Quetiapine XR

Quetiapine, also known by the brand name Seroquel, is an atypical antipsychotic used to manage various psychiatric conditions, including schizophrenia, bipolar disorder, major depressive disorder, and mania/depression associated with bipolar disorder. Its active ingredient is quetiapine, which works by modulating neurotransmitter activity in the brain, particularly affecting serotonin and dopamine systems. It comes in an extended-release tablet with different strengths. It is suitable for use in adults, adolescents, and children. Consult your doctor for personalized guidance and advice on usage, dosage, and storage.

Quetiapine XR contains quetiapine as its main ingredient, which is used to treat several psychiatric conditions, including schizophrenia, bipolar disorder, and major depressive episodes in bipolar patients. It functions by modulating the activity of various neurotransmitters in the brain, particularly serotonin and dopamine, which are key in regulating mood and behavior.

Quetiapine XR is available in various strengths, including 150 mg, 50 mg, 200 mg, 300 mg & 400 mg tablets. It should be taken once daily, typically in the evening, with or without food. The extended-release formulation allows for steady blood medication levels, helping minimize mood fluctuations. Quetiapine XR is suitable for adults and should be used under the guidance of a healthcare provider. It functions by restoring the balance of neurotransmitters in the brain, which helps to enhance thinking, mood, and behavior.

Common side effects of Quetiapine XR may include drowsiness, dizziness, dry mouth, and constipation. Patients should be cautious about operating heavy machinery or driving until they determine how the medication affects them. Important precautions include avoiding alcohol, monitoring for signs of mood changes, and seeking immediate medical attention for any severe reactions. If a dose is missed, take it as soon as you remember unless it is close to your next dose. Do not double doses. In case of Quetiapine overdose, contact emergency services immediately. Store Quetiapine XR in a cool, dry place away from direct sunlight. Always follow the prescribed guidelines and talk to your physician or healthcare provider for any queries or concerns regarding its use.

It is used to treat:

• Depression with bipolar disorder
• Mania with bipolar disorder
• Major depressive disorder
• Schizophrenia

Forms & Strengths of Quetiapine XR?

It comes in the following form and strengths:

Form: Oral tablet, extended-release

Strengths: 150 mg, 50 mg, 200 mg & 300 mg 

What Are the Recommended Dosage of Quetiapine XR?

For Treatment of Depression with Bipolar Disorder

For Adults

• Initial dose: 50 mg once daily in the evening. Your doctor may adjust your dose as required.
• Maximum dose: 300 mg daily

For Pediatric Patients

• Your doctor will determine the usage and dosage

For Treatment of Mania with Bipolar Disorder

For Adults

• Initial dose: 300 mg once daily in the evening. Your doctor may adjust your dose as required.
• Maximum dose: 800 mg daily

For Children and Adolescents Aged 10-17 Years of Age

• Initial dose: 50 mg once daily in the evening. Your doctor may adjust your dose as required.
• Maximum dose: 600 mg daily

For Children Under Ten Years

• Your doctor will determine the usage and dosage

For Treatment of Major Depressive Disorder

For Adults

• Initial dose: 50 mg once daily in the evening. Your doctor may adjust your dose as required.
• Maximum dose: 300 mg daily

For Pediatric Patients

• Your doctor will determine the usage and dosage

For the Treatment of Schizophrenia

For Adults

• Initial dose: 300 mg once daily in the evening. Your doctor may adjust your dose as required.
• Maximum dose: 800 mg daily

For Children and Adolescents Aged 13-17 Years of Age

• Initial dose: 50 mg once daily in the evening. Your doctor may adjust your dose as required.
• Maximum dose: 800 mg daily

For Children Under 13 years

• Your doctor will determine the usage and dosage

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your medication dosage accordingly.]

