Zipol-B
Generic Name
Zipol-B
Manufacturer
Medi Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zipol b tablet | ৳ 3.00 | N/A |
Description
Overview of the medicine
Zipol-B is a combination medication containing Olanzapine and Fluoxetine, used to treat bipolar depression and treatment-resistant depression.
Uses & Indications
Dosage
Adults
Typically 6 mg Olanzapine / 25 mg Fluoxetine once daily in the evening, may be adjusted based on clinical response and tolerability.
Elderly
Lower starting doses (e.g., 3 mg Olanzapine / 25 mg Fluoxetine) may be considered, with careful titration.
Renal_impairment
No specific dose adjustment recommended for mild to moderate renal impairment, but caution is advised. Severe impairment may require dose reduction.
How to Take
Take orally once daily in the evening, with or without food. Swallow the capsule whole.
Mechanism of Action
Olanzapine acts on multiple neurotransmitter receptors, including dopamine (D1, D2, D4) and serotonin (5-HT2A, 5-HT2C) receptors. Fluoxetine selectively inhibits the reuptake of serotonin in the central nervous system.
Pharmacokinetics
Onset
Antidepressant effects of fluoxetine may take 2-4 weeks. Olanzapine's effects on psychosis may be seen within days.
Excretion
Primarily renal excretion, with a small portion excreted in feces.
Half life
Olanzapine has a mean elimination half-life of 21-54 hours. Fluoxetine has a half-life of 4-6 days, and its active metabolite norfluoxetine has a half-life of 4-16 days.
Absorption
Both olanzapine and fluoxetine are well absorbed orally. Peak plasma concentrations are reached in about 6 hours for olanzapine and 6-8 hours for fluoxetine.
Metabolism
Both are extensively metabolized in the liver. Olanzapine primarily by direct glucuronidation and CYP1A2. Fluoxetine by CYP2D6 to norfluoxetine.
Side Effects
Contraindications
- •Hypersensitivity to Olanzapine or Fluoxetine
- •Concomitant use with MAO inhibitors or within 14 days of discontinuing an MAOI
- •Untreated narrow-angle glaucoma
Drug Interactions
MAO inhibitors
Serious, sometimes fatal, reactions including Serotonin Syndrome.
CNS depressants
Additive CNS depressant effects with alcohol, benzodiazepines, hypnotics.
Other serotonergic drugs
Increased risk of Serotonin Syndrome (e.g., triptans, TCAs, fentanyl, lithium, tramadol, St. John's Wort).
CYP1A2 inhibitors (e.g., fluvoxamine)
Increased olanzapine levels.
CYP2D6 inhibitors (e.g., quinidine, fluoxetine)
Increased levels of drugs metabolized by CYP2D6; fluoxetine itself is a strong CYP2D6 inhibitor.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, tachycardia, hypotension, CNS depression, and rarely, seizures or NMS. Management involves supportive care, maintaining airway, and monitoring vital signs. Gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Not recommended during pregnancy unless the potential benefits outweigh the risks. May cause neonatal withdrawal symptoms if used in the third trimester. Avoid during lactation as both components are excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Patent expired (for individual components)
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Global Brand Names
International brand names for this medicine
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