Qmax
Generic Name
Quetiapine 25 mg tablet
Manufacturer
General Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| qmax 25 mg tablet | ৳ 3.01 | ৳ 30.10 |
Description
Overview of the medicine
Qmax (Quetiapine) is an atypical antipsychotic medicine used to treat schizophrenia, bipolar disorder (manic, depressive, or mixed episodes), and as an add-on treatment for major depressive disorder.
Uses & Indications
Dosage
Adults
Initial dose 25-50 mg/day, typically administered in two divided doses. Dosage is then gradually titrated upwards based on clinical response and tolerability, usually ranging from 150-800 mg/day depending on the indication.
Elderly
Lower initial doses (e.g., 25 mg/day) and slower titration are recommended due to increased sensitivity and potential for orthostatic hypotension.
Renal_impairment
No initial dose adjustment is generally required, but caution is advised in severe renal impairment.
How to Take
Take orally with or without food. Swallow the tablet whole; do not chew, crush, or break it.
Mechanism of Action
Quetiapine acts as an antagonist at various neurotransmitter receptors, including serotonin (5-HT2A) and dopamine (D1 and D2) receptors. It also has affinity for histamine H1 and adrenergic alpha1/alpha2 receptors, contributing to its diverse pharmacological effects.
Pharmacokinetics
Onset
Antipsychotic effects may take several days to weeks to become apparent. Sedative effects may be noticed sooner.
Excretion
Approximately 73% excreted via urine and 20% via feces, mainly as inactive metabolites.
Half life
Approximately 7 hours for quetiapine and 12 hours for the active metabolite norquetiapine.
Absorption
Rapidly absorbed after oral administration. Peak plasma concentrations are typically reached within 1.5 hours. Food can increase absorption.
Metabolism
Extensively metabolized in the liver, primarily by the cytochrome P450 3A4 (CYP3A4) enzyme.
Side Effects
Contraindications
- Hypersensitivity to quetiapine or any component of the formulation.
- Concomitant use with strong CYP3A4 inhibitors (e.g., protease inhibitors, azole antifungals, erythromycin, clarithromycin, nefazodone).
Drug Interactions
CNS depressants (e.g., alcohol, benzodiazepines)
May cause additive sedative effects, increasing drowsiness and dizziness.
Strong CYP3A4 inducers (e.g., carbamazepine, rifampin)
May significantly decrease quetiapine levels, potentially reducing efficacy. Dose adjustment may be necessary.
Strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May significantly increase quetiapine levels, leading to increased side effects. Concomitant use is contraindicated.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, sedation, tachycardia, hypotension, and anticholinergic effects. Management is supportive, focusing on maintaining an open airway, ensuring adequate oxygenation and ventilation, and monitoring cardiovascular status. Gastric lavage and activated charcoal may be considered in some cases.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs potential risk to the fetus. Neonates exposed to antipsychotic drugs during the third trimester are at risk for extrapyramidal and/or withdrawal symptoms. Excreted in breast milk; caution advised, and a decision should be made to discontinue nursing or the drug.
Side Effects
Contraindications
- Hypersensitivity to quetiapine or any component of the formulation.
- Concomitant use with strong CYP3A4 inhibitors (e.g., protease inhibitors, azole antifungals, erythromycin, clarithromycin, nefazodone).
Drug Interactions
CNS depressants (e.g., alcohol, benzodiazepines)
May cause additive sedative effects, increasing drowsiness and dizziness.
Strong CYP3A4 inducers (e.g., carbamazepine, rifampin)
May significantly decrease quetiapine levels, potentially reducing efficacy. Dose adjustment may be necessary.
Strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May significantly increase quetiapine levels, leading to increased side effects. Concomitant use is contraindicated.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, sedation, tachycardia, hypotension, and anticholinergic effects. Management is supportive, focusing on maintaining an open airway, ensuring adequate oxygenation and ventilation, and monitoring cardiovascular status. Gastric lavage and activated charcoal may be considered in some cases.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs potential risk to the fetus. Neonates exposed to antipsychotic drugs during the third trimester are at risk for extrapyramidal and/or withdrawal symptoms. Excreted in breast milk; caution advised, and a decision should be made to discontinue nursing or the drug.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of quetiapine in the treatment of schizophrenia, bipolar disorder, and as an adjunct for major depressive disorder.
Lab Monitoring
- Blood glucose (for risk of hyperglycemia and diabetes)
- Lipid profile (for risk of dyslipidemia)
- Weight (for risk of weight gain)
- Blood pressure (for risk of orthostatic hypotension)
- Thyroid function tests (rarely causes hypothyroidism)
- Complete Blood Count (CBC) (for rare leukopenia/neutropenia)
Doctor Notes
- Initiate Qmax with a low dose and titrate slowly to minimize the risk of orthostatic hypotension and sedation.
- Regularly monitor patients for metabolic syndrome parameters (weight, blood glucose, lipid profile) due to the risk of metabolic adverse effects.
- Use with caution in patients with known cardiovascular disease, cerebrovascular disease, or conditions predisposing to hypotension.
Patient Guidelines
- Do not stop taking Qmax suddenly without consulting your doctor, as this can lead to withdrawal symptoms or relapse.
- Avoid consuming alcohol while taking this medicine, as it can increase drowsiness.
- Report any unusual or severe side effects, especially involuntary movements, fever, or muscle rigidity, to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
Driving Precautions
Qmax may cause drowsiness, dizziness, or blurred vision. Avoid driving or operating heavy machinery until you know how this medicine affects you and are sure you can perform such activities safely.
Lifestyle Advice
- Maintain a healthy diet and engage in regular physical activity to help manage potential weight gain associated with quetiapine.
- Regular follow-up appointments and blood tests are important for monitoring potential metabolic side effects.
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