Quetiapine

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Generic Name: Quetiapine Brand Name(s): Generics only. No brands available.

Uses

What is quetiapine used for?

Quetiapine is commonly used to treat schizophrenia or bipolar disorder. It may also be used for other conditions as determined by your doctor.

Quetiapine is an atypical antipsychotic. Exactly how it works is not known. It is thought to affect certain substances in the brain.

How should I take 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.

The dosage is based on your medical condition and response to treatment. 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. Follow your doctor’s instructions carefully. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

It is important to continue taking this medication as prescribed even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as trouble sleeping, nausea, headache, diarrhea, irritability. Your dose may need to be gradually decreased to reduce side effects. Report any new or worsening symptoms immediately.

Tell your doctor if your condition persists or worsens.

How do I store quetiapine?

Quetiapine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store quetiapine in the bathroom or the freezer. There may be different brands of quetiapine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush quetiapine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using quetiapine?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of quetiapine or other medications.
  • You have any other illnesses, disorders, or medical conditions.
  • You or a family member has a history of suicidal thoughts or attempts, bipolar disorder (manic depression) or other mental or mood problems, a certain type of irregular heartbeat (prolonged QT interval), or diabetes or high blood sugar.
  • You drink alcohol or have a history of alcohol or substance abuse.
  • You have Alzheimer disease, dementia, poor health, or trouble swallowing, or you are very overweight.
  • You are dehydrated, have low blood volume, or will be exposed to very high temperatures.
  • You have a history of a heart attack or other heart problems (e.g., enlargement of the heart, heart failure, irregular heartbeat), stroke, blood vessel problems (e.g., in the brain), high blood cholesterol or triglyceride levels, or high or low blood pressure.
  • You have a history of low white blood cell levels, including low levels caused by medicine; kidney, liver, or pancreas problems; stomach or bowel problems; thyroid problems; cataracts; narrow-angle glaucoma; seizures; neuroleptic malignant syndrome (NMS); gallstones; or low blood magnesium or potassium levels.
  • You have had high blood prolactin levels or a history of certain types of cancer (e.g., breast, pancreas, pituitary, brain), or if you are at risk of breast cancer.
  • You take medicines that may harm the liver (e.g., acetaminophen, methotrexate, ketoconazole, isoniazid, certain medicines for HIV infection). Ask your doctor if you are unsure if any of your medicines might harm the liver.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using quetiapine during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking quetiapine. Quetiapine is pregnancy risk category X, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from quetiapine?

Check with your doctor if any of these most common side effects persist or become bothersome:

  • Constipation
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Headache
  • Increased appetite
  • Indigestion
  • Light-headedness
  • Nausea
  • Runny or stuffy nose
  • Sluggishness
  • Sore throat
  • Stomach pain or upset
  • Tiredness
  • Vomiting
  • Weakness
  • Weight gain

Seek medical attention right away if any of these severe side effects occur:

  • Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue)
  • Confusion
  • Difficult or painful urination
  • Fainting
  • Fast, slow, or irregular heartbeat
  • Fever, chills, or persistent sore throat
  • Hallucinations
  • Increased saliva production or drooling
  • Increased sweating
  • Memory problems
  • Menstrual changes
  • Muscle pain, stiffness, or weakness
  • New or worsening mental or mood changes (e.g., aggressiveness, agitation, anxiety, depression, exaggerated feeling of well-being, hostility, impulsiveness, inability to sit still, irritability, panic attacks, restlessness)
  • Numbness, burning, or tingling
  • Persistent, painful erection
  • Red, swollen, blistered, or peeling skin
  • Seizures
  • Severe or prolonged dizziness, light-headedness, or headache
  • Severe stomach or back pain (with or without nausea or vomiting)
  • Shortness of breath
  • Suicidal thoughts or actions
  • Swelling of the arms, hands, legs, or feet
  • Symptoms of high blood sugar (e.g., increased thirst, hunger, or urination; unusual weakness)
  • Symptoms of high prolactin levels (e.g., decreased sexual ability, enlarged breast size, missed menstrual period, nipple discharge)
  • Tremor
  • Trouble concentrating, speaking, or swallowing
  • Trouble sleeping
  • Trouble walking or standing
  • Uncontrollable or involuntary muscle movements (e.g., loss of balance, twitching of the face or tongue, uncontrollable arm or leg movements)
  • Unusual bruising or bleeding
  • Vision changes (e.g., blurred vision, decreased vision)

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with quetiapine?

Quetiapine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with quetiapine?

Quetiapine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with quetiapine?

Quetiapine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using quetiapine.

What is the dose of quetiapine for an adult?

Usual Adult Dose for Schizophrenia

Immediate-release tablets:

  • Initial Dose: 25 mg orally twice a day.
  • The dosage may be increased in increments of 25 to 50 mg two times a day or three times a day on the second and third days (as tolerated). By the fourth day a dosage range of 300 mg to 400 mg daily (divided into 2 or 3 doses a day) may be achieved. Additional dosage adjustments (increases or decreases) of 25 to 50 mg twice a day may be made, as needed. However, at least 2 days should pass between the additional dosage adjustments.
  • Efficacy in schizophrenia has been reported with doses ranging from 150 to 750 mg/day. Maximum clinical effect has been reported at 300 mg/day. The safety of doses above 800 mg/day has not been evaluated in clinical trials.

