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Seroquel - instructions for use, reviews, analogs and formulations (tablets 25 mg, 100 mg, 150 mg, 200 mg and 400 mg Prolong) of a drug of neuroleptic for the treatment of psychoses in adults, children and pregnancy. Composition and alcohol

Seroquel - instructions for use, reviews, analogs and formulations (tablets 25 mg, 100 mg, 150 mg, 200 mg and 400 mg Prolong) of a drug of neuroleptic for the treatment of psychoses in adults, children and pregnancy. Composition and alcohol

In this article, you can read the instructions for using the drug Seroquel. There are reviews of visitors to the site - consumers of this medication, as well as opinions of specialists in the use of the antipsychotic Seroquel in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Seroquel in the presence of existing structural analogs. Use to treat psychosis, depression and schizophrenia in adults, children, as well as during pregnancy and breast-feeding.Composition and interaction of the drug with alcohol.

 

Seroquel - antipsychotic drug (antipsychotic). Has a higher affinity for serotonin 5HT2 receptors (compared to dopamine D1 and D2 receptors) in the brain. It also has a high affinity for histamine and alpha1-adrenergic receptors and is less active with respect to alpha2-adrenergic receptors. Has no affinity for m-holinoretseptoram and benzodiazepine receptors.

 

Has antipsychotic activity in standard tests.

 

The results of the study of extrapyramidal symptoms in animals have revealed that Quetiapine causes only weak catalepsy when exposed to a dose effectively blocking dopamine D2 receptors. Quetiapine selectively reduces the activity of mesolimbic A10-dopaminergic neurons compared to A9-nigrostriral neurons involved in motor function.

 

Clinical studies (with the use of quetiapine in doses of 75-750 mg per day) revealed no difference between quetiapine and placebo in the incidence of extrapyramidal symptoms and the concomitant use of anticholinergic drugs.

 

Seroquel does not cause a prolonged increase in the level of prolactin in the blood plasma.In numerous studies with a fixed dose, there was no difference in the level of prolactin when using Seroquel or placebo.

 

In clinical studies, Seroquel has been shown to be effective in treating the positive and negative symptoms of schizophrenia.

 

The effect of quetiapine on 5HT2- and D2-receptors continues up to 12 hours after taking the drug.

 

Composition

 

Quetiapine fumarate + excipients

 

Pharmacokinetics

 

When administered orally, Seroquel is well absorbed from the digestive tract. The intake of food does not significantly affect the bioavailability of quetiapine. Quetiapine approximately 83% binds to plasma proteins. The pharmacokinetics of quetiapine is linear, and there is no difference between men and women. It is actively metabolized in the liver. The main plasma metabolites do not have a pronounced pharmacological activity. Less than 5% of quetiapine is not metabolized and is excreted unchanged by kidneys or with feces. Approximately 73% of quetiapine is excreted by the kidneys and 21% - with feces.

 

Indications

 

Schizophrenia and other psychoses, including:

  • prevention of relapse in stable patients.

 

Bipolar disorders, including:

  • moderate and severe manic episodes in the structure of bipolar disorder;
  • severe episodes of depression in the structure of bipolar disorder;
  • prevention of recurrence of bipolar disorders in patients with prior effective quetiapine therapy of manic or depressive episodes in the structure of bipolar disorder.

 

Depressive episode:

  • combined therapy with a suboptimal response to antidepressant monotherapy.

 

Forms of release

 

Tablets coated with 100 mg.

 

Tablets of prolonged action, coated with 150 mg (Seroquel Prolong).

 

Instructions for use and dosage

 

Seroquel should be taken 2 times a day, regardless of food intake.

 

Adults for the treatment of acute and chronic psychoses, including schizophrenia, the daily dose for the first 4 days of therapy is: 1st day - 50 mg, Day 2 - 100 mg, Day 3 - 200 mg, Day 4 - 300 mg.

 

Depending on the clinical effect and individual patient tolerance, the dose may vary from 150 mg to 750 mg per day. The maximum daily dose is 750 mg.

 

To treat manic episodes in the structure of bipolar disorder, Seroquel is used as a monotherapy or as an adjuvant therapy for mood stabilization.

 

The daily dose for the first 4 days of therapy is: the 1st day - 100 mg, the second day - 200 mg, the third day - 300 mg, the 4th day - 400 mg. In the future, by the 6th day of therapy, the daily dose of the drug can be increased to 800 mg. The increase in the daily dose should not exceed 200 mg per day.

 

Depending on the clinical effect and individual tolerability, the dose may vary from 200 mg to 800 mg per day. Usually the effective dose is from 400 mg to 800 mg per day. The maximum daily dose is 800 mg.

