► ApoTiapina (quetiapine) - Medycyna Praktyczna

ApoTiapine (quetiapine) - coated tablets

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
ApoTiapina coated tablets; 100 mg; 60 tables Apotex Inc. 52.67 11.37
ApoTiapina coated tablets; 200 mg; 60 tables Apotex Inc. 100.87 15.07
ApoTiapina coated tablets; 25 mg; 30 tabl. Apotex Inc. 8.35 5.99

Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:quetiapine

The drug is available on prescription

What is ApoTiapina?

A drug from the group of neuroleptics, belonging to the group of diazepine derivatives, used in the treatment of schizophrenia and bipolar disorder.

What does ApoTiapina contain and how does it work?

The active substance is Quetiapine . The mechanism of its antipsychotic action is based on interaction with various relay systems. It has the highest affinity for the serotoninergic (5-HT2) and Dopamine rgic (D1 and D2) receptors. It is believed that the antipsychotic effects and the relatively low incidence of extrapyramidal side effects are reflected in the more selective 5HT2 and medium for D receptors. Quetiapine also has affinity for histamine and 1-adrenergic receptors and lower affinity for 2-adrenergic and serotonin receptors. 5HT1A receptors. The affinity of quetiapine for muscarinic cholinergic receptors or benzodiazepine receptors is negligible. Quetiapine is active in tests of antipsychotic activity, such as the avoidance test. It also inhibits the action of dopamine agonists. The increase in the concentration of dopamine metabolites is a neurochemical indicator of the blockade of D2 receptors.

When should I use ApoTiapina?

The preparation is indicated for the treatment of:
· schizophrenia
· Bipolar disorder, including:
treatment of moderate to severe manic episodes in the course of bipolar disorder
treatment of major depressive episodes in the course of bipolar disorder
to prevent the recurrence of bipolar disorder (mixed episodes, mania or depression) in patients who have responded to previous quetiapine treatment.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients.
A contraindication to the use of the preparation is also the parallel use of CYP3A4 inhibitors of cytochrome P450, such as protease inhibitors used in the treatment of HIV, azole antifungals, Erythromycin , Clarithromycin and nefazodone.

When should you take special care with ApoTiapina?

Does this preparation affect the ability to drive vehicles?
The preparation may impair your ability to drive or use machines. Be careful when using it!

Dosage of ApoTiapina

The preparation is in the form of coated tablets. It is intended for oral use. Use the preparation as recommended. Do not exceed the recommended dose, because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts regarding the use of the preparation, consult a physician.
Treatment of schizophrenia.
Adults. The total daily dose should be administered in 2 divided doses:
50 mg / day on day 1, 100 mg / day on day 2, 200 mg / day on day 3 and 300 mg / day on day 4. After the 4th day, 300-450 mg / day. Your doctor may recommend a dose adjustment in the range of 150-750 mg / day, depending on the clinical response and tolerability of the patient.

Treatment of moderate to severe manic episodes in the course of bipolar disorder.
Adults. The total daily dose should be administered in 2 divided doses:
100 mg / day on day 1, 200 mg / day on day 2, 300 mg / day on day 3 and 400 mg / day on day 4. After the 4th day, the dose may be increased (at the doctor's recommendation) up to a maximum of 200 mg / day, up to 800 mg / day on the 6th day. The maintenance dose is 200-800 mg / day depending on the patient's reaction and tolerance, usually 400-800 mg / day.

Treatment of episodes of severe depression in the course of bipolar disorder.
Adults. Serve 1 × / day, in the evening.
50 mg / day on day 1, 100 mg / day on day 2, 200 mg / day on day 3 and 300 mg / day on day 4. After day 4, 300-600 mg / day.

Prevention of recurrence of bipolar disorder in patients with manic or depressive episodes responding to quetiapine treatment.
Adults. It is recommended to continue using doses determined individually during previous treatment; usually 300-800 mg / day in 2 divided doses; the lowest effective doses should be used.

The preparation is used orally, regardless of meals.
Elderly, it may be necessary to increase the dose more slowly and administer a lower daily dose compared to the doses used in younger patients, depending on the clinical response and tolerability of the patient.
The safety and efficacy of use in patients over the age of 65 with episodes of depression in the course of bipolar disorder has not been studied.
There is no need to modify doses in patients with impaired renal function.
In people with hepatic impairment initially 25 mg / day, the dose should be increased (under the supervision of a doctor) daily by 25-50 mg until the therapeutic dose is reached.

Can I use ApoTiapina during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug.
During pregnancy, the preparation can only be used if, in the doctor's opinion, the benefits for the mother outweigh the risk to the fetus. You should not breast-feed while using the preparation.

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter.
The use of quetiapine and inhibitors of the CYP3A4 cytochrome P450 is contra-indicated in parallel.
Quetiapine is not recommended at the same time as grapefruit juice.
Caution should be used when using the product in parallel with the following medicines:
· Other drugs affecting the central nervous system and alcohol
· Carbamazepine, fentyoin, thioridazine (you may need to increase the dose of quetiapine by your doctor)
· Which may cause electrolyte disturbances or prolong the QT interval.

What side effects can occur?

Like all medicines, ApoTiapine can cause side effects, although they will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
Very common may occur: dizziness, drowsiness, headache, dry mouth, withdrawal symptoms, increased triglycerides, increased total cholesterol (mainly LDL), decreased HDL cholesterol, increased body weight.

Common: leukopenia, hyperprolactinemia, increased appetite, unusual dreams and nightmares, syncope, extrapyramidal symptoms, speech disorders, tachycardia, blurred vision, orthostatic hypotension, rhinitis, constipation, indigestion, mild weakness, peripheral edema, irritability, increase in the activity of aminotransferases (ALAT, AST), decrease in the number of neutrophils, increase in blood Glucose up to hyperglycaemia.

Uncommon: eosinophilia, thrombocytopenia, hypersensitivity, epileptic seizures, restless legs syndrome, tardive dyskinesia, dysphagia, increased GGTP3 activity, decreased platelet count, and QT prolongation.

Rarely, you may have: jaundice, priapism (prolonged, painful erection without sexual arousal), milk leakage outside the feeding period (mycotoxins), neuroleptic malignant syndrome, elevation of creatine phosphokinase.

Very rarely may be anaphylactic reaction, diabetes, hepatitis, angioedema, Stevens and Johnson syndrome.

In addition, neutropenia may occur with unknown frequency.

Other preparations on the Polish market containing quetiapine

Alcreno (coated tablets)
Alcreno (Quetiapine Accord) (coated tablets)
Atrolak (prolonged release tablets)
Bonogren (coated tablets)
Bonogren SR (prolonged release tablets)
Etiagen (coated tablets)
Etiagen XR (prolonged release tablets)
Kefrenex (coated tablets)
Ketilept 25 mg (coated tablets)
Ketilept 100 mg (coated tablets)
Ketilept 200 mg (coated tablets)
Ketilept 300 mg (coated tablets)
Ketilept Retard (prolonged release tablets)
Ketipinor (coated tablets)
Ketrel (coated tablets)
Kvelux SR (prolonged release tablets)
Kventiax (coated tablets)
Kventiax SR (prolonged release tablets)
Kwetaplex (coated tablets)
Kwetaplex XR (prolonged release tablets)
Pinexet 25 mg (coated tablets)
Pinexet 100 mg (coated tablets)
Pinexet 200 mg (coated tablets)
Pinexet 300 mg (coated tablets)
Pinexet SR (prolonged release tablets)
Quentapil (coated tablets)
Quetiapin NeuroPharma (coated tablets)
Setinin (coated tablets)
Symquel XR (prolonged release tablets)