Seroquel
Seroquel
Seroquel (Quetiapine)The tablets covered with a cover of pink colour, round, biconcave, with chasing on one party "Seroquel 25".
The tablets covered with a cover of yellow colour, round, biconcave, with chasing on one party "Seroquel 100".
The tablets covered with a cover of yellow colour, round, biconcave, with chasing on one party "Seroquel 200".
Pharmacological action
Possesses also high affinity to histaminic and a1-adrenoretseptoram and is less active in relation to a2-adrenoretseptoram. Does not possess affinity to m-holinoretseptoram and to benzodiazepine receptors.
Showed antipsychotic activity in standard tests.
Results of studying of extrapyramidal symptoms at animals have taped, that Seroquel causes only a weak catalepsy at influence of the dose effectively.
Clinical researches (with application Seroquel in doses of 75-750 mg/sut) have not taped differences between Seroquel in frequency of occurrence of extrapyramidal symptoms and accompanying use of anticholinergic preparations.
Seroquel does not cause long rising of level of Prolactinum in a blood plasma. In numerous researches with the fixed dose it is not taped differences in Prolactinum level at Seroquel use.
In clinical researches Seroquel has shown efficiency at treatment of positive and negative symptoms of schizophrenia.
Indications
- Treatment of acute and chronic psychoses, including schizophrenia;
- Treatment of maniacal episodes in structure of bipolar disorder.
Dosage regimen
Seroquel is necessary to accept 2 times/sut, irrespective of food intake.
The adult for treatment of acute and chronic psychoses, including schizophrenia, the daily dose for first 4 days of therapy makes: 1st day - 50 mg, 2nd day - 100 mg, 3rd day - 200 mg, 4th day - 300 mg.
Since 4th day, the dose should steal up to an effective dosage, usually in limits from 300 mg to 450 mg/days Depending on clinical effect and individual shipping the patient the dose can vary in limits from 150 mg to 750 mg/days the Maximum daily dose makes 750 mg.
The daily dose for first 4 days of therapy makes: 1st day - 100 mg, 2nd day - 200 mg, 3rd day - 300 mg, 4th day - 400 mg. Further by 6 day of therapy the preparation daily dose can be enlarged to 800 mg. The daily dose augmentation should not exceed 200 mg/days
Depending on clinical effect and individual shipping the dose can vary in limits from 200 mg to 800 mg/days usually effective dose the Maximum daily dose makes from 400 mg to 800 mg/days makes 800 mg.
At elderly patients the initial dose makes 25 mg/days the Dose it is necessary to enlarge daily by 25 50 mg before achievement of an effective dose which, possibly, will be less, than at young patients.
At patients with renal or hepatic insufficiency it is recommended to begin Seroquel therapy about 25 mg/days It is recommended to enlarge a dose daily by 25-50 mg before achievement of an effective dose.
Safety and efficiency of Seroquel at children and teenagers was not investigated.
Side effect
From party TSNS and peripheric nervous system: often - drowsiness (17.5 %), giddiness (10 %); seldom - a malignant antipsychotic syndrome (a hyperthermia, consciousness disturbance, a muscular rigidity, vegeto-vascular disturbances); very seldom - cramps. At long Seroquel application there is a potential possibility of development of a late dyskinesia. At occurrence of symptoms of a late dyskinesia it is necessary to reduce a dose or to stop further Seroquel treatment.
From the alimentary system: often - a constipation (9 %), a dyspepsia (6 %), dryness in a mouth (7 %); rising of activity of hepatic enzymes (nuclear heating plant) in blood serum (6 %), and also rising of concentration of cholesterol and triglycerides (against Seroquel treatment these changes, as a rule, were reversible).
From cardiovascular system: often - an orthostatic hypotension (accompanied by giddiness), a tachycardia (7 %), syncopes; these collateral reactions basically meet in an initial stage of selection of a dose.
From hemopoiesis system: seldom - a leukopenia and-or a neutropenia. It is noted cases of a serious neutropenia or an agranulocytosis at the patients accepting Seroquel . At use Seroquel in clinical practice the leukopenia and-or a neutropenia was resolved after preparation cancellation. Possible risk factors of development of a leukopenia and-or a neutropenia include depression of number of leucocytes prior to the beginning of therapy or indicatings available in the anamnesis on a leukopenia and-or a neutropenia caused by a drug intake.
Allergic reactions: seldom - an eosinophilia, allergic reactions, including a Quincke's disease.
The other: seldom - peripheric edemas, a moderate asthenia, a rhinitis, augmentation of mass of a body (mainly in the first weeks of treatment); very seldom - a priapism.
Also it was informed on following often meeting (1/100) by-effects - BP rising, palpitation, a dysarthtia, a pharyngitis, tussis, an anorexia, the raised diaphoresis. The Relationship of cause and effect of the given side effects with Seroquel reception is not established.
Contraindications
- A hypersensibility to any of preparation components.
Pregnancy and lactemia
Safety and efficiency of Seroquel application at pregnant women are not established. Therefore at pregnancy Seroquel is possible to apply only if the expected advantage for mother exceeds potential risk for a foetus.
Special indicatings
It is necessary to be careful at appointment Seroquel to patients with cardiovascular and cerebrovascular diseases or other conditions contributing to an arterial hypotension, and also patients of advanced age, at hepatic insufficiency, convulsive attacks in the anamnesis.
Seroquel can cause an orthostatic hypotension, especially in an initial stage of selection of a dose (at elderly patients it is observed more often, than at young).
At sharp cancellation of high doses of antipsychotic preparations following acute reactions (withdrawal) - a nausea, vomiting can be observed; seldom - a sleeplessness.
It was informed on cases of an exacerbation of psychotic symptoms and occurrence of consensual impellent disorders (an akathisia, a dystonia, a dyskinesia). In this connection preparation cancellation is recommended to be spent gradually.
Overdosage
Data about Seroquel overdosage are limited. Cases of Seroquel reception in a dose exceeding 20 g are described, without fatal consequences and with full restoration, however there are reports on the extremely rare cases of Seroquel overdosage leading to mors or a clod.
Symptoms: noted symptoms basically were a consequence of intensifying of known pharmacological effects of a preparation, such as drowsiness a tachycardia and BP depression.
Treatment: In cases of a serious intoxication it is necessary to survey possibility of symptomatic therapy and it is recommended to carry out the actions referred on maintenance of function of breath, cardiovascular system, maintenance of adequate oxygenation and ventilation. The medical control and observation should be continued before full recover of the patient.
Conditions and periods of storage
The preparation should be stored in a place inaccessible to children at temperature more low 30 C. The Period of validity - 3 years.
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