Seroquel Prolong - Instructions For Use, Price, Reviews, Analogues

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Seroquel Prolong

Seroquel Prolong: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Application during pregnancy and lactation
10. 10. Use in childhood
11. 11. In case of impaired renal function
12. 12. For violations of liver function
13. 13. Use in the elderly
14. 14. Drug interactions
15. 15. Analogs
16. 16. Terms and conditions of storage
17. 17. Terms of dispensing from pharmacies
18. 18. Reviews
19. 19. Price in pharmacies

Latin name: Seroquel Prolong

ATX code: N05AH04

Active ingredient: quetiapine (Quetiapine)

Manufacturer: ZiO-Health (Russia); AstraZeneca UK, Ltd. (AstraZeneca UK, Ltd.) (UK)

Description and photo updated: 30.11.2018

Prices in pharmacies: from 1799 rubles.

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Seroquel Prolong is an atypical antipsychotic drug (neuroleptic).

Release form and composition

The drug is produced in the form of tablets of prolonged action, film-coated: biconvex oblong, pink (50 mg), white (150 and 400 mg), yellow (200 mg) or pale yellow (300 mg); on one of the sides engraved with "XR 50", "XR 150", "XR 200", "XR 300" or "XR 400" according to the dosage (10 tablets in a blister, 6 blisters in a cardboard box and instructions for use Seroquel Prolong).

1 tablet contains:

• active substance: quetiapine fumarate - 57.56; 172.69; 230.26; 345.38 or 460.5 mg (equivalent to 50, 150, 200, 300, or 400 mg of quetiapine, respectively);
• additional components: microcrystalline cellulose, hypromellose (2208), lactose monohydrate, magnesium stearate, sodium citrate dihydrate;
• film shell: titanium dioxide (E171), macrogol 400, hypromellose (2910); additionally for a dosage of 50, 200 and 300 mg - iron oxide yellow dye (E172) and for a dosage of 50 mg - iron oxide red dye (E172).

Pharmacological properties

Pharmacodynamics

Quetiapine, the active ingredient Quetiapine Prolong, is an atypical antipsychotic drug. Quetiapine and N-dezalkyl quetiapine, which is its active metabolite, interact with neurotransmitter receptors in the brain. They exhibit high affinity (affinity) for serotonin receptors 5HT ₂ -type and dopamine receptors D ₁ - and D ₂ -type of the brain. Antagonism to these receptors in combination with a higher selectivity for 5HT ₂ -type serotonin receptors, when compared with the ratio for D ₂-type dopamine receptors, determine the most important clinical antipsychotic properties of Quetiapine Prolong and a low incidence of extrapyramidal adverse reactions. Quetiapine does not show an affinity for the norepinephrine transporter and has a low affinity for serotonin 5HT _1A receptors, in contrast to N-desalkyl quetiapine, which exhibits a high affinity for them. Partial agonism of this metabolite towards 5HT _1A -serotonin receptors and suppression of the norepinephrine transporter can cause the antidepressant effect of Quetiapine Prolong.

Quetiapine and N-desalkyl quetiapine are characterized by high affinity for histamine and α ₁ -adrenoreceptors, moderate - for α ₂ -adrenergic receptors and serotonin 5HT ₁ -type receptors. In addition, quetiapine exhibits no or low affinity for muscarinic receptors, and its active metabolite has moderate / high affinity for several muscarinic receptor subtypes.

Quetiapine has shown antipsychotic properties in standard animal tests. The contribution of N-desalkyl quetiapine to the pharmacological activity of the active substance has not been evaluated. During the study of extrapyramidal symptoms (EPS) in animals, it was found that quetiapine leads to mild catalepsy in doses that provide effective blocking of D ₂ receptors. Quetiapine induces a selective decrease in the activity of mesolimbic A ₁₀ dopaminergic neurons when compared with A ₉ nigrostriatal neurons involved in motor function.

Seroquel Prolong is well tolerated when used in recommended doses, including by elderly patients. In patients with dementia, in the age group from 66 to 89 years, in the implementation of studies, treatment with the drug in daily doses of 50-300 mg compared with placebo reduced the symptoms of depression. On the background of long-term therapy in stable patients with schizophrenia, the incidence of weight gain and EPS did not increase. In the DSM-IV study of major depressive disorder [Diagnostic and Statistical Manual of Mental Disorders (4th ed.) - The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition], Seroquel Prolong did not increase the risk of suicidal ideation and suicidal ideation. behavior compared to placebo.

