Drug Action
Quetiapine is a dopamine D1, dopamine D2, 5-HT2, alpha1-adrenoceptor, and histamine-1 receptor antagonist.
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Drug reference
Quetiapine is a dopamine D1, dopamine D2, 5-HT2, alpha1-adrenoceptor, and histamine-1 receptor antagonist.
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Nervous system Schizophrenia ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: 25 mg twice daily for day 1, then 50 mg twice daily for day 2, then 100 mg twice daily for day 3, then 150 mg twice daily for day 4, then, adjusted according to response, usual dose 300–450 mg daily in 2 divided doses, the rate of dose titration may need to be slower and the daily dose lower in elderly patients; maximum 750 mg per day ▶BY MOUTH USING MODIFIED-RELEASE MEDICINES ▶Adult: 300 mg once daily for day 1, then 600 mg once daily for day 2, then, adjusted according to response, usual dose 600 mg once daily, maximum dose under specialist supervision; maximum 800 mg per day ▶Elderly: Initially 50 mg once daily, adjusted according to response. adjusted in steps of 50 mg daily Treatment of mania in bipolar disorder ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: 50 mg twice daily for day 1, then 100 mg twice daily for day 2, then 150 mg twice daily for day 3, then 200 mg twice daily for day 4, then adjusted in steps of up to 200 mg daily, adjusted according to response, usual dose 400–800 mg daily in 2 divided doses, the rate of dose titration may need to be slower and the daily dose lower in elderly patients; maximum 800 mg per day ▶BY MOUTH USING MODIFIED-RELEASE MEDICINES ▶Adult: 300 mg once daily for day 1, then 600 mg once daily for day 2, then, adjusted according to response, usual dose 400–800 mg once daily ▶Elderly: Initially 50 mg once daily, adjusted according to response. adjusted in steps of 50 mg daily Treatment of depression in bipolar disorder ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: 50 mg once daily for day 1, dose to be taken at bedtime, then 100 mg once daily for day 2, then 200 mg once daily for day 3, then 300 mg once daily for day 4, then, adjusted according to response; usual dose 300 mg once daily, the rate of dose titration may need to be slower and the daily dose lower in elderly patients; maximum 600 mg per day ▶BY MOUTH USING MODIFIED-RELEASE MEDICINES ▶Adult: 50 mg once daily for day 1, dose to be taken at bedtime, then 100 mg once daily for day 2, then 200 mg once daily for day 3, then 300 mg once daily for day 4, then, adjusted according to response; usual dose 300 mg once daily; maximum 600 mg per day Prevention of mania and depression in bipolar disorder ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: Continue at the dose effective for treatment of bipolar disorder and adjust to lowest effective dose; usual dose 300–800 mg daily in 2 divided doses ▶BY MOUTH USING MODIFIED-RELEASE MEDICINES ▶Adult: Continue at the dose effective for treatment of bipolar disorder and adjust to lowest effective dose; usual dose 300–800 mg once daily Adjunctive treatment of major depression ▶BY MOUTH USING MODIFIED-RELEASE MEDICINES ▶Adult: 50 mg once daily for 2 days, dose to be taken at bedtime, then 150 mg once daily for 2 days, then, adjusted according to response, usual dose continued → 150–300 mg once daily ▶Elderly: Initially 50 mg once daily for 3 days, then increased if necessary to 100 mg once daily for 4 days, then adjusted in steps of 50 mg, adjusted according to response, usual dose 50–300 mg once daily, dose of 300 mg should not be reached before day 22 of treatment DOSE EQUIVALENCE AND CONVERSION Nervous system ▶Patients can be switched from immediate-release to modified-release tablets at the equivalent daily dose; to maintain clinical response, dose titration may be required.
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Cerebrovascular disease. elderly. patients at risk of aspiration pneumonia. treatment of depression in patients under 25 years (increased risk of suicide)
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→Appendix 1: quetiapine
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▶Common or very common Appetite increased. asthenia. dysarthria. dyspepsia. dyspnoea. fever. headache. hyperglycaemia. irritability. palpitations. peripheral oedema. rhinitis. sleep disorders. suicidal behaviour (particularly on initiation). suicidal ideation (particularly on initiation). syncope. vision blurred. withdrawal syndrome ▶Uncommon Anaemia. diabetes mellitus. dysphagia. hyponatraemia. hypothyroidism. sexual dysfunction. skin reactions. thrombocytopenia ▶Rare or very rare Angioedema. breast swelling. gastrointestinal disorders. hepatic disorders. hypothermia . menstrual disorder. metabolic syndrome. pancreatitis. rhabdomyolysis. severe cutaneous adverse reactions (SCARs). SIADH
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Use only if potential benefit outweighs risk.
