DEQUIT
QUETIAPINE · by SHAHEEN
Composition
Tab 25 mg/100 mg/150 mg/200 mg/300 mg/400 mg: Quetiapine fumarate equiv to quetiapine 25 mg/100 mg/150 mg/200 mg/300 mg/400 mg. Tab extended release 50 mg/200 mg/300 mg/400 mg: Quetiapin
Indications & Dosage
Schizophrenia: REGULAR TAB: Adult: 25 mg twice daily for day 1, then 50 mg twice daily for day 2, then 100 mg twice daily for day 3, then 150 mg twice daily for day 4, then, adjusted according to response, usual dose 300-450 mg daily in 2 divided doses, the daily dose should be lower and increased at longer interval in elderly patients; max. 750 mg per day. EXTENDED-RELEASE TAB: Adult: 300 mg once daily for day 1, then 600 mg once daily for day 2, then, adjusted according to response, usual dose 600 mg once daily, max. dose under specialist supervision; max. 800 mg per day Elderly: Initially 50 mg once daily, adjusted according to response adjusted in steps of 50 mg daily. Treatment of mania in bipolar disorder: REGULAR TAB: Adult: 50 mg twice daily for day 1, then 100 mg twice daily for day 2, then 150 mg twice daily for day 3, then 200 mg twice daily for day 4, then adjusted in steps of up to 200 mg daily, adjusted according to response, usual dose 400-800 mg daily in 2 divided doses, the daily dose should be lower and increased at longer interval in elderly patients; max. 800 mg per day. EXTENDED-RELEASE TAB: Adult: 300 mg once daily for day 1, then 600 mg once daily for day 2, then, adjusted according to response, usual dose 400-800 mg once daily. Elderly: Initially 50 mg once daily, adjusted according to response adjusted in steps of 50 mg daily. Treatment of depression in bipolar disorder: REGULAR TAB: Adult: 50 mg once daily for day 1, dose to be taken at bedtime, then 100 mg once daily for day 2, then 200 mg once daily for day 3, then 300 mg once daily for day 4, then, adjusted according to response; usual dose 300 mg once daily, the daily dose should be lower and increased at longer interval in elderly patients; max. 600 mg per day. EXTENDED-RELEASE TAB: Adult: 50 mg once daily for day 1, dose to be taken at bedtime, then 100 mg once daily for day 2, then 200 mg once daily for day 3, then 300 mg once daily for day 4, then, adjusted according to response; usual dose 300 mg once daily; max. 600 mg per day. Prevention of mania and depression in bipolar disorder: REGULAR TAB: Adult: Continue at the dose effective for treatment of bipolar disorder and adjust to lowest effective dose; usual dose 300-800 mg daily in 2 divided doses. EXTENDED-RELEASE TAB: Adult: Continue at the dose effective for treatment of bipolar disorder and adjust to lowest effective dose; usual dose 300-800 mg once daily. Adjunctive treatment of major depression: EXTENDED-RELEASE TAB: Adult: 50 mg once daily for 2 days, dose to be taken at bedtime, then 150 mg once daily for 2 days, then, adjusted according to response, usual dose 150-300 mg once daily. Elderly: Initially 50 mg once daily for 3 days, then increased if necessary to 100 mg once daily for 4 days, then adjusted in steps of 50 mg, adjusted according to response, usual dose 50-300 mg once daily, dose of 300mg should not be reached before day 22 of treatment.
Precautions
Renal or hepatic impairment, history of cardio-vascular or cerebrovascular disease, hypotension, epilepsy, elderly, patients at risk of aspiration pneumonia, treatment of depression in patients under 25 years (increased risk of suicide)
Interactions
CNS depressants, drug prolonging QT intervals, phenytoin, carbamazepine barbiturates, thioridazine, rifampicin, erythromycin, ketoconazole.
Pregnancy
Avoid unless potential benefit outweighs risk
Lactation
Contraindicated, avoid
Side Effects
Asthenia, dysarthria, dyspnea, elevated plasma-cholesterol and plasma-triglyceride concentrations, increased appetite, irritability, peripheral oedema, sleep disorders, hyponatraemia, hypothyroidism, restless legs syndrome, rhinitis, suicidal behaviour (particularly on initiation), toxic epidermal necrolysis. Rare: Angioedema, hepatitis, pancreatitis, inappropriate secretion of antidiuretic hormone, rhabdomyolysis, Stevens-Johnson syndrome