Queta-XR
Generic Name
Quetiapine Fumarate Extended-Release 300 mg Tablet
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| queta xr 300 mg tablet | ৳ 20.00 | ৳ 200.00 |
Description
Overview of the medicine
Queta-XR 300 mg Tablet is an atypical antipsychotic medication used to treat schizophrenia, bipolar disorder (manic, depressive, and maintenance episodes), and as an adjunctive treatment for major depressive disorder. It works by affecting the activity of certain neurotransmitters in the brain.
Uses & Indications
Dosage
Adults
Schizophrenia: Initial 300 mg/day, target 400-800 mg/day. Bipolar Mania: Initial 300 mg/day, target 400-800 mg/day. Bipolar Depression: 300 mg/day. MDD (adjunctive): Initial 50 mg/day, target 50-300 mg/day. Doses should be titrated gradually.
Elderly
Lower starting dose (e.g., 50 mg/day) and slower titration, due to potential for orthostatic hypotension and increased sensitivity.
Renal_impairment
No dose adjustment is usually required for patients with renal impairment. However, use caution and consider slower titration.
How to Take
Take orally once daily, preferably in the evening, with or without food. Swallow the tablet whole; do not chew, crush, or split it.
Mechanism of Action
Quetiapine is an antagonist at multiple neurotransmitter receptors in the brain: serotonin 5-HT2A, dopamine D1 and D2, histamine H1, and adrenergic alpha1 and alpha2 receptors. Its antipsychotic effect is thought to be mediated through a combination of dopamine and serotonin antagonism.
Pharmacokinetics
Onset
Variable, symptom improvement for acute psychosis can be seen within days to weeks. Sedative effects may occur rapidly.
Excretion
Approximately 73% excreted in urine and 20% in feces, predominantly as metabolites.
Half life
The elimination half-life of quetiapine is approximately 7 hours, but the XR formulation provides sustained therapeutic levels for 24 hours.
Absorption
Well absorbed from the gastrointestinal tract. Peak plasma concentrations are reached approximately 5-9 hours post-dose for XR formulation.
Metabolism
Extensively metabolized in the liver, primarily by cytochrome P450 3A4 (CYP3A4).
Side Effects
Contraindications
- Hypersensitivity to quetiapine or any component of the formulation.
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) is generally contraindicated due to risk of increased quetiapine exposure.
Drug Interactions
CNS Depressants
May potentiate the effects of alcohol and other CNS depressants. Avoid concomitant use.
CYP3A4 Inducers
Strong inducers (e.g., phenytoin, carbamazepine, rifampicin) can significantly decrease quetiapine plasma concentrations. Increase quetiapine dose.
CYP3A4 Inhibitors
Strong inhibitors (e.g., ketoconazole, ritonavir) can significantly increase quetiapine plasma concentrations. Reduce quetiapine dose.
QT-Prolonging Drugs
Caution with other drugs known to prolong the QT interval.
Antihypertensive Agents
May potentiate orthostatic hypotension due to quetiapine's alpha1-adrenergic antagonism.
Storage
Store below 30°C. Protect from moisture and light. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, sedation, tachycardia, hypotension, and QT prolongation. Management is supportive, including maintaining an open airway, oxygenation, and ventilation, and monitoring cardiovascular function. Activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Quetiapine is excreted in human breast milk; therefore, caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to quetiapine or any component of the formulation.
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) is generally contraindicated due to risk of increased quetiapine exposure.
Drug Interactions
CNS Depressants
May potentiate the effects of alcohol and other CNS depressants. Avoid concomitant use.
CYP3A4 Inducers
Strong inducers (e.g., phenytoin, carbamazepine, rifampicin) can significantly decrease quetiapine plasma concentrations. Increase quetiapine dose.
CYP3A4 Inhibitors
Strong inhibitors (e.g., ketoconazole, ritonavir) can significantly increase quetiapine plasma concentrations. Reduce quetiapine dose.
QT-Prolonging Drugs
Caution with other drugs known to prolong the QT interval.
Antihypertensive Agents
May potentiate orthostatic hypotension due to quetiapine's alpha1-adrenergic antagonism.
Storage
Store below 30°C. Protect from moisture and light. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, sedation, tachycardia, hypotension, and QT prolongation. Management is supportive, including maintaining an open airway, oxygenation, and ventilation, and monitoring cardiovascular function. Activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Quetiapine is excreted in human breast milk; therefore, caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date
Availability
Pharmacies, Hospitals
Approval Status
FDA Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Quetiapine XR has undergone extensive clinical trials demonstrating its efficacy and safety in the treatment of schizophrenia, bipolar disorder, and as an adjunctive therapy for MDD.
Lab Monitoring
- Fasting blood glucose (at baseline and periodically)
- Lipid profile (at baseline and periodically)
- Liver function tests (LFTs) (at baseline and periodically)
- Complete blood count (CBC) (if signs of infection or decreased WBC are present)
- ECG (before treatment and periodically, especially in patients at risk of QT prolongation)
Doctor Notes
- Closely monitor patients for metabolic side effects (weight, glucose, lipids) throughout treatment.
- Assess for symptoms of Neuroleptic Malignant Syndrome (NMS) and Tardive Dyskinesia (TD).
- Educate patients on the importance of adherence and not discontinuing abruptly.
Patient Guidelines
- Take your medication exactly as prescribed by your doctor. Do not stop taking it suddenly, as this can cause withdrawal symptoms.
- Be aware of the potential for drowsiness and dizziness, especially when starting the medication.
- Report any unusual side effects, especially uncontrollable movements or signs of high blood sugar.
- Avoid alcohol while taking this medication.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Queta-XR may cause drowsiness, dizziness, or blurred vision. Do not drive or operate heavy machinery until you know how this medication affects you.
Lifestyle Advice
- Maintain a healthy diet and engage in regular physical activity to help manage potential weight gain and metabolic changes.
- Stay hydrated.
- Avoid abrupt discontinuation of the medication without consulting your doctor.
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