Seroquet
Generic Name
Quetiapine
Manufacturer
AstraZeneca (original innovator)
Country
Global (originating from UK/Sweden)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| seroquet 25 mg tablet | ৳ 3.00 | ৳ 30.00 |
| seroquet 100 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Seroquet (Quetiapine) is an atypical antipsychotic medication used to treat schizophrenia, bipolar disorder (manic, depressive, and maintenance episodes), and as an add-on treatment for major depressive disorder.
Uses & Indications
Dosage
Adults
Schizophrenia: Initial dose 25-50 mg daily, titrated to 150-750 mg/day in divided doses (IR) or once daily (XR). Bipolar Depression: 300 mg once daily (XR). Bipolar Mania: 400-800 mg/day in divided doses (IR) or once daily (XR). MDD (adjunctive): 50-300 mg once daily (XR).
Elderly
Lower starting doses (e.g., 25 mg daily) and slower titration are recommended due to increased sensitivity to side effects.
Renal_impairment
No dose adjustment is generally required for patients with renal impairment.
How to Take
Immediate-release tablets can be taken with or without food. Extended-release tablets (XR) should be taken once daily, preferably in the evening, without food or with a light meal. Swallow tablets whole, do not crush or chew.
Mechanism of Action
Quetiapine acts as an antagonist at serotonin 5-HT2A receptors and dopamine D1 and D2 receptors. It also has affinity for histamine H1 and adrenergic α1/α2 receptors, contributing to its sedative and orthostatic hypotensive effects.
Pharmacokinetics
Onset
Sedative effects may occur relatively quickly. Antipsychotic and mood-stabilizing effects typically take several weeks to fully manifest.
Excretion
Approximately 73% of a dose is excreted in the urine and 20% in the feces.
Half life
The terminal elimination half-life is approximately 6-7 hours for IR and 7-12 hours for the active metabolite norquetiapine from XR.
Absorption
Rapidly absorbed after oral administration. Peak plasma concentrations reached in 1-2 hours for IR tablets and about 6 hours for XR tablets.
Metabolism
Extensively metabolized in the liver, primarily by the cytochrome P450 3A4 (CYP3A4) enzyme system. The main active metabolite is N-desalkylquetiapine (norquetiapine).
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 during initiation.
Drug Interactions
CNS Depressants
Increased risk of sedation and CNS depression with alcohol and other CNS depressants.
CYP3A4 Inducers
Strong CYP3A4 inducers (e.g., phenytoin, carbamazepine, rifampin) can significantly decrease quetiapine levels, requiring dose increase.
Antihypertensives
May potentiate the hypotensive effects of antihypertensive agents.
CYP3A4 Inhibitors
Strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) can significantly increase quetiapine levels, requiring dose reduction. Avoid concurrent use at initiation.
Anticholinergic drugs
May increase the risk of anticholinergic side effects.
Storage
Store below 30°C (86°F) in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, sedation, tachycardia, and hypotension. Management is primarily supportive, including maintaining an adequate airway, oxygenation, and ventilation, and monitoring cardiovascular function. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human milk; mothers should not breastfeed while on quetiapine due to potential risks to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, specific expiry date is printed on the packaging.
Availability
Available in pharmacies and hospitals
Approval Status
FDA Approved
Patent Status
Off-patent (for immediate-release formulation, some XR still patented)
Clinical 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
- Baseline and periodic monitoring of blood glucose and lipid profile due to risk of metabolic changes.
- Weight monitoring.
- Complete Blood Count (CBC) if symptoms of infection or agranulocytosis occur.
- Thyroid function tests (TFTs) if clinically indicated.
Doctor Notes
- Counsel patients on potential metabolic side effects and the importance of monitoring weight, glucose, and lipids.
- Emphasize gradual titration and the risks of abrupt discontinuation.
- Be vigilant for signs of Neuroleptic Malignant Syndrome (NMS) and tardive dyskinesia.
Patient Guidelines
- Do not stop taking Seroquet abruptly, as this can lead to withdrawal symptoms.
- Avoid alcohol and other CNS depressants.
- Report any unusual muscle movements, fever, or changes in heart rhythm to your doctor immediately.
- Be aware of the risk of orthostatic hypotension (dizziness when standing up).
- Monitor for signs of hyperglycemia (increased thirst, urination, hunger).
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Seroquet can cause drowsiness, dizziness, and impaired judgment, especially at the start of treatment. Patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Seroquet therapy does not affect them adversely.
Lifestyle Advice
- Maintain a healthy diet and engage in regular physical activity to manage potential weight gain and metabolic changes.
- Avoid smoking, as it can affect quetiapine metabolism.
- Ensure adequate hydration.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.