Quetiapine 200mg Film-Coated Tablet
Package leaflet: Information for the user Quetiapine 25/100/150/200/300 mg Film-coated tablets (quetiapine)
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet:
1. What Quetiapine tablets are and what they are used for
2. What you need to know before you take Quetiapine tablets
3. How to take Quetiapine tablets
4. Possible side effects
5. How to store Quetiapine tablets
6. Contents of the pack and other information.
1. What Quetiapine Tablets are and what they are used for
Quetiapine tablets belong to a group of medicines called antipsychotics. Quetiapine can be used to treat sevela illnesses, such as:
• Bipolar depression: where you feel sad. You may find that you feel depressed, feel guilty, lack energy, lose your appetite or can’t sleep.
• Mania: where you may feel very excited, elated, agitated, enthusiastic or hyperactive or have poor judgment including being aggressive or disruptive.
• Schizophrenia: where you may hear or feel things that are not there, believe things that are not true or feel unsually suspicious, anxious, confused, guilty, tense or depressed.
You doctor may continue to prescribe Quetiapine even when you are feeling better.
2. What you need to know before you take Quetiapine Tablets Do not take Quetiapine tablets:
• if you are allergic to quetiapine or any of the other ingredients of this medicine (listed in section 6)
• if you are taking any of the following medicines:
- some medicines for HIV
- azole medicines (for fungal infections)
- erythromycin or clarithromycin (for infection)
- nefazodone (for depression)
Do not take Quetiapine if the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking Quetiapine tablets.
Warnings and precautions
Talk to your doctor or pharmacist before taking Quetiapine if:
• You, or someone in your family, have or have had any heart problems, for example heart rhythm problems, weakening of the heart muscle or inflammation of the heart or if you are taking any medicines that may have an impact on the way your heart beats.
• You have low blood pressure.
• You have had a stroke, especially if you are elderly.
• You have problems with your liver.
• You have ever had a fit (seizure).
• You have diabetes or have a risk for getting diabetes. If you do, your doctor may check your blood sugar levels while you are taking Quetiapine.
• You know that you have had low levels of white blood cells in the past (which may or may not have been caused by other medicines).
• You are an older person with dementia (loss of brain function). If you are, Quetiapine should not be taken because the group of medicines that Quetiapine belongs to may increase the risk of stroke, or in some cases the risk of death, in older people with dementia. You or someone else in your family has a history of blood clots, as medicines like these have been associated with formation of blood clots.
Tell your doctor immediately if you experience any of the following after taking Quetiapine:
• A combination of fever, severe muscle stiffness, sweating or a lowered level of consciousness (a disorder called “neuroleptic malignant syndrome”). Immediate medical treatment may be needed.
• Uncontrollable movements, mainly of your face or tongue.
• Dizziness or severe sense of feeling sleepy. This could increase the risk of accidental injury (fall) in older patients.
• Fits (seizures)
• A long-lasting and painful erection (Priapism).
These conditions can be caused by this type of medicine.
Tell your doctor as soon as possible if you have:
• A fever, flu-like symptoms, sore throat, or any other infection, as this could be a result of a very low white blood cell count, which may require Seroquel to be stopped and/or treatment to be given.
• Constipation along with persistent abdominal pain, or constipation which has not responded to treatment, as this may lead to a more serious blockage of the bowel.
Thoughts of suicide and worsening of your depression
If you are depressed you may sometimes have thoughts of harming or killing yourself. These may be increased when first starting treatment, since these medicines all take time to work, usually about two weeks but sometimes longer. These thoughts may also be increased if you suddenly stop taking your medication. You may be more likely to think like this if you are young adult. Information from clinical trials has shown an increased risk of suicidal thoughts and/or suicidal behaviour in young adults aged less than 25 years with depression.
If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away. You may find it helpful to tell a relative or close friend that you are depressed, and ask them to read this leaflet. You might ask them to tell you if they think your depression is getting worse, or if they are worried about changes in your behaviour.
Weight gain
Weight gain has been seen in patients taking Quetiapine. You and your doctor should check your weight regularly.
