Seroquel/Seroquel XR Dosage/Direction for Use

Seroquel: Adults: For the treatment of acute and chronic psychoses, including schizophrenia: Quetiapine (SEROQUEL) should be administered twice daily, with or without food.
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).
From Day 4 onwards, the dose should be titrated to the usual effective dose range of 300 to 450 mg/day. However, this may be adjusted, depending on the clinical response and tolerability of the individual patient, within the range of 150 to 750 mg/day.
For the treatment of manic episodes associated with bipolar disorder: Quetiapine (SEROQUEL) should be administered twice daily, with or without food.
The total daily dose for the first four days of therapy is 100 mg (Day 1), 200 mg (Day 2), 300 mg (Day 3) and 400 mg (Day 4). Further dosage adjustments up to 800 mg/day by Day 6 should be in increments of no greater than 200 mg/day.
The dose may be adjusted depending on clinical response and tolerability of the individual patient, within the range of 200 to 800 mg/day. The usual effective dose is in the range of 400 to 800 mg/day.
For the treatment of depressive episodes associated with bipolar disorder: Quetiapine (SEROQUEL) should be administered once daily at bedtime, with or without food.
Quetiapine (SEROQUEL) should be titrated as follows: 50 mg (Day 1), 100 mg (Day 2), 200 mg (Day 3) and 300 mg (Day 4). Quetiapine (SEROQUEL) can be titrated to 400 mg on Day 5 and up to 600 mg by Day 8.
Antidepressant efficacy was demonstrated with Quetiapine (SEROQUEL) at 300 mg and 600 mg, however no additional benefit was seen in the 600 mg group during short-term treatment. (See Pharmacology: Pharmacodynamics: Clinical efficacy under Actions and Adverse Reactions.)
For preventing recurrence in maintenance treatment of bipolar disorder: Patients who have responded to Quetiapine (SEROQUEL) in combination therapy to a mood stabilizer (lithium or valproate) for acute treatment of bipolar disorder should continue on Quetiapine (SEROQUEL) therapy at the same dose. The Quetiapine (SEROQUEL) dose can be re-adjusted depending on clinical response and tolerability of the individual patient within the dose range of 400 mg to 800 mg/day.
Patients who have responded to Quetiapine (SEROQUEL) for acute treatment of bipolar disorder should continue on Quetiapine (SEROQUEL) therapy at the same dosing regimen. The Quetiapine (SEROQUEL) dose can be re-adjusted depending on clinical response and tolerability of the individual patient within the dose range of 300 mg to 800 mg/day.
Elderly: As with other antipsychotics, Quetiapine (SEROQUEL) should be used with caution in the elderly, especially during the initial dosing period. The rate of dose titration may need to be slower, and the daily therapeutic dose lower, than that used in younger patients, depending on the clinical response and tolerability of the individual patient. The mean plasma clearance of quetiapine was reduced by 30% to 50% in elderly patients when compared with younger patients.
Children and adolescents: For the treatment of schizophrenia (adolescents 13 to 17 years of age): Quetiapine (SEROQUEL) should be administered twice daily, with or without food in adolescents 13-17 years of age. However, Quetiapine (SEROQUEL) may be administered three times daily based on response and tolerability.
The total daily dose for the initial 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). After day 5, the dose should be adjusted within the effective dose range of 400 to 800 mg a day based on response and tolerability in the individual patient. Dosage adjustments should be in increments of no greater than 100 mg a day.
Safety and effectiveness of Quetiapine (SEROQUEL) in children less than 13 years of age with schizophrenia have not been established.
For the treatment of manic episodes associated with bipolar disorder (children and adolescents 10 to 17 years of age): Quetiapine (SEROQUEL) should be administered twice daily, with or without food in children and adolescents 10 to 17 years of age. However, Quetiapine (SEROQUEL) may be administered three times daily based on response and tolerability.
The total daily dose for the initial 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). After day 5, the dose should be adjusted within the effective dose range of 400 to 600 mg a day based on response and tolerability in the individual patient. Dosage adjustments should be in increments of no greater than 100 mg a day.
Safety and effectiveness of Quetiapine (SEROQUEL) in children less than 10 years of age with bipolar mania have not been established.
Renal impairment: Dosage adjustment is not necessary.
Hepatic impairment: Quetiapine is extensively metabolised by the liver. Therefore, Quetiapine (SEROQUEL) 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 should be increased daily in increments of 25 to 50 mg/day to an effective dose, depending on the clinical response and tolerability in the individual patient.
Seroquel XR: Quetiapine (SEROQUEL XR) should be administered once daily, with or without food. The tablets should be swallowed whole and not split, chewed or crushed.
