QUETIAPINE

COMMON BRAND NAME(S): Seroquel

GENERIC NAME(S): QUETIAPINE FUMARATE

 

Description: Quetiapine is an atypical antipsychotic agent that blocks 5-HT2 and D2 receptors. Its action is still unknown but it is thought to affect certain substances in the brain.

Pharmacokinetics:

Absorption: Well absorbed. Time to peak plasma concentration: Approx 1.5 hr.

Distribution: Widely distributed throughout the body. Volume of distribution: 6-14 L/kg. Plasma protein binding: Approx 83%.

Metabolism: Extensively metabolised in the liver via sulfoxidation and oxidation mediated mainly by CYP3A4 isoenzyme.

Excretion: Excreted mainly as inactive metabolites via urine (approx 73%) and faeces (approx 20%). Elimination half-life: Approx 6-7 hr.

Indications:

This medication is used to treat certain mental/mood conditions (such as schizophrenia, bipolar disorder, sudden episodes of mania or depression associated with bipolar disorder).

This medication can decrease hallucinations and improve your concentration. It helps you to think more clearly and positively about yourself, feel less nervous, and take a more active part in everyday life. It may also improve your mood, sleep, appetite, and energy level. Quetiapine can help prevent severe mood swings or decrease how often mood swings occur.

OTHER USES:

Quetiapine may also be used in combination with other medication to treat depression. If you are using quetiapine in combination with other medication to treat depression, carefully read the drug information for the other medication.

Contraindications:

Should not be given to patients with allergic reactions from the drug.

How to use quetiapine

  • Take this medication by mouth as directed by your doctor, usually 2 or 3 times daily with or without food.
  • For the treatment of depression associated with bipolar disorder, take this medication by mouth as directed by your doctor, usually once daily at bedtime.
  • To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose.
  • It is important to continue taking this medication as prescribed even if you feel well.

Fatal side effects: There may be a slightly increased risk of serious, possibly fatal side effects (such as stroke, heart failure, fast/irregular heartbeat, pneumonia) when this medication is used by older adults with dementia.

Dementia-related problems: This medication is not approved for the treatment of dementia-related behavior problems. Discuss the risks and benefits of this medication, as well as other effective and possibly safer treatments for dementia-related behavior problems, with the doctor.

Worsening depression: Studies have shown that a small number of people (especially people younger than 25) who take drugs to treat depression may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of drugs used to treat depression (especially for people younger than 25), even if treatment is not for a mental/mood condition.

This medication is not approved for use in children under 10 years old.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Common side effects:

  • constipation,
  • drowsiness,
  • upset stomach,
  • tiredness,
  • weight gain,
  • blurred vision, or
  • dry mouth

Tell your doctor right away if you have any serious side effects, including:

  • restlessness/constant need to move,
  • shakiness (tremor),
  • signs of infection (such as fever, persistent sore throat),
  • mental/mood changes (such as increased anxiety, depression, thoughts of suicide),
  • difficulty swallowing,
  • constipation with persistent abdominal pain,
  • persistent nausea/vomiting,
  • loss of appetite,
  • yellowing eyes/skin.

Get medical help right away if you have any very serious side effects, including:

  • fainting,
  • seizure,
  • severe dizziness.

This medication may infrequently make your blood sugar level rise, which can cause or worsen diabetes. Tell your doctor immediately if you develop symptoms of high blood sugar, such as increased thirst and urination. If you already have diabetes, be sure to check your blood sugars regularly. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

This drug may also cause significant weight gain and a rise in your blood cholesterol (or triglyceride) levels. These effects, along with diabetes, may increase your risk for developing heart disease. Discuss the risks and benefits of treatment with your doctor. (See also Notes section.)

Quetiapine may rarely cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor immediately if you develop any unusual/uncontrolled movements (especially of the face, lips, mouth, tongue, arms or legs).

This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, change in the amount of urine.

Quetiapine may increase a certain natural substance (prolactin) made by your body. For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor immediately.

Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions:

  • Allergy: Before taking quetiapine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
  • Medical History: Before using this medication, tell your doctor or pharmacist if you had: eye cataracts, liver disease, low white blood cell count (including history of low white blood cell count caused by medications), seizure disorder, trouble swallowing, thyroid problems, stomach/intestinal blockage (such as severe constipation, bowel obstruction), stomach/intestines that are not moving (such as ileus), personal or family history of diabetes, heart disease, high blood pressure, high cholesterol/triglyceride levels.
  • QT prolongation: Quetiapine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can infrequently result in serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.
  • Heat stroke: This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat.
  • Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Pregnancy Risk: Category C.  During pregnancy, this medication should be used only when clearly needed.

Breastfeeding: This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Interactions:

  • Many drugs besides quetiapine may affect the heart rhythm (QT prolongation), including amiodarone, moxifloxacin, procainamide, quinidine, sotalol, thioridazine, among others.
  • Other medications can affect the removal of quetiapine from your body, which may affect how quetiapine works. Examples include azole antifungals (such as itraconazole, ketoconazole), rifamycins (such as rifampin), drugs used to treat seizures (such as carbamazepine, phenytoin), among others.

Overdose:

If overdose is suspected, contact a poison control center or emergency room immediately.

Notes

Do not share this medication with others.

Keep all regular medical and psychiatric appointments. Laboratory and/or medical tests (such as blood sugar, blood pressure, cholesterol levels, eye exams, weight, blood counts) should be performed before you start treatment, periodically to monitor your progress, or to check for side effects. Consult your doctor for more details.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Brands:

Available Brands

  • Ketilept [ Egis ]
  • Qtipine 25/Qtipine 300 [ Torrent ]
  • Quekline [ GlaxoSmithKline ]
  • Quetiapro [ InnoGen Pharmaceuticals ]
  • Q-win [ Brown & Burk Phils ]
  • Seroquel/Seroquel XR [ AstraZeneca ]
  • Serotia 25/Serotia 100/Serotia 200/Serotia 300 [ Sun Pharma ]

Also marketed as

  • Qpine 50/Qpine 100/Qpine 200 [ XL Lab ]

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