In two short studies of 6 weeks each, Quetiroquel Prolong was used to treat a depressive episode at a daily dose of 150 and 300 mg in combination with drugs such as bupropion, amitriptyline, duloxetine, citalopram, fluoxetine, escitalopram, sertraline, venlafaxine, or paroxetine in patients with a suboptimal response to quetiapine monotherapy. There was an improvement in the signs of depression at the root-mean-square change level by 2-3.3 points on the MADRS (Montgomery - Asberg Depression Rating Scale) compared with taking an antidepressant as a monotherapy drug.

Pharmacokinetics

Quetiapine is well absorbed from the gastrointestinal tract (GIT). The maximum concentration (C _max) of quetiapine and N-dealkyl quetiapine in blood plasma is observed approximately 6 hours after oral administration of the tablets. The equilibrium molar concentration of N-dealkyl quetiapine is 35% of that of quetiapine. In the case of using Quetiapine Prolong once a day at a dose not exceeding 800 mg, the pharmacokinetics of quetiapine and its main active metabolite are linear and dose-dependent.

When Seroquel Prolong was taken once a day at a dose equal to the daily dose used in 2 doses, similar values of the area under the pharmacokinetic curve (AUC) were observed, but the C _max in plasma was 13% lower. The AUC of N-dealkyl quetiapine was 18% less.

Simultaneous administration of the drug with food with a low fat content did not significantly affect the value of AUC and C _{max of} quetiapine. When the drug was taken with food rich in fats, there was a statistically significant increase in its AUC and C _max in plasma by an average of 20 and 50%, respectively. In this connection, it is recommended to use Seroquel Prolong 1 time per day, not combining with food intake.

Quetiapine binds to blood plasma proteins at about 83%.

The main role in the metabolic transformation of quetiapine belongs to the isoenzyme CYP3A4 of cytochrome P ₄₅₀; it is involved in the formation of N-dealkyl quetiapine. Quetiapine and its individual metabolites (including N-dezalkyl quetiapine) exhibit weak inhibitory activity against cytochrome P ₄₅₀ isoenzymes, such as 1A2, 2C19, 2C9, 3A4 and 2D6, but only at a concentration level 5-50 times higher than the concentration, fixed against the background of commonly used effective daily doses of 300-800 mg. Given the in vitro results, it should not be assumed that the combined use of quetiapine with other drugs will cause a clinically pronounced inhibition of their metabolism mediated by cytochrome P ₄₅₀.

The half-life (T _1/2) of quetiapine and N-dealkyl quetiapine is 7 and 12 hours, respectively. Less than 5% of the molar dose of the plasma fraction of free quetiapine and N-desalkyl quetiapine is eliminated in the urine. On average, 73% of quetiapine is excreted in the urine, 21% in the feces. The metabolic process of quetiapine actively proceeds in the liver, less than 5% of the substance remains unchanged, which are excreted in the urine or with feces.

Pharmacokinetic parameters in men and women do not differ.

Indications for use

• schizophrenia, including prevention of relapse in patients with stable remission;
• bipolar disorder, including moderate / severe manic episodes in bipolar disorder; severe depressive episodes in the structure of bipolar disorder; prevention of recurrence of bipolar disorder in the case of effective prior treatment with quetiapine for manic / depressive episodes in this disease;
• depressive episode: combination therapy with a suboptimal response to antidepressant treatment in monotherapy.

Contraindications

Absolute:

• glucose-galactose malabsorption, lactase deficiency and galactose intolerance;
• age up to 18 years;
• combined use with inhibitors of cytochrome P ₄₅₀, including antifungal agents of the azole group, clarithromycin, erythromycin, nefazodone and protease inhibitors;
• hypersensitivity to any of the constituents of the drug.

Relative (taking quetiapine Prolong tablets is required with extreme caution):

• liver failure;
• cerebrovascular and cardiovascular diseases or other conditions that predispose to arterial hypotension;
• risk of stroke and aspiration pneumonia;
• a history of seizures;
• elderly age.

Seroquel Prolong, instructions for use: method and dosage

Seroquel Prolong tablets are taken orally, once a day, on an empty stomach (before meals or not earlier than 1 hour after meals). They must be swallowed whole, without dividing, chewing or crushing.