 

To treat depressive episodes in the structure of bipolar disorder, Seroquel is prescribed once a day at night. The recommended dose is 300 mg. The daily dose for the first 4 days of therapy is: Day 1 - 50 mg, Day 2 - 100 mg, Day 3 - 200 mg, Day 4 - 300 mg. The maximum daily dose is 600 mg. There was no clinical improvement with a dose increase of more than 600 mg.

 

In elderly patients, the initial dose is 25 mg per day. The dose should be increased daily by 25-50 mg until an effective dose is obtained, which is likely to be less than in young patients.

 

In patients with renal or hepatic insufficiency, it is recommended to start therapy with quetiapine with 25 mg per day. It is recommended to increase the dose daily by 25-50 mg until the effective dose is reached.

 

Safety and effectiveness of quetiapine in children and adolescents have not been investigated.

 

Seroquel Prolong

 

Seroquel Prolong should be taken 1 time per day on an empty stomach (at least 1 hour before meals). Tablets must be swallowed whole, not divided, not chewed and not broken.

 

Adults in the treatment of schizophrenia, moderate and severe manic episodes in the structure of bipolar disorder should take the drug at least 1 hour before meals. The daily dose for the first 2 days of therapy is: 1 day - 300 mg, 2 day - 600 mg. The recommended daily dose is 600 mg and, if necessary, can be increased to 800 mg per day. Depending on the clinical effect and individual tolerability, the dose may vary from 400 to 800 mg per day. For maintenance therapy in schizophrenia, there is no need to adjust the dose after relieving the exacerbation.

 

When treating episodes of depression in the structure of bipolar disorder Seroquel Prolong should be taken before bedtime. The daily dose for the first 4 days of therapy is: 1 day - 50 mg, 2 days - 100 mg, 3 days - 200 mg, 4 days - 300 mg. The recommended daily dose is 300 mg.Depending on the clinical effect and individual tolerability, the dose can be increased to 600 mg. The benefits of using Seroquel Prolong in a daily dose of 600 mg, compared with 300 mg, was not revealed. Seroquel Prolong in a dose exceeding 300 mg, should appoint a doctor with experience in the therapy of bipolar disorders.

 

In order to prevent the recurrence of bipolar disorders in patients with prior effective quetiapine treatment of manic or depressive episodes in the structure of bipolar disorder, treatment with Seroquel Prolong should continue therapy at the same daily dose as at the beginning of therapy. Seroquel Prolong should be taken before bedtime. Depending on the clinical effect and individual tolerability, the dose may vary from 300 to 800 mg per day. For maintenance therapy, the minimum effective dose of Seroquel Prolong is recommended.

 

When combined therapy of a depressive episode with a suboptimal response to monotherapy with antidepressant Seroquel Prolong should be taken before bedtime. The drug should be used in the minimum effective dose, starting therapy with 50 mg per day.The daily dose is: 1 and 2 days - 50 mg, 3 and 4 days - 150 mg. An increase in the dose from 150 mg per day to 300 mg per day should be based on an individual assessment of the patient's condition. When using the drug in high doses, the risk of undesirable reactions increases.

 

When translated from taking the drug Seroquel Seroquel Prolong on: for the convenience of receiving patients currently receiving fractional therapy with Seroquel, may be transferred to the drug Seroquel Prolong 1 time a day at a dose equivalent to the total daily dose of Seroquel drug. In some cases, a dose adjustment may be necessary.

 

Elderly patients Seroquel Prolong (as well as other antipsychotics) should be used with caution, especially at the beginning of therapy. Selection of an effective dose of Seroquel Prolong drug in these patients may be slower, and the daily therapeutic dose of less than younger patients. The average plasma clearance of quetiapine in elderly patients is 30-50% lower than in young patients. In elderly patients, the initial dose of Seroquel ProLong is 50 mg per day.The dose can be increased by 50 mg per day to an effective dose, depending on the clinical response and the tolerance of the drug to the individual patient.

 

In elderly patients with a depressive episode, the daily dose for the first 3 days of therapy is 50 mg per day with an increase to 100 mg per day on the 4th day and up to 150 mg per day on the 8th day. The drug should be used in the minimum effective dose, starting therapy with 50 mg per day. If necessary, the dose of the drug can be increased to 300 mg per day, but not earlier than 22 days of therapy.

 

For patients with renal insufficiency, dose adjustment is not required.

 

Patients with hepatic insufficiency Seroquel Prolong should be administered with caution, especially at the beginning of therapy, because Quetiapine is extensively metabolized in the liver. It is recommended to start therapy with Seroquel Prolong from a dose of 50 mg per day and increase the dose daily by 50 mg until an effective dose is reached.

