Quetiapine

Details About Generic Salt ::  Quetiapine 

Main Medicine Class:: #N/A   Sub Medicine Class ::  #N/A

1E. ANTI-PSYCHOTICS in 1. NERVOUS SYSTEM
QUETIAPINE
DOPAMINE, SEROTONIN & ADRENERGIC ANTAGONIST | ATYPICAL ANTI-PSYCHOTIC
PK: A: Rapid D: 6-14L/kg (Vd) M: Hepatic E: Urine (73% as metabolites), feces (20%)

Indications & Dose: DEPRESSION PO Adult IR tablet: Initially 50mg OD day 1; increase to 100mg OD day 2, further increasing by 100mg/day each day until target dose of 300mg OD is reached by day 4. ER tablet: Initially 50mg/day day 1, increase to 100mg day 2, further increasing by 100mg/day Elderly IR tablet: 50-200mg/day gradually increase dose by 25-50mg/day. ER tablet: 50mg/day, increase dose by 50mg/day to effective dose, based on response & tolerability | MANIA PO Adult IR tablet: Initially 50mg BID day 1 then increase dose in increments of 100mg/day to 200mg BID day 4, may increase to target dose 800mg/day by day 6 at increments <200mg/day, ER tab: Initially 300mg day 1, increase to 600mg day 2 & adjust dose to 400-800mg Child IR tablet: Initially 25mg BID day 1, increase to 50mg BID day 2, further increasing by 100mg/day until target dose of 400mg/day is reached on day 5, max increase up to 600mg/day at increments <100mg/day Elderly IR tablet: 50-200mg/day gradually increase dose by 25-50mg/day. ER tablet: 50mg/day, increase dose by 50mg/day to effective dose, based on response & tolerability | SCHIZOPHRENIA PO Adult IR tablet: Day 1 50mg, day 2 100mg, day 3 200mg, day 4 300mg in 2 divided doses. Adjust dose based on response, usual range 300-450mg/day max 750mg/day. ER tablet: Initially 300mg OD increase in increments of up to 300mg/day (in intervals of >1 day), MD 400-800mg/day Elderly IR tablet: 50-200mg/day gradually increase dose by 25-50mg/day. ER tablet: 50mg/day, increase dose by 50mg/day to effective dose, based on response & tolerability

Contra: Hypersensitivity

Precautions: suicidal thinking & behavior, elderly, withdrawal syndrome, patients with antipsychotics

ADR: Serious: tardive dyskinesia, somnolence, dizziness, peripheral edema, raised liver enzyme, increased BP, increased cholesterol level, orthostatic hypotension, EPS, blurred vision, leukopenia, NMS, Others: rash, nausea, vomiting, xerostomia, increased appetite & weight gain, constipation, dyspepsia, dry mouth, asthenia, anxiety, fever, rhinitis

DDI: Serious Levodopa causes mild motor deterioration, Alcohol causes postural hypotension & drowsiness, Olanzapine causes seizure, Ketoconazole/Erythromycin increased drug plasma levels, Phenytoin increases drug clearance, Ziprasidone leads to arrhythmia with extrasystoles & prolonged QTc interval, Lithium leads to delirium, Valproic acid modestly raises drug levels, Carbamazepine reduces drug plasma levels

Diet: With/without food

Monitor: CBC, lipid profile, blood glucose/Hgb A1c, eyes checked for cataracts

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