Victus

Quetiapine

Acute & chronic psychoses including schizophrenia in adult & adolescents 13-17 yr. Acute treatment of manic episodes associated w/ bipolar I disorder both as monotherapy & adjunct to lithium or divalproex in adult, adolescents (10-17 yr) & childn. Acute treatment of depressive episodes associated w/ bipolar disorder in adult. Maintenance treatment of bipolar I disorder & adjunct to lithium & divalproex in adult.

Schizophrenia Adult Initially 25 mg bid. Increase in increments of 25-50 mg divided 2 or 3 times on days 2 & 3, & to target dose range 300-400 mg by day 4. May adjust dose increments or decrements of 25-50 mg divided 2 times/day. Day 4 onwards: 300-450 mg/day, may be adjusted w/in 150-750 mg/day. Max: 750 mg/day. Adolescent 13-17 yr Initial 5 days therapy: Day 1: 50 mg bid, day 2: 100 mg bid, day 3: 200 mg bid, day 4: 300 mg bid, day 5: 400 mg bid. After day 5, may be adjusted to 400-800 mg/day in increments not >100 mg/day. Maintenance: Adult & adolescent 400-800 mg/day. Max: 800 mg/day. Acute treatment of manic episodes in bipolar I disorder Adult Initial dose: Day 1: 100 mg bid, day 2: 200 mg bid, day 3: 300 mg bid, day 4: 400 mg bid, day 5: up to 600 mg bid. May be adjusted up to 800 mg/day by day 6 in increments not >200 mg/day. Dose range: 400-800 mg/day. Max: 800 mg/day. Adolescent 10-17 yr & childn Initial 5 days therapy: Day 1: 50 mg bid, day 2: 100 mg bid, day 3: 200 mg bid, day 4: 300 mg bid, day 5: 400 mg. May be adjusted w/in 400-600 mg/day after day 5 in increments of not >100 mg/day. Max: 600 mg/day. Acute treatment of depressive episodes in bipolar I disorder Adult Initial dose once a day at bedtime: Day 1: 50 mg, day 2: 100 mg, day 3: 200 mg, day 4: 300 mg to reach target dose 300 mg/day by day 4. Max: 300 mg/day. Adjunct therapy to lithium or divalproex Maintenance: Total dose 400-800 mg/day bid. Max: 800 mg/day. Elderly & patient who are debilitated or who have a predisposition to hypotensive reactions Initially 50 mg/day, may increase in increments of 50 mg/day depending on response & tolerability. Hepatic impairment Start on 25 mg/day, may be increased daily in increments of 25-50 mg/day.

May be taken with or without food.

Hypersensitivity.

Not for treatment of patients w/ dementia-related psychosis. Suicide attempt. Monitor & closely observe for clinical worsening, suicidality or unusual changes in behavior. May precipitate mixed/manic episode in patients at risk for bipolar disorder; induce orthostatic hypotension. History of seizures. Neuroleptic malignant syndrome; hyperglycemia & DM, wt gain hyperprolactinemia, hypothyroidism; dysphagia & aspiration pneumonia; priapism; leukopenia, neutropenia & agranulocytosis; venous thromboembolism; transaminase elevations, pancreatitis; tardive dyskinesia. Patients w/ known CV disease, cerebrovascular disease or conditions predisposing to hypotension; increased risk of QT prolongation (eg, CV disease, history of QT prolongation, CHF & heart hypertrophy). May mask toxicity by anti-emetic effect. Determine BP in childn & adolescents at the beginning of & periodically during treatment. Cholesterol & triglycerine elevations. False +ve urine drug screens for methadone or TCAs. May impair ability to drive or operate machinery. Pregnancy. Not recommended during lactation. Bipolar mania in childn <10 yr & bipolar depression in childn <18 yr. Elderly (w/ dementia-related psychosis).

W/drawal symptoms, fatigue; dizziness, somnolence, EPS (eg, akathisia, tremor, hypokinesia, hypertonia, restlessness, psychomotor hyperactivity, muscle rigidity, dyskinesia), headache, agitation; elevations in nonfasting serum triglyceride levels & total cholesterol (predominantly LDL cholesterol), decreases in HDL cholesterol, wt gain; dry mouth; decreased Hb. Asthenia, fever, flu syndrome, pain, back pain; tachycardia, palpitations, postural hypotension, prolonged QT interval T-wave abnormality, bundle branch block, T-wave inversion; irritability, dysarthria, abnormal dreams & nightmares, suicide attempt, sedation, lethargy, anxiety, paresthesia, hypersomnia; rash; peripheral edema, hyperglycemia, serum prolactin elevations, hypothyroidism, hyperthyroidism, increased appetite; constipation, dyspepsia, vomiting, abdominal pain, anorexia; leukopenia, eosinophilia, neutropenia; serum transaminases eg, ALT/AST elevations, γ-glutmayl transpeptidase levels; increased cough, dyspnea, pharyngitis; nasal congestion; blurred vision, amblyopia, conjunctivitis, abnormal vision, dry eyes, blepharitis, eye pain, tinnitus, ear pain.

Potentiates the cognitive & motor effects of alcohol. Potential pharmacologic interaction w/ anticholinergic activity. Increased exposure w/ grapefruit juice. Increase dose up to 5-fold w/ chronic treatment of potent hepatic CYP3A4 inducer eg, phenytoin, carbamazepine, barbiturates, rifampicin, glucocorticoids, St. John's wort) & inhibitors (eg, ketoconazole, itraconazole, fluconazole, erythromycin, HIV-PIs). Potentiate BP-lowering effects of antihypertensive agents. Drugs known to cause electrolyte imbalance or increase QT interval. May reduce clearance of lorazepam & increased w/ thioridazine. May antagonize effects of levodopa & dopamine agonists. Decreased oral clearance of cimetidine.

Antipsychotics

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

Rx