Zyprexa Adhera is a new formulation of Eli LIlly’s
antipsychotic medication, olanzapine.
It contains the same active ingredient as the pills, but it
is a long-acting injection. It is supposed to last two to
There is not a lot of specific information available yet. It
is not on the market yet, either. The milestone is that in
was just recommended for approval by the FDA.
Background: after a drug is developed, but before it is marketed, it
goes through a lengthy evaluation by the FDA. Near the end of
this process, an expert panel meets to make a preliminary, nonbinding
recommendation. Drugs that receive such a recommendation
usually are approved.
In this case, the Psychopharmacologic
Drugs Advisory Committee met
on 6 February 2008. They voted
10 to zero for approval. Now it should be a matter of a few
months before the product receives final approval. It
probably will be on pharmacy shelves shortly after that.
What is it for? First, let me say what it is not for.
It is not for treatment of any kind of emergency situation.
If a person with psychosis is seriously out of touch with
reality, and would benefit from rapid control of symptoms, Zyprexa
Adhera is not the drug to use. Long-acting injectable
antipsychotic medication takes weeks or months to have any effect.
As a general rule, if a drug is given repeatedly, the amount of the
drug in the person’s bloodstream will increase with each successive
dose. (That assumes the half-life is not a lot shorter than
the interval between doses.) It takes about five half-lives
to reach a peak.
A drug that is intended to be given at intervals of two weeks would
have a very long half-life. That means it would take a very
long time to reach a peak.
For this reason, Zyprexa Adhera would not have any effect in an
emergent or urgent situation. Rather, its intended use is for
persons with chronic psychosis who, for whatever reason, may not take
pills every day. Naturally, it would be appropriate to use it
only when the expected benefit outweighs the risks. That
calculation is a very individualized matter. So much so, that
it would not be useful (or even meaningful) to make general
recommendation in a blog post.