The usual initial dose for schizophrenia is 10 mg daily as a single dose by mouth, dosage adjustments may be according to response at intervals of not less than 24 hours to within the range of 5 to 20 mg daily.
For the treatment of acute mixed or manic episodes in bipolar disorder, a recommended initial dose is 10 or 15 mg daily by mouth as monotherapy or 10 mg if given as part of combination therapy; the daily dosage may be adjusted in increments or decrements of 5 mg if necessary, at intervals of not less than 24 hours to a dose of between 5 and 20 mg daily. If a response is achieved, therapy may continue at the same dosage to prevent recurrence. For prevention of recurrence in patients whose manic episodes have been responded previously to olanzapine, the recommended starting dose is 10 mg daily.
The metabolism of olanzapine might be slower in female elderly, or non-smoking patients; if more than one of these factors is present, a lower initial dose (e.g. 5 mg daily if given by mouth) and a more gradual dose escalation should be considered. The intramuscular dose should be reduced by half in the elderly.
Administration in hepatic or renal impairment: A starting dose of 5 mg daily of olanzapine by mouth or by intramuscular injection may be necessary for patients with renal or hepatic impairment; for patients with moderate hepatic insufficiency, the starting dose should only be increased with caution.
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