II. Class
- Atypical Antipsychotic (Second Generation agent)
- Neuroleptic
- Dibenzothiazepine Antipsychotic
IV. Indications
- Schizophrenia
- Psychosis in Dementia
- Mania (not FDA approved)
- Bipolar Disorder (not FDA approved)
- Autism (not FDA approved)
- Insomnia (not FDA approved)
V. Dosing
- Adults
- Initial: 25 mg PO bid-tid
- Increase in 25-50 mg/day increments
- Target: 300-400 mg/day divided bid-tid
- Maximum dose: 750 mg/day
- Elderly
- Initial dose: 12.5 mg PO qhs
- Titrate up every few days (caution due to sedation)
VI. Adverse Effects: General
- Sedation
- Headache
- Orthostatic Hypotension
- Cataract formation
- Dry Mouth
- Weight gain
- Neuroleptic Malignant Syndrome
- QTc Prolongation
VII. Adverse Effects: Overdose
VIII. Drug Interactions
- Increase Antipsychotic levels (toxicity risk): Monitor for toxicity
- Decrease Antipsychotic levels (lower efficacy)
- Barbiturates
- Carbamazepine
- Phenytoin
- Rifampin
- Theophylline
- Other effects
- Avoid concurrent use of other medications prolonging QT Interval
IX. Monitoring
- See Antipsychotic
- Screen for Cataract formation every 6 months
- Consider EKG, electrolyte and Magnesium monitoring due to QT Interval prolongation risk
X. Pharmacokinetics
- Metabolized by Cytochrome P450 3A4
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| quetiapine (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| QUETIAPINE ER 150 MG TABLET | Generic | $10.87 each |
| QUETIAPINE ER 200 MG TABLET | Generic | $11.65 each |
| QUETIAPINE ER 300 MG TABLET | Generic | $15.35 each |
| QUETIAPINE ER 400 MG TABLET | Generic | $17.19 each |
| QUETIAPINE ER 50 MG TABLET | Generic | $6.02 each |
| QUETIAPINE FUMARATE 100 MG TAB | Generic | $0.10 each |
| QUETIAPINE FUMARATE 200 MG TAB | Generic | $0.19 each |
| QUETIAPINE FUMARATE 25 MG TAB | Generic | $0.07 each |
| QUETIAPINE FUMARATE 300 MG TAB | Generic | $0.27 each |
| QUETIAPINE FUMARATE 400 MG TAB | Generic | $0.26 each |
| QUETIAPINE FUMARATE 50 MG TAB | Generic | $0.08 each |
| seroquel (on 6/22/2016 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| SEROQUEL 100 MG TABLET | Generic | $0.10 each |
| SEROQUEL 200 MG TABLET | Generic | $0.19 each |
| SEROQUEL XR 150 MG TABLET | Generic | $10.87 each |
| SEROQUEL XR 200 MG TABLET | Generic | $11.65 each |
| SEROQUEL XR 300 MG TABLET | Generic | $15.35 each |
| SEROQUEL XR 400 MG TABLET | Generic | $17.19 each |
| SEROQUEL XR 50 MG TABLET | Generic | $6.02 each |
Ontology: quetiapine (C0123091)
| Definition (NCI) | A dibenzothiazepine derivative with antipsychotic property. Quetiapine fumarate antagonizes serotonin activity mediated by 5-HT 1A and 5-HT2 receptors. With a lower affinity, this agent also reversibly binds to dopamine D1 and D2 receptors in the mesolimbic and mesocortical areas of the brain leading to decreased psychotic effects, such as hallucinations and delusions. In addition, quetiapine also binds to other alpha-1, alpha-2 adrenergic and histamine H1 receptors. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C069541 |
| SnomedCT | 108443001, 386850001 |
| LNC | LP21161-2, MTHU012935 |
| English | 2-(2-(4-dibenzo(b,f)(1,4)thiazepine-11-yl-1-piperazinyl)ethoxy)ethanol, quetiapine, quetiapine (medication), quetiapine [Chemical/Ingredient], QUEtiapine, QUETIAPINE, Quetiapine, Quetiapine (product), Quetiapine (substance) |
| Spanish | quetiapina (producto), quetiapina (sustancia), quetiapina |
Ontology: Seroquel (C0287163)
| Definition (CHV) | brand name of quetiapine, a drug used to treat schizophrenia and bipolar disorder |
| Definition (CHV) | brand name of quetiapine, a drug used to treat schizophrenia and bipolar disorder |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C069541 |
| English | quetiapine (Seroquel), seroquel, seroquel [brand name], SEROquel, AstraZeneca Brand of Quetiapine Fumarate, Zeneca Brand of Quetiapine Fumarate, Seroquel |
