List PLR Article Directory Alaska: quetiapine

kwe-TYE-a-peen FUE-ma-rate

Oral route(Tablet;Tablet, Extended Release)

Elderly patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo. Although the causes of death were varied in clinical trials, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Not approved for the treatment of patients with dementia-related psychosis. Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Regular strength tablets not approved for use in patients under 10 years of age ; extended-release tablets not approved for use in patients under 18 years of age .

Commonly used brand name(s)

In the U.S.

Seroquel

Seroquel XR

Available Dosage Forms:

Tablet

Tablet, Extended Release

Therapeutic Class: Antipsychotic

Chemical Class: Quetiapine

Uses For quetiapine

Quetiapine is used to treat nervous, emotional, and mental conditions (e.g., schizophrenia). It may be used alone or together with other medicines (e.g., lithium or divalproex) to treat symptoms of bipolar disorder (manic-depressive illness) or mania that is part of bipolar disorder. quetiapine should not be used to treat behavioral problems in older adult patients who have dementia or Alzheimer's disease.

Quetiapine extended-release tablets is also used together with other medicines to treat major depressive disorder (MDD) in adults.

quetiapine is available only with your doctor's prescription.

Before Using quetiapine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For quetiapine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to quetiapine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of quetiapine tablets in children with schizophrenia younger than 13 years of age, in children with bipolar mania younger than 10 years of age, and in children with bipolar depression younger than 18 years of age. Safety and efficacy have not been established in these age groups.

Appropriate studies have not been performed on the relationship of age to the effects of quetiapine extended-release tablets in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of quetiapine in the elderly. However, elderly patients are more likely to have dementia or age-related heart, liver, or kidney problems, which may require caution and an adjustment in the dose for patients receiving quetiapine.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking quetiapine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using quetiapine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil

Cisapride

Dronedarone

Fluconazole

Mesoridazine

Metoclopramide

Pimozide

Posaconazole

Terfenadine

Thioridazine

Using quetiapine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acecainide

Ajmaline

Alfuzosin

Amiodarone

Amitriptyline

Amobarbital

Amoxapine

Apomorphine

Aprindine

Aprobarbital

Arsenic Trioxide

Asenapine

Astemizole

Azimilide

Azithromycin

Betamethasone

Bretylium

Butabarbital

Butalbital

Chloral Hydrate

Chloroquine

Chlorpromazine

Ciprofloxacin

Citalopram

Clarithromycin

Clomipramine

Clozapine

Cortisone

Crizotinib

Dasatinib

Deflazacort

Desipramine

Dexamethasone

Dibenzepin

Disopyramide

Dofetilide

Dolasetron

Doxepin

Droperidol

Encainide

Enflurane

Erythromycin

Eterobarb

Flecainide

Fluoxetine

Foscarnet

Gatifloxacin

Gemifloxacin

Granisetron

Halofantrine

Haloperidol

Halothane

Hydrocortisone

Hydromorphone

Hydroquinidine

Ibutilide

Iloperidone

Imipramine

Isoflurane

Isradipine

Lapatinib

Levofloxacin

Lidoflazine

Lorcainide

Lumefantrine

Mefloquine

Mephobarbital

Methadone

Methohexital

Methylprednisolone

Milnacipran

Moxifloxacin

Nilotinib

Norfloxacin

Nortriptyline

Octreotide

Ofloxacin

Ondansetron

Paliperidone

Paramethasone

Pazopanib

Pentamidine

Pentobarbital

Perflutren Lipid Microsphere

Phenobarbital

Pirmenol

Prajmaline

Prednisolone

Prednisone

Primidone

Probucol

Procainamide

Prochlorperazine

Promethazine

Propafenone

Protriptyline

Quinidine

Quinine

Ranolazine

Rifampin

Risperidone

Salmeterol

Secobarbital

Sematilide

Sodium Phosphate

Sodium Phosphate, Dibasic

Sodium Phosphate, Monobasic

Solifenacin

Sorafenib

Sotalol

Sparfloxacin

Spiramycin

Sulfamethoxazole

Sunitinib

Tedisamil

Telavancin

Telithromycin

Tetrabenazine

Thiopental

Toremifene

Trazodone

Triamcinolone

Trifluoperazine

Trimethoprim

Trimipramine

Vandetanib

Vardenafil

Vasopressin

Vemurafenib

Voriconazole

Ziprasidone

Zolmitriptan

Using quetiapine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Fosphenytoin

Ketoconazole

Phenytoin

Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using quetiapine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use quetiapine, or give you special instructions about the use of food, alcohol, or tobacco.