 

Side effect

  • dizziness;
  • drowsiness;
  • headache;
  • dry mouth;
  • withdrawal syndrome;
  • an increase in the concentration of triglycerides, total cholesterol (mainly LDL cholesterol), a decrease in the concentration of HDL cholesterol;
  • increase in body weight;
  • decrease in hemoglobin concentration;
  • leukopenia, eosinophilia, thrombocytopenia;
  • dysarthria;
  • unusual and nightmarish dreams;
  • fainting;
  • extrapyramidal symptoms;
  • increased appetite;
  • suicidal thoughts and behavior;
  • tachycardia;
  • a feeling of palpitations;
  • orthostatic hypotension;
  • blurred vision;
  • rhinitis;
  • dyspnea;
  • constipation;
  • dyspepsia;
  • vomiting;
  • irritability;
  • peripheral edema;
  • fever;
  • hypersensitivity reactions;
  • convulsions;
  • dysphagia;
  • venous thromboembolism;
  • jaundice;
  • priapism;
  • galactorrhea;
  • somnambulism and similar phenomena;
  • hypothermia;
  • angioedema;
  • anaphylactic reactions;
  • diabetes;
  • hepatitis;
  • Stevens-Johnson syndrome.

 

Contraindications

  • deficiency of lactase, glucose-galactose malabsorption and galactose intolerance;
  • combined use with cytochrome P450 isoenzyme inhibitors, such as the azole antifungals, erythromycin, clarithromycin and nefazodone, as well as protease inhibitors;
  • hypersensitivity to the components of the drug.

 

Application in pregnancy and lactation

 

The safety and efficacy of Seroquel in pregnant women have not been established.Therefore, in pregnancy Seroquel can only be used if the expected benefit for the mother exceeds the potential risk to the fetus.

 

The degree of excretion of quetiapine with human milk is not known. Women should be advised not to breast-feed while taking Seroquel.

 

Use in children

 

The safety and efficacy of quetiapine in children and adolescents under 18 years of age have not been investigated.

 

Application in elderly patients

 

In elderly patients, the initial dose is 25 mg per day. The dose should be increased daily by 25-50 mg until an effective dose is obtained, which is likely to be less than in young patients.

 

special instructions

 

Care should be taken when prescribing Seroquel to patients with cardiovascular and cerebrovascular diseases or other conditions predisposing to arterial hypotension, as well as patients of advanced age, with hepatic insufficiency, convulsive seizures in the anamnesis.

 

Seroquel can cause orthostatic hypotension, especially in the initial period of dose selection (in elderly patients it is observed more often than in young patients).

 

With a sharp cancellation of high doses of antipsychotic drugs, the following acute reactions (withdrawal syndrome) can occur: nausea, vomiting; rarely - insomnia.

 

Cases of exacerbation of psychotic symptoms and the appearance of involuntary motor disorders (akathisia, dystonia, dyskinesia) have been reported. In connection with this, it is recommended to gradually phase out the drug.

 

The origin of NSA may be associated with ongoing antipsychotic treatment. Clinical manifestation of the syndrome includes: hyperthermia, altered mental status, muscular rigidity, instability of the autonomic nervous system, increased level of CK. In such cases, Seroquel should be withdrawn and treated accordingly.

 

There were no differences in the incidence of seizures in patients taking Seroquel or placebo. However, caution should be exercised in the therapy of patients with seizures in the anamnesis.

 

There was no correlation between the use of quetiapine and the increase in the QTc interval. However, when prescribing quetiapine concurrently with drugs that extend the QTc interval, care must be taken, especially in the elderly.

 

Given that quetiapine mainly affects the central nervous system, Seroquel should be used with caution in combination with other drugs that have a depressant effect on the central nervous system,or alcohol.

 

Impact on the ability to drive vehicles and manage mechanisms

 

Seroquel can cause drowsiness, so patients are advised not to work with mechanisms that are dangerous, including. it is not recommended to drive and other moving means.

 

Drug Interactions

 

When concurrently prescribing drugs with a strong inhibitory effect on the CYP3A4 isoenzyme (such as the azole antifungal agents and macrolide antibiotics), the concentration of quetiapine in the plasma may increase. In such cases, lower doses of quetiapine should be used. Particular attention should be paid to elderly and weakened patients. It is necessary to individually evaluate the relationship between risk and benefit for each patient.

 

Simultaneous administration of quetiapine with preparations inducing the enzyme system of the liver, such as carbamazepine, may reduce the concentration of the drug in plasma, which may require an increase in the dose of quetiapine, depending on the clinical effect. In a study of the pharmacokinetics of quetiapine when used in various doses, when administered prior to or concomitantly with Carbamazepine (inducer of hepatic enzymes),possibly a significant increase in clearance of quetiapine. This increase in quetiapine clearance reduced the AUC by an average of 13% compared with the use of quetiapine without carbamazepine.

