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Cited by 185Schizophrenia research and treatmentTreatment of Major DepressionHistorical Psychiatry and Medical Practices

Dose correspondence between olanzapine long-acting injection and oral olanzapine: recommendations for switching

Detke, Holland C., Zhao, Fangyi, Garhyan, Parag, Carlson, Janice, McDonnell, David·2011·International Clinical Psychopharmacology
DOI 10.1097/yic.0b013e32834093d1
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Abstract

Oral-to-depot dose correspondence was explored in a 24-week study of olanzapine long-acting injection (LAI). Patients with schizophrenia stabilized on oral olanzapine of 10, 15, or 20 mg/day (n=1065) were randomized to continue their oral treatment or switch directly to a fixed dose of olanzapine LAI [(mg/weeks) 45/4, 150/2, 405/4, or 300/2] without oral supplementation. Six-month relapse rates for each LAI-dose group stratified by earlier oral dose were analyzed using a Cox proportional hazard model assessing risk of relapse relative to each oral dose. Relapse rates for the therapeutic LAI doses (≥ 150 mg) varied depending on earlier oral dose, ranging from 1.5% (patients switched from 10 mg/day to 300 mg/2 weeks) to 18.8% (patients switched from 20 mg/day to 150 mg/2 weeks). Switching from 10 mg/day to 405 mg/4 weeks produced a comparable risk of relapse as remaining on that oral dose [Hazard ratio (HR)=1.03]. Switching from 15 or 20 mg/day to 300 mg/2 weeks produced comparable risk of relapse as remaining on those oral doses (HR=0.68 and 1.13, respectively). Pharmacokinetic modeling was conducted to evaluate the resulting dosing recommendations. Findings suggest that patients can be switched directly from oral to olanzapine LAI without the need for oral supplementation and with a low risk of relapse when initiated on an appropriate LAI dose.

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  • Although plasma concentrations of olanzapine can be lower after the first dose of olanzapine pamoate than those maintained by a corresponding oral dose, the concentrations achieved by the LAI dose are in the therapeutically effective range, suggesting that oral supplementation is not needed during LAI initiation.

    “Although plasma concentrations of olanzapine can be lower after the first dose of olanzapine pamoate than those maintained by a corresponding oral dose, the concentrations achieved by the LAI dose are in the therapeutically effective range, suggesting that oral supplementation is not needed during LAI initiation [73].”

    From Pharmacokinetic Characteristics of Long-Acting Injectable Antipsychotics for Schizophrenia: An Overview (2021) · cites this paper as [73]

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Authors
Detke, H. C., Zhao, F., Garhyan, P., Carlson, J., & McDonnell, D.
Affiliations
Eli Lilly (United States) (US)
Corresponding author
Detke, Holland C.
ORCID
Venue
International Clinical Psychopharmacology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2011-01
Volume
26
Issue
1
Pages
35-42
ISSN
0268-1315 (ISSN-L)
DOI
10.1097/yic.0b013e32834093d1
OpenAlex
W2090734001
Cited by
185
References
0
Citations by year
2026: 1 · 2025: 3 · 2024: 1 · 2023: 1 · 2021: 2 · 2020: 158 · 2017: 2 · 2014: 3 · 2013: 6 · 2012: 3
FWCI
3.05
Type
journal article
Language
en
Open access
closed
Locations
  • International Clinical Psychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Eli Lilly and Company
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
Keywords
schizophrenia, relapse risk, pharmacokinetic modeling, antipsychotic dosing
MeSH terms
Olanzapine, Administration, Oral, Adult, Aged, Benzodiazepines, Delayed-Action Preparations, Double-Blind Method, Drug Administration Routes, Female, Humans, Injections, Intramuscular, Male, Middle Aged, Recurrence, Schizophrenia, Antipsychotic Agents, Drug Substitution

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