Ethanol

Proper Use of quetiapine

Take quetiapine exactly as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

quetiapine should come with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Quetiapine tablets may be taken with or without food on a full or empty stomach. However, if your doctor tells you to take it a certain way, take it as directed.

Swallow the extended-release tablets whole. Do not break, crush, or chew it. It is best to take quetiapine without food or with a light meal (approximately 300 calories).

Dosing

The dose of quetiapine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of quetiapine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (extended-release tablets):
- For treatment of depression with bipolar disorder:
  - Adults—At first, 50 milligrams (mg) once per day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 300 mg per day.
  - Children—Use and dose must be determined by the doctor.
- For treatment of mania with bipolar disorder:
  - Adults—At first, 300 milligrams (mg) once per day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
  - Children—Use and dose must be determined by the doctor.
- For treatment of major depressive disorder (MDD):
  - Adults—At first, 50 milligrams (mg) once per day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 300 mg per day.
  - Children—Use and dose must be determined by the doctor.
- For treatment of schizophrenia:
  - Adults—At first, 300 milligrams (mg) once per day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
  - Children—Use and dose must be determined by the doctor.

For oral dosage form (tablets):
- For treatment of depression with bipolar disorder:
  - Adults—At first, 50 milligrams (mg) once per day at bedtime. The dose is usually increased daily to reach 300 mg per day on the fourth day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 600 mg per day.
  - Children—Use and dose must be determined by the doctor. .
- For treatment of mania with bipolar disorder:
  - Adults—At first, 100 milligrams (mg) per day, given in two equally divided doses. The dose is usually increased to 400 mg per day, which is divided and given in two doses per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
  - Children 10 to 17 years of age—At first, 25 milligrams (mg) two times per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 600 mg per day.
  - Children younger than 10 years of age—Use and dose must be determined by the doctor.
- For treatment of schizophrenia:
  - Adults—At first, 25 milligrams (mg) two times per day. The dose is usually increased to 300 to 400 mg per day, which is divided and given in two or three doses per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
  - Teenagers 13 to 17 years of age—At first, 25 milligrams (mg) two times per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg per day.
  - Children younger than 13 years of age—Use and dose must be determined by the doctor.

Missed 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 go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using quetiapine

It is very important that your doctor should check the progress of you or your child at regular visits to make sure quetiapine is working properly. Blood tests may be needed to check for unwanted effects. You may also need to have your or your child's eyes tested on a regular basis.

quetiapine may add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; medicine for seizures or barbiturates; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you or your child are using quetiapine.

For some patients, quetiapine can increase thoughts of suicide. Tell your doctor right away if you or your child start to feel more depressed and have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you, especially if they are new or are getting worse quickly. Make sure the doctor knows if you or your child have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive illness) or has tried to commit suicide.

Quetiapine may cause drowsiness, trouble with thinking, or trouble with your vision (especially during the first week of use). Make sure you know how you react to quetiapine before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to think or see well.

quetiapine may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or urination. If you or your child have diabetes, you may notice a change in the results of your urine or blood sugar tests. Check your blood sugar closely and talk with your doctor if you have any questions.

Check with your doctor right away if you or your child are having convulsions (seizures); difficulty with breathing; a fast heartbeat; high fever; high or low blood pressure; increased sweating; loss of bladder control; severe muscle stiffness; unusually pale skin; or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.

Quetiapine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

If you can, avoid people with infections. Check with your doctor immediately if you or your child think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

Check with your doctor immediately if you or your child notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.

Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.

Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.

Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.

Avoid contact sports or other situations where bruising or injury could occur.

quetiapine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you or your child have any of the following symptoms while taking quetiapine: lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

Quetiapine may increase your cholesterol and fats in the blood. If this condition occurs, your doctor may give you or your child some medicines that can lower the amount of cholesterol and fats in the blood.

quetiapine may increase your weight. Your doctor may need to check your or your child's weight on a regular basis while you are using quetiapine.

