Quetiapine

Administration
  • Type: Atypical antipsychotics
  • Dosage Forms: ER, IR
  • Routes of Administration: oral
  • Common Trade Names: Seroquel

Adult Dosing
  • 25-400 mg PO 1-2 times daily

Pediatric Dosing

Safety/efficacy not established in children <10 years old

    • 25-400 mg PO 1-2 times daily

Special Populations
  • Pregnancy Rating: C
  • Lactation risk: Infant risk cannot be ruled out
  • Renal: No adjustment
  • Hepatic dosing: initial dose 25 mg/day, titrate up slowly
  • Concomitant use with strong CYP3A4 inducer: may need increased dose
  • Concomitant use with strong CYP3A4 inhibitor: reduce quetiapine dose

Contraindications
  • Allergy to class/drug

Adverse Reactions

Serious
  • Prolonged QT interval, sudden cardiac death, syncope
  • Neuroleptic malignant syndrome, tardive dyskinesia
  • DKA
  • Agranulocytosis, neutropenia
  • Seizure
  • Pancreatitis
  • Suicidal ideation

Common
  • Hypertension, weight gain, hyperlipidemia
  • Abdominal pain, constipation, nausea/vomiting, xerostomia
  • Somnolence, dizziness, asthenia, tremor, insomnia
  • Extrapyramidal disease
  • Headache
  • URI-like symptoms

Pharmacology
  • Half-life: 6-7 hours
  • Metabolism: hepatic, extensive via CYP3A4
  • Excretion: mostly renal

Mechanism of Action
  • Mechanism not well understood
  • Antagonizes D2, 5HT, histamine H1, and α1 receptors, as well as muscarinic and norepinepherine receptors.

Comments

See Also

References
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