Liquid Formulation Availability for Quetiapine
Yes, quetiapine is available in liquid formulation, but only as compounded oral suspensions prepared from commercially available tablets—there is no FDA-approved or commercially manufactured liquid formulation. 1
Formulation Status
Quetiapine is available in oral formulations only for acute management, as explicitly stated in ESMO clinical practice guidelines. 1 This contrasts with olanzapine and aripiprazole, which have parenteral or orally dispersible formulations available in some countries. 1
Compounded Liquid Options
Since no commercial liquid formulation exists, compounded oral suspensions are widely used in clinical settings, particularly for:
- Pediatric populations who cannot swallow tablets 2
- Critically-ill infants and children requiring off-label delirium treatment 2
- Patients with swallowing difficulties, which are common and often concealed in elderly populations 3
- Situations requiring transparent compliance under supervised administration 3
Compounding Specifications
Quetiapine oral suspension can be compounded at 10 mg/mL concentration from commercial tablets using readily available vehicles. 2
- Ora-Blend vehicle is preferable, demonstrating superior 60-day stability at both room temperature and refrigerated storage 2
- Ora-Sweet is an alternative vehicle option with documented stability 2
- Physical and chemical stability must be evaluated through pH monitoring, degradation assessment, and drug content measurement 2
Clinical Advantages of Liquid Formulation
Liquid quetiapine facilitates oral administration while avoiding common medication errors that occur with solid formulations. 3
- Prevents omission of treatment, which could lead to non-adherence and discontinuation symptoms 3
- Avoids alteration of extended-release formulations, which can change pharmacokinetics when crushed or split 3
- Enables fast sedation in mildly agitated, cooperative patients, potentially avoiding involuntary intramuscular injections 3
- Reduces medication administration errors in elderly patients, protecting caregivers from liability 3
Important Caveats
Aspiration remains a risk with liquid formulations, particularly in patients with dysphagia. 3 This must be weighed against the benefits of liquid administration in vulnerable populations.
The extended-release (XR) formulation of quetiapine provides once-daily dosing but is only available as tablets, not as a liquid. 4, 5, 6 Converting XR tablets to liquid suspension eliminates the extended-release properties and alters the pharmacokinetic profile. 3