Adults: For the treatment of schizophrenia: The daily dose at the start of therapy is 300 mg on Day 1, 600 mg on Day 2 and up to 800 mg after Day 2. The dose should be adjusted within the effective dose range of 400 mg to 800 mg per day, depending on the clinical response and tolerability of the patient. For maintenance therapy in schizophrenia no dosage adjustment is necessary.
For the treatment of manic episodes associated with bipolar disorder: The daily dose at the start of therapy is 300 mg on Day 1, 600 mg on Day 2 and up to 800 mg after Day 2. The dose should be adjusted within the effective dose range of 400 mg to 800 mg per day, depending on the clinical response and tolerability of the patient.
For the treatment of depressive episodes associated with bipolar disorder: Quetiapine (SEROQUEL XR) should be administered once daily in the evening.
Quetiapine (SEROQUEL XR) should be titrated as follows: 50 mg (Day 1), 100 mg (Day 2), 200 mg (Day 3) and 300 mg (Day 4). Quetiapine (SEROQUEL XR) can be titrated to 400 mg on Day 5 and up to 600 mg by Day 8.
Antidepressant efficacy was demonstrated with Quetiapine (SEROQUEL) at 300 mg and 600 mg, however no additional benefit was seen in the 600 mg group during short-term treatment. (See Pharmacology: Pharmacodynamics: Clinical efficacy under Actions and Adverse Reactions.)
For preventing recurrence in maintenance treatment of bipolar disorder: Patients who have responded to Quetiapine (SEROQUEL XR) in combination therapy to a mood stabilizer (lithium or valproate) for acute treatment of bipolar disorder should continue on Quetiapine (SEROQUEL XR) therapy at the same dose. The Quetiapine (SEROQUEL XR) dose can be re-adjusted depending on clinical response and tolerability of the individual patient within the dose range of 400 mg to 800 mg/day.
Patients who have responded to Quetiapine (SEROQUEL XR) for acute treatment of bipolar disorder should continue on Quetiapine (SEROQUEL XR) therapy at the same dosing regimen. Quetiapine (SEROQUEL XR) dose can be re-adjusted depending on clinical response and tolerability of the individual patient within the dose range of 300 mg to 800 mg/day.
For the treatment of major depressive disorder: Quetiapine (SEROQUEL XR) should be administered once daily in the evening.
Initial dosing should begin at 50 mg on Day 1 and 2, increased to 150 mg on Day 3 and 4. Further adjustments can be made upwards or downwards within the recommended dose range of 50 mg to 300 mg depending upon the clinical response and tolerability of the patient.
For maintenance therapy in major depressive disorder the effective dose during initial treatment should be continued. The dose can be adjusted within the recommended dose range depending upon the clinical response and tolerability of the patient.
For the treatment of generalised anxiety disorder: Quetiapine (SEROQUEL XR) should be administered once daily in the evening.
Initial dosing should begin at 50 mg on Day 1 and 2, increased to 150 mg on Day 3 and 4. Further adjustments can be made upwards or downwards within the recommended dose range of 50 mg to 300 mg depending upon the clinical response and tolerability of the patient.
For maintenance therapy in generalised anxiety disorder the effective dose during initial treatment should be continued. The dose can be adjusted within the recommended dose range depending upon the clinical response and tolerability of the patient.
Switching from Quetiapine (SEROQUEL) immediate-release tablets: For more convenient dosing, patients who are currently being treated with divided doses of Quetiapine (SEROQUEL) immediate release tablets may be switched to Quetiapine (SEROQUEL XR) extended release tablets at the equivalent total daily dose taken once daily. Individual dosage adjustments may be necessary.
Elderly: As with other antipsychotics, Quetiapine (SEROQUEL XR) should be used with caution in the elderly, especially during the initial dosing period. The rate of dose titration of Quetiapine (SEROQUEL XR) 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 with younger patients. Elderly patients should be started on 50 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.
In elderly patients with major depressive disorder or generalised anxiety disorder initial dosing should begin at 50 mg on Days 1-3, the dose can be increased to 100 mg on Day 4, 150 mg on Day 8 and then up to 300 mg depending on clinical response and tolerability (see Pharmacology: Pharmacodynamics under Actions).
Children and Adolescents: The safety and efficacy of Quetiapine (SEROQUEL XR) was evaluated in an 8-week study of children and adolescent patients (10-17 years of age) with bipolar depression. Efficacy in this study was not established (see Adverse Reactions).
Renal Impairment: Dosage adjustment is not necessary.
Hepatic Impairment: Quetiapine is extensively metabolized by the liver. Therefore, Quetiapine (SEROQUEL XR) 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 50 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.