What indicates prescribing Olanzapine (Zyprexa) orally disintegrating tablet (ODT) instead of a regular tablet?

From the Guidelines

Zyprexa ODT should be prescribed instead of regular Zyprexa tablets for patients who have difficulty swallowing, such as the elderly or those with dysphagia, as well as for patients who require medication administration without water or have a history of non-compliance with traditional oral medications. The primary indication for prescribing Zyprexa ODT is for patients who have difficulty swallowing regular tablets, such as elderly patients, those with dysphagia, or patients who are non-compliant with traditional oral medications 1. Zyprexa ODT is also beneficial for patients who might try to "cheek" or hide regular tablets to avoid taking their medication, as the ODT formulation dissolves rapidly in the mouth and cannot be easily removed once placed on the tongue. Additionally, Zyprexa ODT may be appropriate for patients who need medication administration without water, including those in settings where water access is limited or for patients who are nauseated and have difficulty taking medications with fluids. Some key points to consider when prescribing Zyprexa ODT include:

• The ODT formulation contains the same active ingredient (olanzapine) as regular tablets and provides equivalent therapeutic effects, but its rapid dissolution improves absorption and potentially leads to faster onset of action in some cases 1.
• Zyprexa ODT may be used in patients with cancer, as olanzapine is listed as a pharmacological intervention that may have a role in the management of delirium symptoms in adult patients 1.
• However, it's essential to note that Zyprexa ODT contains phenylalanine, so it should be used with caution in patients with phenylketonuria.
• The dosage of Zyprexa ODT should be adjusted according to the patient's response and tolerance, with a recommended starting dose of 2.5-5 mg per day 1. In terms of specific patient populations, Zyprexa ODT may be particularly useful for:
• Elderly patients with dementia or other conditions that affect swallowing or medication compliance 1.
• Patients with a history of non-compliance with traditional oral medications, as the ODT formulation can help improve adherence to treatment regimens.
• Patients who require medication administration without water, such as those in palliative care or hospice settings.

From the FDA Drug Label

1. 3 Administration of ZYPREXA ZYDIS (olanzapine orally disintegrating tablets) 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.

The decision to prescribe Zyprexa ODT instead of regular tablet may be indicated for patients who have difficulty swallowing tablets. The orally disintegrating tablet formulation allows for easy administration without the need for water, making it a suitable option for patients with dysphagia or those who have trouble swallowing tablets. 2

From the Research

Indications for Prescribing Zyprexa ODT

The following points indicate when Zyprexa ODT (orally disintegrating tablet) may be preferred over the regular tablet:

• Dysphagia: Patients with difficulty swallowing may benefit from Zyprexa ODT, as it can be easily dissolved in the mouth without the need for water 3, 4, 5.
• Esophageal dysmotility: Patients with esophageal dysmotility or other swallowing disorders may find Zyprexa ODT easier to take than traditional tablets 3, 5.
• Mental illness: Patients with mental illnesses, such as schizophrenia or bipolar disorder, may experience dysphagia or other swallowing difficulties, making Zyprexa ODT a more suitable option 4, 6, 7.

Patient Factors to Consider

When deciding between Zyprexa ODT and regular tablets, consider the following patient factors:

• Age: Older patients may be more likely to experience dysphagia or swallowing difficulties, making Zyprexa ODT a better choice 4, 5.
• Gender: Female patients may be more likely to experience swallowing difficulties than male patients 4.
• Medical history: Patients with a history of dysphagia, esophageal dysmotility, or other swallowing disorders may benefit from Zyprexa ODT 3, 4, 5.