Trilock
Generic Name
Olanzapine
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| trilock 5 mg tablet | ৳ 8.06 | ৳ 112.84 |
Description
Overview of the medicine
Olanzapine is an atypical antipsychotic medication primarily used to treat schizophrenia and bipolar disorder. It helps to restore the balance of certain natural substances in the brain.
Uses & Indications
Dosage
Adults
Schizophrenia: Initial dose of 10 mg once daily. Target dose 10-15 mg/day. Bipolar mania: Monotherapy 10-15 mg once daily. Adjunctive therapy: 10 mg once daily. Adjust dosage based on clinical response and tolerability, up to a maximum of 20 mg/day.
Elderly
A lower starting dose (e.g., 5 mg once daily) may be considered, particularly for those with factors that could lead to slower metabolism, such as female gender, non-smoking status, or impaired hepatic function.
Renal_impairment
No routine dosage adjustment is required for patients with mild to moderate renal impairment. For severe impairment, caution is advised and monitoring is recommended.
How to Take
Trilock tablets should be taken orally, once daily, with or without food. It is recommended to take the dose at approximately the same time each day to maintain consistent drug levels.
Mechanism of Action
Olanzapine acts as an antagonist at several receptors, including dopamine D1, D2, D3, D4, and D5, serotonin 5-HT2A, 5-HT2C, 5-HT3, and 5-HT6, muscarinic M1-M5, and alpha-1 adrenergic and histamine H1 receptors. Its antipsychotic effect is primarily attributed to its combined antagonism of dopamine D2 and serotonin 5-HT2A receptors.
Pharmacokinetics
Onset
Clinical improvement can be observed within a few days, with full therapeutic effects appearing over several weeks.
Excretion
Approximately 57% of the dose is excreted in the urine and 30% in the feces, mainly as metabolites.
Half life
Mean elimination half-life is 21-54 hours (average 33 hours), allowing for once-daily dosing.
Absorption
Rapidly and well absorbed after oral administration, reaching peak plasma concentrations within 5-8 hours. Absolute bioavailability is approximately 60%.
Metabolism
Extensively metabolized in the liver, primarily by direct glucuronidation and by the cytochrome P450 system (specifically CYP1A2 and, to a lesser extent, CYP2D6).
Side Effects
Contraindications
- Known hypersensitivity to olanzapine or any component of the formulation.
- Patients with narrow-angle glaucoma.
Drug Interactions
Dopamine Agonists
Olanzapine may antagonize the effects of dopamine agonists.
Antihypertensive Agents
May increase the risk of orthostatic hypotension.
CYP1A2 Inhibitors (e.g., Fluvoxamine)
May increase olanzapine plasma concentrations, requiring a reduction in olanzapine dose.
CYP1A2 Inducers (e.g., Carbamazepine, Rifampin)
May decrease olanzapine plasma concentrations, potentially requiring an increase in olanzapine dose.
CNS Depressants (e.g., Alcohol, Benzodiazepines)
May enhance the sedative effects of olanzapine.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, blurred vision, tachycardia, agitation, delirium, extrapyramidal symptoms, and respiratory depression. Management is supportive, including gastric lavage, activated charcoal, and monitoring of cardiovascular and respiratory functions.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Not recommended during breastfeeding as olanzapine is excreted in breast milk and may cause adverse effects in the infant.
Side Effects
Contraindications
- Known hypersensitivity to olanzapine or any component of the formulation.
- Patients with narrow-angle glaucoma.
Drug Interactions
Dopamine Agonists
Olanzapine may antagonize the effects of dopamine agonists.
Antihypertensive Agents
May increase the risk of orthostatic hypotension.
CYP1A2 Inhibitors (e.g., Fluvoxamine)
May increase olanzapine plasma concentrations, requiring a reduction in olanzapine dose.
CYP1A2 Inducers (e.g., Carbamazepine, Rifampin)
May decrease olanzapine plasma concentrations, potentially requiring an increase in olanzapine dose.
CNS Depressants (e.g., Alcohol, Benzodiazepines)
May enhance the sedative effects of olanzapine.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, blurred vision, tachycardia, agitation, delirium, extrapyramidal symptoms, and respiratory depression. Management is supportive, including gastric lavage, activated charcoal, and monitoring of cardiovascular and respiratory functions.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Not recommended during breastfeeding as olanzapine is excreted in breast milk and may cause adverse effects in the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture.
Availability
Pharmacies nationwide
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Olanzapine has been extensively studied in numerous clinical trials for its efficacy and safety in treating schizophrenia and bipolar disorder. These trials have demonstrated its effectiveness in reducing symptoms and preventing relapse.
Lab Monitoring
- Fasting blood glucose (at baseline, 4-6 weeks after initiation, then annually)
- Lipid panel (at baseline, 12 weeks after initiation, then annually)
- Weight and BMI (at baseline, monthly for first few months, then quarterly)
- Liver function tests (LFTs) periodically, especially in patients with pre-existing hepatic impairment or those taking other hepatotoxic drugs
- ECG (before treatment, especially in patients with cardiovascular risk factors)
Doctor Notes
- Prioritize regular monitoring of metabolic parameters (weight, BMI, fasting glucose, lipids) in all patients, especially those with pre-existing risk factors.
- Educate patients thoroughly about the potential for weight gain and strategies for mitigation.
- Consider dose adjustments for patients on CYP1A2 inhibitors or inducers.
- Advise patients against abrupt discontinuation to avoid withdrawal symptoms.
Patient Guidelines
- Take Trilock exactly as prescribed by your doctor.
- Do not stop taking Trilock suddenly without consulting your doctor, as this can lead to withdrawal symptoms.
- Report any new or worsening side effects to your doctor promptly.
- Be aware of the risk of weight gain and metabolic changes, and discuss management strategies with your healthcare provider.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
Driving Precautions
Trilock may cause drowsiness, dizziness, or blurred vision. Do not drive or operate machinery until you know how this medication affects you.
Lifestyle Advice
- Adopt a healthy diet and engage in regular physical activity to help manage potential weight gain.
- Avoid alcohol consumption while taking Trilock due to enhanced sedative effects.
- Regular monitoring of blood sugar and lipid levels is important.
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