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Why it's used

Quetiapine is a prescription medicine that is used to treat schizophrenia. This medicine works by altering the activity of certain natural chemicals in the brain. Quetiapine is also used for the acute treatment of moderate to severe episodes of mania or depression associated with bipolar I disorder, and for the maintenance of bipolar disorder.
Quetiapine may also be used along with other medicines in the treatment of certain conditions as recommended by the doctor. It is used with Lithium, or Divalproex for the acute treatment of manic episodes associated with bipolar I disorder. It is also used together with Lithium, or Divalproex for the maintenance of bipolar disorder.
When not to use
Quetiapine cannot be used to treat dementia-related psychosis.
Atypical Antipsychotics
Quetiapine belongs to the Atypical Antipsychotics class of medicines. Atypical antipsychotics are a group of antipsychotic drugs used to treat psychiatric conditions. These medicines are used to treat schizophrenia, bipolar disorder, autism, and used along with other medicines in the treatment of major depressive disorder.

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How to use

Read the directions on the product label, patient guide, or medicine guide provided by the medicine company or your pharmacist before starting to use Quetiapine. If you have any questions related to this medicine, ask your doctor or pharmacist. Eat this medicine as recommended by your doctor.
Quetiapine is eaten with or without food. Quetiapine is eaten usually just before getting into bed.

Typical Dosage

The typical dose of Quetiapine is 150-750 mg/day (for schizophrenia), 400-800 mg/day (for bipolar mania), 300 mg/day (for bipolar depression). The usual dose for children is 400-800 mg/day (for schizophrenia), 400-600 mg/day (for bipolar mania). Quetiapine is commonly used at the same time every day.
This medicine is to be used for longer periods of time. Quetiapine may be used in combination with divalproex or lithium for the long-term for the treatment of bipolar 1 disorder. You should continue to use this medicine as directed by the doctor even if you feel well.
To decrease the possibility of side-effects, you might be recommended to use the extended-release form of this medicine by your doctor. The extended-release medicine helps in maintaining a steady level of the medicine in your body for a longer period of time. Do not crush or chew the medicine, unless indicated on the package or by your doctor.

Talk to Your Doctor

Talk to your doctor if your condition persists or worsens or if you develop new symptoms. Tell your doctor if suicidal thoughts, attempts to commit suicide, depression, anxiety, feeling restless, panic attacks, insomnia, acting aggressive, or violent, acting on dangerous impulses, an extreme increase in activity and talking, and unusual changes in behavior or mood. If you have issues with the health of your liver, A low starting dose of Quetiapine (25 mg/day) should be given in patients with an abnormality in the functioning of the liver and dose should be increased gradually as needed. You should consult with your doctor before stopping the use of Quetiapine.
Your doctor may recommend a lower initial dose of this medicine to see the impact of this medicine on the body. Please follow your doctor's directions. Older patients may see an increase in the incidence of side-effects with this medicine. As a result, a lower dose may be recommended for older patients.
When stopping this medicine, you may experience withdrawal symptoms such as vomiting, nausea, headache, dizziness, irritability, diarrhea, and insomnia. You may need to gradually decrease the dose of this medicine before stopping.

Use in Children

If you are giving Quetiapine to a child, be sure to use a product that is meant for children. Before giving this medicine to a child, use the child's weight or age to find the right dose from the product package. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.

Avoid Alcohol

Avoid the consumption of alcohol with Quetiapine. Avoid grapefruit juice while using Quetiapine.

Lab Tests

Your doctor may request that specific lab tests be performed before you start using Quetiapine. You may need to have Blood Glucose test. Blood glucose levels should be checked before starting the treatment with Quetiapine as high blood sugar can happen. Your doctor may request lipid levels test. Changes in the lipid levels such as an increase in triglycerides, low-density lipoproteins, and a decrease in high-density lipoprotein can occur in patients undergoing Quetiapine therapy. You may need to undergo blood pressure test. Quetiapine may cause an increase in blood pressure levels in children. It should be checked before starting Quetiapine therapy.

Storage

You should store Quetiapine at 15°C to 30°C (59°F to 86°F), and away from moisture. Store the medicine away from the reach of children and pets.
Medicines may be prescribed for uses other than those listed in the medicine guide. Do not use Quetiapine for conditions for which it was not prescribed. Do not give Quetiapine to other people who might have the same conditions or symptoms that you have. Self-medication may harm them.

