PATIENT INFORMATION LEAFLET

Psicotric Retard 600 mg prolonged-release tablets

Quetiapina

Read this leaflet carefully before you start taking this medicine, because it contains important information for you.

- Keep this leaflet, as you may need to read it again.

- If you have any questions, ask your doctor or pharmacist.

- This medicine has been prescribed for you and should not be given to others, even if they have the same symptoms as you, as it may harm them.

- If you experience any side effects, consult your doctor or pharmacist, even if they are not listed in this leaflet. See section 4.

1. What is Psicotric Retard 600 mg and what is it used for

2. What you need to know before taking Psicotric Retard 600 mg

3. How to take Psicotric Retard 600 mg

4. Possible side effects

5. Storage of Psicotric Retard 600 mg

6. Contents of the pack and additional information

Psiotric Retard 600 mg contains a substance called quetiapine. It belongs to a group of medications called antipsychotics. This medication may be used to treat various diseases, such as:

·Major depressive episodes in bipolar disorder. You may find that you feel depressed, guilty, lack energy, lose your appetite, or cannot sleep.

·Mania: by which you may feel very excited, euphoric, agitated, enthusiastic, or hyperactive, or present poor judgment, which includes being aggressive or violent.

·Schizophrenia: by which you may hear or feel things that are not there, believe things that are not true, or feel abnormally suspicious, anxious, confused, guilty, tense, or depressed.

Your doctor may continue prescribing this medication, even when you are feeling better.

Do not take Psicotric Retard 600 mg:

·If you are allergic (hypersensitive) to quetiapine or to any of the other components of this medication, (including those listed in section 6).

·If you are taking any of the following medications:

-some medications for HIV

-azole-type medications (for fungal infections)

-erythromycin or clarithromycin (for infections)

-nefazodone (for depression).

Do not take this medication if the above mentioned is applicable to you. If you have any doubts, consult your doctor or pharmacist before taking this medication.

Warnings and precautions

Consult your doctor or pharmacist before starting to take PsicotricRetard600 mg, if:

·You, or a family member, have or have had any heart problems, for example, heart rhythm problems, heart muscle weakness, or heart inflammation, or if you are taking any medication that may affect your heart rate.

·You have low blood pressure.

·You have had a stroke, especially if you are elderly.

·You have liver problems.

·You have ever had a seizure (convulsion).

·You have diabetes or are at risk of developing diabetes. Your doctor may monitor your blood sugar levels while taking quetiapine.

·You know that you have had low white blood cell counts (which may or may not have been caused by other medications).

·You are an elderly person with dementia (loss of brain functions). If so, do not take quetiapine, because the group of medications to which this medication belongs may increase the risk of stroke or, in some cases, death in these people.

. If you are an elderly person with Parkinson's disease/parkinsonism.

·You or a family member has a history of blood clots, as medications like these have been associated with blood clot formation.

. You have or have had a condition in which you stop breathing for short periods during normal nighttime sleep (called "sleep apnea") and are taking medications that relax normal brain activity ("depressants").

• You have or have had a condition in which you cannot completely empty your bladder (urinary retention), prostate hypertrophy, intestinal obstruction, or increased eye pressure. These conditions are sometimes caused by medications (called "anticholinergics") that affect the functioning of nerve cells and are used to treat certain diseases.
• You have a history of alcoholism or drug abuse.
• You have depression or other conditions that are treated with antidepressants.

The use of these medications with quetiapine may cause serotonin syndrome, a potentially life-threatening condition (see Other medications and Psicotric Retard 600 mg).

Inform your doctor immediately if after taking PsicotricRetard600 mg you experience any of the following:

·A combination of fever, intense muscle stiffness, sweating, or a decrease in consciousness (a condition called "neuroleptic malignant syndrome"). You may need immediate medical treatment.

·Uncontrolled movements, mainly of your face or tongue.

·Dizziness or feel very drowsy. This may increase the risk of accidental injuries (falls) in elderly patients.

