Last Updated on February 19, 2017 by Dr.Derek Fhisher
Most popular brand: Seroquel
Active ingredient: Quetiapine
Available dosage forms: 25, 50, 100, 200, 300 mg
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Quetiapine general information
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QUETIAPINE (quetiapine)
When using the adult starting dose is 50 mg / day for elderly patients – 25 mg / day. Thereafter, the dosage is gradually increased according to the scheme. Depending on the clinical effect and individual sensitivity of the effective therapeutic dose may be 150 – 750 mg / day,.
In patients with impaired liver and / or kidney initial dose is 25 mg / day. Daily dose increase should be 25 – 50 mg to achieve the optimal effect.
CNS: headache, drowsiness, dizziness, anxiety; rarely -. CSN
Cardio – vascular system: orthostatic hypotension, tachycardia, hypertension.
From the digestive system: constipation, dry mouth, dyspepsia, diarrhea, transient increase in liver enzymes (ALT, AST, GGT), abdominal pain.
From the side of hematopoiesis: asymptomatic leukopenia and / or neutropenia; rarely – eosinophilia.
From the bone – muscular system: myalgia.
The respiratory system: Rhinitis.
Dermatological reactions: skin rash, dry skin.
On the part of the organ of hearing: earache.
With the genitourinary system: urinary tract infection.
From the metabolic side: a slight increase in cholesterol and triglycerides in the blood.
From endocrine system: a small dose-related reversible reduction in thyroid hormone levels (such as total and free T 4 ).
Other: asthenia, back pain, weight gain, fever, chest pain.
Contraindications
Hypersensitivity to quetiapine.
Pregnancy and breastfeeding
During pregnancy and lactation is possible to use in cases where the expected benefit to the mother outweighs the potential risk to the fetus. It is not known whether quetiapine is excreted in breast milk. If necessary, use during lactation should stop breastfeeding.
In experimental studies, on animals showed no mutagenic and clastogenic action of quetiapine. There was no effect of quetiapine on fertility (a decrease in male fertility, pseudopregnancy, increase in the period between the two heats, the increase prekoitalnogo interval and reducing pregnancy rates), but you can not directly transfer the received data to a person, because there are specific differences in hormonal control of reproduction.
Application for violations of liver function
Quetiapine undergoes active metabolism in the liver. Patients with impaired liver function clearance of quetiapine is reduced by approximately 25%. Therefore, quetiapine should be used with caution in patients with impaired hepatic function.
Application for violations of renal function
In patients with impaired renal function, clearance of quetiapine is reduced by approximately 25%. Therefore, quetiapine should be used with caution in patients with impaired renal function.
The use in elderly patients
To use caution in the elderly, especially while taking medications, prolonging the interval QT.
To use caution in patients with cardio – vascular disease and other conditions associated with the risk of hypotension, especially at the beginning of treatment, and the elderly; When specifying a history of seizure attacks.
Quetiapine undergoes active metabolism in the liver. In patients with impaired hepatic function and renal clearance of quetiapine is reduced by approximately 25%. Therefore, quetiapine should be used with caution in patients with impaired liver and / or kidney disease.
To use caution in conjunction with drugs that prolong the interval QT (especially in the elderly); with drugs that have a depressing effect on the CNS, as well as ethanol; with potent inhibitors of CYP3A4 isoenzyme (including ketoconazole, erythromycin).
When developing during treatment with ZNS quetiapine should be discontinued and appropriate treatment.
With long-term use there is a possibility of tardive dyskinesia. In such cases it is necessary to reduce the dose of quetiapine or cancel it.
To apply caution in combination with other drugs that affect the central nervous system activity, as well as with ethanol.
In experimental studies, in the study of carcinogenicity of quetiapine was an increase in the incidence of adenocarcinomas of the breast in rats (at doses of 20, 75 and 250 mg / kg / day), which is associated with prolonged hyperprolactinemia.
In male rats (250 mg / kg / day) and mice (250 and 750 mg / kg / day) there was an increase in the incidence of benign adenomas of the thyroid follicular cells, which was associated with a known, specific to the rodent mechanism to increase hepatic thyroxine clearance.
Effects on ability to drive vehicles and management mechanisms
Quetiapine can cause drowsiness, so patients are not recommended to perform work related to the need to focus and speed of psychomotor reactions (including driving vehicles).
In an application with ketoconazole, erythromycin may theoretically increase quetiapine concentration in blood plasma and the development of side effects.
In an application with phenytoin, carbamazepine, barbiturates, rifampicin increased the clearance of quetiapine, its concentration in the blood plasma decreases.
While the use of thioridazine may increase the clearance of quetiapine.
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