Qutap
Generic Name
Quetiapine
Manufacturer
ACME Laboratories Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| qutap 25 mg tablet | ৳ 3.00 | ৳ 30.00 |
Description
Overview of the medicine
Qutap 25 mg Tablet contains Quetiapine, an atypical antipsychotic medicine used to treat mental health conditions such as schizophrenia, bipolar disorder (manic, depressive, or mixed episodes), and as an add-on treatment for major depressive disorder.
Uses & Indications
Dosage
Adults
For schizophrenia: Initial dose 25 mg twice daily, increasing gradually to 300-450 mg/day in divided doses. For bipolar mania: Initial dose 50 mg twice daily, increasing to 400-800 mg/day in divided doses. For bipolar depression: 50 mg at bedtime on day 1, 100 mg at bedtime on day 2, then 300 mg at bedtime. For MDD augmentation: 50 mg at bedtime, increasing to 150-300 mg/day.
Elderly
A lower initial dose of 25 mg/day (once daily) should be used, with gradual titration, especially in patients with impaired hepatic function.
Renal_impairment
No dosage adjustment is necessary for mild to moderate renal impairment. Use with caution in severe renal impairment.
How to Take
Take orally, with or without food. Tablets should be swallowed whole. Do not crush or chew.
Mechanism of Action
Quetiapine is an antagonist at multiple neurotransmitter receptors including serotonin 5HT2, 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 D2 and serotonin 5HT2 receptor antagonism.
Pharmacokinetics
Onset
Initial effects may be noticed within days, but full therapeutic response can take several weeks.
Excretion
Mainly excreted via urine (73%) and feces (20%) as metabolites. Less than 1% is excreted unchanged.
Half life
Approximately 7 hours for quetiapine; the active metabolite norquetiapine has a half-life of approximately 12 hours.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations occurring within 1-2 hours. Food increases absorption.
Metabolism
Primarily hepatic, extensively metabolized by cytochrome P450 3A4 (CYP3A4) to active (norquetiapine) and inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to quetiapine or any of the excipients.
- Concomitant use with strong cytochrome P450 3A4 (CYP3A4) inhibitors (e.g., ketoconazole, erythromycin, protease inhibitors, nefazodone).
Drug Interactions
CNS Depressants
May cause additive sedative effects (e.g., alcohol, benzodiazepines, other antipsychotics).
CYP3A4 Inducers
Decrease quetiapine plasma concentrations (e.g., carbamazepine, phenytoin, rifampin).
Antihypertensives
May enhance orthostatic hypotensive effects.
CYP3A4 Inhibitors
Increase quetiapine plasma concentrations (e.g., ketoconazole, erythromycin, protease inhibitors).
Drugs affecting QT interval
Use with caution due to potential for QT prolongation.
Storage
Store in a cool and dry place, below 30°C. Protect 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 care, including airway management, cardiovascular monitoring, and activated charcoal to reduce absorption.
Pregnancy & Lactation
Pregnancy: Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. Neonates exposed to antipsychotics during the third trimester are at risk for extrapyramidal and/or withdrawal symptoms. Lactation: Quetiapine is excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Side Effects
Contraindications
- Hypersensitivity to quetiapine or any of the excipients.
- Concomitant use with strong cytochrome P450 3A4 (CYP3A4) inhibitors (e.g., ketoconazole, erythromycin, protease inhibitors, nefazodone).
Drug Interactions
CNS Depressants
May cause additive sedative effects (e.g., alcohol, benzodiazepines, other antipsychotics).
CYP3A4 Inducers
Decrease quetiapine plasma concentrations (e.g., carbamazepine, phenytoin, rifampin).
Antihypertensives
May enhance orthostatic hypotensive effects.
CYP3A4 Inhibitors
Increase quetiapine plasma concentrations (e.g., ketoconazole, erythromycin, protease inhibitors).
Drugs affecting QT interval
Use with caution due to potential for QT prolongation.
Storage
Store in a cool and dry place, below 30°C. Protect 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 care, including airway management, cardiovascular monitoring, and activated charcoal to reduce absorption.
Pregnancy & Lactation
Pregnancy: Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. Neonates exposed to antipsychotics during the third trimester are at risk for extrapyramidal and/or withdrawal symptoms. Lactation: Quetiapine is excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture.
Availability
Pharmacies nationwide
Approval Status
Approved by regulatory authorities
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of quetiapine across its approved indications, including positive effects on symptoms of schizophrenia, mood stabilization in bipolar disorder, and augmentation in major depressive disorder.
Lab Monitoring
- Fasting blood glucose/HbA1c (regularly, due to risk of hyperglycemia and diabetes)
- Lipid panel (regularly, due to risk of dyslipidemia)
- Weight/BMI (regularly)
- Blood pressure (regularly)
- Complete blood count (CBC) (if clinically indicated)
Doctor Notes
- Regularly monitor patients for metabolic parameters (weight, fasting glucose, lipid profile) due to the risk of metabolic adverse effects.
- Educate patients and caregivers about the symptoms of Neuroleptic Malignant Syndrome (NMS) and Tardive Dyskinesia, and advise immediate reporting if these occur.
- Caution patients about orthostatic hypotension and sedation, particularly during initiation and dose titration.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor. Do not stop taking it suddenly, as this can lead to withdrawal symptoms.
- Avoid alcohol consumption while on this medication, as it can worsen drowsiness and other side effects.
- Be cautious when driving or operating machinery, especially when starting treatment, due to potential dizziness or drowsiness.
- Inform your doctor immediately if you experience any unusual side effects like uncontrollable movements, high fever, or severe muscle stiffness.
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 dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Qutap may cause drowsiness, dizziness, or blurred vision. Patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that quetiapine therapy does not affect them adversely.
Lifestyle Advice
- Maintain a healthy diet and engage in regular physical activity to help manage potential weight gain.
- Stay adequately hydrated to alleviate dry mouth.
- Avoid sudden changes in position (e.g., standing up quickly) to minimize the risk of orthostatic hypotension (dizziness upon standing).
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