• Before taking Quetiapine and each time you get a refill, carefully read and follow the instructions for use that came with your prescription. Ask your doctor if you have any questions or do not understand any part of this leaflet.
• You should take this medication by mouth exactly as prescribed by your doctor. Do not take it more or less than prescribed, in large doses, or more frequently. Doing so will not improve your mental health condition any faster but will increase your risk of unwanted side effects.
• The medication dosage is based on your condition, your body’s response to treatment, your needs, and other medications you may be taking.
• The best time to take Quetiapine XR is at least one hour before and two hours after a meal.
• Your doctor may ask you to start using this medication at a low dose and slowly increase it to reduce your risk of unwelcome side effects.
• To get the most benefit of your medication, you should maintain consistency in dosage and take it around the same time every day to help you remember it.
• Do not crush, chew, or break the Quetiapine XR tablet. Swallow it whole with a full glass of water.
• Continue taking this medication even if you feel well.
• You should not abruptly stop taking this medication without consulting your doctor, as certain conditions, including mental health conditions, may become worse if you suddenly stop taking this medication. Additionally, you may experience symptoms such as nausea, headache, irritability, difficulty sleeping, and diarrhea.
• If you plan to discontinue taking this medication, consult your doctor. They will help you gradually taper off the drug to help reduce the risk of unwanted side effects.
• Let your doctor know if your condition does not improve or worsen. Also, report any new or worsening symptoms to your doctor right away.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

Quetiapine XR, an extended-release formulation of Quetiapine, is an atypical antipsychotic prescription medication that functions by modulating neurotransmitter activity in the brain, specifically affecting serotonin and dopamine systems, by acting as an antagonist at various receptor sites. The extended-release formulation provides gradual, sustained medication release, allowing for once-daily dosing and more consistent therapeutic effects. This mechanism helps stabilize mood, reduce psychotic symptoms, and improve cognitive function while minimizing side effects associated with rapid drug level fluctuations.

Like other medications, Quetiapine XR can cause side effects in some people. It is noteworthy to mention that not everyone using Quetiapine XR experiences these side effects. Most side effects do not require medical attention and go away within a few days or weeks as your body adjusts to the medication. If you are concerned about the potential side effects caused by this medication, you should consult your doctor.

Common Side Effects of Quetiapine XR:

• Dizziness
• Drowsiness and sedation
• Dry mouth
• Headache
• Increased appetite
• Nausea
• Weight gain

Mild Side Effects of Quetiapine XR:

Mild side effects may cause discomfort but usually don’t require stopping the medication. They are as follows:

• Constipation
• Indigestion or upset stomach
• Mild weakness or fatigue
• Nasal congestion
• Blurred vision
• Mild skin rash
• Increased sweating
• Changes in sleep patterns
• Mild anxiety or restlessness
• Mild changes in heart rate

Serious Side Effects of Quetiapine XR:

In rare cases, Quetiapine XR may cause severe side effects that require immediate medical attention. These symptoms are potentially dangerous, and if not treated properly, they may be life-threatening. Consult your doctor to prevent and manage these symptoms. Report any new or bothersome symptoms to your healthcare provider. Call your doctor immediately if you experience any of the symptoms given below:

• Metabolic changes include increased blood sugar, cholesterol, and triglycerides, which can lead to or worsen diabetes.
• Extrapyramidal symptoms: Such as tremors, stiffness, or involuntary movements.
• Tardive dyskinesia: Involuntary, repetitive body movements that can be irreversible.
• Neuroleptic malignant syndrome: A rare but fatal condition characterized by fever, muscle rigidity, and altered mental status.
• QT prolongation: A heart rhythm abnormality that can lead to severe arrhythmias.
• Severe allergic reactions: Including anaphylaxis, angioedema, or Stevens-Johnson syndrome.
• Increased risk of death in elderly patients with dementia-related psychosis.
• Suicidal thoughts or behaviors: Particularly in younger patients or those with depression.
• Cataracts: Long-term use may increase the risk of cataracts.
• Blood disorders: A decrease in white blood cell count (leukopenia, neutropenia).
• Hypothyroidism: Decreased thyroid function.
• Priapism: Prolonged and painful erection requiring immediate medical attention.
• Increased prolactin levels: Can lead to galactorrhea, menstrual irregularities, or sexual dysfunction.

[Note: This list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

• This medication is related to an increased risk of death in geriatric patients with dementia-associated psychosis and is not approved for use in this population. They may also be at an increased risk of cerebrovascular adverse events, including stroke.
• Quetiapine XR can cause significant metabolic changes, including increases in blood sugar levels, weight gain & alterations in cholesterol and triglyceride levels, which require regular monitoring.
• Quetiapine XR has anticholinergic effects that can cause constipation, urinary retention, and other related issues, necessitating caution in patients with certain pre-existing conditions.
• Esophageal dysmotility and aspiration have been related to antipsychotic drug use, including Quetiapine XR, warranting caution in patients at risk for aspiration pneumonia.
• This medication is not suitable for use in children under ten years of age.
• Tell your doctor if you get pregnant while using this medication, as it should only be taken during pregnancy when it is needed. Tell your doctor if you are pregnant, suspect pregnancy, or planning to become pregnant while using this medication.
• Quetiapine XR may pass into your breast milk and cause harm to the nursing infant. Tell your doctor if you are breastfeeding or plan to breastfeed while using Quetiapine XR.

