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QUETIAPINE

(Also Known As: SEROQUEL)

Take this medicine only as directed by your doctor to benefit your condition as much as possible. Do not take more or less of it and do not take it more or less often than your doctor ordered.

Quetiapine may be taken with or without food on a full or empty stomach. However, if your doctor tells you to take it a certain way, take it as directed.

Dosing

The dose of quetiapine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of quetiapine. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking quetiapine.

• For oral dosage form (tablets):
  • For schizophrenia:
    • Adults At first, 25 milligrams (mg) two times a day. The dose usually is increased to 300 to 400 mg a day, which is divided and given in two or three doses a day. Your doctor may increase your dose further, if needed. However, the dose usually is not more than 800 mg a day.
    • Children Use and dose must be determined by the doctor.

Missed dose

If you miss a dose of quetiapine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For quetiapine, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to quetiapine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Quetiapine has not been studied in pregnant women. However, studies in rats and rabbits have shown that quetiapine at doses higher than the highest human dose causes reduced weight and other problems in the fetus. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding Quetiapine has been shown to pass into the milk of animals. It is not known whether this medicine passes into breast milk. However, quetiapine is not recommended for use during breast-feeding, because it may cause unwanted effects in nursing babies. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of quetiapine in children with use in other age groups.

Older adults This medicine has been tested in a limited number of patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults. However, quetiapine may be removed from the body more slowly in older adults, so an older adult may receive a lower dose than a younger adult.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking quetiapine, it is especially important that your health care professional know if you are taking any of the following:

• Alcohol (with chronic use) or
• Barbiturates or
• Carbamazepine (e.g., Tegretol) or
• Griseofulvin (e.g., Fulvicin) or
• Phenylbutazone (e.g., Butazolidin) or
• Phenytoin (e.g., Dilantin) or
• Primidone (e.g., Mysoline) or
• Rifampin (e.g., Rifadin) or
• Saquinavir (e.g., Invirase) or
• Troglitazone (e.g., Rezulin) These medicines may cause lower blood levels of quetiapine; the dose of quetiapine may need to be changed if one of these medicines is started or stopped during treatment with quetiapine

• Central nervous system (CNS) depressants (medicines that cause drowsiness) or
• Tricyclic antidepressants (medicine for depression) Quetiapine may increase the CNS depressant effects of these medicines, such as drowsiness

• Clarithromycin (e.g., Biaxin) or
• Diltiazem (e.g., Cardizem) or
• Erythromycin (e.g., E-Mycin, E.E.S.) or
• Fluconazole (e.g., Diflucan) or
• Itraconazole (e.g., Sporanox) or
• Ketoconazole (e.g., Nizoral) or
• Nefazodone (e.g., Serzone) or
• Verapamil (e.g., Calan) These medicines may cause higher blood levels of quetiapine, increasing the chance of side effects

• Alzheimer's disease Quetiapine may cause problems with swallowing, which may increase the chance of pneumonia; also, the chance of seizures may be increased

• Breast cancer, or history of or
• Underactive thyroid Quetiapine may make these conditions worse

• Dehydration Decreased blood pressure caused by quetiapine may be more severe; chance of developing heatstroke may be increased

• Heart disease or
• Stroke, or history of Decreased blood pressure caused by quetiapine may be more severe or may make these conditions worse

• Kidney disease (severe) or
• Liver disease Higher blood levels of quetiapine may occur, increasing the chance of side effects; the dose may need to be changed

• Seizures, or history of Chance of seizures may be increased