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Zyprexa Summary of Product Characteristics (SmPC)
Information on signs and symptoms of olanzapine overdose and its management.
Signs
and symptoms
Very
common symptoms in overdose (> 10 % incidence) include
tachycardia, agitation/aggressiveness, dysarthria, various
extrapyramidal symptoms, and reduced level of consciousness ranging
from sedation to coma.
Other
medically significant sequelae of overdose include delirium,
convulsion, coma, possible neuroleptic malignant syndrome,
respiratory depression, aspiration, hypertension or hypotension,
cardiac arrhythmias (< 2 % of overdose cases) and cardiopulmonary
arrest. Fatal outcomes have been reported for acute overdoses as low
as 450 mg but survival has also been reported following acute
overdose of approximately 2 g of oral olanzapine.
Management
There
is no specific antidote for olanzapine. Induction of emesis is not
recommended. Standard procedures for management of overdose may be
indicated (i.e. gastric lavage, administration of activated
charcoal). The concomitant administration of activated charcoal was
shown to reduce the oral bioavailability of olanzapine by 50 to 60 %.
Symptomatic
treatment and monitoring of vital organ function should be instituted
according to clinical presentation, including treatment of
hypotension and circulatory collapse and support of respiratory
function. Do not use epinephrine, dopamine, or other sympathomimetic
agents with beta- agonist activity since beta stimulation may worsen
hypotension. Cardiovascular monitoring is necessary to detect
possible arrhythmias. Close medical supervision and monitoring should
continue until the patient recovers.
REFERENCE
Zyprexa
[Summary of Product Characteristics]. Utrecht, The Netherlands: Eli
Lilly Nederland B.V.
Date of Last Review:December 07, 2018
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