·Seizures (convulsions).

·Prolonged and painful erection (priapism).

. Rapid and irregular heartbeats, even when at rest, palpitations, respiratory problems, chest pain, or inexplicable fatigue. Your doctor should examine your heart and, if necessary, refer you to a cardiologist immediately.

These conditions may be caused by this type of medication.

Inform your doctor as soon as possible if you have:

·Fever, symptoms similar to the flu, sore throat, or any other infection, as it could be a consequence of very low white blood cell counts and require discontinuation of quetiapine treatment and/or additional treatment.

·Constipation along with persistent abdominal pain, or constipation that has not responded to treatment, as it may lead to more severe intestinal blockage.

Thoughts of suicide and worsening of depression

If you are depressed, sometimes you may think about harming yourself or committing suicide. This may increase at the beginning of treatment, as all these medications take time to be effective, usually around two weeks but sometimes more. These thoughts may also increase if you stop taking your medication abruptly. You may be more likely to think this way if you are a young adult. Information obtained from clinical trials has shown an increase in the risk of suicidal thoughts and/or suicidal behavior in young adults under 25 years old with depression.

If you ever think about harming yourself or committing suicide, contact your doctor or go to the hospital immediately. It may help to tell a close family member or friend that you are depressed, and ask them to read this leaflet. You may ask them to tell you if they think your depression is getting worse, or if they are concerned about changes in your behavior.

Severe skin reactions (SCARs)

With the use of this medication, very rare severe skin reactions (SCARs) have been reported, which may put your life at risk or be fatal. These typically manifest as:

?Sjögren's syndrome (SSJ), a generalized rash with blisters and skin peeling, particularly around the mouth, nose, eyes, and genitals.

?Toxic epidermal necrolysis (NET), a more severe form that causes extensive skin peeling

?Drug reaction with eosinophilia and systemic symptoms (DRESS), which consists of flu-like symptoms with rash, fever, swollen lymph nodes, and abnormal blood test results (including elevated white blood cell count (eosinophilia) and elevated liver enzymes).

• Pustular psoriasis (PEGA), small pus-filled blisters.
• Erythema multiforme (EM), skin rash with irregular patches that cause itching.

If you develop these symptoms, stop using Psicotric Retard 600 mg and contact your doctor or seek medical attention immediately.

Weight gain

Weight gain has been observed in patients taking quetiapine. You and your doctor should monitor your weight regularly.

Children and adolescents

This medication should not be used in children and adolescents under 18 years of age.

Other medications andPsicotric Retard 600 mg

Inform your doctor if you are taking, have taken recently, or may need to take any other medication.

Do not take PsicotricRetard600 mg if you are using any of the following medications:

·Some medications for HIV.

·Azole-type medications (for fungal infections).

·Erythromycin or clarithromycin (for infections).

·Nefazodone (for depression).

Inform your doctor if you are using any of the following medications:

·Medications for epilepsy (such as phenytoin or carbamazepine).

·Medications for high blood pressure.

·Barbiturates (for difficulty falling asleep).

·Thioridazine or Lithium (other antipsychotic medications).

·Medications that affect your heart rate, for example, medications that may cause an imbalance of electrolytes (low potassium or magnesium) such as diuretics (medications for urination) or certain antibiotics (medications for treating infections).

·Medications that may cause constipation.

.Medications (called “anticholinergics”) that affect the functioning of nerve cells and are used to treat certain diseases.

. Antidepressants. These medications may interact with quetiapine and you may experience symptoms such as involuntary and rhythmic muscle contractions, including those that control eye movement, agitation, hallucinations, coma, excessive sweating, tremors, exaggerated reflexes, increased muscle tension, and body temperature above 38?C (serotonin syndrome). Contact your doctor when you experience these symptoms.

Antes of stopping any of your medications, consult your doctor first.

Taking Psicotric Retard 600 mg with food, drinks, and alcohol

·This medication may be affected by food, and therefore you should take your tablets at least one hour before a meal or before bedtime.