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How to take Quetiapine

Your dose may depend on several personal factors. You should consult with your doctor to find out the dose that is best for you. The dose of Quetiapine depends on the following factors:
  • patient's age
  • patient's health
  • the health of the patient's kidneys
  • medicines recommended by your doctor
  • any other medicines in use
  • herbal supplements consumed

Quetiapine Dosage

Dosage for Schizophrenia

Adult
  • Recommended: 150-750 mg/day
  • Initial: The first four days of therapy is 25 mg twice daily (Day 1), 25-50 mg divided into two or three doses (Day 2 or 3), and 300 mg to 400 mg daily (Day 4). Further dose adjustments should be made in the intervals of not less than 2 days.
Children (aged 13-17 years)
  • Recommended: 400-800 mg/day
  • Initial: The first five days of treatment is 25 mg twice daily (Day 1), 100 mg twice daily (Day 2), 200 mg twice daily (Day 3), 300 mg twice daily (Day 4), and 400 mg twice daily (Day 5). Further dose adjustments should be made according to the recommended dose range of 400-800 mg/day but not more than 100 mg/day.

Dosage for single/combined therapy (lithium/divalproex) for bipolar mania

Adult
  • Recommended: 400-800 mg/day
  • Initial: The first five days of treatment is 100 mg twice daily (Day 1), 200 mg twice daily (Day 2), 300 mg twice daily (Day 3), and 400 mg twice daily (Day 4). The further dose should be adjusted up to 800 mg/day by Day 6 but not more than 100 mg/day.
Children (aged 10-17 years)
  • Recommended: 400-600 mg/day
  • Initial: The first five days of treatment is 25 mg twice daily (Day 1), 100 mg twice daily (Day 2), 200 mg twice daily (Day 3), 300 mg twice daily (Day 4) and 400 mg twice daily (Day 5). Further dose adjustments should be made according to the recommended dose range of 400-600 mg/day but not more than 100 mg/day. Based on response and tolerability, Quetiapine should be given three times daily.

Dosage for bipolar depression

Adult
  • Recommended: 300 mg/day
  • Initial: The first four days of therapy at bedtime is 50 mg/day (Day 1), 100 mg/day (Day 2), 200 mg/day (Day 3), and 300 mg/day (Day 4).

Dosage for maintenance therapy of bipolar I disorder

Adult
  • Initial: 400-800 mg/day in divided dose as a combined therapy (lithium or divalproex). Patients should be continued on the same dose in the maintenance phase.

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Tablet
Strength: 25 mg, 50 mg, 100 mg, 150 mg, 200 mg, 300 mg, and 400 mg
Tablet, multilayer extended release
Strength: 25 mg, 100 mg, 200mg, 300mg
Tablet extended release
Strength: 25 mg, 50 mg, 100 mg, 150 mg, 200 mg, 300 mg, 400 mg

Special Instructions

Extended-release tablets
Swallow the tablet as a whole. Do not crush, chew or split the tablet.

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed dose.

Overdose

What to do if you overdose on Quetiapine?
No specific antidote is available for an overdose of Quetiapine. However, appropriate supportive measures such as intravenous fluids and sympathomimetic agents should be considered to treat low blood pressure and failure of the blood circulatory. Dopamine, beta stimulation, and epinephrine should be avoided because it may worsen low blood pressure. Monitoring of the heart parameters (cardiography, electrocardiography) should also be considered if abnormal heart rhythm occurs. Ventilation, oxygenation, adequate airway should be considered in the management of overdose. Cleaning out of the stomach contents and combined use of laxative with activated charcoal should be considered. In cases of severe drug-induced movement disorders and mental illness (delirium/agitation), anticholinergic medicines (physostigmine) should be given. Physostigmine should not be used in case of heart problems. Continue medical supervision and monitoring should be considered until the patient recovers.
Symptoms of an overdose of Quetiapine
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • anticholinergic effects
  • coma
  • confusion
  • drowsiness
  • fatality
  • inability to completely empty the bladder
  • increased heartbeat
  • low blood pressure
  • mental illness (delirium/agitation)
  • muscle injury (rhabdomyolysis)
  • prolonged heartbeat (QT prolongation)
  • sedation
  • seizures (status epileptics)
  • slow and ineffective breathing
If you think you have overdosed on Quetiapine, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Quetiapine

