Last update June 14, 2022

N05AH04

Compatible

Safe substance and/or breastfeeding is the best option.

It is a dibenzothiazepine atypical antipsychotic (second generation antipsychotics and serotonin–dopamine antagonists). It is used in the treatment of schizophrenia and of bipolar and other psychotic disorders, and borderline personality disorders. Oral administration in two daily doses.

It is excreted into breast milk in clinically insignificant amounts. (Yazdani 2018, Aydin 2015, Van Boekholt 2015, Rampono 2007, Misri 2006, Lee 2004, Seppala 2004)

Clinical or development problems in infants whose mothers were treated have not been observed, whether at the short or long term. (Levesque 2016, Sharma 2016, Aydin 2015, Van Boekholt 2015, Newport 2009, Rampono 2007, Misri 2006, Ritz 2005, Gentile 2005, Seppala 2004, Lee 2004)

Very low plasma-levels of quetiapine in these infants were found. (Rampono 2007)

Galactorrhea may occur with or without an increased of prolactin. (Glocker 2021, Suttajit 2013, Mushtaq 2012, Sethi 2010, Gupta 2007, Atmaca 2002)

Expert authors consider the use of quetiapine to be safe or very probably safe during breastfeeding. (Hale, Lactmed, Uguz 2021, Teodorescu 2020, Rybakowski 2019, Pacchiarotti 2016, Schaefer 2015, Grover 2005, Larsen 2015, Parikh 2014, Rowe 2013)


See below the information of this related product:

Alternatives

  • Olanzapine (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Other names

N05AH04 is Quetiapine Fumarate in ATC Code/s.

Is written in other languages:

Groups

N05AH04 belongs to these groups or families:

Tradenames

Main tradenames from several countries containing N05AH04 in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 10 %
Molecular weight 883 daltons
Protein Binding 83 %
VD 10 l/Kg
pKa 15.12 -
Tmax 1.5 hours
T½ 7 hours
M/P ratio 0.3 -
Theoretical Dose 0.01 - 0.1 mg/Kg/d
Relative Dose 0.1 - 0.43 %