You will need to have your blood pressure measured before starting quetiapine and while you or your child are using it. If you notice any change to your recommended blood pressure, call your doctor right away. If you have questions about this, talk to your doctor.

quetiapine can cause changes in heart rhythms, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Contact your doctor right away if you or your child have any symptoms of heart rhythm problems, such as fast, pounding, or uneven heartbeats.

Quetiapine may make it more difficult for your body to cool down. It might reduce how much you sweat. Your body could get too hot if you do not sweat enough. If your body gets too hot, you might feel dizzy, weak, tired, or confused. You might vomit or have an upset stomach. Do not get too hot while you are exercising. Avoid places that are very hot. Call your doctor if you or your child are too hot and can not cool down.

Do not suddenly stop taking your quetiapine without checking first with your doctor. Your doctor may want you or your child to gradually reduce the amount you are using before stopping it completely. This is to decrease the chance of having symptoms such as nausea, sleeplessness, trouble in sleeping, unable to sleep, or vomiting.

Before you have any medical tests, tell the medical doctor in charge that you are taking quetiapine. The results of some tests (e.g., urine drug screens) may be affected by quetiapine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

quetiapine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Chills

cold sweats

confusion

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

sleepiness or unusual drowsiness

Less common

Black, tarry stools

blurred vision

changes in patterns and rhythms of speech

chest pain

cough

difficulty with swallowing

drooling

fever, muscle aches, or sore throat

inability to move the eyes

inability to sit still

increased blinking or spasms of the eyelid

lip smacking or puckering

loss of balance control

mask-like face

need to keep moving

painful or difficult urination

puffing of the cheeks

rapid or worm-like movements of the tongue

restlessness

shakiness in the legs, arms, hands, or feet

shortness of breath

shuffling walk

slowed movements

slurred speech

sores, ulcers, or white spots on the lips or in the mouth

sticking out of the tongue

stiffness of the arms or legs

sweating

swelling of the face, arms, hands, feet, or lower legs

swollen glands

trembling and shaking of the hands and fingers

trouble with breathing, speaking, or swallowing

uncontrolled chewing movements

uncontrolled movements of the arms and legs

uncontrolled twisting movements of the neck, trunk, arms, or legs

unusual bleeding or bruising

unusual facial expressions

unusual tiredness or weakness

Rare

Dry, puffy skin

fast, pounding, or irregular heartbeat

loss of appetite

menstrual changes

tiredness

unusual secretion of milk (in females)

weight gain

Incidence not known

Aching or discomfort in the lower legs or sensation of crawling in the legs

hives

itching

painful or prolonged erection of the penis

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

skin rash

tightness in the chest

tingling of the hands or feet

unusual weight gain or loss

wheezing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Convulsions (seizures)

decreased urine

dry mouth

increased thirst

low blood pressure

mood changes

muscle pain or cramps

nausea or vomiting

numbness or tingling in the hands, feet, or lips

weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Constipation

headache

Less common

Abnormal vision

acid or sour stomach

belching

decreased appetite

decreased strength and energy

headache

heartburn

increased appetite

increased muscle tone

increased sweating

increased weight

indigestion

sneezing

stomach discomfort, upset, or pain

stuffy or runny nose

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: quetiapine side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More quetiapine resources

Quetiapine Side Effects (in more detail)
Quetiapine Use in Pregnancy & Breastfeeding
Quetiapine Drug Interactions
Quetiapine Support Group
277 Reviews for Quetiapine - Add your own review/rating

Quetiapine MedFacts Consumer Leaflet (Wolters Kluwer)

Quetiapine Fumarate Monograph (AHFS DI)

Seroquel Prescribing Information (FDA)

Seroquel Consumer Overview

Seroquel XR Prescribing Information (FDA)

Seroquel XR Sustained-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

Compare quetiapine with other medications

Bipolar Disorder
Borderline Personality Disorder
Depression
Generalized Anxiety Disorder
Insomnia
Obsessive Compulsive Disorder
Paranoid Disorder
Post Traumatic Stress Disorder
Schizoaffective Disorder
Schizophrenia
Tourette's Syndrome

List PLR Article Directory Alaska

Tuesday, September 27, 2016

quetiapine