Recommended dosage regimen of Quetiqel Prolong:

• schizophrenia, moderate / severe manic episodes in the structure of bipolar disorder (for the purpose of therapy): 1st day - at a dose of 300 mg, 2nd - at a dose of 600 mg; further, the recommended daily dose is 600 mg, however, if necessary, it can be increased to 800 mg; taking into account the clinical effect and individual tolerance, the daily dose can be adjusted in the range from 400 to 800 mg; for maintenance therapy in schizophrenia, there is no need to adjust the dose after stopping the exacerbation;
• depressive episodes in bipolar disorder (for the purpose of therapy): Seroquel Prolong is taken at night; in the first four days of the course, use in the following doses: 1st day - 50 mg, 2nd - 100 mg, 3rd - 200 mg, 4th - 300 mg; further, the recommended daily dose is 300 mg, in some cases the dose may be increased to 600 mg, taking into account the therapeutic effect and tolerability of treatment; no advantages were found of using the drug at a dose of 600 mg per day compared to 300 mg; Seroquel Prolong above 300 mg should be prescribed by a physician experienced in the treatment of bipolar disorders;
• relapses of bipolar disorders in the case of previous effective quetiapine therapy of manic / depressive episodes in the structure of bipolar disorder (for prophylaxis): the pill is taken before bedtime, treatment should be continued at the same daily dose as at the beginning of the course of therapy; depending on the clinical response and tolerability of the drug, the daily dose can be adjusted within the range from 300 to 800 mg; use the lowest effective dose for maintenance therapy;
• depressive episode with a suboptimal response to drug treatment in monotherapy (as part of combination therapy): taken before bedtime in the minimum effective dose, the course should be started with a daily dose of 50 mg; on days 1–2, 50 mg is taken, in 3–4 days - 150 mg per day, the daily dose should be increased from 150 to 300 mg only after an individual assessment of the patient's condition; when high doses are prescribed, the risk of side effects is aggravated.

For the convenience of admission, patients who have previously received fractional doses of quetiapine can be switched to using quetiapine Prolong once a day in a dose equal to the total daily dosage of quetiapine. In some cases, dose adjustment may be required to achieve a clinical response.

Side effects

On the background of Queloquel Prolong therapy, the following adverse events were most often observed: dry mouth, dizziness, drowsiness, headache, withdrawal syndrome, a decrease in high-density lipoprotein cholesterol (HDL) levels, an increase in total cholesterol concentration (mostly, low-density lipoprotein cholesterol - LDL)), increased triglyceride levels, decreased hemoglobin levels, increased body weight.

The frequency of adverse reactions from systems and organs:

• nervous system: very often - dizziness ^14,17, drowsiness ^{2, 17}, headache; often - dysarthria, fainting ^14,17, EPS; infrequently - convulsions, restless legs syndrome, tardive dyskinesia ⁶;
• endocrine system: often - an increase in the level of prolactin in the serum ¹⁶; increased concentration of thyroid-stimulating hormone (TSH) ²⁰; a decrease in the level of total triiodothyronine (T3) ²⁰, a decrease in the level of both total and free thyroxine (T4) ²⁰; infrequently - a decrease in the level of free T3 ²⁰; extremely rarely - syndrome of inappropriate secretion of antidiuretic hormone (ADH);
• hematopoietic system: very often - a decrease in the level of hemoglobin ²³, often - leukopenia ¹³, a decrease in the number of neutrophils ²², an increase in the number of eosinophils ¹; infrequently - thrombocytopenia, a decrease in the number of platelets ¹⁴; rarely - agranulocytosis; with an unknown frequency - neutropenia;
• metabolic disorders: very often - an increase in the serum concentration of triglycerides in the blood ¹¹, total cholesterol (mainly LDL cholesterol) ¹², a decrease in HDL cholesterol ¹⁸, an increase in body weight ⁹; often - increased appetite, hyperglycemia ⁷; infrequently - diabetes mellitus ^5.6, hyponatremia;
• immune system: infrequently - hypersensitivity reactions; extremely rare - anaphylactic reactions ⁶;
• mental disorders: often - unusual / nightmares, suicidal thoughts / behavior; rarely - somnambulism and other similar phenomena;
• cardiovascular system: often - palpitations ¹⁹, tachycardia ⁴, orthostatic hypotension ^4.17; infrequently - lengthening of the QT interval, bradycardia; rarely - venous thromboembolism;
• organ of vision: often - blurred vision;
• digestive system: very often - dry mouth; often - vomiting ²¹, dyspepsia, constipation, increased serum gamma-glutamyltransferase (GGT) activity ³, increased serum alanine aminotransferase (ALT) and aspartate aminotransferase (ACT) levels ³; infrequently - dysphagia ⁸; rarely - pancreatitis, intestinal obstruction / ileus, jaundice ⁶, hepatitis ⁶;
• kidneys and urinary tract: infrequently - urinary retention;
• respiratory system: often - rhinitis, shortness of breath ¹⁹;
• musculoskeletal system: extremely rare - rhabdomyolysis;
• skin and subcutaneous tissues: extremely rare - Stevens-Johnson syndrome ⁶, angioedema ⁶;
• reproductive system: infrequently - sexual dysfunction; rarely - menstrual disorders, galactorrhea, priapism;
• changes in laboratory and instrumental parameters: rarely - increased activity of creatine phosphokinase in the blood ¹⁵;
• general disorders: very often - withdrawal syndrome ¹⁰; often - irritability, mild asthenia, fever, peripheral edema; rarely - neuroleptic malignant syndrome (NMS), the clinical manifestations of which may be hyperthermia, muscle rigidity, lability of the autonomic nervous system, altered mental status, increased creatine phosphokinase activity (in this reaction, it is necessary to stop taking Seroquel Prolong and conduct appropriate therapy).