What Are the FDA Boxed Warning for Quetiapine XR?

Quetiapine XR carries FDA-boxed warnings for:

• Increased mortality in geriatric patients with dementia-associated psychosis
• Suicidal thoughts & behaviors in children, adolescents, and young adults
• Metabolic changes, including hyperglycemia, dyslipidemia, and weight gain

• Before taking this medication, tell your doctor if you have an allergy to Quetiapine or if you have any other allergies. This medication contains certain inactive ingredients that can cause severe allergic reactions or other problems. Contact your pharmacist, doctor, or healthcare provider for the complete list of ingredients.
• Before starting to take this medication, share your complete medical history with your healthcare provider or doctor, especially if you or anyone in your family has bipolar disorder or has tried to commit suicide.
• This medication may increase the risk of suicide in some people. Tell your doctor immediately if you are experiencing suicidal thoughts or depression. Report any new or worsening symptoms to your doctor immediately.
• This medication may cause vision changes, drowsiness, and trouble thinking or controlling body movements, especially during the initial week of treatment, which may lead to injuries. You should not drive, operate heavy machinery, or engage in activities that require attention or clear vision unless you determine how this medication affects you.
• This medication can raise your blood sugar levels. Call your doctor immediately if you experience increased thirst or urination. If you have diabetes, your blood or urine tests may change. Monitor your blood sugar levels closely while taking this medication, and consult your doctor if you have any questions or concerns.
• Call your doctor immediately if you experience symptoms of neuroleptic malignant syndrome such as seizures, trouble breathing, rapid heartbeat, increased sweating, severe muscle stiffness, unusually pale skin, fatigueness, or high or low blood pressure.
• You may experience dizziness, fainting, or lightheadedness, especially after getting up suddenly after lying down or sitting for a while. You should get up slowly.
• This medication may temporarily reduce the number of white blood cells in your bloodstream, increasing your chance of infection.
• Quetiapine XR may cause tardive dyskinesia, a movement disorder. Consult your doctor immediately if you have uncontrolled chewing movements, lip smacking or puckering, puffing of the cheeks, or rapid or worm-like tongue movements.
• This medication may increase your weight. You may be required to check your weight regularly while taking this medication.
• Quetiapine may cause a condition called QT prolongation, which can change the way your heart beats and cause fainting or other problems. Call your doctor immediately if you experience uneven, rapid, or pounding heartbeats.
• You should not abruptly stop taking this medication without consulting your doctor, as it may increase your risk of withdrawal symptoms. If you plan to discontinue taking this medication, talk to your doctor. They will help you gradually taper off the drug to prevent your risk of unwanted side effects.

Quetiapine XR is contraindicated for use in patients who have:

• Hypersensitivity to Quetiapine or any other ingredients present in the product.
• Dementia-related psychosis (in geriatric patients)
• Concurrent use of certain medications, including potent CYP3A4 inhibitors
• Severe liver disease
• Prolonged QT interval
• Electrolyte imbalance
• Heart problems
• Seizures

• If you have missed a dose of Quetiapine XR, you should take it as soon as you remember.
• However, if it is almost time for your next dose, you may omit the missed dose and take the next dose of Quetiapine according to your regular dosing schedule.
• You should not simultaneously take double or extra doses of the same medication to compensate for the missed dose, as this may cause unwanted side effects.
• You can set a reminder on your phone to prevent missing doses further.
• If you are unsure when to take the missed dose, consult your doctor.

[Note: If you have missed a medication dose and are unsure when to take the next one, immediately consult your doctor or pharmacist.]

An overdose of Quetiapine XR can be serious or, in extreme cases, fatal. Symptoms of a Quetiapine overdose may include low blood pressure, difficulty breathing, blurred vision, or drowsiness. The severity of symptoms depends on the amount taken and individual factors. If you suspect a medication overdose, seek immediate medical attention. You can call your doctor, poison control helpline, or 911. You can also head to the nearest emergency room.

