© 2005 The Royal College of Psychiatrists
© 2005 The Royal College of Psychiatrists
Correspondence |
Zyprexa Velotab (olanzapine): suitable for vegetarians?
Child and Adolescent Unit, New Street Clinic, Upper New Street, Barnsley S70 1LP, e-mail: davidwhleung{at}hotmail.com
Northern General Hospital, Sheffield
Rotherham General Hospital, Rotherham
Zyprexa Velotab (olanzapine) is one of the most commonly used antipsychotics in the UK, but how many of us are aware that the gelatin used to make the orodispersible tablets is of bovine origin?
This would obviously impact widely upon the vegetarian, Muslim, Jewish and Hindu communities, to name but a few. There are over four million vegetarians in the UK but this number is likely to be vastly expanded by the other religious faiths described above.
We think that it is important that not only do the manufacturers of this medication publicise this constituent in their summary of product characteristics but we as healthcare professionals are knowledgeable of and culturally sensitive to our patients’ beliefs and wishes.
We are all aware that the major reason for relapse of any mental illness is poor compliance with treatment (Robinson et al, 1999). How many of those mentioned above would continue with their Zyprexa Velotab upon discovering the formulation of their medication and how would this impact upon their trust in us? Is our current practice of prescribing this formulation to this population not analogous to offering them a roast beef dinner?
References
- ROBINSON, D., WOERNER, M. G., ALVIR, J. M. et al
(1999) Predictors of relapse following response from a first
episode of schizophrenia or schizoaffective disorder. Archives of
General Psychiatry, 56, 241
-247.
[Abstract/Free Full Text]
Reply
Eli Lilly, Lilly House, Priestley Road, Basingstoke, Hampshire RG24 9NL
It is correct to state that Zyprexa Velotab (olanzapine orodispersible tablets) contains gelatin as an excipient of the formulation. This information is listed in the Summary of Product characteristics section 6.1. The gelatin is of bovine origin and this information is available from the Lilly Medical Information Department on request. If a patient is prescribed Zyprexa Velotab and is concerned about the bovine gelatin in the preparation because they are vegetarian or for religious reasons, Lilly advise them to discuss their treatment with their doctor who should consider an alternative formulation such as Zyprexa tablets.
If readers are interested in the wider issue of the presence of bovine gelatin in prescription medicines it should be pointed out that the alternative licensed orodispersible atypical antipsychotic Risperdal Quicklet also contains this excipient. Furthermore, bovine gelatin is used as a major structural excipient in the majority of encapsulated medications. This is because it has properties of flexibility combined with rapid solubility, allowing predictable dispersal of the drug. The pharmaceutical industry is investigating alternatives to bovine gelatin, but it should be noted that any change to the formulation of a medicine requires resubmission to the regulatory authorities with the demonstration that the new formulation is bioequivalent to the existing formulation.
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