Notes

¹ According to potentially clinically significant deviations from the normal level observed in all studies, an increase in the number of eosinophils ≥ 1 × 10 ⁹ / L at least 1 determination.

² Drowsiness usually appears during the first 14 days of treatment, and in most cases goes away with further therapy.

³ There may be an asymptomatic increase in serum GGT, AST and ALT, usually reversible on the background of further administration of Seroquel Prolong.

⁴ Orthostatic hypotension may occur, accompanied by tachycardia, dizziness, and sometimes fainting, mainly at the beginning of treatment.

⁵ Extremely rare cases of diabetes mellitus decompensation were recorded. It is recommended to monitor patients with diagnosed diabetes mellitus and patients with risk factors for the development of this disease.

⁶ The frequency of this undesirable effect was estimated only on the basis of post-marketing research data. This violation can manifest itself by violent involuntary movements, the appearance of symptoms of dyskinesia or their aggravation is possible even after the cancellation of Quetiquel Prolong.

⁷ Increase in fasting blood glucose ≥ 126 mg / dL (≥ 7.0 mmol / L) or after meals ≥ 200 mg / dL (≥ 11.1 mmol / L) in at least 1 case.

⁸ More frequent development of dysphagia with quetiapine use compared with placebo was recorded only in the course of studies of bipolar depression.

⁹ An increase in the initial body weight of no less than 7% was mainly noted at the beginning of therapy.

¹⁰ The most common withdrawal symptoms observed in the monotherapy regimen of Quetiquel Prolong were the following disorders: headache, insomnia, dizziness, irritability, diarrhea, nausea, and vomiting. The frequency of these phenomena decreased significantly 7 days after the end of the drug intake. Its cancellation should be carried out gradually, for at least 7-14 days.

¹¹ Increase in triglyceride levels ≥ 200 mg / dL (≥ 2.258 mmol / L) at least 1 determination.

¹² Increase in total cholesterol concentration ≥ 240 mg / dL (≥ 6.2064 mmol / L) in at least 1 case.

¹³ According to potentially clinically significant deviations from the normal level, recorded in all studies, a decrease in the number of leukocytes ≤ 3 × 10 ⁹ / L when determined in at least 1 case.

¹⁴ Decrease in the number of platelets ≤ 100 × 10 ⁹ / l, at least with 1 determination.

^{15 The} increase is not associated with ZNS, according to data from clinical studies.

¹⁶ Increase in prolactin concentration in men - ≥ 20 μg / L (≥ 869.56 pmol / L), in women - ≥ 30 μg / L (≥ 1304.34 pmol / L).

¹⁷ Symptom may result in uncontrolled fall (use caution).

¹⁸ Decrease in HDL cholesterol concentration in men - <40 mg / dL and in women - <50 mg / dL.

