Olanzapine pamoate LAI

Zyprexa Relprevv·Psychiatry - Depot Antipsychotics

Maintenance treatment of Schizophrenia

Authority requiredPBSDEPOT Q2-4WZyprexa RelprevvPowder for reconstitution+2

Max Dose

300 mg Q2W

Half-life

30 Days

PDSS Risk

CRITICAL

Monitoring

3 HOURS

Rapid Summary

Overview

A depot formulation of Olanzapine. Exceptional efficacy, but restricted by one of the most intense and dangerous post-injection monitoring protocols in modern psychiatry.

Maximum Dose

Max 300 mg every 2 weeks or 405 mg every 4 weeks.

Clinical Focus

Can cause Post-Injection Delirium/Sedation Syndrome (PDSS), where the drug accidentally hits a blood vessel, inducing a sudden, profound coma.

Bottom Line

Olanzapine pamoate LAI is a long-acting injectable olanzapine for treatment-resistant schizophrenia, but carries unique post-injection delirium/sedation syndrome (PDSS) requiring 3-hour observation.

Formulation & Access

Brand Names

Zyprexa Relprevv

Parenteral

Powder for reconstitution. Forms a thick yellow suspension.

Prescribing & PBS

Authority Required (PBS). Must be administered in a registered healthcare facility with resuscitation equipment.

Indications & Use

Primary

PBSTGA

Maintenance treatment of Schizophrenia.

Clinical Place

Reserved for severely non-compliant patients who respond brilliantly to oral olanzapine but fail on other depots. The strict monitoring limits its use in the community.

Quick reference

Class & Role

Zyprexa Relprevv — A depot formulation of Olanzapine.

Route / Formulation

Powder for reconstitution. Forms a thick yellow suspension. (Zyprexa Relprevv)

Usual Dose & Max

IM 150-300 mg every 2 weeks, or 300-405 mg every 4 weeks. Deep gluteal injection ONLY. Max 300 mg every 2 weeks or 405 mg every 4 weeks.

Key Indication Doses

Schizophrenia Maintenance: IM 150-300 mg every 2 weeks, or 300-405 mg every 4 weeks. Deep gluteal injection ONLY. Initiation: No oral overlap is strictly required if target depot doses are used, though 1-2 days of oral is often given to confirm tolerance.

Best Uses

Olanzapine pamoate LAI is a long-acting injectable olanzapine for treatment-resistant schizophrenia, but carries unique post-injection delirium/sedation syndrome (PDSS) requiring 3-hour observation.

Avoid / Cautions

Unmonitored administration environments. Severe CNS depression. Acute narrow-angle glaucoma. Pregnancy Category C.

Key Risks

Neurological: Post-Injection Delirium/Sedation Syndrome (PDSS). Presents within 1-3 hours of injection as severe ataxia, delirium, excessive sedation, and coma. Caused by accidental intravascular entry of the suspension. Metabolic: Massive weight gain, new-onset diabetes, extreme hyperlipidemia. Gastrointestinal: Constipation, dry mouth.

Key Interactions

Benzodiazepines/Opioids (Additive severe CNS depression). Smoking induces CYP1A2, accelerating olanzapine clearance.

Monitoring

The patient MUST remain in the clinic/ward and be physically observed by a nurse every 30 minutes for exactly 3 HOURS post-injection. They cannot leave early. They must not drive home. Strict routine BSL, HbA1c, Lipids, and Weight.

Clinical Pearl

When injecting, you MUST aspirate the syringe for 5-10 seconds before pushing the plunger. If ANY blood appears, you must withdraw and start again. If the pamoate salt hits a vein, it dissolves instantly, hitting the brain with 300mg of Olanzapine at once, causing a PDSS coma.

Access

Authority requiredZyprexa Relprevv

Brand: Zyprexa Relprevv
PBS status: Authority required

Olanzapine pamoate LAI

Zyprexa Relprevv·Psychiatry - Depot Antipsychotics

Maintenance treatment of Schizophrenia

Authority requiredPBSDEPOT Q2-4WZyprexa RelprevvPowder for reconstitution+2

Max Dose

300 mg Q2W

Half-life

30 Days

PDSS Risk

CRITICAL

Monitoring

3 HOURS

Rapid Summary

Overview

A depot formulation of Olanzapine. Exceptional efficacy, but restricted by one of the most intense and dangerous post-injection monitoring protocols in modern psychiatry.

Maximum Dose

Max 300 mg every 2 weeks or 405 mg every 4 weeks.

Clinical Focus

Can cause Post-Injection Delirium/Sedation Syndrome (PDSS), where the drug accidentally hits a blood vessel, inducing a sudden, profound coma.

Bottom Line

Olanzapine pamoate LAI is a long-acting injectable olanzapine for treatment-resistant schizophrenia, but carries unique post-injection delirium/sedation syndrome (PDSS) requiring 3-hour observation.

Formulation & Access

Brand Names

Zyprexa Relprevv

Parenteral

Powder for reconstitution. Forms a thick yellow suspension.

Prescribing & PBS

Authority Required (PBS). Must be administered in a registered healthcare facility with resuscitation equipment.

Indications & Use

Primary

PBSTGA

Maintenance treatment of Schizophrenia.

Clinical Place

Reserved for severely non-compliant patients who respond brilliantly to oral olanzapine but fail on other depots. The strict monitoring limits its use in the community.

Quick reference

Class & Role

Zyprexa Relprevv — A depot formulation of Olanzapine.

Route / Formulation

Powder for reconstitution. Forms a thick yellow suspension. (Zyprexa Relprevv)

Usual Dose & Max

IM 150-300 mg every 2 weeks, or 300-405 mg every 4 weeks. Deep gluteal injection ONLY. Max 300 mg every 2 weeks or 405 mg every 4 weeks.

Key Indication Doses

Best Uses

Olanzapine pamoate LAI is a long-acting injectable olanzapine for treatment-resistant schizophrenia, but carries unique post-injection delirium/sedation syndrome (PDSS) requiring 3-hour observation.

Avoid / Cautions

Unmonitored administration environments. Severe CNS depression. Acute narrow-angle glaucoma. Pregnancy Category C.

Key Risks

Key Interactions

Benzodiazepines/Opioids (Additive severe CNS depression). Smoking induces CYP1A2, accelerating olanzapine clearance.

Monitoring

Clinical Pearl

Access

Authority requiredZyprexa Relprevv

Brand: Zyprexa Relprevv
PBS status: Authority required