Avoiding a Poke: A Case Series of Intravenous Olanzapine in Pediatric Patients

Although it was originally developed and approved for the treatment of various psychiatric conditions, such as schizophrenia and bipolar I disorder, recent studies have identified the role of olanzapine in the treatment of intensive care unit (ICU)-related delirium and nausea and vomiting. Unfortunately, olanzapine is currently only indicated to be administered via the intramuscular (IM) route or enteral route, limiting the opportunity of its use in certain pediatric patients. IM injections are typically avoided in pediatrics whenever possible, and it is not uncommon for pediatric patients, especially those in an ICU setting, to be restricted to nothing by mouth. Studies in the adult population have demonstrated both safety and efficacy for the administration of reconstituted olanzapine powder by the intravenous (IV) route, which would provide an ideal administration route for pediatric patients unable to receive IM or enteral administration. We report a case series of 4 pediatric patients who received at least 1 dose of IV olanzapine. All 4 patients reported a positive response from the medication and no safety concerns were noted.