Seroquel XR

Seroquel XR is prescribed for managing schizophrenia in individuals aged 13 and older.

It is also utilized alone or in conjunction with divalproex or lithium to address manic episodes in adults diagnosed with bipolar disorder.

In adults with bipolar disorder, Seroquel XR is indicated for the treatment of depressive episodes.

Additionally, Seroquel XR is used as a standalone treatment for manic episodes in children aged 10 and older with bipolar disorder.

Extended-release Seroquel XR is sometimes prescribed alongside antidepressants to help manage major depressive disorder in adults.

This medication may also have off-label uses that are not covered in this guide.

Potential Side Effects

Seek emergency medical attention if you experience signs of a severe allergic reaction, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.

Long-term or high-dose use of quetiapine may lead to an irreversible movement disorder. The longer the medication is used, the higher the risk—especially in women and older adults.

Notify your doctor immediately if you experience sudden mood or behavioral changes, including worsening depression, anxiety, panic attacks, difficulty sleeping, impulsive actions, irritability, restlessness, hostility, aggression, excessive activity, excessive talkativeness, or thoughts of self-harm or suicide.

Severe reactions

Contact your doctor right away is you notice:

• Uncontrollable facial muscle movements (chewing, lip-smacking, frowning, tongue movement, blinking, or abnormal eye movements).
• Hormonal changes, including breast swelling, nipple discharge, impotence, or missed menstrual cycles.
• Severe digestive issues, such as difficulty swallowing or extreme constipation.
• Painful or difficult urination.
• Heart-related symptoms, including high blood pressure, an irregular or rapid heart rate.
• Neurological concerns, such as sudden numbness or weakness, severe headache, blurred vision, or seeing halos around lights.
• Seizures, abnormal body temperature regulation (feeling too hot or cold).
• Signs of infection, such as fever, chills, sore throat, body aches, fatigue, appetite loss, bruising, or abnormal bleeding.
• Severe nervous system reactions, including extreme muscle stiffness, high fever, sweating, confusion, tremors, irregular heartbeat, or fainting.
• Symptoms of an underactive thyroid, such as fatigue, low mood, dry skin, hair thinning, reduced sweating, weight gain, facial puffiness, or sensitivity to cold.
• High blood sugar indicators, such as excessive thirst, frequent urination, dry mouth, or a fruity odor on the breath.
• Low white blood cell count, which may cause fever, mouth or skin sores, sore throat, or cough.

Common side effects

• Difficulty with speech.
• Dizziness, drowsiness, or fatigue.
• Sensation of lightheadedness or fainting.
• Low energy levels.
• Rapid heartbeat.
• Increased appetite, weight gain.
• Nausea, vomiting, constipation, or stomach pain.
• Abnormal liver function results, sore throat.
• Stuffy nose, dry mouth.
• Trouble with movement.

Important warnings

Individuals experiencing depression or other mental health conditions may be at risk of suicidal thoughts. In some cases, young people may notice an increase in these thoughts when beginning treatment with Seroquel XR. If you experience sudden mood or behavioral changes, or have thoughts of self-harm, contact your doctor immediately.

Seroquel XR has been associated with an increased risk of death in elderly individuals with dementia-related psychiatric disorders.

Before using this medication

Avoid Seroquel XR if you have a known allergy to quetiapine.

Depression and other mental health conditions may increase the likelihood of suicidal thoughts, especially when starting a new medication. Monitor any changes in mood or symptoms closely. Family members and caregivers should also stay vigilant for sudden shifts in behavior.

Let your doctor know if you have a past history of:

• Neurological reactions related to antipsychotic medications.
• Heart-related conditions, including a history of heart attack or stroke.
• Long QT syndrome (personal or family history).
• Imbalances in electrolytes, including deficiencies in potassium or magnesium.
• Blood pressure issues, whether high or low.
• Low white blood cell counts.
• Thyroid abnormalities or irregular prolactin levels.
• Prostate enlargement, constipation, or urinary difficulties.
• Seizures.
• Glaucoma or cataracts.
• Diabetes (personal or family history).
• Elevated cholesterol or triglycerides.
• Liver disease.

