Patients should be treated initially with oral olanzapine before administering olanzapine pamoate, to establish tolerability and response.2

In order to identify the first olanzapine pamoate dose for all patients, the scheme in Recommended dose scheme between oral olanzapine and olanzapine pamoate should be considered.2

Some specific patient populations may require lower starting doses.1 For full information please refer to summary of product characteristics.

Patients should be monitored carefully for signs of relapse during the first one to two months of treatment.2

During antipsychotic treatment, improvement in the patient's clinical condition may take several days to some weeks. Patients should be closely monitored during this period.2

During treatment, dose may subsequently be adjusted on the basis of individual clinical status. After clinical reassessment, dose may be adjusted within the range 150 mg to 300 mg every 2 weeks or 300 to 405 mg every 4 weeks (Recommended dose scheme between oral olanzapine and olanzapine pamoate).2

Some specific patient populations may require cautious dose escalation.1 For full information please refer to summary of product characteristics.

Supplementation with oral olanzapine was not authorised in double-blind clinical studies.2

Antipsychotic supplementation is not required at the initiation of olanzapine pamoate treatment.2

If oral olanzapine supplementation is clinically indicated, then the combined total dose of olanzapine from both formulations should not exceed the corresponding maximum oral olanzapine dose of 20 mg/day.2

After a single intramuscular injection with olanzapine pamoate, the slow dissolution of the olanzapine pamoate salt in muscle tissue begins immediately and provides a slow continuous release of olanzapine for more than four weeks.2

During the initial three months of treatment with olanzapine pamoate, accumulation of olanzapine was observed but there was no additional accumulation during long-term use (12 months) in patients who were injected with up to 300 mg every two weeks.2