Children and Adolescents
Quetiapine is not for use in children and adolescents below 18 years of age.
Other medicines and Quetiapine
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Do not take Quetiapine if you are taking any of the following medicines:
• Some medicines for HIV.
• Azole medicines (for fungal infections).
• Erythromycin or clarithromycin (for infections).
• Nefazodone (for depression).
Tell your doctor if you are taking any of the following medicines:
• Epilepsy medicines (like phenytoin or carbamazepine).
• High blood pressure medicines.
• Barbiturates (for difficulty sleeping).
• Thioridazine or Lithium (other anti-psychotic medicines).
• Medicines that have an impact on the way your heart beats, for example, drugs that can cause an imbalance in electrolytes (low levels of potassium or magnesium) such as diuretics (water pills) or certain antibiotics (drugs to treat infections). Medicines that can cause constipation.
Before you stop taking any of medicines, please talk to you doctor first.
Quetiapine with food, drink and alcohol
• Quetiapine can be taken with or without food.
• Be careful how much alcohol you drink. This is because the combined effect of Seroquel and alcohol can make you sleepy.
• Do not drink grapefruit juice while you are taking Seroquel. It can affect the way the medicine works.
Pregnancy and breast-feeding
If you are pregnant or breast feeding, think you may be pregnant or planning to have a baby ask your doctor for advice before taking Quetiapine. You should not take Quetiapine during pregnancy unless this has been discussed with your doctor. Quetiapine should not be taken if you are breast-feeding.
The following symptoms which can represent withdrawal may occur in newborn babies of mothers that have used Quetiapine in the last trimester (last three months of their pregnancy): shaking, muscle stiffness and/or weakness, sleepiness, agitation, breathing problems, and difficulty in feeding. If your baby develops any of these symptoms you may need to contact your doctor.
Driving and using machines
Your tablets may make you feel sleepy. Do not drive or use any tools or machines until you know how the tablets affect you.
Quetiapine contains lactose
Quetiapine contains lactose which is a type of sugar. If you have been told by your doctor that you have an intolerance to some sugars, speak to your doctor before taking this medicine.
Effect on Urine Drug Screens
If you are having a urine drug screen, taking Quetiapine may cause positive results for methadone or certain drugs for depression called tricyclic antidepressants (TCAs) when some test methods are used, even though you may not be taking methadone or TCAs. If this happens, a more specific test can be performed.
3. How to take Quetiapine tablets
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Your doctor will decide on your starting dose. The maintenance dose (daily dose) will depend on your illness and needs but will usually be between 150 mg and 800 mg.
• You will take your tablets once a day, at bedtime or twice a day, depending on your illness
• Swallow your tablets whole with a drink of water.
• You can take your tablets with or without food.
• Do not drink grapefruit juice while you are taking Seroquel. It can affect the way the medicine works.
• Do not stop taking your tablets even if you feel better, unless your doctor tells you.
Liver problems
If you have liver disease your doctor may change your dose.
Older patients
If you are older your doctor may change your dose.
Use in children and adolescents
Quetiapine should not be used by children and adolescents aged under 18 years.
If you take more Quetiapine than you should
If you take more Quetiapine than prescribed by your doctor, you may feel sleepy, feel dizzy and experience abnormal heart beats. Contact your doctor or nearest hospital straight away. Keep the Quetiapine tablets with you.
If you forget to take a dose of Quetiapine
If you forget to take a dose, take it as soon as you remember. If it is almost time to take the next dose, wait until then. Do not take a double dose to make up for a forgotten tablet.
If you stop taking Quetiapine
If you suddenly stop taking Quetiapine, you may be unable to sleep (insomnia), or you may feel sick (nausea), or you may experience headache, diarrhoea, being sick (vomiting), dizziness or irritability. Your doctor may suggest you reduce the dose gradually before stopping treatment.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
If any of the following happen, stop taking quetiapine and contact a doctor or go to the nearest hospital immediately, as you may need urgent medical attention.