Before you use Quetiapine, tell your doctor of your medical and health history including the following:
  • abnormal thyroid tests
  • alcohol or drug abuse
  • blockage in the intestine/ileus (intestinal obstruction/ileus)
  • blockage in the intestines
  • blood clots
  • blood vessel related heart and brain disease
  • breast cancer
  • breathing problems during sleep
  • cloudiness of the lens in the eye
  • dehyration
  • enlarged prostate
  • family history of depression, suicide, and bipolar disorder
  • heart muscle disease (cardiomyopathy or myocarditis)
  • heart problems
  • high blood sugar
  • high or low blood pressure
  • high prolactin level
  • inability to empty the bladder
  • increased level of triglycerides, total cholesterol, high-density lipoprotein, or low-density lipoprotein
  • increased or decreased heartbeat (QT prolongation)
  • increased pressure in the eyes (intraocular pressure)
  • liver problems
  • low levels of potassium or magnesium, birth defect related to irregular heart rhthym
  • low levels of white blood cells, leukocytes and neutrophils
  • memory problems (Alzheimer's dementia)
  • mental disorder associated with learning abnormality
  • nerve eye damage (narrow-angle glaucoma)
  • overweight
  • reduced or absent activity of lactase (galactose intolerance and Lapp lactase deficiency) and abnormal absorption of glucose and galactose
  • schizophrenia
  • seizure
  • severe nausea/diarrhea
  • suicdial thoughts
  • taking drugs increasing QT prolongation, central nervous system depressants, neuroleptics, medicines used to treat high blood pressure, depression, anxiety, irritable bowel syndrome, mental illness, ulcer, human immunodeficiency virus, urinary problems, Parkinson's disease, abnormal heart rhythm or beats or difficulty in sleeping, phenytoin, carbamazepine, divalproex, barbiturates, rifampin, thioridazine, erythromycin, gatifloxacin, levomethadyl acetate, antifungals, antihistamines, barbiturates, carbamazepine, or protease inhibitor, chlorpromazine, dopamine agonists, methadone, moxifloxacin, pentamidine, rifampin, oral steroids, tranquilizers, or ziprasidone
Patients with a family history of depression, bipolar disorder, and suicide, or suicidal thoughts are at an increased risk of occurrence of bipolar disorder, suicidal thoughts, and suicide. Patients with high blood sugar and who are overweight are at an incraesed risk of worsening of high blood sugar. Patients with a history of blood vessel related heart and brain disease are at an increased risk of low blood pressure. Patients with a history irregular heart rhythm, low levels of potassium or magnesium, birth defects related to irregular heart rhythm are at an increased risk of increased heartbeat (torsade de pointes) and fatality. Patients with a history of seizure or Alzheimer's dementia may experience seizures when using Quetiapine. Elderly patients with a mental disorder associated with learning abnormality (dementia-related psychosis) are at increased risk of possibly fatal when using Quetiapine.
Before you use Quetiapine, discuss with your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.
Before having surgery during the use of Quetiapine, discuss with your doctor and dentist about the medicinal products you use including prescription/non-prescription/herbal medicines.
The use of this medicine may change hemoglobin. Female patients may experience a decrease in hemoglobin levels when using Quetiapine.
The use of this medicine may change body weight. Quetiapine may cause an increase in weight in patients taking this medicine.
The use of Quetiapine may change fat levels. Quetiapine may cause abnormal changes in the levels of lipids (cholesterol and triglycerides, low-density lipoprotein and high-density lipoprotein) in the blood.
The use of this medicine may change blood sugar. Quetiapine may cause high blood sugar or worsen the blood sugar in patients taking Quetiapine or in patients with high blood sugar respectively. These patients should be observed for symptoms and signs of high blood sugar such as weakness, increased thirst or urine passage and excessive eating.
The use of Quetiapine may change blood cells. Quetiapine may decrease the number of leukocytes (leukopenia), granulocytes, platelets or neutrophils in the blood. This medicine should be discontinued on the occurrence of a decline in white blood cells. Monitoring of complete blood cell count should be considered in these patients.

