Qtipine 25/Qtipine 300 Dosage/Direction for Use

Different dosing schedules exist for each indication. It must therefore be ensured that patients receive clear information on the appropriate dosage for their condition.
Quetiapine should be administered with or without food and swallowed whole and not split, chewed or crushed.
Adults: For the treatment of schizophrenia: The usual initial dose is 25 mg twice daily on day one, 50 mg twice daily on day two, 100 mg twice daily on day three, and 150 mg twice daily on day four. The dosage is then adjusted according to response to a usual range of 300 to 450 mg daily given in 2 or 3 divided doses, although 150 mg daily may be adequate for some patients. The maximum recommended dose is 750 mg daily.
For the treatment of manic episodes associated with bipolar disorder: The initial dose is 50 mg twice daily on day one, 100 mg twice daily on day two, 150 mg twice daily on day three, and 200 mg twice daily on day four. The dose may then be adjusted to a usual range of 400 to 800 mg daily, although, in some patients, 200 mg daily may be adequate. Increments in dosage should be no greater than 200 mg daily.
For the treatment of major depressive episodes in bipolar disorder: Quetiapine fumarate should be administered once daily at bedtime. The total daily dose for the first four days of therapy is 50 mg (Day 1), 100 mg (Day 2), 200 mg (Day 3) and 300 mg (Day 4). The dose may then be adjusted to 400 mg on Day 5 and up to 600 mg by Day 8. In clinical trials, no additional benefit was seen in the 600 mg group compared to the 300 mg group. Individual patients may benefit from a 600 mg dose.
For preventing recurrence in bipolar disorder: For preventing recurrence of manic, mixed or depressive episodes in bipolar disorder, patients who have responded to Quetiapine fumarate for acute treatment of bipolar disorder should continue on Quetiapine fumarate at the same dose administered at bedtime. Quetiapine fumarate dose can be adjusted depending on clinical response and tolerability of the individual patient within the dose range of 300 mg to 800 mg/day. It is important that the lowest effective dose is used for maintenance therapy.
Elderly: As with other antipsychotics and antidepressants, Quetiapine fumarate should be used with caution in the elderly, especially during the initial dosing period. The rate of dose titration of Quetiapine fumarate may need to be slower, and the daily therapeutic dose lower, than that used in younger patients. The mean plasma clearance of quetiapine was reduced by 30% to 50% in elderly patients when compared to younger patients.
Children and Adolescents: For treatment of schizophrenia associated with bipolar disorder (children and adolescents 13 to 17 years of age): Quetiapine Fumarate should be administered twice daily. However, it may be administered three times daily based on response and tolerability. The total daily dose for the first five days of therapy is 50 mg (Day 1), 100 mg (Day 2), 200 mg (Day 3), 300 mg (Day 4) and 400 mg (Day 5). The dose should be adjusted within the effective dose range of 400 mg to 800 mg a day based on response and tolerability of the individual patient after day 5. Increments in dosage should be no greater than 100 mg daily. Safety and effectiveness of Quetiapine Fumarate in children less than 13 years of age with bipolar mania have not been established.
For treatment of manic episodes associated with bipolar disorder (children and adolescents 10 to 17 years of age): Quetiapine Fumarate should be administered twice daily. However, it may be administered three times daily based on response and tolerability. The total daily dose for the first five days of therapy is 50 mg (Day 1), 100 mg (Day 2), 200 mg (Day 3), 300 mg (Day 4) and 400 mg (Day 5). The dose should be adjusted within the effective dose range of 400 mg to 800 mg a day based on response and tolerability of the individual patient after day 5. Increments in dosage should be no greater than 100 mg daily. Safety and effectiveness of Quetiapine Fumarate in children less than 10 years of age with bipolar mania have not been established.
Renal impairment: Dosage adjustment is not necessary in patients with renal impairment.
Hepatic impairment: Quetiapine is extensively metabolized by the liver. Therefore, Quetiapine Fumarate should be used with caution in patients with known hepatic impairment, especially during the initial dosing period. Patients with hepatic impairment should be started on 25 mg/day. The dose can be increased in increments of 50 mg/day to an effective dose, depending on the clinical response and tolerability of the individual patient.