Uncommon: may affect up to 1 in 100 people
• Uncontrollable movements, mainly of your face or tongue.
• Fits (seizures).
Allergic reactions that may include raised lumps (weals), swelling of the skin and swelling around the mouth.
Rare: may affect up to 1 in 1,000 people
• A long lasting and painful erection (priapism)
• Blood clots in the veins especially in the legs (symptoms include swelling, pain and redness in the leg), which may travel through blood vessels to the lungs causing chest pain and difficulty in breathing.
• A combination of high temperature (fever), sweating, stiff muscles, feeling very drowsy or faint (a disorder called “neuroleptic malignant syndrome”).
• Yellowing of the skin or whites of the eyes (jaundice)
• Inflammation of the liver (hepatitis).
• Inflammation of the pancreas.
Very rare: may affect up to 1 in 10,000 people
• Rapid swelling of the skin, usually around the eyes, lips and throat (angioedema).
• A severe allergic reaction (called anaphylaxis) which may cause difficulty in breathing or shock.
• A serious blistering condition of the skin, mouth, eyes and gentials (Stevens-Johnson syndrome).
• Severe rash, blisters, or red patches on skin.
Other side effects
Very common: may affect more than 1 in 10 people
• Dizziness (may lead to falls), headache, dry mouth
• Feeling sleepy [(this may go away with time as you keep taking Quetiapine) (may lead to falls)]Discontinuation symptoms (symptoms which occur when you stop taking Quetiapine) include not being able to sleep (insomnia), feeling sick (nausea), headache, diarrhoea, being sick (vomiting), dizziness and irritability. Gradual withdrawal over a period of at least 1 to 2 weeks is advisable.
• Putting on weight
• Abnormal muscle movements. These include difficulty starting muscle movements, shaking, feeling restless or muscle stiffness without pain
• Changes in the amount of certain fats (triglycerides and total cholesterol)
Common: may affect up to 1 in 10 people
• Rapid heartbeat
• Feeling like your heart is pounding, racing or has skipped beats
• Constipation, upset stomach (indigestion)
• Feeling weak
• Swelling of arms or legs
• Low blood pressure when standing up. This may make you feel dizzy or faint (may lead to falls)
• Blurred vision
• Abnormal dreams and nightmares
• Feeling more hungry
• Feeling irritated
• Disturbance in speech or language
• Thoughts of suicide and worsening of your depression
• Shortness of breath
• Vomiting (mainly in the older people)
• Fever
• Changes in the amount of thyroid hormones in your blood
• Decreases in the number of certain types of blood cells
• Increases in the amount of liver enzymes measured in the blood
• Increases in the amount of the hormone prolactin in the blood. Increases in the hormone prolactin could in rare cases lead to the following:
- Men and women to have swelling of breasts and unexpectedly produce breast milk.
- Women to have no monthly period or irregular periods.
Uncommon: may affect up to 1 in 100 people
• Unpleasant sensations in the legs (also called restless legs syndrome)
• Difficulty swallowing
• Sexual dysfunction
• Diabetes
• Change in electrical activity of the heart seen on ECG (QT prolongation).
• A slower than normal heart rate which may occur when starting treatment and which may be associated with low blood pressure and fainting.
• Difficulty in passing urine
• Fainting (may lead to falls)
• Stuffy nose
• Decrease in the amount of red blood cells
• Decrease in the amount of sodium in the blood
Rare: may affect up to 1 in 1,000 people
• Swelling of the breasts and unexpected production of milk (galactorrhoea)
• Menstrual disorder
• Walking, talking, eating or other activities while you are asleep
• Body temperature decreased (hypothermia)A condition (called “metabolic syndrome”) where you may have a combination of 3 or more of the following: an increase in fat around your abdomen, a decrease in “good cholesterol” (HDL-C), an increase in a type of fat in your blood called triglycerides, high blood pressure and an increase in your blood sugar.
• Bowel obstruction
• Increased blood creatine phosphokinase (a substance from the muscles)
Very rare: may affect up to 1 in 10,000 people
• inappropriate secretion of a hormone that controls urine volume
• Breakdown of muscle fibres and pain in muscles (rhabdomyolysis).
