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Dose correspondence between olanzapine long-acting injection and oral olanzapine: recommendations for switching
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 [73].”
From Pharmacokinetic Characteristics of Long-Acting Injectable Antipsychotics for Schizophrenia: An Overview (2021) · cites this paper as [73]
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Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.099
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.025
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.022
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.030
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.023
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.068
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.041
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.092
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.004
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.067
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.039
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.047
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.065
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.084
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.002
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.057
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.013
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.003
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.079
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.091
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.042
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.006
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.038
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.005
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.100
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.110
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0152
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0145
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0128
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.119
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0106
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0144
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0143
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.146
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0132
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0147
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.113
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0130
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.101
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.115
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0156
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0123
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0150
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0124
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0139
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.126
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.111
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.155
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.121
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0131
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.114
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.141
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0105
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0153
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.118
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0112
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0129
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.116
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0103
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0135
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0109
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.151
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0149
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.104
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0120
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0142
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0125
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0154
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.136
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.137
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0138
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0107
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.102
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.127
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.140
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0108
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.117
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.133
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0122
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0134
Stahl, S. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108921275.0148
Bediako-Kakari, P., Monyo, M., Atoyebi, S., & Olagunju, A. (2024) · medRxiv · doi:10.1101/2024.10.22.24315924
“Additionally, the most recommended starting oral dose for olanzapine is 10 - 15 mg once daily, with corresponding LAI doses being 300 and 405 mg once monthly respectively 66-68 .”
BackgroundGrabowski, J., Bidzan, L., & Brzozowska, A. (2025) · Pharmaceuticals · doi:10.3390/ph18091366
“Using more recent sources, equivalent doses were established for atypical drugs [101], including risperidone long-acting injectable (LAI) [102] and olanzapine LAI [103,104], as well as for first-generation extended-release haloperidol (based on a bioavailability study) [105].”
Pharmacokinetic aspects of the second generation long acting injectable antipsychotics
Hýža, M., & Skřont, T. (2025) · Psychiatrie pro praxi · doi:10.36290/psy.2025.025
Strawn, J. R., & Stahl, S. M. (2026) · doi:10.1017/9781009642187.047
Metadata
- Authors
- Detke, H. C., Zhao, F., Garhyan, P., Carlson, J., & McDonnell, D.
- Affiliations
- Eli Lilly (United States) (US)
- Corresponding author
- Detke, Holland C.
- Venue
- International Clinical Psychopharmacology
- Published
- 2011-01
- Volume
- 26
- Issue
- 1
- Pages
- 35-42
- ISSN
- 0268-1315 (ISSN-L)
- 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 (medical) › 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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