Quetiapin Hexal
Quetiapin Hexal is an antipsychotic medicine used to treat mental health conditions such as bipolar depression, mania, and schizophrenia.
Form
depottabletti
Strength
300 mg
Active Ingredient
Quetiapine fumarate
Manufacturer
Hexal A/S
How to Use
Dosage
Your doctor will decide your starting dose, and the daily dose usually ranges from 150 mg to 800 mg.
Method
Take one prolonged-release tablet once a day, whole with water. Do not break, chew, or crush it. Take it without food (at least 1 hour before a meal or at bedtime). Do not drink grapefruit juice.
Important
The usual maximum daily dose is 800 mg, but your doctor will decide the right dose for you.
Possible Side Effects
COMMON
- •Dizziness (may lead to falls), headache, dry mouth
- •Drowsiness (may lead to falls), which might go away with continued use
- •Withdrawal symptoms (insomnia, nausea, headache, diarrhea, vomiting, dizziness, and irritability) when stopping the medication, usually alleviated by gradually reducing the dose over 1-2 weeks
- •Weight gain
- •Unusual muscle movements, like difficulty starting movements, shaking, restlessness, or muscle stiffness without pain
- •Changes in blood fat levels (triglycerides and total cholesterol)
- •Fast heartbeat
- •Palpitations or irregular heartbeats
- •Constipation, upset stomach (indigestion)
- •Weakness
- •Swelling in arms or legs
- •Low blood pressure, especially when standing up, which may cause dizziness or fainting (and falls)
- •High blood sugar
- •Blurred vision
- •Abnormal dreams and nightmares
- •Increased appetite
- •Irritability
- •Speech and language problems
- •Suicidal thoughts and worsening depression
- •Shortness of breath
- •Vomiting (mostly in older people)
- •Fever
- •Changes in thyroid hormone levels in the blood
- •Decrease in certain types of blood cells
- •Increased levels of liver enzymes in blood tests
- •Increased levels of prolactin hormone in the blood, which can rarely cause breast swelling in men and women, unexpected milk production, or irregular/absent periods in women
RARE
- •Seizures or fits
- •Allergic reactions, such as hives, skin swelling, or swelling around the mouth
- •Uncomfortable feeling in the legs (restless legs syndrome)
- •Difficulty swallowing
- •Uncontrolled movements, especially of the face or tongue
- •Sexual dysfunction
- •Diabetes
- •Changes in heart's electrical activity (prolonged QT interval on ECG)
- •Slower than normal heart rate, which may occur at the start of treatment and be linked to low blood pressure and fainting
- •Difficulty urinating
- •Fainting (may lead to falls)
- •Stuffy nose
- •Decrease in red blood cell count
- •Decrease in sodium levels in the blood
- •Worsening diabetes
- •Confusion
- •Malignant neuroleptic syndrome (a combination of fever, sweating, muscle stiffness, severe drowsiness, or fainting)
- •Yellow skin and eyes (jaundice)
- •Liver inflammation (hepatitis)
- •Long-lasting and painful erection (priapism)
- •Breast swelling and unexpected milk production (galactorrhea)
- •Menstrual disorders
- •Blood clots in veins, especially in the legs (with symptoms like swelling, pain, redness in legs), which can travel to the lungs, causing chest pain and breathing difficulties. Seek immediate medical attention if these symptoms occur.
- •Sleepwalking, sleep-talking, sleep-eating, or other activities while asleep
- •Drop in body temperature (hypothermia)
- •Inflammation of the pancreas (pancreatitis)
- •Metabolic syndrome (a combination of at least three symptoms: increased belly fat, low "good" cholesterol (HDL), high triglycerides, high blood pressure, and high blood sugar)
- •Agranulocytosis (a condition with fever, flu-like symptoms, sore throat, or other infection, and a very low white blood cell count)
- •Bowel blockage
- •Increased levels of creatine phosphokinase (a substance from muscles) in the blood
- •Severe rash, blisters, or red patches on the skin
- •Severe allergic reaction (anafylactic shock), which can cause breathing difficulties or shock
- •Rapid swelling of the skin, usually around the eyes, lips, or throat (angioedema)
- •Severe blistering on the skin, mouth, eyes, or genitals (Stevens-Johnson syndrome)
- •Abnormal secretion of a hormone that regulates urine volume
- •Muscle fiber breakdown and muscle pain (rhabdomyolysis)
- •Rash with irregular red patches (erythema multiforme)
- •Rapidly appearing red skin areas with small pus-filled blisters (Acute Generalized Exanthematous Pustulosis, AGEP)
- •Severe, sudden allergic reaction with symptoms like fever, skin blisters, and skin peeling (Toxic Epidermal Necrolysis)
- •DRESS syndrome (drug rash with eosinophilia and systemic symptoms) with flu-like symptoms, rash, fever, swollen lymph nodes, and abnormal blood test results (including increased eosinophils and liver enzymes)
- •Withdrawal symptoms in newborns if the mother used quetiapine during pregnancy
- •Stroke
- •Heart muscle disease (cardiomyopathy)
- •Heart muscle inflammation (myocarditis)
- •Blood vessel inflammation (vasculitis), often with a rash of small red or purple bumps
Important Warnings
- Do not take if you are allergic to quetiapine or any other ingredient in this medicine.
- Do not take this medicine if you are currently taking certain medications for HIV, fungal infections (azoles), antibiotics like erythromycin or clarithromycin, or the antidepressant nefazodone.
- Seek immediate medical help if you have a fever, severe muscle stiffness, sweating, and confusion, as these could be signs of a serious condition called neuroleptic malignant syndrome.
- Tell your doctor if you experience uncontrolled movements, especially in your face or tongue.
- Report dizziness or severe drowsiness, as this can increase the risk of falls, especially in older patients.
Show 11 more warnings
- Inform your doctor if you have seizures or fits.
- Contact your doctor if you have a long-lasting, painful erection.
- Seek immediate medical attention if you experience fast or irregular heartbeats, palpitations, shortness of breath, chest pain, or unusual tiredness.
- Report any fever, flu-like symptoms, sore throat, or other infection signs to your doctor, as this could mean you have a low white blood cell count.
- Tell your doctor immediately if you have constipation with stomach pain that doesn't go away, as this could lead to a serious bowel blockage.
- If you have thoughts of harming yourself or suicide, contact your doctor or go to the nearest hospital right away.
- Stop taking this medicine and see a doctor immediately if you get severe skin reactions like widespread rash with blisters, peeling skin, flu-like symptoms, fever, swollen glands, or pus-filled bumps.
- Take this medicine at least one hour before a meal or at bedtime, as food can affect its effectiveness.
- Be careful with alcohol, as combining it with this medicine can make you very sleepy.
- Do not drink grapefruit juice while taking this medicine, as it can affect how the medicine works.
- This medicine can make you sleepy. Do not drive or use machines until you know how it affects you.
Use in Elderly Patients
Category D
Avoid use in older adults. Anticholinergic. Sedative. For treatment of psychosis only. Inappropriate as a hypnotic. Increases the risk of cardiovascular events, QT prolongation and orthostatic hypotension. Increases risk of falls, extrapyramidal symptoms and cognitive impairment. Reduces the effectiveness of drugs for Alzheimer’s disease. Avoid grapefruit. (updated 15.1.2024)