Introduction
Pericam is a prescription medicine used in the treatment of schizophrenia (a mental disorder that can result in hallucinations or delusions and also adversely affects a person’s ability to think and behave) and mania.
Pericam may be taken with or without food. However, it is advised to take it at the same time each day as this helps to maintain a consistent level of medicine in the body. Take this medicine in the dose and duration as advised by your doctor and if you have missed a dose, take it as soon as you remember. It is important that this medication is not stopped suddenly without talking to your doctor as it may worsen your symptoms.
Some common side effects of this medicine include dryness in mouth, constipation, muscle rigidity and restlessness. Initially, this medicine may cause a sudden drop in blood pressure when you change positions, so it is better to rise slowly if you have been sitting or lying down. It also causes dizziness and sleepiness, so do not drive or do anything that requires mental focus until you know how this medicine affects you.
However, this medicine may increase your weight, blood sugar and cholesterol levels but, modifying your lifestyle by having a healthy diet and exercising regularly can reduce this side effect. You should be cautious as in rare cases it may cause serious side effects like very high blood sugar levels or seizures.
Side effects of Pericam
Common
- Dizziness
- Sleepiness
- Orthostatic hypotension (sudden lowering of blood pressure on standing)
- Dryness in mouth
- Weight gain
- Increased prolactin level in blood
- Constipation
- Muscle stiffness
- Restlessness
- Tremor
How to use Pericam
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Pericam may be taken with or without food, but it is better to take it at a fixed time.
How Pericam works
Pericam is an atypical antipsychotic. It works by affecting the levels of chemical messengers (dopamine and serotonin) to improve mood, thoughts and behavior.
Indication
Schizophrenia, Bipolar disorder, Agitation, Mania
Administration
May be taken with or without food.
Adult Dose
Oral
Schizophrenia
Adult: 5-10 mg/day initially; if necessary, may be titrated upward in increments of 5 mg/day at intervals >1 week
Maintenance: 10-20 mg/day; not to exceed 20 mg/day
Bipolar Mania
Used as monotherapy or in combination with lithium or valproate
Monotherapy: 10-15 mg/day PO initially
Adjunct to lithium or valproate: 10 mg/day PO initially
Maintenance: 5-20 mg/day PO; not to exceed 20 mg/day
Depression in bipolar disorder
Use in combination with fluoxetine
5 mg in evening; adjusted to range of 5-12.5 mg/day; may be increased up to 20 mg/day in resistant depression
Hepatic impairment: Initial: 5 mg daily.
Child Dose
Oral
Bipolar I Disorder (Manic or Mixed Episodes)
<13 years: Safety and efficacy not established
13-17 years: 2.5-5 mg/day PO initially; target dosage, 10 mg/day; adjust by increments/decrements of 2.5-5 mg; dosage range, 2.5-20 mg/day
Schizophrenia
<13 years: Safety and efficacy not established
13-17 years: 2.5-5 mg/day PO initially; target dosage, 10 mg/day; adjust by increments/decrements of 2.5-5 mg; dosage range, 2.5-20 mg/day
Renal Dose
Renal impairment: Initial: 5 mg daily.
Contraindication
Angle-closure glaucoma; lactation. IM: History of CVS disease, heart surgery.
Mode of Action
Olanzapine is an atypical antipsychotic with affinity for serotonin 5-HT2A/2C, dopamine, muscarinic M1-M5, histamine H1 and adrenergic alpha1 receptors.
Precaution
Patient w/ cerebrovascular disease or conditions predisposing to hypotension, benign prostatic hyperplasia, paralytic ileus, DM, Parkinson's disease, history of blood dyscrasias, bone marrow depression, hypereosinophilic disorders, myeloproliferative disease, history of seizures or conditions that lower the seizure threshold. IM: Acute MI, unstable angina, severe hypotension or bradycardia, sick sinus syndrome, recent heart surgery. Elderly w/ dementia-related psychosis. Hepatic and renal impairment. Pregnancy and lactation. Patient Counselling This drug may cause somnolence and dizziness, if affected, avoid driving and operating machinery. Avoid cigarette smoking. Monitoring Parameters Monitor BP, pulse and resp rate for at least 4 hr after IM inj. Clinical monitoring for hyperglycaemia, plasma lipids and wt.
Lactation: Drug enters breast milk; not recommended
Side Effect
>10%
Orthostatic hypotension (>20%),Weight gain, dose dependent (5-40%),Hypertriglyceridemia (<39%),Hypercholesterolemia (<39%),Somnolence, dose dependent (6-39%),Extrapyramidal symptoms (EPS), dose dependent (15-32%),Xerostomia (9-22%),Weakness (2-20%),Dizziness (4-18%),Accidental injury (12%),Insomnia (12%),Elevated alanine aminotransferase (ALT) level (5-12%),Constipation (9-11%),Dyspepsia (7-11%),Hyperprolactinemia (30%),Hyperglycemia (12.8%)
1-10%
Hypotension (2%),Postural hypotension (1%),Tremor (1%),Asthenia (2%),Akathisia reactions (2%),Parkinsonism reactions (4%)
<1%
Syncope,Sudden cardiac death,Hyperglycemia,Diabetic coma with ketoacidosis,Diabetic ketoacidosis,Acute hemorrhagic pancreatitis,Venous thromboembolism,Immune hypersensitivity reaction,Cerebrovascular disease,Seizure, status epilepticus,Suicidal intent,Pulmonary embolism,Death,Neuroleptic malignant syndrome (NMS),Tardive dyskinesia
Potentially Fatal: Exacerbation of preexisting diabetes sometimes leading to ketoacidosis. Neuroleptic malignant syndrome.
Interaction
Olanzapine may antagonise the effects of levodopa and dopamine agonists. Drugs that induce CYP1A2 or glucuronyl transferase enzymes e.g. omeprazole and rifampicin, may increase olanzapine clearance. Inhibitors of CYP1A2 may potentially inhibit olanzapine elimination. Carbamazepine may increase the clearance of olanzapine. Concomitant admin of activated charcoal reduced the oral bioavailability of olanzapine by 50-60%. Caution should be taken when olanzapine is administered with centrally acting drugs and alcohol.