·Be careful with the amount of alcohol you consume. This is because the combined effect of this medication and alcohol may cause drowsiness.

·Do not take orange juice while taking this medication. It may affect how the medication works.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, consult your doctor before using this medication.

Do not take this medication during pregnancy, unless you have consulted your doctor. Do not use this medication if you are breastfeeding.

The following symptoms, which may represent withdrawal syndrome, may appear in newborns of mothers who have used quetiapine in the last trimester (last three months of pregnancy): tremors, muscle stiffness, and/or weakness, drowsiness, agitation, respiratory problems, and feeding difficulties. If your newborn develops any of these symptoms, you may need to contact your doctor.

Driving and operating machines

This medication may cause drowsiness. Do not drive or operate tools or machines until you know how the tablets affect you.

Effect on Drug Detection Tests in Urine

If you are undergoing a urine drug detection test, taking quetiapine may produce positive results for methadone or certain antidepressant medications (tricyclic antidepressants, ATCs) when using certain analysis methods, although you may not be taking methadone or ATCs. If this occurs, a more specific test may be performed.

PsitricRetard600 mg contains lactose

This medication contains lactose. If your doctor has told you that you have a certain sugar intolerance, consult him before taking this medication.

Follow exactly the administration instructions of this medication indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.

Your doctor will decide your initial dose. The maintenance dose (daily dose) will depend on your disease and needs, but will usually be between 150 mg and 800 mg.

·Take the tablets once a day.

·Do not break, chew, or crush the tablets.

·Swallow your tablets whole with the help of water.

·Take the tablets without food (at least one hour before a meal or before going to bed, your doctor will tell you when).

·Do not take grapefruit juice while taking this medication. It may affect how the medication works.

·Do not stop taking your tablets even if you feel better, unless your doctor tells you to.

Patients with liver problems

If you have liver problems, your doctor may change your dose.

Older adults

If you are an older adult, your doctor may change your dose.

Use in children and adolescents

This medication should not be used in children and adolescents under 18 years of age.

If you take more Psicotric Retard 600 mg than you should

If you take more PsicotricRetard600 mg than your doctor prescribed, you may feel drowsy, feel dizzy, and experience abnormal heartbeats. Contact your doctor or the nearest hospital immediately. Bring the tablets of this medication with you.

You can also call the Toxicological Information Service, Tf: 915620420, indicating the medication and the amount taken.

If you forget to take Psicotric Retard 600 mg

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 the missed dose.

If you interrupt treatment with Psicotric Retard 600 mg

If you stop taking PsicotricRetard600 mg abruptly, you may be unable to sleep (insomnia), or you may feel nausea, or you may experience headaches, diarrhea, vomiting, dizziness, or irritability.

Your doctor may suggest reducing the dose gradually before interrupting treatment.

If you have any other questions about the use of this medication, ask your doctor or pharmacist.

This medication, like all medicines, can cause side effects, although not everyone will experience them.

Very common side effects (may affect more than 1 in 10 people):

·Dizziness (may lead to falls), headache, dry mouth.

·Sensation of drowsiness (which may disappear over time as you continue to take quetiapine), (may lead to falls).

·Withdrawal symptoms (symptoms that occur when you stop taking quetiapine), which include insomnia, nausea, headache, diarrhea, vomiting, dizziness, and irritability. A gradual withdrawal over a period of at least 1 to 2 weeks is recommended.

·Weight gain.

·Abnormal muscle movements. These include difficulty initiating muscle movements, tremor, sensation of restlessness or muscle rigidity without pain.

·Changes in the amount of certain fats (triglycerides and total cholesterol).

Common side effects (may affect up to 1 in 10 people):

·Fast heart rate.

·Feeling like your heart is beating strongly, rapidly, or irregularly.

·Constipation, indigestion.

·Sensation of weakness.

·Swelling of arms or legs.

·Low blood pressure when standing. This may cause dizziness or fainting (may lead to falls).

·Increased blood sugar levels.

