Advanced

Therapeutic drug monitoring data on olanzapine and its N-demethyl metabolite in the naturalistic clinical setting

Skogh, E; Reis, Margareta LU ; Dahl, ML; Lundmark, J and Bengtsson, F (2002) In Therapeutic Drug Monitoring 24(4). p.518-526
Abstract
Olanzapine (Zyprexa(R)) was approved for general prescription in Sweden in November 1996, and an HPLC-based therapeutic drug monitoring (TDM) routine for serum olanzapine (OLA) and its major metabolite. N-demethylolanzapine (DMO) was established in February 1997. During 1997 to 1999, a total of 753 TDM requests for a total of 545 Swedish patients was analyi.ed. Additional patient information oil certain clinical variables was collected on specifically designed TDM request forms. After the exclusion process. samples from 194 patients were found to be eligible for further scrutiny. The concentration-to-dose (C/D) ratio for OLA varied 25-fold and that of DMO 22-fold. Women had a higher (P < 0.01) median C/D ratio for OLA than men (median,... (More)
Olanzapine (Zyprexa(R)) was approved for general prescription in Sweden in November 1996, and an HPLC-based therapeutic drug monitoring (TDM) routine for serum olanzapine (OLA) and its major metabolite. N-demethylolanzapine (DMO) was established in February 1997. During 1997 to 1999, a total of 753 TDM requests for a total of 545 Swedish patients was analyi.ed. Additional patient information oil certain clinical variables was collected on specifically designed TDM request forms. After the exclusion process. samples from 194 patients were found to be eligible for further scrutiny. The concentration-to-dose (C/D) ratio for OLA varied 25-fold and that of DMO 22-fold. Women had a higher (P < 0.01) median C/D ratio for OLA than men (median, 7.2 nmol/L/mg, vs 5.2 nmol/L/mg). Nonsmokers had a higher (P < 0.001) C/D ratio for OLA than smokers (median, 9.2 nmol/L/mg vs 4.0 nmol/L/mg). Smokers got higher prescribed (P < 0.05) doses of OLA than nonsmokers did. In the group with reported side effects, the median serum OLA concentration was 22% higher (P < 0.05) than in the group without side effects. Patients co-medicated with carbamazepine had a 71% lower median C/D ratio for OLA than patients on OLA monotherapy. The present TDM-based follow-up suggests that the influence of gender, smoking habits. and certain drug interactions may need to be considered for optimal dosage of OLA. TDM may be used for this purpose more readily in the future. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
side-effect, gender, smoking, therapeutic drug monitoring, olanzapine
in
Therapeutic Drug Monitoring
volume
24
issue
4
pages
518 - 526
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:12142637
  • wos:000177060100010
  • scopus:0036337410
ISSN
0163-4356
language
English
LU publication?
yes
id
b2323992-02e3-45f0-bb6e-4a8e8d12729d (old id 332191)
alternative location
http://www.drug-monitoring.com/pt/re/tdm/abstract.00007691-200208000-00010.htm
date added to LUP
2007-11-07 18:46:11
date last changed
2017-11-05 04:33:05
@article{b2323992-02e3-45f0-bb6e-4a8e8d12729d,
  abstract     = {Olanzapine (Zyprexa(R)) was approved for general prescription in Sweden in November 1996, and an HPLC-based therapeutic drug monitoring (TDM) routine for serum olanzapine (OLA) and its major metabolite. N-demethylolanzapine (DMO) was established in February 1997. During 1997 to 1999, a total of 753 TDM requests for a total of 545 Swedish patients was analyi.ed. Additional patient information oil certain clinical variables was collected on specifically designed TDM request forms. After the exclusion process. samples from 194 patients were found to be eligible for further scrutiny. The concentration-to-dose (C/D) ratio for OLA varied 25-fold and that of DMO 22-fold. Women had a higher (P &lt; 0.01) median C/D ratio for OLA than men (median, 7.2 nmol/L/mg, vs 5.2 nmol/L/mg). Nonsmokers had a higher (P &lt; 0.001) C/D ratio for OLA than smokers (median, 9.2 nmol/L/mg vs 4.0 nmol/L/mg). Smokers got higher prescribed (P &lt; 0.05) doses of OLA than nonsmokers did. In the group with reported side effects, the median serum OLA concentration was 22% higher (P &lt; 0.05) than in the group without side effects. Patients co-medicated with carbamazepine had a 71% lower median C/D ratio for OLA than patients on OLA monotherapy. The present TDM-based follow-up suggests that the influence of gender, smoking habits. and certain drug interactions may need to be considered for optimal dosage of OLA. TDM may be used for this purpose more readily in the future.},
  author       = {Skogh, E and Reis, Margareta and Dahl, ML and Lundmark, J and Bengtsson, F},
  issn         = {0163-4356},
  keyword      = {side-effect,gender,smoking,therapeutic drug monitoring,olanzapine},
  language     = {eng},
  number       = {4},
  pages        = {518--526},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Therapeutic Drug Monitoring},
  title        = {Therapeutic drug monitoring data on olanzapine and its N-demethyl metabolite in the naturalistic clinical setting},
  volume       = {24},
  year         = {2002},
}