[Note: If you consumed more than the recommended dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

• You should store Quetiapine XR in a tightly closed container at a controlled room temperature, away from excess heat, direct sunlight, and moisture. Do not keep it in the bathroom or near the sink.
• Keep all medications, including Quetiapine XR, in a safe place that is away from the sight and reach of children.
• Do not use medications that have passed their expiration date. The expiration date is the last date of the month mentioned on the back of the prescription label or carton.
• Do not keep medications that are outdated or no longer needed. Discard them safely.
• Do not pour them down the drain, flush them down the toilet, or throw them into your household garbage bin.
• You should eliminate unwanted medications in such a way that prevents children, animals, and others from consuming them.
• The best way to discard unwanted medications is to give them to the medicine take-back program. For more information on properly disposing of unwanted medications, consult your healthcare provider, pharmacist, or local waste disposal company.

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

Certain medications can interact with Quetiapine XR and affect how it may work or increase your risk of severe side effects. Before starting to use this medication, you should tell your doctor about all the medications you are currently taking or plan to take, including all prescription, non-prescription, over-the-counter drugs, and herbal or vitamin supplements. This information will help you and your doctor prevent and manage potential drug interactions. The list given below does not contain all possible drug interactions. Consult your healthcare provider for more information.

• Anticholinergic drugs
• Azole antifungals
• Barbiturates
• Benzodiazepines
• Ketoconazole
• Itraconazole
• Fluconazole
• Erythromycin
• Clarithromycin
• Ritonavir
• Nefazodone
• Phenytoin
• Carbamazepine
• Rifampin
• St. John’s Wort
• Phenobarbital
• Amiodarone
• Sotalol
• Quinidine
• Procainamide
• Moxifloxacin
• Haloperidol
• Lisinopril
• Amlodipine
• Metoprolol
• Hydrochlorothiazide
• Levodopa and dopamine agonists
• Other antipsychotics
• Anticonvulsants
• Antidepressants
• Antihistamines
• Antiarrhythmics
• Antibiotics
• HIV Medications

What Are the Other Quetiapine XR Interactions?

Certain supplements, herbs, foods, and beverages may interact with Quetiapine XR, affecting its effectiveness or increasing the risk of unwanted side effects.

• Supplements such as melatonin, St. John’s wort, vitamin B6, and vitamin B12.
• Herbs such as ginkgo biloba, valerian root and kava kava.
• Food items such as high-fat meals and grapefruit
• Beverages such as alcohol, caffeine, and energy drinks
• Probiotics

Apart from these interactions, certain disease interactions of Quetiapine XR should also be considered before taking this medication.

• Cardiovascular disease
• Cerebrovascular disease
• Diabetes or risk of diabetes
• Seizure disorder
• Thyroid disorder
• Hepatic impairment
• Renal impairment
• Parkinson’s disease
• Glaucoma
• Prostatic hypertrophy
• Dementia-related psychosis
• History of suicidal thoughts/behavior
• Dysphagia or risk of aspiration
• Body temperature regulation disorder
• Cataracts or lens disorder
• Pregnancy or breastfeeding

[Note: This isn’t a complete list, and there could be other drugs that interact with Quetiapine XR. Tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

People look for alternative medicines to Quetiapine XR when the medication does not suit them, or they do not get the desired results with it. Many effective substitutes are available in the market, but you should consult a licensed healthcare professional before switching your medication. Based on your condition, age, and needs, they will help you determine the most suitable substitute drug to Quetiapine XR that works best for you. Some of the alternatives to Quetiapine XR are listed below:

For Schizophrenia:

• Risperdal (risperidone)
• Zyprexa (olanzapine)
• Abilify (aripiprazole)
• Geodon (ziprasidone)
• Invega (paliperidone)
• Latuda (lurasidone)

For Bipolar Disorder:

• Lithium (lithium carbonate)
• Depakene (valproic acid)
• Lamictal (lamotrigine)
• Zyprexa (olanzapine)
• Abilify (aripiprazole)
• Vraylar (cariprazine)

For Major Depressive Disorder or MDD (as an adjunct therapy):

• Abilify (aripiprazole)
• Rexulti (brexpiprazole)
• Trintellix (vortioxetine)
• Fetzima (levomilnacipran)
• Viibryd (vilazodone)
• Wellbutrin (bupropion)

For Generalized Anxiety Disorder:

• Cymbalta (duloxetine)
• Lexapro (escitalopram)
• Paxil (paroxetine)
• Effexor XR (venlafaxine)
• Buspar (buspirone)
• Vistaril (hydroxyzine)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

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