Seizures

Quetiapine can make you feel sleepy. Be careful when using any machinery, driving a vehicle, or doing any other activity that needs you to be fully alert. The consumption of alcohol with Quetiapine can worsen the sleepiness. Quetiapine may cause rarely seizures in some people. If you perform any activities where a loss of consciousness may cause harm to you (or others), you should discuss with your doctor.

Use in Pregnancy

The use of Quetiapine during pregnancy should only be when required. Quetiapine may increase the risk of drug-induced movement disorder (extrapyramidal)/withdral symptoms in infants when pregnant women take this medicine during late pregnancy. Therefore, this medicine should be used during pregnancy only after evaluating that the possible benefit justifies the possible risk to the fetus.

Use while Breastfeeding

The use of Quetiapine is not safe for use in women who are breastfeeding. If you are breastfeeding a baby, discuss with your doctor if you should either discontinue breastfeeding or stop using this medicine while breastfeeding. Quetiapine may pass into breast milk.

Use while Conceiving

Consult with your doctor on the use of Quetiapine, if you are trying to conceive.

Alcohol

Avoid consuming alcohol together with Quetiapine. Drinking alcohol may cause alcohol intolerance, unpleasant, sudden reaction, increased memory and movement disorder, increased drowsiness/sedation, swelling in the pancreas (pancreatitis), and misuse and abuse.

Increased Risks

This medicine may increase your sensitivity to sunlight. If this happens, use a sunscreen and cover your skin when you are outdoors. Limit your time in the sun.

Side-effects in Older Patients

Quetiapine may cause increased incidence of side-effects in older patients. Elderly patients may see an increased risk of irreversible and involuntary body movements (tardive dyskinesia), prolonged heartbeat (QT prolongation), complication due to inhalation of food, acid or saliva (aspiration pneumonia), low blood pressure on quickly standing up, dizziness, falls, and stroke.

Side-effects in Children

Quetiapine may cause an increased risk of side-effects in children. Children using this medicine may see an increased risk of suicidal thinking and behavior, high blood pressure, increased appetite, vomiting, stuffy nose (rhinitis), increased levels of prolactin, loss of consciousness, and drug-induced movement disorder (extrapyramidal symptoms).

Long-term Use

Patients using Quetiapine for long-term may experience lens changes. Children and adults may experience high blood pressure. Whereas drug-induced movement disorder, increased levels of prolactin and weight gain are more frequent in children than adults.

What precautions should be taken during Pregnancy and Nursing, and administering Quetiapine to Children or the Older Adults?

Pregnant Women

Only when required
Warning: Pregnant women using this medicine during late pregnancy may see an increase in the risk of drug-induced movement disorder (extrapyramidal)/withdral symptoms in infants. Careful monitoring of the infants should be considered.

Breastfeeding

Contraindicated or Not Recommended
Warning: Quetiapine may pass into breast milk

Younger Adults Population

Precaution
Warning: Quetiapine should not be used in children suffering from depression because it may cause worsening of the depression, suicide-related behavior or unusual changes in the behavior.

Older Adults Population

Precaution
Warning: Quetiapine should not be used in patients who have a mental disorder associated learning abnormality (dementia-related psychosis) as it may increase the risk of stroke, heart failure or lung infection which can be possibly fatal. These patients are also at an increased risk of involuntary body movements (tardive dyskinesia), prolonged heartbeat (QT prolongation), poor tolerance, low blood pressure on quickly standing up, dizziness, falls, difficulty in swallowing (dysphagia), excessive salivation, or complication due to inhalation of food, acid, and saliva (aspiration pneumonia).