 

Simultaneous administration of quetiapine with another inducer of microsomal liver enzymes (phenytoin) also led to increased clearance of quetiapine. With the simultaneous administration of quetiapine and phenytoin (or other inducers of hepatic enzymes, such as barbiturates, rifampicin), an increase in Seroquel dose may be required. It may also be necessary to reduce the dose of quetiapine when removing phenytoin or carbamazepine or another inducer of the liver enzyme system or substituting for a drug that does not induce microsomal liver enzymes (eg, sodium valproate).

 

The pharmacokinetics of lithium preparations does not change with the simultaneous administration of quetiapine.

 

There were no clinically significant changes in the pharmacokinetics of valproic acid and quetiapine in the joint appointment of sodium divalproex (sodium valproate and valproic acid in a molar ratio of 1: 1) and quetiapine (quetiapine).

 

Quetiapine did not induce the induction of hepatic enzyme systems involved in the metabolism of antipyrine.

 

The pharmacokinetics of quetiapine does not change significantly when administered simultaneously with antipsychotic drugs Risperidone or haloperidol. However, simultaneous administration of quetiapine and thioridazine led to an increased clearance of quetiapine.

 

The CYP3A4 isozyme is a key enzyme involved in cytochrome P450-mediated quetiapine metabolism. The pharmacokinetics of quetiapine does not change significantly with the simultaneous use of cimetidine, a cytochrome P450 inhibitor.

The pharmacokinetics of quetiapine did not change significantly with the simultaneous administration of an antidepressant imipramine (CYP2D6 inhibitor) or Fluoxetine (CYP3A4- and CYP2D6 inhibitor). However, caution is advisable when applying Seroquel at the same time and using systemically strong inhibitors of the CYP3A4 isoenzyme (such as the azole antifungal agents and macrolide antibiotics).

 

Drugs that oppress the central nervous system, and ethanol (alcohol) increase the risk of developing side effects of quetiapine.

 

Analogues of the drug Seroquel

 

Structural analogs for the active substance:

  • Victor;
  • Hedonin;
  • Quentiaks;
  • Quetiapine;
  • Ketiap;
  • Ketilept;
  • Kutipin;
  • Lakvel;
  • Nantarid;
  • The servicer;
  • Seroquel Prolong.

Similar medicines:

Other medicines:

Reviews (7):
Guests
Irina
My son has a psychosis. In 2013, the first time he drank 300 mg, then reduced to 25 mg. In 2015, the attack repeated. Now he takes 300 mg. Psychoses are not treated. The medicine did not help. It is observed at the doctor. I hope that my son will not recover.
Visitors
Tasia
Good afternoon! The doctor transferred me to quetiapine. I read the instructions, and there are side effects of diabetes. I have type 2 diabetes. In addition, I have elevated cholesterol. The doctor knows this and still said to drink and do not read the instructions. Doses small 100 mg per day. Please advise how to proceed in this case?
Administrators
admin
TasiaThe diseases and conditions indicated in the question are not a contraindication to taking Quetiapine and Seroquel preparations. So your doctor is right. Tracking periodically the level of glucose in the blood and cholesterol is necessary, as with any long-term intake of any medication.
Visitors
Tasia
Thanks for your site, thanks for the reply!
Visitors
Tasia
Tasia, Moved your question to the drug Quetiapine, where it is more appropriate.
admin
Administrators
admin
The visitor question of the Directory Tatyana moved to the required section:
Hello. My mother (79 years) was discharged from increased anxiety Seroquel - 1/2 tab. at night, 1/2 in the morning. Takes 2 weeks. Very much it suffers from by-effects. He falls asleep well, wakes up steadily at 3.00, takes 1/4, because otherwise he will not fall asleep, and again falls asleep until the morning. In the morning takes 1/4. The whole day sick and tends to sleep, sometimes she even cries, so bad for her. Sometimes, but rarely, suddenly lets go and I see my old mother again. Forces can not see how the old man is tormented. Is there no means that will ease her suffering and how soon can an adaptation to the medicine come? Thank you in advance.
Tatyana, Suffering from taking medication is facilitated only by replacing or canceling the medication taken. The dosage of Seroquel is small (I narrow down the dosage of half a tablet, although the dosage of tablets is not indicated,but let's say it's minimal), so I would question that this symptom complex is caused precisely by taking medications, and not by the progression of the disease, possibly concomitant. A re-examination of the patient by the attending physician with adjustment of therapy is recommended.
Guests
ANYA
With long-term use of Seroquel, this 5 years a day receives 300 mg and entomin 40 mg as there were hallucinations and visions, in my opinion it got worse. There can be a backlash.

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