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Quetiapine Fumarate: Brands, Price & Uses in Bangladesh
Established / FDA-Approved Uses Schizophrenia — treatment of schizophrenia in adults and adolescents (13–17 years).
About Quetiapine Fumarate
Indications of Quetiapine Fumarate
Established / FDA-Approved Uses
- Schizophrenia — treatment of schizophrenia in adults and adolescents (13–17 years).
- Bipolar I Disorder, Manic Episodes — acute treatment of manic episodes associated with Bipolar I Disorder, as monotherapy or as an adjunct to lithium or divalproex, in adults and in children/adolescents (10–17 years).
- Bipolar I Disorder or Bipolar II Disorder, Depressive Episodes — acute treatment of depressive episodes associated with bipolar disorder, as monotherapy, in adults.
- Bipolar I Disorder, Maintenance Treatment — as an adjunct to lithium or divalproex, in adults.
Guideline-Supported / Adjunct Use (Extended-Release Formulation)
- Major Depressive Disorder (MDD) — as adjunctive therapy to antidepressants in adults with an inadequate response to antidepressant treatment alone (extended-release formulation only).
Quetiapine Fumarate is not approved for the treatment of dementia-related psychosis in elderly patients (see Boxed Warning under Precautions and Warnings).
Off-Label Use
Low-dose Quetiapine Fumarate is sometimes used off-label (by physician judgment) for insomnia, generalized anxiety disorder, or agitation in certain settings; such use is not FDA-approved and should only be undertaken under close medical supervision.
Dosage & Administration of Quetiapine Fumarate
Adult Dosing
| Indication | Starting Dose | Usual Target / Range |
|---|---|---|
| Schizophrenia | 25 mg twice daily (IR) | Titrate over ~4 days to 300–400 mg/day in divided doses (IR) or once daily (XR); usual range 150–750 mg/day |
| Bipolar Mania (mono or adjunct) | 100 mg on Day 1 | Titrate to 400 mg/day by Day 4; usual range 400–800 mg/day |
| Bipolar Depression | 50 mg at bedtime (Day 1) | Titrate to 300 mg/day at bedtime by Day 4 |
| Bipolar I Maintenance (adjunct) | Continue dose that controlled acute episode | Individualized, typically 400–800 mg/day |
| MDD, Adjunctive (XR only) | 50 mg once daily in the evening | Usual range 150–300 mg/day |
Pediatric Dosing
| Indication | Age | Dosing |
|---|---|---|
| Schizophrenia | 13–17 years | Start 25 mg twice daily; titrate to a target of 400–800 mg/day |
| Bipolar Mania | 10–17 years | Start 25 mg twice daily; titrate to a target of 400–600 mg/day |
Safety and efficacy of Quetiapine Fumarate have not been established in children below 10 years of age for any indication.
Dose Adjustment in Special Situations
- Hepatic impairment: Lower starting dose (e.g., 25 mg/day) with slower titration and lower target dose, as clearance is reduced.
- Elderly / debilitated patients: Lower starting dose and slower titration due to increased sensitivity to hypotension and sedation.
- Renal impairment: No specific dose adjustment is generally required, as Quetiapine Fumarate is predominantly hepatically metabolized with minimal unchanged renal excretion; use with caution.
- Concomitant strong CYP3A4 inhibitors or inducers: Dose adjustment required (see Drug Interactions).
Administration
Immediate-release tablets may be taken with or without food, usually in divided doses. Extended-release tabletsshould be taken once daily, preferably in the evening, without food or with a light meal (a high-fat mealsignificantly increases absorption and should be avoided at the same time each day for consistency), and must beswallowed whole — not split, crushed, or chewed. Do not stop Quetiapine Fumarate abruptly; dose should betapered gradually under medical supervision when discontinuing.
Side Effects of Quetiapine Fumarate
Very Common / Common
- Somnolence and sedation (especially at initiation)
- Dizziness and orthostatic hypotension
- Dry mouth
- Constipation
- Weight gain and increased appetite
- Fatigue
- Elevated blood glucose, lipids (dyslipidemia)
- Tachycardia
- Headache
Less Common but Clinically Important
- Extrapyramidal symptoms (tremor, rigidity, akathisia)
- Elevated prolactin levels
- Hypothyroidism (decreased free T4)
- Leukopenia, neutropenia (rarely agranulocytosis)
- Cataracts (lens changes) with long-term use
Serious / Rare (Seek Immediate Medical Attention)
- Neuroleptic malignant syndrome (fever, muscle rigidity, altered mental status, autonomic instability)
- QT-interval prolongation and abnormal heart rhythm
- Seizures
- Severe allergic reaction (rash, swelling, difficulty breathing)
- Suicidal thoughts or behavior, especially in young people (see Precautions and Warnings)
- Priapism (rare)
See Precautions and Warnings for full detail on the boxed warnings and major risks associated with Quetiapine Fumarate.
Contraindications of Quetiapine Fumarate
Quetiapine Fumarate is contraindicated in patients with known hypersensitivity to quetiapine, quetiapine fumarate, or any component of the formulation.
Frequently Asked Questions about Quetiapine Fumarate
What is Quetiapine Fumarate used for?
Quetiapine Fumarate is an atypical antipsychotic used to treat schizophrenia, manic and depressive episodes of bipolar disorder, and (as an extended-release add-on) major depressive disorder that has not responded fully to an antidepressant alone. Your physician will determine the appropriate use for your condition.
Does Quetiapine Fumarate carry any serious warnings?
Yes. Quetiapine Fumarate carries two boxed warnings: an increased risk of death in elderly patients with dementia-related psychosis (it is not approved for this use), and an increased risk of suicidal thoughts and behavior in children, adolescents, and young adults, especially early in treatment. Report any worsening mood or new suicidal thoughts to your physician immediately.
Can I stop taking Quetiapine Fumarate suddenly if I feel better?
No. Quetiapine Fumarate should never be stopped abruptly, as this can cause withdrawal symptoms such as nausea, vomiting, and insomnia, or a relapse of your underlying condition. Always consult your physician, who will guide a gradual dose taper if discontinuation is appropriate.
What side effects should I watch for with Quetiapine Fumarate?
Common side effects of Quetiapine Fumarate include drowsiness, dizziness, dry mouth, constipation, and weight gain. Seek immediate medical attention for signs of a serious reaction such as high fever with muscle stiffness (possible neuroleptic malignant syndrome), fainting, an irregular heartbeat, seizures, or new/worsening suicidal thoughts.
Is Quetiapine Fumarate safe during pregnancy or breastfeeding?
Quetiapine Fumarate should be used in pregnancy only if the potential benefit clearly justifies the potential risk to the fetus, and babies exposed in the third trimester should be monitored for withdrawal or extrapyramidal symptoms after birth. The drug also passes into breast milk, so a decision about breastfeeding versus continuing treatment should be made together with your physician.
Can Quetiapine Fumarate affect my weight or blood sugar?
Yes. Quetiapine Fumarate is associated with weight gain, increased appetite, elevated blood sugar (including new-onset diabetes), and abnormal cholesterol/triglyceride levels. Your physician should monitor your weight, blood glucose, and lipid profile periodically during treatment.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.