Quetiapine Side-effects

The following side-effects may commonly occur when using Quetiapine. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
  • a sudden drop in blood pressure upon standing
  • abnormal dreams
  • abnormal liver tests
  • blurred vision
  • breathlessness
  • constipation
  • decrease leukocytes count
  • decreased hemoglobin levels
  • decreased in high-density lipoproteins (HDL) cholesterol
  • decreased neutrophil count
  • decreased thyroid level
  • dizziness
  • drowsiness
  • drug-induced movement disorders (extrapyramidal symptoms)
  • dry mouth
  • fainting
  • fatigue
  • fever
  • fluid buildup in lower limbs
  • headache
  • high blood sugar levels
  • increased alanine aminotransferase levels
  • increased appetite
  • increased eosinophils
  • increased gamma-glutamyl transferase (GGT) levels
  • increased low-density lipoproteins (LDL) cholesterol
  • increased prolactin level
  • increased triglycerides levels
  • increases in thyroid stimulating hormones (TSH)
  • indigestion
  • inflammation of the pharynx (pharyngitis)
  • irregular heartbeat
  • irritability
  • lack of energy
  • nausea
  • nightmares
  • rapid heartbeat
  • sluggishness
  • slurred or slow speech
  • sneezing and watery eyes (rhinitis)
  • sore throat
  • stomach pain
  • stomach upset
  • suicidal ideation and suicidal behaviour
  • vomiting
  • weakness
  • weight gain
  • withdrawal symptoms
The following side-effects may commonly occur in children when using Quetiapine. Discuss with your doctor if any of these side-effects last for a long time or are severe:
Rarely, the use of Quetiapine may cause the following side-effects:
The following severe side-effects may also occur when using Quetiapine:
  • Symptoms: abnormally low levels of thrombocytes, ncrease in the total number of white blood cells, reduced red blood cell volume (anemia/ hypochromic anemia), destruction of red blood cells, abnormally low count of neutrophils, decreased platelet count decreased number of granulocytes
    If this happens, stop taking Quetiapine and contact your doctor as soon as possible.
  • Immune system disorders such as allergic reaction and life-threatening allergic reaction (anaphylactic reaction)
    Symptoms: raised lumps (weals), swelling of the skin and swelling around the mouth, difficulty in breathing or shock, fever, blister on the skin peeling of the skin
    If this happens, stop taking Quetiapine and contact your doctor as soon as possible.
  • Mental and nervous system disorders
    Symptoms: agitation, anxiety, confusion, hallucinations, psychosis, serious mental illness (delusions/delirium), depression, seizure, involuntary body movements (tardive dyskinesia), collection of blood outside the brain (subdural hematoma) suicide attempt
    If a seizure happens, stop taking Quetiapine and contact your doctor as soon as possible. Quetiapine should be discontinued, or dose reduction should be considered in patients developing symptoms of involuntary body movements.
  • Metabolic and endocrine disorders (possibly fatal)
    Symptoms: low thyroid hormones (hypothyroidism), low blood sugar, low potassium pressure, high blood glucose (symptoms such as weakness, increased thirst or urine passage and excessive eating), overproduction of thyroid hormone, low levels of sodium, alcohol intolerance, dehydration, increased alkaline phosphatase increased creatinine
    Patients should be monitored and observed for symptoms and signs of high blood sugar or weight gain.
  • Heart and respiratory disorders
    Symptoms: low and high blood pressure, prolong heartbeat (QT interval prolonged), slow heart rate, heart block (bundle branch block), abnormal heart rhythm (atrial fibrillation), congestive heart failure, inflammation of the nasal sinus (sinusitis), bleeding from the nasal cavity (epistaxis) bleeding (hemorrhage)
  • Eye disorders
    Symptoms: inflammation of the conjunctiva of the eye (conjunctivitis) optic nerve damage
  • Stomach and intestinal disorders
    Symptoms: difficulty in swallowing (dysphagia), eating disorder (anorexia), inflammation of the stomach (gastritis), painful swelling and sores inside the mouth, intestinal obstruction, swelling of the pancreas rectal bleeding
    If this happens, stop taking Quetiapine and contact your doctor as soon as possible.
  • Liver, kidney and urinary disorders
    Symptoms: increased aspartate aminotransferase, inability to empty the bladder, yellowing of the skin (jaundice), swelling in the liver (hepatitis), urinary tract infection, inflammation of the bladder (cystitis), vaginal bleeding acute kidney failure
    If this happens, stop taking Quetiapine and contact your doctor as soon as possible.
  • Skin and subcutaneous tissue disorders
    Symptoms: sun allergic reaction (photosensitivity reaction), skin ulcer, swelling of the lower layer of the skin, life-threatening skin reaction (Stevens-Johnson Syndrome), skin allergic reaction caused by infection (erythema multiforme) life-threatening drug-induced skin reaction
    If this happens, stop taking Quetiapine and contact your doctor as soon as possible.
  • Drug-induced life-threatening reaction (Neuroleptic Malignant Syndrome) | (possibly fatal)
    Symptoms: high fever, stiff muscles, confusion, excessive sweating (diaphoresis), irregular blood pressure, rapid heartbeat, muscle rigidity, altered mental status, abnormal heartbeat, increased creatine phosphokinase, presence of myoglobin in the urine (myoglobinuria) acute kidney failure
    If this happens, stop taking Quetiapine and contact your doctor as soon as possible.
Your doctor has prescribed this medicine because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious cases of side-effects. This page does not contain a complete list of all possible side-effects.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Quetiapine by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Older Adults

