Quetiapine

Extended-release: Should be taken on an empty stomach. Take w/o food or w/ a light meal. Swallow whole, do not chew/crush.
May be taken with or without food.

Concomitant use with CYP3A4 inhibitors (e.g. HIV protease inhibitor, azole-antifungal agents, erythromycin, clarithromycin, nefazodone).

Patient at risk of seizures (e.g. head trauma, brain damage), with Lewy body dementia, Parkinson disease dementia, cardiovascular disease or cerebrovascular disease, conditions predisposing to hypotension; at risk of QT prolongation (e.g. heart failure, cardiac myopathy), urinary retention, BPH, increased intraocular pressure, Alzheimer's disease, diabetes, hyperlipidaemia, breast cancer or other prolactin-dependent tumours. History of alcohol or drug abuse. Behavioural changes and increased risk of suicidal thinking. Avoid abrupt withdrawal. Not intended for treatment in elderly patients with dementia-related psychosis. Renal and hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling May impair ability to drive or operate machinery. Monitoring Parameters Monitor worsening and emergence of suicidal thoughts and behaviours. Monitor blood pressure, weight, height, BMI, waist circumference, CBC, electrolytes, LFT, TSH, free T4, thyroid assessment, fasting glucose level, fasting lipid panel. Assess for changes in menstruation, libido, erectile and ejaculatory function, abnormal involuntary movements or parkinsonian signs, tardive dyskinesia. Monitor for symptoms of hyperprolactinaemia (e.g. breast enlargement, galactorrhoea). Observe for visual changes and perform ocular and lens examinations prior to treatment and at 6-month intervals. Complete fall risk assessment prior to therapy and periodically during treatment. Monitor for symptoms of hyperglycaemia (e.g. polydipsia, polyuria, polyphagia, weakness).

Significant: Anticholinergic effects (e.g. confusion, agitation, constipation, xerostomia, blurred vision, urinary retention), blood dyscrasias (e.g. leucopenia), oesophageal dysmotility and aspiration, extrapyramidal symptoms (e.g. pseudoparkinsominsm, acute dystonic reactions, akathisia, tardive dyskinesia), withdrawal symptoms, orthostatic hypertension, hyperlipidaemia, hyperprolactinaemia, anaphylactic reactions, hypothyroidism, weight gain, cataracts, impaired body temperature regulation, pancreatitis, venous thromboembolism (VTE), constipation, cardiomyopathy, myocarditis, dysphagia, constipation, intestinal obstruction. Blood and lymphatic system disorders: Decreased haemoglobin. Cardiac disorders: Tachycardia, palpitation. Endocrine disorders: Decrease T3 and T4, increase TSH. Eye disorders: Blurred vision. Gastrointestinal disorders: Dry mouth, constipation, dyspepsia, vomiting. General disorders and administration site conditions: Mild asthenia, irritability, pyrexia. Hepatobiliary disorders: Increased serum transaminases. Metabolism and nutrition disorders: Serum triglyceride elevations, total cholesterol elevation, HDL decrease, increase appetite, peripheral oedema. Nervous system disorders: Dizziness, somnolence, headache. Psychiatric disorders: Abnormal dreams and nightmares. Respiratory, thoracic and mediastinal disorders: Dyspnoea, rhinitis, nasal congestion.
Potentially Fatal: Suicidal ideation and behaviour, neuroleptic malignant syndrome (e.g. hyperpyrexia, muscle rigidity, altered mental status, autonomic instability), hyperglycaemia and/or development or exacerbation associated with ketoacidosis or coma, severe neutropenia, agranulocytosis, QT prolongation.

Increased serum concentration with CYP3A4 inhibitors (e.g. ketoconazole, ritonavir, nefazodone). Decreased serum concentration with CYP3A4 inducers (e.g. phenytoin, carbamazepine, rifampin). Extended-release preparations may antagonise actions of dopaminergics (e.g. levodopa). Increased risk of QT prolongation with class IA antiarrhythmics (e.g. quinidine, procainamide), class III antiarrhythmics (e.g. amiodarone, sotalol), antipsychotic medications (e.g. ziprasidone, chlorpromazine, thioridazine), antibiotics (e.g. gatifloxacin, moxifloxacin), pentamidine, levomethadyl acetate, methadone).

Antipsychotics

N05AH04 - quetiapine ; Belongs to the class of diazepines, oxazepines and thiazepines antipsychotics.