¹⁹ These abnormalities have often been observed with dizziness, tachycardia, orthostatic hypotension, and / or concomitant respiratory or cardiovascular disease.

²⁰ Based on potentially clinically significant deviations from baseline reported in all clinical trials. The deviation of the concentration of total and free T4, total and free T3 to values of 5 milli-International Units per liter (mIU / L).

²¹ Based on increased incidence of vomiting in persons over 65 years of age.

²² In clinical trials of quetiapine monotherapy in patients with an initial neutrophil count ≥ 1.5 × 10 ⁹ / L, neutropenia (neutrophil count <1.5 × 10 ⁹ / L) was observed in 1.9% of patients in the quetiapine group versus 1, 5% in the placebo group. A decrease in the number of neutrophils ≥ 0.5 × 10 ⁹ / L, but <1.0 × 10 ⁹ / L was noted with a frequency of 0.2% in the quetiapine group and in the placebo group. A decrease in the number of neutrophils <0.5 × 10 ⁹ / L with at least 1 determination was recorded in 0.21% of patients in the quetiapine group versus 0% in the placebo group.

^{23 A} decrease in hemoglobin levels ≤ 13 g / dL in men and ≤ 12 g / dL in women was observed in 11% of patients, at least in 1 case in all studies, including long-term treatment.

In short-term studies against the background of schizophrenia and mania in the structure of bipolar disorder, the frequency of EPS was comparable in the quetiapine group and in the placebo group, with depression - it was 8.9% in the quetiapine group and 3.8% in the placebo group. In long-term studies of quetiapine treatment for schizophrenia, bipolar disorder and depressive episode, the frequency of EPS was comparable in the quetiapine and placebo groups.

Ventricular arrhythmias, prolongation of the QT interval, bidirectional ventricular tachycardia, cardiac arrest, and sudden death are considered adverse reactions that are associated with antipsychotics.

Overdose

Cases of lethal outcome were recorded when using quetiapine at a dose of 13.6 g in a patient who took part in the study, and after taking the drug at a dose of 6 g, by a patient during a post-registration study. At the same time, there is a description of the case of using quetiapine at a dose above 30 g without lethal outcome.

Reported individual cases of overdose, which were the cause of prolongation of the QTc interval, coma or death. The threat of developing adverse reactions can be aggravated in the case of concomitant severe cardiovascular diseases. When taking Seroquel Prolong in doses significantly higher than therapeutic doses, tachycardia, decreased blood pressure, drowsiness and sedation may occur. In isolated cases, the occurrence of rhabdomyolysis, urinary retention, respiratory depression, confusion, delirium and agitation were noted.

Quetiapine does not have a specific antidote. In case of severe intoxication, it is necessary to take into account the risk of overdose of several drugs. It is recommended to carry out activities designed to restore and maintain respiratory and cardiovascular function, to ensure adequate oxygenation and ventilation. If refractory arterial hypotension occurs, intravenous fluids and / or sympathomimetic drugs are prescribed. In this case, you should not use norepinephrine and dopamine, since activation of β-adrenergic receptors can lead to an aggravation of the decrease in blood pressure against the background of α-adrenergic receptor blockade caused by quetiapine.

Gastric lavage (when the patient is unconscious - after intubation) and the use of activated charcoal and laxatives may promote the excretion of unabsorbed quetiapine, but the effectiveness of these measures has not been studied. The patient needs careful medical monitoring until the condition improves.

special instructions

Against the background of depression, the threat of the emergence of a tendency to self-harm, the development of suicidal thoughts of suicide and events associated with it, is aggravated. This danger persists until a pronounced remission is established. Due to the fact that improvement in the condition is not always possible to achieve during the first weeks of treatment, at the beginning of the course, before fixing the improvement, patients must be closely monitored, since the risk of suicide increases in the early stages of remission. In the event of an abrupt discontinuation of quetiapine Prolong, the potential risk of developing phenomena associated with suicidal tendencies should be considered.

All the precautions recommended in the treatment of patients with a depressive episode should also be taken in the treatment of patients with other mental disorders, since they may also be associated with an increased risk of suicide-related events.

Patients with a history of suicidal events and patients who exhibit suicidal ideation before starting Quetiroquel Prolong should be closely monitored during therapy. An increased risk of suicidal behavior during treatment with antidepressants, according to a meta-analysis of placebo-controlled trials of antidepressants, was recorded in patients with mental disorders under 25 years of age.

