Drug Interactions between quetiapine and Urimar-T

The following interaction applies only to products containing sodium biphosphate that are used for bowel cleansing. It does not apply to products containing sodium biphosphate that are used for other, non-laxative related purposes.

Bowel cleansing with sodium biphosphate can cause kidney failure, in some cases up to several months after the procedure. Although it rarely occurs, the risk is increased in individuals receiving treatment with phenyl salicylate, especially if they are also elderly or frail. You may need a dose adjustment or special tests to safely use both medications. Combining these medications may also increase the risk of dehydration and electrolyte abnormalities. In severe cases, dehydration and electrolyte abnormalities can lead to irregular heart rhythm, seizures, and kidney problems. You should use sodium biphosphate exactly as prescribed by your doctor, and drink plenty of clear fluids before, during, and after the cleansing process to keep yourself hydrated. Your doctor may also recommend an electrolyte rehydration solution that you can use. Talk to your doctor if you have any concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Using hyoscyamine together with QUEtiapine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

The following interaction applies only to products containing sodium biphosphate that are used for bowel cleansing. It does not apply to products containing sodium biphosphate that are used for other, non-laxative related purposes.

QUEtiapine can cause seizures and an irregular heart rhythm that may be serious and potentially life-threatening, although these are relatively rare side effects. The risk is increased if you have low blood levels of electrolytes such as calcium, magnesium, potassium or sodium, which can occur with bowel cleansing preparations or excessive use of medications that have a laxative effect. You should use sodium biphosphate exactly as prescribed by your doctor, and drink plenty of clear liquids before, during, and after the cleansing process to avoid becoming dehydrated. Your doctor may be able to recommend specific fluids you can drink before starting sodium biphosphate to help maintain your electrolyte levels. He/she may also want to monitor your electrolyte levels and/or heart rhythm. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications. In addition, you should let your doctor know if you experience signs and symptoms of low electrolyte levels such as weakness, tiredness, drowsiness, dizziness, confusion, tingling, numbness, muscle pain, cramps, nausea, or vomiting. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Consumer information for this interaction is not currently available.

MONITOR: Coadministration of quetiapine with drugs that possess serotonergic activity (e.g., selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), etc.) may increase the risk of serotonin syndrome, a rare but serious and potentially fatal condition. Combining quetiapine with other serotonergic drugs may increase the risk of serotonin syndrome by relatively enhancing 5-HT1A receptor activity. However, data are currently limited to case reports. In one case report, an 85-year-old woman developed serotonin syndrome within hours of increasing quetiapine from 12.5 mg to 25 mg/day while also taking escitalopram, mirtazapine, sulpiride, and olanzapine; symptoms resolved within 48 hours after the discontinuation of all serotonergic medications. Symptoms of serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. In addition, central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that also cause these effects (e.g., buspirone, desvenlafaxine, dextromethorphan, mianserin, reboxetine).

MANAGEMENT: Some authorities advise caution and closer monitoring for serotonin syndrome when quetiapine is coadministered with other serotonergic agents, especially during initiation and dose escalations. Patients should be instructed to promptly notify their healthcare provider if they experience symptoms of serotonin syndrome. If serotonin syndrome is suspected, a dose reduction or discontinuation of therapy should be considered depending on the severity of the symptoms. If serotonin syndrome develops during therapy, all serotonergic agents should be discontinued immediately, and supportive care rendered as necessary. Due to variability and occasionally prolonged half-lives of these coadministered agents, consulting individual product labeling for specific guidance is advised.