References

  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  3. Glocker C, Grohmann R, Engel R, Seifert J, Bleich S, Stübner S, Toto S, Schüle C. Galactorrhea during antipsychotic treatment: results from AMSP, a drug surveillance program, between 1993 and 2015. Eur Arch Psychiatry Clin Neurosci. 2021 Dec;271(8):1425-1435. Abstract
  4. Uguz F. A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation. Am J Ther. 2021 Jan-Feb 01;28(1):e118-e126. Abstract
  5. Teodorescu A, Dima L, Popa MA, Moga MA, Bîgiu NF, Ifteni P. Antipsychotics in Postpartum Psychosis. Am J Ther. 2020 Jun 22;28(3):e341-e348. Abstract
  6. Rybakowski J, Cubała WJ, Gałecki P, Rymaszewska J, Samochowiec J, Szulc A, Dudek D. Recommendations of the Polish Psychiatric Association regarding the treatment of affective disorders in women of childbearing age. Part II: Bipolar disorder. Psychiatr Pol. 2019 Apr 30;53(2):263-276. Abstract Full text (link to original source)
  7. Yazdani-Brojeni P, Tanoshima R, Taguchi N, Garcia-Bournissen F, Wallach I, Moretti ME, Verjee Z, Ito S. Quetiapine Excretion Into Human Breast Milk. J Clin Psychopharmacol. 2018 Aug;38(4):362-364. Abstract
  8. Levesque S, Riley C. Fetal exposure to lamotrigine and quetiapine in two consecutive pregnancies. Arch Womens Ment Health. 2017 Feb;20(1):237-239. Abstract
  9. Sharma V, Sommerdyk C. Lamotrigine in the Prevention of Bipolar II Postpartum Depression. Prim Care Companion CNS Disord. 2016 Nov 3;18(6). Abstract Full text (link to original source) Full text (in our servers)
  10. Pacchiarotti I, León-Caballero J, Murru A, Verdolini N, Furio MA, Pancheri C, Valentí M, Samalin L, Roigé ES, González-Pinto A, Montes JM, Benabarre A, Crespo JM, de Dios Perrino C, Goikolea JM, Gutiérrez-Rojas L, Carvalho AF, Vieta E. Mood stabilizers and antipsychotics during breastfeeding: Focus on bipolar disorder. Eur Neuropsychopharmacol. 2016 Oct;26(10):1562-78. Abstract
  11. Aydin B, Nayir T, Sahin S, Yildiz A. Olanzapine and quetiapine use during breastfeeding: excretion into breast milk and safe breastfeeding strategy. J Clin Psychopharmacol. 2015 Apr;35(2):206-8. Abstract
  12. Grover S, Avasthi A. Mood stabilizers in pregnancy and lactation. Indian J Psychiatry. 2015 Abstract Full text (link to original source) Full text (in our servers)
  13. Larsen ER, Damkier P, Pedersen LH, Fenger-Gron J, Mikkelsen RL, Nielsen RE, Linde VJ, Knudsen HE, Skaarup L, Videbech P. Use of psychotropic drugs during pregnancy and breast-feeding. Acta Psychiatr Scand Suppl. 2015 Abstract
  14. Van Boekholt AA, Hartong EG, Huntjens-Fleuren H, Grootens KP, Semmekrot BA. Quetiapine concentrations during exclusive breastfeeding and maternal quetiapine use. Ann Pharmacother. 2015 Abstract
  15. Sriraman NK, Melvin K, Meltzer-Brody S. ABM Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers. Breastfeed Med. 2015 Abstract Full text (link to original source) Full text (in our servers)
  16. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  17. Parikh T, Goyal D, Scarff JR, Lippmann S. Antipsychotic drugs and safety concerns for breast-feeding infants. South Med J. 2014 Abstract
  18. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  19. Klinger G, Stahl B, Fusar-Poli P, Merlob P. Antipsychotic drugs and breastfeeding. Pediatr Endocrinol Rev. 2013 Mar-Apr;10(3):308-17. Review. Abstract
  20. Suttajit S, Srisurapanont M, Xia J, Suttajit S, Maneeton B, Maneeton N. Quetiapine versus typical antipsychotic medications for schizophrenia. Cochrane Database Syst Rev. 2013 Abstract
  21. Mushtaq S, Khan S, Patel H. Quetiapine-induced galactorrhea with normal prolactin level in an adult female patient. Prim Care Companion CNS Disord. 2012 Abstract Full text (in our servers)
  22. Davanzo R, Copertino M, De Cunto A, Minen F, Amaddeo A. Antidepressant drugs and breastfeeding: a review of the literature. Breastfeed Med. 2011 Abstract
  23. Sethi S, Sharma M, Malik A. Dose-dependent galactorrhea with quetiapine. Indian J Psychiatry. 2010 Abstract
  24. Yazdani-Brojeni P, Taguchi N, Garcia-Bournissen F, Moretti M, Verjee Z, Koren G, Ito S. Quetiapine in human milk and simulation-based assessment of infant exposure. American Society for Clinical Pharmacology and Therapeutics. Abstracts of papers 2010 Annual Meeting Atlanta, Georgia, March 17–20, 2010. Clin Pharmacol Ther 2010;87 (Suppl. 1):S3-4. Abstract PT 08.
  25. Newport DJ, Ritchie JC, Knight BT, Glover BA, Zach EB, Stowe ZN. Venlafaxine in human breast milk and nursing infant plasma: determination of exposure. J Clin Psychiatry. 2009 Abstract
  26. Rampono J, Kristensen JH, Ilett KF, Hackett LP, Kohan R. Quetiapine and breast feeding. Ann Pharmacother. 2007 Abstract
  27. Klier CM, Mossaheb N, Saria A, Schloegelhofer M, Zernig G. Pharmacokinetics and elimination of quetiapine, venlafaxine, and trazodone during pregnancy and postpartum. J Clin Psychopharmacol. 2007 Abstract
  28. Gupta M. Low dose quetiapine induced galactorrhoea: a case report. Clin Pract Epidemiol Ment Health. 2007 Abstract
  29. Gentile S. Prophylactic treatment of bipolar disorder in pregnancy and breastfeeding: focus on emerging mood stabilizers. Bipolar Disord. 2006 Abstract
  30. Misri S, Corral M, Wardrop AA, Kendrick K. Quetiapine augmentation in lactation: a series of case reports. J Clin Psychopharmacol. 2006 Oct;26(5):508-11. Abstract
  31. Gentile S. Quetiapine-fluvoxamine combination during pregnancy and while breastfeeding. Arch Womens Ment Health. 2006 Abstract Full text (link to original source) Full text (in our servers)
  32. Ritz S. Quetiapine monotherapy in post-partum onset bipolar disorder with a mixed affective state. Eur Neuropsychopharmacol 2005;15 (Suppl 3):S407. Abstract P2.036.
  33. Seppala J. Quetiapine (Seroquel) is effective and well tolerated in the treatment of psychotic depression during breast-feeding. XXIVth CINP Congress Paris, France, 20–24 June 2004. Int J Neuropsychopharmacol 2004;7 (Suppl 2):S245. Abstract P01.431.
  34. Lee A, Giesbrecht E, Dunn E, Ito S. Excretion of quetiapine in breast milk. Am J Psychiatry. 2004 Abstract Full text (link to original source) Full text (in our servers)
  35. Atmaca M, Kuloglu M, Tezcan E, Canatan H, Gecici O. Quetiapine is not associated with increase in prolactin secretion in contrast to haloperidol. Arch Med Res. 2002 Nov-Dec;33(6):562-5. Abstract

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