During the period of taking Seroquel Prolong, hyperglycemia and / or the onset and aggravation of diabetes mellitus may occur, in some cases leading to ketoacidosis or coma. When using antipsychotics, regular clinical monitoring of hyperglycemic symptoms (polyphagia, polyuria, polydipsia, weakness) and body weight is recommended.

Influence on the ability to drive vehicles and complex mechanisms

Since quetiapine can cause drowsiness, it is not recommended to drive vehicles, other complex mechanisms and work with high-precision equipment during the treatment period.

Application during pregnancy and lactation

There is no data to support the safe and effective use of quetiapine in pregnant women. As a result, quetiapine Prolong should be taken during pregnancy only if the expected benefit of the treatment to the woman justifies the potential risk to fetal health.

In the case of the use of antipsychotic drugs, including quetiapine, in the third trimester of pregnancy in newborns, the threat of adverse reactions of varying duration and severity (including EPS and / or withdrawal symptoms) is aggravated. The following side effects were recorded: hypertension / hypotension, agitation, drowsiness, tremors, respiratory distress syndrome or feeding disorders. These newborns require close medical supervision.

There are reports of the excretion of quetiapine in breast milk, although the extent of its excretion has not been established. If it is necessary to take Seroquel Prolong during lactation, breastfeeding should be discontinued.

Pediatric use

In the course of clinical studies in children and adolescents aged 10–17 years, the efficacy and safety of using quetiapine Prolong was studied. According to research data, in children and adolescents, side effects such as increased appetite, an increase in serum prolactin levels in the blood and EPS occurred more often than in adults. In the course of research in patients of this age group, an increase in blood pressure was recorded, which was not observed in adults, and changes in laboratory parameters of the thyroid gland were also recorded. The effect of long-term quetiapine therapy on mental development, puberty, growth, and behavioral responses has not been studied.

In connection with the above, the use of quetiapine Prolong in patients under 18 years of age is contraindicated.

With impaired renal function

It was found that in the presence of severe renal failure with creatinine clearance (CC) below 30 ml / min / 1.73 m2, the mean plasma clearance of quetiapine was reduced by about 25%, however, individual clearance rates did not go beyond the values characteristic of healthy volunteers. No dose adjustment is required for patients with impaired renal function.

For violations of liver function

In patients with compensated alcoholic cirrhosis, the mean plasma clearance of quetiapine was reduced by about 25%. Against the background of liver failure, due to the fact that quetiapine is metabolized to a large extent in the liver, an increase in its concentration in plasma is possible, which may require dose adjustment.

In the presence of liver failure, the drug is recommended to be taken with caution, starting therapy with a daily dose of 50 mg and daily increasing it by 50 mg until the most effective is achieved.

Use in the elderly

In the elderly, the mean clearance of quetiapine is 30-50% lower than in patients aged 18-65. Elderly patients should take quetiapine Prolong with caution, especially at the beginning of the course. Dose titration in such patients may need to be carried out more slowly, while the daily therapeutic dose in them may be lower than in adult patients. Elderly people are recommended to take quetiapine Prolong at an initial daily dose of 50 mg, which can be further increased by 50 mg per day, taking into account the tolerability of the drug and the clinical response, until the most effective dose is reached.

Elderly patients with a depressive episode are prescribed Seroquel Prolong in the first three days of the course in a daily dose of 50 mg, on the fourth day the dose is increased to 100 mg, and on the eighth to 150 mg. Use of the drug is required in the minimum effective dose. If necessary, it can be increased to 300 mg per day, but not earlier than 22 days after the start of the course.

Quetiapine is not indicated for the treatment of psychosis associated with dementia. In the process of randomized placebo-controlled trials with the use of some atypical antipsychotic drugs in patients with dementia, an approximately 3-fold increase in the risk of cerebrovascular complications was recorded. The mechanism of this phenomenon has not been studied, but the aggravation of the threat cannot be ruled out for other antipsychotics or for other categories of patients. Seroquel Prolong should be taken with caution in patients at risk of stroke.