Following are the side-effects of this medicine in elderly patients:
  • QT prolongation
  • accidental injury (fall)
  • vomiting

Side-effects in Children

Following are the side-effects of this medicine in young patients:

Mild Allergic Reactions

Following are the symptoms of mild allergic reactions to this medicine:
  • raised lumps (weals)
  • swelling around the mouth
  • swelling of the skin
If this happens, stop taking Quetiapine and contact your doctor as soon as possible.

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
If this happens, stop taking Quetiapine and contact your doctor as soon as possible.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Elderly Patients

Elderly patients suffering from a mental disorder associated learning abnormality (dementia-related psychosis) are at an increased risk when using Quetiapine. These patients may experience an increased incidence of blood vessel-related brain diseases, heart failure or lung infection (pneumonia) which can be possibly fatal. Quetiapine should not be used in such patients. Take necessary precautions while using Quetiapine in patients with a risk factor for stroke.

Suicidal Thoughts and Behavior

Children and young adults (age 18 to 24 years) or patients with mood disorder, schizophrenia, and depression/psychotics disorders are at an increased risk when using Quetiapine. These patients may experience worsening of the depression and suicide-related/unusual changes in behaviors such as agitation, anxiety, panic attacks, irritability, etc. Patients should be monitored closely for suicide-related/unusual changes in behaviors in the starting of therapy or during dose adjustment. Discontinuation of Quetiapine, the lowest effective dose or changes in the therapy should be considered in such patients.

Neuroleptic Malignant Syndrome

Patients taking Quetiapine are at an increased risk. Drug-induced life-threatening reaction (neuroleptic malignant syndrome) may occur in these patients and may experience symptoms such as high fever, abnormal mental status, muscle rigidity, irregular blood pressure, abnormal heart rhythm, increased heart rate, sweating, increased creatinine phosphokinase, kidney failure, and myoglobin in the urine. Monitoring and treatment of neuroleptic malignant syndrome, discontinuation of Quetiapine or other drugs not required for the combined therapy should be considered. Antipsychotic drug therapy should be reintroduced after recovery from the neuroleptic malignant syndrome.

High Blood Sugar

Patients with high blood sugar are at an increased risk while taking Quetiapine. These patients may experience an increased level of glucose and acids in the blood, weight gain, a complication of high blood sugar (diabetic hyperosmolar coma) or fatality. These patients should be observed for symptoms of high blood sugar such as weakness, increased thirst or urine passage and excessive eating (polyphagia). Such patients should be monitored regularly for body weight changes or worsening of sugar level. Fasting blood sugar test should be performed in the starting and during the treatment with Quetiapine.

Metabolic Changes

Children or patients taking Quetiapine are at an increased risk. These patients may experience metabolic changes such as an increase in weight, changes in lipids levels such as an increase in triglycerides, total cholesterol, high-density lipoprotein, and a decrease in high-density lipoprotein. Patients should be monitored for metabolic changes, and appropriate treatment should be used.

Tardive Dyskinesia

Elderly patients especially elderly women taking Quetiapine, are at an increased risk. These patients may experience irreversible and involuntary body movements (tardive dyskinesia). This risk increases as the treatment duration increases. Long-term antipsychotic treatment should be given in patients with serious illness. The smallest dose for the shortest duration should be used in such patients. Quetiapine should be discontinued, or dose reduction should be considered in patients developing symptoms of involuntary body movements.