• worsening of pre-existing diabetes
Not known: frequency cannot be estimated from the available data
• Skin rash with irregular red spots (erythema multiforme).
• Serious, sudden allergic reaction with symptoms such as fever and blisters on the skin and peeling of the skin (toxic epidermal necrolysis).
• Symptoms of withdrawal may occur in newborn babies of mothers that have used Quetiapine during their pregnancy.
The class of medicines to which Quetiapine belongs can cause heart rhythm problems, which can be serious and in severe cases may be fatal.
Some side effects are only seen when a blood test is taken. These include changes in the amount of certain fats (triglycerides and total cholesterol) or sugar in the blood, changes in the amount of thyroid hormones in your blood, increased liver enzymes, decreases in the number of certain types of blood cells, decrease in the amount of red blood cells, increased blood creatine phosphokinase (a substance in the muscles), decrease in the amount of sodium in the blood and increases in the amount of the hormone prolactin in the blood. Increases in the hormone prolactin could in rare cases lead to the following:
- Men and women to have swelling of breasts and unexpectedly produce breast milk.
- Women to have no monthly period or irregular periods.
Your doctor may ask you to have blood tests from time to time.
Additional side effects in children and adolescents
The same side effects that may occur in adults may also occur in children and adolescents.
The following side effects have been seen more often in children and adolescents or have not been seen in adults:
Very common: may affect up to 1 in 10 people
• Increase in the amount of a hormone called prolactin, in the blood. Increases in the hormone prolactin could in rare cases lead to the following:
- Boys and girls to have swelling of breasts and unexpectedly produce breast milk
- Girls to have no monthly period or irregular periods
• Increased appetite
• Vomiting
• Abnormal muscle movements. These include difficulty starting muscle movements, shaking, feeling restless or muscle stiffness without pain.
• Increase in blood pressure
Common: may affect up to 1 in 10 people
• Feeling weak, fainting (may lead to falls)
• Stuff nose
• Feeling irritated
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.
You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store Quetiapine tablets
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month.
This medicine does not require any special storage conditions
Do not throw away any medicine via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Quetiapine tablets contain
- The active substance is Quetiapine.
- The other ingredients are: calcium hydrogen phosphate, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, Macrogol 400, povidone (PVP K30), sodium starch glycollate (type A), and titanium dioxide (E 171). The 100mg, 150mg, 200mg and 300mg also contain talc. The 25mg also contains iron oxide (E172).
What Quetiapine tablets look like and contents of the pack
Quetiapine 25mg Film-coated Tablets are peach coloured, round tablets debossed with ‘Q1’ on one side and plain on the other side.
Quetiapine 100mg Film-coated Tablets are white coloured, round tablets debossed with ‘Q3’ on one side and plain on the other side.
Quetiapine 150mg Film-coated Tablets are white coloured, round tablets debossed with ‘Q4’ on one side and plain on the other side.
Quetiapine 200mg Film-coated Tablets are white coloured, round tablets debossed with ‘Q5’ on one side and plain on the other side.
Quetiapine 300mg Film-coated Tablets are white coloured, capsule shaped tablets debossed with ‘Q6’ on one side and plain on the other side.
Quetiapine tablets are available in blister packs of 1, 6, 10, 20, 30, 50, 60, 90 or 100 tablets.
Not all pack sizes may be marketed.
Marketing Authorization Holder and Manufacturer
Marketing Authorisation Holder:
Focus Farma B.V.
Lagedijk 1-3
1541 KA Koog aan de Zaan The Netherlands
Manufacturer:
Ranbaxy Ireland Ltd Spafield, Cork Road, Cashel,
Co-Tipperary,
Republic of Ireland
Basics GmbH,
Hemmelrather Weg 201,
D-51377 Leverkusen,
Germany
TERAPIA SA,
124 Fabricii Str,
400632 Cluj-Napoca,
Romania
This leaflet was last revised in November 2015.
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