Monograph Details
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Central Nervous System
> Psychosis
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SEROQUEL XR |
| Manufacturer |
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AstraZeneca Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Dibenzothiazepine. |
| Generic Name |
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Quetiapine (as fumarate) 50mg, 150mg, 200mg, 300mg, 400mg; ext-rel tabs. |
| Also |
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• SEROQUEL
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| Indications |
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Schizophrenia. |
| Children |
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Not recommended. |
| Adults |
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Swallow whole. Take on an empty stomach or with light meal. Initially 300mg once daily in the PM; may increase at 1-day intervals in increments of up to 300mg/day. Usual range: 400–800mg/day; max 800mg/day. Elderly, debilitated, or risk of postural hypotension: titrate more slowly to lower target dose. Elderly or hepatic impairment: initially 50mg/day; may increase in increments of 50mg/day. Switching from Seroquel immediate-release: give XR at equivalent total daily dose taken once daily. |
| Precautions |
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Diabetes risk factors (obtain baseline fasting blood sugar). Monitor for hyperglycemia. Cardio- or cerebrovascular disease. Hepatic dysfunction. Seizure risk. Exclude neuroleptic malignant syndrome if fever or other symptoms occur. Risk of aspiration pneumonia. Exposure to extreme heat. Dehydration. Hypovolemia. Do eye exam initially and every 6 months. History of breast cancer. Pre-existing low WBCs or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; discontinue if WBCs decline. Reevaluate periodically. Avoid abrupt cessation. Write Rx for smallest practical amount. Risk of suicide. Hypothyroidism. Elderly (not for dementia-related psychoses; may increase risk of death). Debilitated. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
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Potentiates CNS effects with alcohol (avoid), other CNS depressants. Antagonized by CYP3A inducers (eg, thioridazine, phenytoin, carbamazepine, phenobarbital, rifampin); adjust dose. Potentiates antihypertensives, lorazepam. Antagonizes effects of levodopa, dopamine agonists. Caution with drugs that interfere with temperature regulation (eg, anticholinergics) and with CYP3A inhibitors (eg, azole antifungals, erythromycin). |
| Adverse Reactions |
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Dry mouth, sedation, somnolence, dizziness, constipation, asthenia, abdominal pain, postural hypotension, pharyngitis, weight gain, lethargy, hyperglycemia, nasal congestion, dyspepsia; increased ALT (transient), total cholesterol +/or triglycerides; leukopenia, neutropenia, agranulocytosis; rarely: tardive dyskinesia, neuroleptic malignant syndrome. |
| How Supplied |
XR (50mg, 150mg)—60, 500 (available soon)
XR (200mg, 300mg, 400mg)—60, 500
Tabs 25mg, 50mg—100, 1000
100mg, 200mg, 400mg—100
300mg—60 |
| Additional Resources |
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• Related Prescribing Note |
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