Extended-release tablets:

  • Initial dose: 300 mg orally once daily without food or with a light meal.
  • Maintenance dose: 400 to 800 mg orally once daily depending on response and tolerance.
  • Maximum dose: Doses above 800 mg daily have not been studied.
  • The dosage of the extended-release tablets may be increased in increments of up to 300 mg daily at intervals as short as 1 day.
  • The efficacy of quetiapine in long-term use (over 6 weeks) has not been studied in clinical trials. Patients who respond favorably to quetiapine may be continued on the lowest dose which is effective in maintaining their remission. Patients should be periodically reassessed to determine their need for maintenance treatment.

Usual Adult Dose for Bipolar Disorder

Immediate-release tablets:

Mania associated with bipolar I disorder as monotherapy or as adjunct therapy to lithium or divalproex:

  • Initial Dose: 50 mg orally twice a day
  • The dose may be increased to 200 mg orally twice daily on day 4 in increments of up to 50 mg twice daily. Further dosage adjustments up to 800 mg per day by day 6 should be in increments of no greater than 200 mg/day. Data has been reported to indicate that the majority of patients responded between 400 mg per day to 800 mg per day. The safety of doses above 800 mg per day has not been evaluated in clinical trials.

Immediate-release tablets:

Depressive episodes associated with bipolar disorder:

  • Initial dose: 50 mg orally once a day
  • The dose may be increased to reach 300 mg orally once a day by day 4. Some patients may require a further increase to 600 mg once a day by increasing the daily dose to 400 mg on day 5 and 600 mg on day 8 of treatment. Efficacy was demonstrated in this patient population at both 300 mg and 600 mg per day. However, no additional benefit was observed in patients receiving 600 mg per day as compared to those patients receiving 300 mg per day.

Extended-release tablets:

Bipolar Depression: (Depressive Episodes Associated with Bipolar Disorder)

  • Usual dose for Acute Treatment: administer orally once daily in the evening starting with 50 mg per day and increasing doses to reach 300 mg per day by day 4.
  • Recommended Dosing Schedule: Day 1 – 50 mg, Day 2 – 100, mg, Day 3 – 200 mg, & Day 4 – 300 mg.

Bipolar Mania:

  • Usual dose for Acute Monotherapy or Adjunct Therapy (with lithium or divalproex): administer orally once daily in the evening starting with 300 mg on day 1, 600 mg on day 2, and adjust between 400 mg and 800 mg per day thereafter depending on the clinical response and tolerance of the individual patient.

Bipolar Maintenance:

  • Continue treatment at the dosage required to maintain symptom remission.
  • While there is no body of evidence available to specifically address how long patients should remain on quetiapine extended-release tablets, maintenance of efficacy in Bipolar I Disorder has been demonstrated with quetiapine (administered orally twice daily totaling 400 to 800 mg per day) as adjunct therapy to lithium or divalproex. Generally, in the maintenance phase, patients continued on the same dose on which they were stabilized during the stabilization phase. Patients should be periodically reassessed to determine the need for maintenance treatment and the appropriate dose for such treatment.

Usual Adult Dose for Depression

As adjunctive therapy to antidepressants for use in the treatment of major depressive disorder:

Extended-release tablets:

  • Initial dose: 50 mg orally once daily in the evening
  • On day 3, the dose can be increased to 150 mg once daily in the evening.
  • Range: 150 mg to 300 mg orally daily. Doses above 300 mg have not been studied.

Usual Geriatric Dose for Schizophrenia

Immediate-release tablets:

  • Initial Dose: 25 mg orally once a day.
  • The dose may be increased daily in increments of 25 mg/day to 50 mg/day to an effective dose, depending on the clinical response and tolerability of the patient.
  • Efficacy in schizophrenia has been reported with doses ranging from 150 to 750 mg/day. Maximum clinical effect has been reported at 300 mg/day. The safety of doses above 800 mg/day has not been evaluated in clinical trials.

Extended-release tablets:

  • When an effective immediate-release dose has been reached (above 200 mg), the patient may be switched to the extended-release formulation at an equivalent dose.
  • The efficacy of quetiapine in long-term use (over 6 weeks) has not been studied in clinical trials. Patients who respond favorably to quetiapine may be continued on the lowest dose which is effective in maintaining their remission. Patients should be periodically reassessed to determine their need for maintenance treatment.

Usual Geriatric Dose for Bipolar Disorder

Extended-release tablets:

  • Initial dose: 50 mg/day
  • The dose can be increased in increments of 50 mg/day depending on the response and tolerance of the individual patient.

What is the dose of quetiapine for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is quetiapine available?

Quetiapine is available in the following dosage forms and strengths:

  • Tablets 25 mg; 50 mg; 100 mg; 200 mg; 300 mg; 400 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of quetiapine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: July 26, 2017 | Last Modified: August 1, 2017

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