·Blurred vision.

·Abnormal dreams and nightmares.

·Feeling hungrier.

·Feeling irritable.

·Speech and language disorder.

·Thoughts of suicide and worsening of depression.

·Shortness of breath.

·Vomiting (mainly in elderly people).

·Fever.

·Changes in the amount of thyroid hormones in the blood.

·Decrease in the number of certain types of blood cells.

·Increases in liver enzymes measured in the blood.

·Increases in prolactin hormone in the blood. Increases in prolactin hormone may, in rare cases, lead to:

oBoth in men and women, breast swelling and unexpected milk production.

oIn women, not having a menstrual period or having irregular periods.

Uncommon side effects (may affect up to 1 in 100 people):

·Seizures or convulsions.

·Allergic reactions that may include hives, skin swelling, and swelling around the mouth.

·Unpleasant sensations in the legs (also known as restless leg syndrome).

·Difficulty swallowing.

·Involuntary movements, mainly of the face or tongue.

·Sexual dysfunction.

·Diabetes.

·Prolongation of the QT interval seen on the ECG.

·Slower than normal heart rate that may occur at the start of treatment and may be associated with low blood pressure and fainting.s.

·Difficulty urinating.

·Fainting (may lead to falls).

·Stuffy nose.

·Decrease in the number of red blood cells in the blood.

·Decrease in the amount of sodium in the blood.

. Worsening of pre-existing diabetes.

Rare side effects (may affect up to 1 in 1,000 people):

·A combination of high temperature (fever), sweating, muscle stiffness, feeling very drowsy or dizzy (a condition known as "neuroleptic malignant syndrome").

·Yellowish discoloration of the skin and eyes (jaundice).

·Inflammation of the liver (hepatitis).

·Long-lasting and painful erection (priapism).

·Swelling of the breasts and unexpected milk production (galactorrhea).

·Menstrual disorder.

·Clots in the veins, especially in the legs (symptoms include swelling, pain, and redness in the leg), which may travel through the blood vessels to the lungs, causing chest pain and difficulty breathing. If you notice any of these symptoms, seek immediate medical attention.

·Walking, talking, eating, or other activities while you are asleep.

·Decrease in body temperature (hypothermia).

·Inflammation of the pancreas.

·A condition (called "metabolic syndrome") where you may experience a combination of 3 or more of the following effects: increase in fat around your abdomen, decrease in "good" cholesterol (HDL-C), increase in a type of fat in the blood called triglycerides, increase in blood pressure, and increase in blood sugar levels.

·A combination of fever, symptoms similar to the flu, sore throat, or any other infection with a very low white blood cell count, a condition known as agranulocytosis.

·Intestinal obstruction.

·Increased creatine phosphokinase in the blood (a substance found in muscles).

Very rare side effects (may affect up to 1 in 10,000 people):

·Severe skin rash, blisters, or red spots on the skin.

·Severe allergic reaction (anaphylaxis) that may cause difficulty breathing or shock.

·Rapid swelling of the skin, usually around the eyes, lips, and throat (angioedema).

·Severe skin condition with blisters on the skin, mouth, eyes, and genitals (Stevens-Johnson syndrome).

·Inappropriate secretion of a hormone that controls urine volume.

·Rhabdomyolysis (rupture of muscle fibers and pain in the muscles).

Not known (frequency cannot be estimated from available data):

·Severe skin rash with irregular red spots (erythema multiforme). See section 2.

. Rapid appearance of skin areas that are red, covered with small pustules (small blisters filled with white/yellow liquid), called Pustulosis Exantemática Generalizada Aguda (PEGA). See section 2.

·Severe allergic reaction with symptoms such as fever and blisters on the skin and peeling of the skin (toxic epidermal necrolysis). See section 2.