Low Blood Pressure on Quickly Standing

Elderly patients or patients taking Quetiapine are at an increased risk. Quetiapine may cause dizziness, increased heart rate, loss of consciousness, falls, or low blood pressure on quickly standing up in these patients in the starting period of Quetiapine therapy. Precaution should be taken in patients with low blood volume, low body fluid, taking antihypertensive drugs, and in blood vessel related heart and brain diseases. Starting dose should be kept small, and dose should be increased slowly afterward. If low blood pressure still develops, then the previous dose should be considered.

Low Levels of Blood Cells

Patients with history or already low levels of white blood cells count/absolute neutrophil count, or taking Quetiapine are at an increased risk. Quetiapine may decrease the number of leukocytes (leukopenia), granulocytes, or neutrophils in these patients. Complete blood count test should be performed in such patients in the initial period and during drug therapy. Patients should be informed to report the doctor immediately on the occurrence of any signs of infection and low levels of granulocytes. On the occurrence of low white blood cell or neutrophil count, Quetiapine should be discontinued. Patients should be monitored and treated for symptoms of infection such as fever.

Cloudiness of the Lens in the Eye

Adults and children using Quetiapine for long-term are at an increased risk. Long-term use of Quetiapine may cause cloudiness of the lens in the eye (cataracts) in these patients. An appropriate method such as slit lamp exam should be used for the diagnosis of the cataract in the starting and during Quetiapine therapy.

Abnormal Heart Rhythm

Elderly patients, patients taking medicines known to cause electrolyte imbalance/QT prolongation, an overdose of Quetiapine or with any other illness are at an increased risk. These patients may experience prolonged heartbeat (QT prolongation). Quetiapine should not be used in patients with a history of abnormal heartbeat, low levels of potassium/magnesium, birth defects related to abnormal heart rhythm, or taking drugs known to cause QT prolongation such as quinidine, gatifloxacin, or methadone. Precaution should be used in patients with heart failure, thickened heart muscles (heart hypertrophy) or taking neuroleptics.

Seizures

Elderly patients, patients with a history of seizures, condition associated with seizures, or taking Quetiapine are at an increased risk. Quetiapine may cause seizures in these patients. Precaution should be taken in such patients.

Increased Levels of Prolactin

Patients taking Quetiapine are at an increased risk. These patients may experience increased levels of prolactin, which may lead to reduced pituitary gonadotrophin secretion and ultimately reduced functioning of the reproductive system. These patients may also experience abnormal milky discharge from breasts (galactorrhea), the absence of menstruation (amenorrhea), enlarged breasts in men (gynecomastia), and erection abnormality (impotence). Decreased bone density may occur in these patients.

Increased Levels of Liver Enzymes

Patients taking Quetiapine are at an increased risk. These patients may experience increased levels of transaminases such as alanine aminotransferase.

Memory and Movement Problems

Patients taking Quetiapine are at an increased risk. Quetiapine may cause drowsiness, sedation, falls, and abnormality in thinking, judgment or movements. Patients should take necessary precaution while operating heavy machines such as automobiles.

Prolonged Erection of the Penis

Patients taking Quetiapine are at an increased risk. These patients may experience prolonged erection of the penis (priapism). Surgical procedures should be considered for the treatment of priapism.

Interactions with Quetiapine

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Quetiapine. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Divalproex

Your doctor's guidelines may need to be followed while taking this medicine along with divalproex, which is used to treat mood disorder. When Quetiapine is used with divalproex, it may increase the levels of Quetiapine.

Drugs Known to Cause Electrolyte Imbalance

Quetiapine interacts with drugs known to cause electrolyte imbalance. Precaution should be taken when using Quetiapine with drugs known to cause electrolyte imbalance.

Drugs Known to Increase QT Prolongation

There may be an interaction of Quetiapine with drugs known to increase QT prolongation (quinidine, amiodarone, and ziprasidone). Quetiapine should not be used in combination with drugs known to increase QT prolongation.

Centrally Acting Drugs

Quetiapine may interact with Centrally acting drugs (antihypertensive, levodopa, and dopamine), which are sued to treat high blood pressure. When Quetiapine is used with centrally acting drugs, it may either decrease the blood pressure or oppose the effects of centrally acting drugs. Take necessary precautions while using Quetiapine with centrally acting drugs.

