Zyprexa May Treat Chemotherapy-Induced Nausea, Vomiting: Study

The findings of a new study suggest that the antipsychotic Zyprexa may help chemotherapy patients avoid debilitating nausea that often follows the harsh anti-cancer treatments. 

Researchers from the Indiana University School of Medicine found that three quarters of chemotherapy patients given Zyprexa reported experiencing no nausea in the first 24 hours after treatment. The findings were published on July 14 in the New England Journal of Medicine.

Approved in 1996, Zyprexa (olanzapine) is used to treat schizophrenia and bipolar disorder, decreasing hallucinations and mania. In 2015, oral versions of the medication were given out in 4.1 million prescriptions to about 849,000 patients in the U.S. The drug is now available cheaply as a generic, costing only about $2 for a five-day treatment.

Researchers conducted a double-blind clinical trial including 380 patients, 192 of whom were given Zyprexa after chemotherapy, and 188 who were given a placebo. According to the findings, 74% of the patients given Zyprexa experienced no nausea in the first 24 hours after surgery, compared with 45% of those given a placebo. In the period of 25 hours to 120 hours, 42% of Zyprexa users were still without nausea, compared to 25% of those given a placebo.

“Olanzapine, as compared with placebo, significantly improved nausea prevention, as well as the complete-response rate, among previously untreated patients who were receiving highly emetogenic chemotherapy,” the researchers concluded.

However, Zyprexa has also been linked to some severe, and potentially life-threatening side effects. In May, the FDA issued a drug safety communication warning that Zyprexa could cause a severe skin condition, known as Drug Reaction with Eosinophilla and Systemic Symptoms (DRESS).

The risk of Zyprexa skin reactions was identified from a review of the FDA Adverse Event Reporting System (FAERS) database, which found at least 23 cases of DRESS linked to the use of olonzapine-based medications. At least one of those skin reactions from Zyprexa may have resulted in death.

The FDA indicates that the median onset of DRESS from Zyprexa was 19 days after treatment began, and the median dose was 20 mg per day. However, reactions occurred with doses as low as 5 mg per day.

The regulators indicate that there are likely additional Zyprexa skin reaction cases that have gone unreported, as most experts agree that only about 1% to 10% of all adverse drug problems are ever reported to the FDA.

DRESS is a severe skin reaction that starts as a rash and then can spread to the rest of the body. It can eventually cause injury to the liver, kidney, lungs, heart, and pancreas and can result in death. The condition is caused by the body producing too many white blood cells, which the body uses to fight infections.

Symptoms of DRESS can include a rash, swollen lymph nodes, and swelling of the face. The FDA advises any patient taking these drugs who experiences this combination of symptoms to seek medical care immediately. However, the agency also warns patients taking the drugs to not stop or change their dosage without first talking to a health care professional, as sudden cessation of Zyprexa can result in harmful side effects.