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Manufacturer advises avoid.
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Manufacturer advises caution (risk of increased plasma concentrations). Dose adjustments Manufacturer advises for immediate- release tablets, initially 25 mg daily, increased daily in steps of 25–50 mg. Manufacturer advises for modified-release tablets, initially 50 mg daily, increased daily in steps of 50 mg.
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution, powder Modified-release tablet CAUTIONARY AND ADVISORY LABELS 2, 23, 25 ▶Atrolak XL (Accord Healthcare Ltd) Quetiapine (as Quetiapine fumarate) 50 mg Atrolak XL 50mg tablets | 60 tablet P £67.65 DT = £67.66 Quetiapine (as Quetiapine fumarate) 150 mg Atrolak XL 150mg tablets | 60 tablet P £107.45 DT = £113.10 Quetiapine (as Quetiapine fumarate) 200 mg Atrolak XL 200mg tablets | 60 tablet P £113.09 DT = £113.10 Quetiapine (as Quetiapine fumarate) 300 mg Atrolak XL 300mg tablets | 60 tablet P £169.99 DT = £170.00 Quetiapine (as Quetiapine fumarate) 400 mg Atrolak XL 400mg tablets | 60 tablet P £226.19 DT = £226.20 ▶Biquelle XL (Aspire Pharma Ltd) Quetiapine (as Quetiapine fumarate) 50 mg Biquelle XL 50mg tablets | 60 tablet P £29.45 DT = £67.66 Quetiapine (as Quetiapine fumarate) 150 mg Biquelle XL 150mg tablets | 60 tablet P £49.45 DT = £113.10 Quetiapine (as Quetiapine fumarate) 200 mg Biquelle XL 200mg tablets | 60 tablet P £49.45 DT = £113.10 Quetiapine (as Quetiapine fumarate) 300 mg Biquelle XL 300mg tablets | 60 tablet P £74.45 DT = £170.00 Quetiapine (as Quetiapine fumarate) 400 mg Biquelle XL 400mg tablets | 60 tablet P £98.95 DT = £226.20 ▶Brancico XL (Zentiva) Quetiapine (as Quetiapine fumarate) 50 mg Brancico XL 50mg tablets | 60 tablet P £8.99 DT = £67.66 Quetiapine (as Quetiapine fumarate) 150 mg Brancico XL 150mg tablets | 60 tablet P £19.49 DT = £113.10 Quetiapine (as Quetiapine fumarate) 200 mg Brancico XL 200mg tablets | 60 tablet P £19.49 DT = £113.10 Quetiapine (as Quetiapine fumarate) 300 mg Brancico XL 300mg tablets | 60 tablet P £33.74 DT = £170.00 Quetiapine (as Quetiapine fumarate) 400 mg Brancico XL 400mg tablets | 60 tablet P £44.99 DT = £226.20 ▶Mintreleq XL (Aristo Pharma Ltd) Quetiapine (as Quetiapine fumarate) 50 mg Mintreleq XL 50mg tablets | 60 tablet P £14.99 DT = £67.66 Quetiapine (as Quetiapine fumarate) 150 mg Mintreleq XL 150mg tablets | 60 tablet P £29.99 DT = £113.10 Quetiapine (as Quetiapine fumarate) 200 mg Mintreleq XL 200mg tablets | 60 tablet P £29.99 DT = £113.10 Quetiapine (as Quetiapine fumarate) 300 mg Mintreleq XL 300mg tablets | 60 tablet P £49.99 DT = £170.00 Quetiapine (as Quetiapine fumarate) 400 mg Mintreleq XL 400mg tablets | 60 tablet P £64.99 DT = £226.20 ▶Seroquel XL (AstraZeneca UK Ltd) Quetiapine (as Quetiapine fumarate) 50 mg Seroquel XL 50mg tablets | 60 tablet P £67.66 DT = £67.66 Quetiapine (as Quetiapine fumarate) 150 mg Seroquel XL 150mg tablets | 60 tablet P £113.10 DT = £113.10 Quetiapine (as Quetiapine fumarate) 200 mg Seroquel XL 200mg tablets | 60 tablet P £113.10 DT = £113.10 Quetiapine (as Quetiapine fumarate) 300 mg Seroquel XL 300mg tablets | 60 tablet P £170.00 DT = £170.00 Quetiapine (as Quetiapine fumarate) 400 mg Seroquel XL 400mg tablets | 60 tablet P £226.20 DT = £226.20 ▶Sondate XL (Teva UK Ltd) Quetiapine (as Quetiapine fumarate) 50 mg Sondate XL 50mg tablets | 60 tablet P £11.99 DT = £67.66 Quetiapine (as Quetiapine fumarate) 150 mg Sondate XL 150mg tablets | 60 tablet P £25.99 DT = £113.10 Quetiapine (as Quetiapine fumarate) 200 mg Sondate XL 200mg tablets | 60 tablet P £25.99 DT = £113.10 Quetiapine (as Quetiapine fumarate) 300 mg Sondate XL 300mg tablets | 60 tablet P £44.99 DT = £170.00 Quetiapine (as Quetiapine fumarate) 400 mg Sondate XL 400mg tablets | 60 tablet P £59.99 DT = £226.20 ▶Zaluron XL (Fontus Health Ltd) Quetiapine (as Quetiapine fumarate) 50 mg Zaluron XL 50mg tablets | 60 tablet P £27.96 DT = £67.66 Quetiapine (as Quetiapine fumarate) 150 mg Zaluron XL 150mg tablets | 60 tablet P £46.96 DT = £113.10 Quetiapine (as Quetiapine fumarate) 200 mg Zaluron XL 200mg tablets | 60 tablet P £46.96 DT = £113.10 Quetiapine (as Quetiapine fumarate) 300 mg Zaluron XL 300mg tablets | 60 tablet P £70.71 DT = £170.00 Quetiapine (as Quetiapine fumarate) 400 mg Zaluron XL 400mg tablets | 60 tablet P £93.98 DT = £226.20 Tablet CAUTIONARY AND ADVISORY LABELS 2 ▶Quetiapine (Non-proprietary) Quetiapine (as Quetiapine fumarate) 25 mg Quetiapine 25mg tablets | 60 tablet P £38.05 DT = £2.68 Quetiapine (as Quetiapine fumarate) 100 mg Quetiapine 100mg tablets | 60 tablet P £113.10 DT = £4.10 Quetiapine (as Quetiapine fumarate) 150 mg Quetiapine 150mg tablets | 60 tablet P £113.10 DT = £4.51 Quetiapine (as Quetiapine fumarate) 200 mg Quetiapine 200mg tablets | 60 tablet P £133.10 DT = £5.82 Quetiapine (as Quetiapine fumarate) 300 mg Quetiapine 300mg tablets | 60 tablet P £170.00 DT = £6.37 ▶Seroquel (AstraZeneca UK Ltd) Quetiapine (as Quetiapine fumarate) 25 mg Seroquel 25mg tablets | 60 tablet P £48.60 DT = £2.68 Quetiapine (as Quetiapine fumarate) 100 mg Seroquel 100mg tablets | 60 tablet P £135.72 DT = £4.10 Quetiapine (as Quetiapine fumarate) 200 mg Seroquel 200mg tablets | 60 tablet P £135.72 DT = £5.82 Quetiapine (as Quetiapine fumarate) 300 mg Seroquel 300mg tablets | 60 tablet P £204.00 DT = £6.37 Oral suspension CAUTIONARY AND ADVISORY LABELS 2 ▶Quetiapine (Non-proprietary) Quetiapine (as Quetiapine fumarate) 20 mg per 1 ml Quetiapine 20mg/ml oral suspension sugar free sugar-free | 150 ml P £99.28 DT = £99.28 eiiii F 401
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25 mg twice daily for day 1, then 50 mg twice
First-line fragment. Read the complete Indications and Dose section above.
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300 mg once daily for day 1, then 600 mg once
First-line fragment. Read the complete Indications and Dose section above.
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Initially 50 mg once daily, adjusted according
First-line fragment. Read the complete Indications and Dose section above.
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50 mg twice daily for day 1, then 100 mg twice
First-line fragment. Read the complete Indications and Dose section above.
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300 mg once daily for day 1, then 600 mg once
First-line fragment. Read the complete Indications and Dose section above.
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Initially 50 mg once daily, adjusted according
First-line fragment. Read the complete Indications and Dose section above.
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50 mg once daily for day 1, dose to be taken at
First-line fragment. Read the complete Indications and Dose section above.
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50 mg once daily for day 1, dose to be taken at
First-line fragment. Read the complete Indications and Dose section above.
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Continue at the dose effective for treatment of
First-line fragment. Read the complete Indications and Dose section above.
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Continue at the dose effective for treatment of
First-line fragment. Read the complete Indications and Dose section above.
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50 mg once daily for 2 days, dose to be taken at
First-line fragment. Read the complete Indications and Dose section above.
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Initially 50 mg once daily for 3 days, then
First-line fragment. Read the complete Indications and Dose section above.
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