Comparative Pharmacology
Head-to-head clinical analysis: NUPLAZID versus SEROQUEL XR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NUPLAZID versus SEROQUEL XR.
NUPLAZID vs SEROQUEL XR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Selective serotonin 5-HT2A receptor inverse agonist and antagonist; also has moderate affinity for 5-HT2C and 5-HT1A receptors.
SEROQUEL XR (quetiapine fumarate) is an atypical antipsychotic that acts as an antagonist at multiple neurotransmitter receptors: serotonin 5-HT1A and 5-HT2A, dopamine D1 and D2, histamine H1, and adrenergic α1 and α2 receptors. It also has partial agonist activity at 5-HT1A receptors. The therapeutic efficacy in schizophrenia and bipolar disorder is primarily attributed to dopamine D2 and serotonin 5-HT2A antagonism.
34 mg orally once daily.
Initial: 300 mg orally once daily; may increase by 300 mg/day every 2-3 days. Target dose: 400-800 mg/day for schizophrenia; 300-600 mg/day for bipolar depression; 400-800 mg/day for acute mania. Maximum: 800 mg/day.
None Documented
None Documented
Terminal elimination half-life is approximately 50 hours (range 40-70 hours), allowing once-daily dosing.
Terminal elimination half-life: approximately 7 hours (range 6-9 hours) for the extended-release formulation. Clinical context: once-daily dosing achieves steady-state within 2 days.
Fecal (approximately 60%) as unchanged drug and metabolites; renal (approximately 13%) as unchanged drug and metabolites.
Primarily hepatic; 70-73% excreted in urine as metabolites (mostly inactive), 20-24% in feces. Less than 1% excreted unchanged in urine.
Category C
Category C
Atypical Antipsychotic
Atypical Antipsychotic