According to the results of a study of the use of atypical antipsychotics for the treatment of psychoses caused by dementia in elderly patients, an increase in mortality was found in the group of people taking drugs of this class, compared with placebo. However, according to two 10-week studies of quetiapine in a similar group of patients, whose age range was 56–99 years, and the average age was 83 years, a causal relationship between quetiapine therapy and the threat of increased mortality was not established.

Drug interactions

• ketoconazole (an inhibitor of the CYP3A4 isoenzyme responsible for the biotransformation of quetiapine): when combined with quetiapine at a dose of 25 mg, there is an increase in the latter's AUC by 5-8 times; the combined use of quetiapine Prolong with inhibitors of the isoenzyme CYP3A4 is contraindicated;
• fluoxetine (inhibitor of CYP3A4 and CYP2D6 isoenzymes), imipramine (inhibitor of CYP2D6 isoenzyme), risperidone / haloperidol (antipsychotics), cimetidine: no significant changes in quetiapine pharmacokinetic parameters;
• carbamazepine, phenytoin and other inducers of microsomal liver enzymes: while taking quetiapine with these drugs, a significant increase in the clearance of quetiapine and, as a result, a decrease in AUC is recorded, which leads to a decrease in its plasma concentration and effectiveness; the use of these combinations is allowed only if the expected benefit of treatment with quetiapine exceeds the threat caused by the abolition of the inducer of microsomal enzymes, the dose adjustment of the latter should be done gradually; if necessary, it is possible to replace these substances with agents that do not induce liver enzymes (in particular, valproic acid preparations);
• thioridazine: the clearance of quetiapine increases by an average of 70%;
• drugs prescribed for diseases of the heart and vascular system: no studies have been conducted to study their pharmacokinetic interaction with quetiapine;
• lorazepam (with a single dose of 2 mg): a decrease in the clearance of this agent by approximately 20% is recorded when combined with quetiapine at a dose of 250 mg 2 times a day;
• lithium preparations, valproic acid: the pharmacokinetics of these drugs does not change; with the combined use of the drug lithium and quetiapine against the background of an acute manic episode in a randomized study, a higher incidence of side effects associated with EPS (especially tremor), weight gain and drowsiness was recorded when compared with patients receiving quetiapine with placebo;
• phenazone: there is no induction of liver microsomal enzymes involved in the metabolism of this substance;
• drugs affecting the central nervous system, alcohol: it is necessary to use Quetiapel Prolong with caution in this combination;
• drugs that can lead to a prolongation of the QTc interval and electrolyte imbalance: care must be taken with these combinations, especially in patients with congenital prolongation of the QT interval, myocardial hypertrophy, chronic heart failure, hypomagnesemia / hypokalemia, as well as in the elderly;
• grapefruit juice: should not be eaten during treatment with quetiapine.

In patients taking quetiapine, false-positive results were noted when using screening tests for the detection of methadone and tricyclic antidepressants by enzyme immunoassay. It is recommended to check the screening results by means of a chromatographic study.

Analogs

Seroquel Prolong analogues are Servitel, Kventiax, Quetiapin Canon Prolong, Kumenthal, Quetiapin San, Quetiapin, Quetiapin-Vial, Ketiap, Kventiax SR, Lakwell.

Terms and conditions of storage

Store out of the reach of children at a temperature not exceeding 30 ° C.

The shelf life is 3 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Seroquel Prolong

According to most reviews, quetiapine Prolong is an effective antipsychotic that has shown positive results in the treatment and prevention of bipolar disorders and schizophrenia. At the same time, almost all patients note a large number of side effects that occur during drug therapy, including such as severe drowsiness, dizziness, pronounced sedation, a significant increase in appetite, dyspepsia.

Price for Seroquel Prolong in pharmacies

The price for Quetiquel Prolong, extended-release film-coated tablets, per pack containing 60 pcs., May be:

• dosage 200 mg - 7,500-9,100 rubles;
• dosage of 300 mg - 9700-10500 rubles;
• dosage 400 mg - 12,000-16,500 rubles.

Seroquel Prolong: prices in online pharmacies

Drug name Price Pharmacy

Seroquel Prolong 200 mg film-coated tablets of prolonged action 60 pcs. 1799 RUB Buy

Seroquel Prolong 300 mg film-coated prolonged-release tablets 60 pcs. RUB 3799 Buy

Seroquel Prolong 400 mg film-coated tablets of prolonged action 60 pcs. RUB 5481 Buy

Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!