Can Zyprexa Velotab Be Split in Half?
No, you should not split Zyprexa Velotab (olanzapine orally disintegrating tablets) in half. The Velotab formulation is specifically designed as an orally disintegrating tablet that dissolves rapidly in the mouth and is not intended to be split.
Why Velotab Should Not Be Split
The FDA-approved prescribing information for Zyprexa Velotab provides clear administration instructions: "After opening sachet, peel back foil on blister. Do not push tablet through foil. Immediately upon opening the blister, using dry hands, remove tablet and place entire ZYPREXA ZYDIS in the mouth. Tablet disintegration occurs rapidly in saliva so it can be easily swallowed with or without liquid" 1. These instructions emphasize placing the entire tablet in the mouth, not a portion of it.
Key Reasons Against Splitting:
Formulation design: Orally disintegrating tablets (ODTs) are engineered with a specific matrix that allows rapid dissolution. Splitting disrupts this matrix and can lead to uneven drug distribution 2
Handling difficulties: The Velotab is designed to be fragile and dissolve quickly. This makes it extremely difficult to split accurately without crumbling or losing drug content 3
Dose accuracy concerns: Research on tablet splitting shows that even with conventional tablets, 15-16% of half tablets fall outside acceptable weight and content uniformity specifications 4. ODTs would be even more problematic given their friable nature
Alternative Dosing Options
If dose adjustment is needed, use the appropriate strength of intact Velotab tablets rather than splitting. Zyprexa Velotab is available in multiple strengths (2.5 mg, 5 mg, 10 mg, 15 mg, and 20 mg) 1, allowing for precise dosing without the need to split tablets.
For patients requiring doses between available strengths:
- Consider using standard oral olanzapine tablets if splitting is absolutely necessary for dose titration, as these are more suitable for division than ODTs
- Work with your pharmacist to obtain the appropriate tablet strength rather than splitting
Clinical Context
The Velotab formulation was specifically developed to improve medication adherence, particularly in patients who may hide or "cheek" standard tablets 5, 2. Splitting defeats this purpose and introduces unnecessary variability in dosing. The rapid dissolution in the mouth (within seconds) makes it impractical to handle a split portion effectively.
Bottom line: Use intact Velotab tablets at the prescribed strength. If dose adjustment is needed, prescribe a different tablet strength rather than instructing patients to split the orally disintegrating formulation.