyskinesia: • Orthostatic hypotension associated with dizziness, tachycardia, bradycardia and, in some program called ZYPREXA RELPREVV Patient Care Program and requires prescriber, healthcare facility, Orthostatic Hypotension: patients, syncope, may occur especially during initial dose titration. Use caution in patients with cardiovascular patient, and pharmacy enrollment. (2.1, 5.1, 5.2, 10.2, 17.2) disease, cerebrovascular disease, and those conditions that could affect hemodynamic responses. (5.9) • Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased • Leukopenia, Neutropenia, and Agranulocytosis: Has been reported with antipsychotics, including ZYPREXA. risk of death. ZYPREXA RELPREVV is not approved for the treatment of patients with dementia-related Patients with a history of a clinically significant low white blood cell count (WBC) or drug induced leukopenia/ psychosis. (5.3, 5.16, 17.3) neutropenia should have their complete blood count (CBC) monitored frequently during the first few months of therapy and discontinuation of ZYPREXA RELPREVV should be considered at the first sign of a clinically significant RECENT MAJOR CHANGES decline in WBC in the absence of other causative factors. (5.11) Warnings and Precautions: • Seizures: Use cautiously in patients with a history of seizures or with conditions that potentially lower the seizure Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) (5.6) 10/2016 threshold. (5.13) Falls (5.10) 01/2017 • Potential for Cognitive and Motor Impairment: Has potential to impair judgment, thinking, and motor skills. Use caution when operating machinery. (5.14) INDICATIONS AND USAGE • Hyperprolactinemia: May elevate prolactin levels. (5.17) ® ZYPREXA RELPREVV™ is a long-acting atypical antipsychotic for intramuscular injection indicated for the treatment • Laboratory Tests: Monitor fasting blood glucose and lipid profiles at the beginning of, and periodically during, of schizophrenia. (1.1) treatment. (5.18) Efficacy was established in two clinical trials in patients with schizophrenia: one 8-week trial in adults and one ADVERSE REACTIONS maintenance trial in adults. (14.1) Most common adverse reactions (≥5% in at least one of the treatment groups and greater than placebo) associated DOSAGE AND ADMINISTRATION with ZYPREXA RELPREVV treatment: headache, sedation, weight gain, cough, diarrhea, back pain, nausea, somnolence, 150 mg/2 wks, 300 mg/4 wks, 210 mg/2 wks, 405 mg/4 wks, or 300 mg/2 wks. See Table 1 for dosing dry mouth, nasopharyngitis, increased appetite, and vomiting. (6.1) recommendations. (2.1) To report SUSPECTED ADVERSE REACTIONS, contact Eli Lilly and Company at 1‑800‑LillyRx (1‑800‑545‑5979) ZYPREXA RELPREVV is intended for deep intramuscular gluteal injection only. or FDA at 1‑800‑FDA‑1088 or www.fda.gov/medwatch • Do not administer intravenously or subcutaneously. (2.1) DRUG INTERACTIONS • Be aware that there are two ZYPREXA intramuscular formulations with different dosing schedules. ZYPREXA • CNS Acting Drugs: Caution should be used when used in combination with other centrally acting drugs and alcohol. (7.2) IntraMuscular (10 mg/vial) is a short-acting formulation and should not be confused with ZYPREXA RELPREVV. (2.1) • Antihypertensive Agents: Enhanced antihypertensive effect. (7.2) • Establish tolerability with oral olanzapine prior to initiating treatment. (2.1) • Levodopa and Dopamine Agonists: May antagonize levodopa/dopamine agonists. (7.2) • ZYPREXA RELPREVV doses above 405 mg every 4 weeks or 300 mg every 2 weeks have not been evaluated in • Diazepam: May potentiate orthostatic hypotension. (7.1, 7.2) clinical trials. (2.1) • Alcohol: May potentiate orthostatic hypotension. (7.1) • Use in specific populations (including renal and hepatic impaired, and pediatric population) has not been