Antiepileptic Drug

Special instructions need to be followed while taking this medicine along with Antiepileptic drug such as phenytoin, which is used to treat seizures. When Quetiapine is used with phenytoin or carbamazepine, it may increase the clearance of Quetiapine. When using Quetiapine with carbamazepine, rifampin, barbiturates, or glucocorticoids dose of Quetiapine should be increased for maintaining the control of symptoms in patients who have schizophrenia. This combination should be used when the benefits of using Quetiapine outweigh the risk of stopping liver enzyme inducer. Precaution should be taken when withdrawing phenytoin and replacing it with valproate.

Cytochrome P450 3A Inhibitors

Your doctor's guidelines may need to be followed while taking this medicine along with Cytochrome P450 3A Inhibitors (fluconazole, erythromycin, and ketoconazole), which are used to treat bacterial and fungal infections. Use of Quetiapine with cytochrome P450 3A Inhibitors may increase the levels of Quetiapine. Precaution should be taken in patients using this combination.

Antimanic Agent

Quetiapine interacts with Antimanic agent such as lithium, which is used to treat depression. Use of Quetiapine with lithium in patients with mania may cause increased occurrence of tremor, sleepiness, and weight gain.

Drugs with Anticholinergic Effects

Special instructions need to be followed while taking this medicine along with drugs with anticholinergic effects. When Quetiapine is used with drugs with anticholinergic effects, it may cause harmful effects. Precaution should be taken when Quetiapine is used with drugs with anticholinergic effects.

Histamine-2 Blockers

There may be an interaction of Quetiapine with Histamine-2 blocker such as cimetidine, which is used to treat stomach ulcers. When multiple doses of cimetidine is used with Quetiapine, it may decrease the clearance of Quetiapine.

Thioridazine

Quetiapine may interact with thioridazine, which is used to treat mental illness. The use of Quetiapine with thioridazine may increase the clearance of Quetiapine.

Benzodiazepine

Quetiapine may interact with Benzodiazepine such as lorazepam, which is used to treat anxiety. When Quetiapine is used with lorazepam, it may decrease the clearance of lorazepam.

Methadone and Tricyclic Antidepressants

There may be an interaction of Quetiapine with Methadone and Tricyclic Antidepressants, which are used to treat severe pain and depression respectively. When Quetiapine is used during enzyme immunoassay for tricyclic antidepressants and methadone, it may cause false positive results. An appropriate method such as chromatographic technique should be used instead of using the enzyme immunoassay method.

Interactions of Quetiapine by Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Quetiapine be not used?

Allergic to Quetiapine

This medicine should not be used in patients allergic to Quetiapine. These patients may have the following symptoms if they use this medicine:
  • allergic skin reactions
  • raised lumps (weals)
  • swelling of the skin
  • swelling around the mouth
  • fever
  • blister on the skin
  • drug-induced life-threatening reaction

Drugs Prolonging QT Interval

Patients taking drugs prolonging QT interval (such as amiodarone, sotalol, moxifloxacin) should not use Quetiapine. Patients using Quetiapine with drugs prolonging QT interval are at an increased risk of increased heartbeat (torsade de pointes) and fatality.

Low Levels of Potassium or Magnesium

This medicine should not be used in patients with low levels of potassium or sodium. Quetiapine may increase the risk of increased heartbeat (torsade de pointes) and fatality in these patients.

Birth Defect of QT Prolongation

Use of this medicine is not recommended in patients with birth defects of prolonged heartbeat (QT prolongation). Quetiapine may increase the risk of increased heartbeat (torsade de pointes) and fatality in such patients.

Mental Disorder Associated Learning Abnormality

Quetiapine should not be used in patients with a mental disorder associated with learning abnormality. These patients are at an increased incidence of fatality. These patients may have the following symptoms if they use this medicine:

Genetic Problems

This medicine should not be used in patients with a reduced or absent activity of lactase (galactose intolerance, Lapp lactase deficiency) and abnormal absorption of glucose and galactose in the body.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Quetiapine is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Quetiapine .
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Bipolar Disorder
Manic Depression
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