Psychopharmacologic Drugs : Antipsychotics
IZYPR1 “Zyprexa injection” 10 mg/vial
OZYPR5 “Zyprexa Zydis OD tablet” 5 mg/tab
適應症：
IZYPR1：成人精神分裂及成人雙極性第I型躁症之激動症狀。
OZYPR5：精神分裂症及其它明顯有正性及/或負性之精神病，雙極性疾患之躁期發作，預防雙極性疾患之復發。
Usual dose:
Bipolar I disorder, acute mixed or manic episodes: PO
10-15 mg/day, dose adjustments should be made in 5 mg increments in intervals > 24 h, max. 20 mg/day; maintenance, 5-20 mg/day.
Schizophrenia: PO
5-10 mg/day, with a target dose 10 mg/day within several days; further dose adjustments should be made in 5 mg increments on a wk basis; max. 20 mg/day.
Dose adjustment:
Geriatric: 5 mg PO/IM qd.
Adverse effect:
Common: chest pain, orthostatic hypotension, peripheral edema, tachyarrhythmia, hypercholesterolemia, hyperglycemia, increased appetite, prolactin level raised, serum triglycerides raised, weight gain, constipation, indigestion, xerostomia, arthralgia, backache, pain in limb, abnormal gait, akathisia, asthenia, dizziness, extrapyramidal disease, parkinsonian, somnolence, tremor, agitation, personality disorder, cough, rhinitis, accidental injury, fever.
Serious: diabetic ketoacidosis, tardive dyskinesia, death.
健保使用規範：
1.需合乎衛生主管機關許可之適應症範圍，並需符合下列條件 (1)開始使用「第二代抗精神病藥品」時需於病歷記載：醫療理由或診斷，以及臨床整體評估表(CGI)之分數；(2)經規則使用六至八週後，需整體評估其療效，並於病歷記載：臨床整體評估表之分數：(3)日劑量超過20 mg/day，須於病歷記載理由。
2.本類藥品不得使用於雙極性疾患之鬱症發作。(95/10/1)
3.用於預防雙極性疾患復發時，限lithium、carbamazepine、valproate等藥品至少使用兩種以上，治療無效或無法耐受副作用時使用(91/9/1, 92/1/1, 92/7/1, 94/1/1, 95/10/1, 97/5/1)。