• Drug reaction with eosinophilia and systemic symptoms (DRESS), which consists of symptoms similar to the flu with rash, fever, swollen lymph nodes, and abnormal blood test results (including increased white blood cell count (eosinophilia) and elevated liver enzymes). See section 2.
• Reactions in newborns of mothers who have used quetiapine during pregnancy.
• Stroke
• Cardiomyopathy (heart muscle disorder).
• Myocarditis (inflammation of the heart muscle)
• Vasculitis (inflammation of blood vessels), often with skin rash with small red or purple spots.

This class of medications to which this medication belongs can cause serious heart rhythm problems that can be life-threatening in severe cases.

Some side effects are only observed when a blood test is performed. 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 the blood, increases in liver enzymes, decreases in the number of certain types of blood cells, decreases in the number of red blood cells, increases in creatine phosphokinase in the blood (a substance found in muscles), decreases in the amount of sodium in the blood, and increases in the amount of prolactin hormone in the blood. Increases in prolactin hormone may, in rare cases, lead to:

·Both in men and women, breast swelling and unexpected milk production.

·In women, not having a menstrual period or having 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 observed more frequently in children and adolescents or have not been observed in adults:

Very common side effects (may affect more than 1 in 10 people):

·Increased amount of a hormone called prolactin in the blood. Increases in prolactin hormone may, in rare cases, lead to:

-Both in boys and girls, breast swelling and unexpected milk production.

-In girls, not having a menstrual period or having irregular periods.

·Increased appetite.

·Vomiting.

·Abnormal muscle movements. These include difficulty initiating muscle movements, tremors, sensation of restlessness or muscle rigidity without pain.

·Increased blood pressure.

Common side effects (may affect up to 1 in 10 people):

·Sensation of weakness, fainting (may lead to falls).

·Stuffy nose.

·Feeling irritable.

Reporting of side effects

If you experience any type of side effect, consult your doctor, pharmacist, or nurse, even if it is a possible side effect that does not appear in this leaflet. You can also report them directly through the Spanish System for the Pharmacovigilance of Medicines for Human Use: https//www.notificaram.es. By reporting side effects, you can contribute to providing more information on the safety of this medication.

Keep this medication out of the sight and reach of children.

Do not use this medication after the expiration date that appears on the packaging after CAD. The expiration date is the last day of the month indicated.

Thismedication does not require special storage conditions.

Medications should not be disposed of through drains or in the trash. Dispose of the packaging and medications you no longer need at the SIGRE drop-off point at the pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and medications you no longer need. By doing so, you will help protect the environment.

Composition ofPsicotric Retard 600 mg

The active ingredient is quetiapine. The tablets contain600 mg of quetiapine (as quetiapine fumarate).

The other components are:

Tablet core: lactose, copolymer of methacrylic acid – ethyl acrylate (1:1), crystalline maltose type A, magnesium stearate, and talc.

Tablet coating: Copolymer of methacrylic acid – ethyl acrylate (1:1), type A, triethyl citrate.

Appearance of Psicotric Retard 600 mg, and contents of the package

The prolonged-release tablets of 600 mg are white or off-white, oval, biconvex, with “600” engraved on one side.

They are presented in aluminum/PVC/PCTFE blister in a cardboard box.

The package sizes are: 10, 20, 30, 50, 60, and 100 tablets.

Only some package sizes may be commercially available.

Holder of the marketing authorization

Neuraxpharm Spain, S.L.U.

Avda. Barcelona, 69

08970 Sant Joan Despí

Barcelona

Spain

Responsible for manufacturing

Pharmathen International, S.A.

Industrial Park Sapes Rodopi Prefecture Block Nº 5

Rodopi 69300

Greece

or

Pharmathen, S.A.

Dervenakion 6 Str.

Pallini Attiki, 15351

Greece

or

Neuraxpharm Arzneimittel GmbH

Elisabeth-Selbert-Straße 23

40764 Langenfeld

Germany

This medicine is authorized in the member states of the European Economic Area with the following names:

Last review date of this leaflet: June 2024

Detailed and updated information on this medicine is available on the website of the Spanish Agency of Medicines and Medical Devices (AEMPS)http://www.aemps.gob.es/