studied. (2.1) • Carbamazepine: Increased clearance of olanzapine. (7.1) • Must be suspended using only the diluent for ZYPREXA RELPREVV provided in the convenience kit. (2.2) • Fluvoxamine: May increase olanzapine levels. (7.1) DOSAGE FORMS AND STRENGTHS USE IN SPECIFIC POPULATIONS Powder for suspension for intramuscular use only: 210 mg/vial, 300 mg/vial, and 405 mg/vial (3, 11, 16) • Pregnancy: ZYPREXA RELPREVV should be used during pregnancy only if the potential benefit justifies the potential CONTRAINDICATIONS risk to the fetus. (8.1) None. • Nursing Mothers: Breast-feeding is not recommended. (8.3) • Pediatric Use: Safety and effectiveness of ZYPREXA RELPREVV in children <18 years of age have not been WARNINGS AND PRECAUTIONS established. (8.4) • Elderly Patients with Dementia-Related Psychosis: Increased risk of death and increased incidence of cerebrovascular adverse events (e.g. stroke, transient ischemic attack). (5.3) • Suicide: The possibility of a suicide attempt is inherent in schizophrenia, and close supervision of high-risk See 17 for PATIENT COUNSELING INFORMATION and FDA-approved Medication Guide patients should accompany drug therapy. (5.4) Revised: 01/2017 FULL PRESCRIBING INFORMATION: CONTENTS* WARNING: POST-INJECTION DELIRIUM/SEDATION SYNDROME 5.17 Hyperprolactinemia 13 NONCLINICAL TOXICOLOGY AND INCREASED MORTALITY IN ELDERLY PATIENTS WITH 5.18 Laboratory Tests 13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility DEMENTIA-RELATED PSYCHOSIS 6 ADVERSE REACTIONS 13.2 Animal Toxicology and/or Pharmacology 1 INDICATIONS AND USAGE 6.1 Clinical Trials Experience 14 CLINICAL STUDIES 1.1 Schizophrenia 6.2 Extrapyramidal Symptoms 14.1 Schizophrenia 2 DOSAGE AND ADMINISTRATION 6.3 Other Adverse Reactions 16 HOW SUPPLIED/STORAGE AND HANDLING 2.1 Dosage 6.4 Postmarketing Experience 16.1 How Supplied 2.2 Instructions to Reconstitute and Administer ZYPREXA RELPREVV 7 DRUG INTERACTIONS 16.2 Storage and Handling 3 DOSAGE FORMS AND STRENGTHS 7.1 Potential for Other Drugs to Affect Olanzapine 17 PATIENT COUNSELING INFORMATION 7.2 Potential for Olanzapine to Affect Other Drugs 17.1 Information on Medication Guide 4 CONTRAINDICATIONS 8 USE IN SPECIFIC POPULATIONS 17.2 Post-Injection Delirium/Sedation Syndrome 17.3 Elderly Patients with Dementia-Related Psychosis: Increased 5 WARNINGS AND PRECAUTIONS 8.1 Pregnancy 5.1 Post-Injection Delirium/Sedation Syndrome Mortality and Cerebrovascular Adverse Events (CVAE), Including 8.2 Labor and Delivery 5.2 Prescribing and Distribution Program for ZYPREXA RELPREVV Stroke 8.3 Nursing Mothers 5.3 Elderly Patients with Dementia-Related Psychosis 17.4 Neuroleptic Malignant Syndrome (NMS) 8.4 Pediatric Use 5.4 Suicide 17.5 Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) 8.5 Geriatric Use 5.5 Neuroleptic Malignant Syndrome (NMS) 17.6 Hyperglycemia and Diabetes Mellitus 5.6 Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) 9 DRUG ABUSE AND DEPENDENCE 17.7 Dyslipidemia 5.7 Metabolic Changes 9.3 Dependence 17.8 Weight Gain 17.9 Orthostatic Hypotension 5.8 Tardive Dyskinesia 10 OVERDOSAGE 5.9 Orthostatic Hypotension 17.10 Potential for Cognitive and Motor Impairment 10.1 Human Experience 17.11 Body Temperature Regulation 5.10 Falls 10.2 Management of Overdose 5.11 Leukopenia, Neutropenia, and Agranulocytosis 17.12 Concomitant Medication 5.12 Dysphagia 11 DESCRIPTION 17.13 Alcohol 5.13 Seizures 12 CLINICAL PHARMACOLOGY 17.14 Use in Specific Populations 5.14 Potential for Cognitive and Motor Impairment 12.1 Mechanism of Action 5.15 Body Temperature Regulation 12.2 Pharmacodynamics *Sections or subsections omitted from the full prescribing information 5.16 Use in Patients with Concomitant Illness 12.3 Pharmacokinetics are not listed ZYPREXA RELPREVV (olanzapine) ZYPREXA RELPREVV
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