Seroquel XR has been linked to a higher risk of mortality in older adults with dementia-related psychosis.

• Taking antipsychotic medications during the final trimester of pregnancy may lead to serious health issues for the newborn. If you become pregnant during treatment with this medication, contact your doctor without delay. Do not discontinue use without medical supervision.
• Using Seroquel XR may affect fertility.
• Pregnant individuals may be included in a monitoring registry to evaluate the effects of quetiapine on infants.

Consult your healthcare provider before breastfeeding while using this medication.

Proper usage of Seroquel XR

1. Follow your doctor’s instructions precisely and review all prescription details and medication guides before use.
2. Seroquel XR can be taken with or without food, but it should be taken consistently in the same manner each time.
3. Swallow the tablet whole; do not crush, chew, or break it.
4. Routine blood tests and other medical evaluations may be necessary during treatment. Additionally, your blood pressure may need to be monitored regularly.
5. Abruptly stopping Seroquel XR can lead to worsening symptoms or withdrawal effects such as insomnia, nausea, or vomiting. Never do it by yourself, always speak with your doctor.
6. This medication may interfere with urine drug screening tests, potentially producing inaccurate results. Inform laboratory personnel that you are taking Seroquel XR.
7. Keep in a cool, dry place at room temperature, away from heat and moisture.

What should I do if I miss a dose?

What if I take too much?

In case of an overdose, seek emergency medical assistance immediately or contact the Poison Control Center at 1-800-222-1222.

What to avoid?

1. Avoid drinking alcohol, as it may cause serious adverse reactions.
2. To prevent dizziness, avoid standing up too quickly from a seated or lying position. Do not drive or engage in activities that require full alertness until you know how this medication affects you.
3. Stay hydrated and avoid overheating, especially during physical activity or in hot weather.

Medications that may interact with Seroquel XR

Certain drugs should not be taken together, as they can interfere with each other, leading to increased side effects or reduced effectiveness.

Seroquel XR may cause severe heart-related complications. The risk is heightened if combined with medications used to treat infections, asthma, high blood pressure, heart conditions, depression, psychiatric disorders, cancer, malaria, or HIV.

Call your doctor if you are taking these medications:

• Asthma medications that act as bronchodilators.
• Cold or allergy medicines, including antihistamines like Benadryl.
• Treatments for overactive bladder.
• Medications for Parkinson’s disease.
• Drugs for gastrointestinal conditions, motion sickness, or irritable bowel syndrome.

Seroquel XR (quetiapine) interacts with a wide range of medications. Here are the details of the drug interactions:

Major drug interactions

1. Benzodiazepines:

• Examples: alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin)
• Effect: Increased risk of sedation and drowsiness

2. QT prolongation-causing drugs:

• Examples: amiodarone (Pacerone), haloperidol (Haldol), citalopram (Celexa)
• Effect: Increased risk of abnormal heart rhythm (long QT syndrome)

3. CYP3A4 inhibitors:

• Examples: ketoconazole, itraconazole, indinavir, ritonavir, nefazodone
• Effect: Increased Seroquel XR blood levels; dose should be reduced to one-sixth of the original dose

Moderate drug interactions

1. Anticholinergics:

• Examples: oxybutynin (Oxytrol), solifenacin (Vesicare), tiotropium (Spiriva)
• Effect: Increased risk of digestive side effects, such as constipation

2. Certain antibiotics:

• Examples: azithromycin (Z-Pak), clarithromycin, moxifloxacin (Avelox)
• Effect: Increased risk of Seroquel XR side effects

3. Certain antifungals:

• Examples: itraconazole (Sporanox), ketoconazole, posaconazole (Noxafil)
• Effect: Increased risk of Seroquel XR side effects

4. HIV drugs:

• Examples: cobicistat (Tybost), nelfinavir (Viracept), ritonavir (Norvir)
• Effect: Increased risk of Seroquel XR side effects

5. Other CNS depressants:

• Examples: opioids, alcohol, other antipsychotics
• Effect: Increased sedation and CNS depression

Other notable interactions

1. Antidepressants: May increase the risk of side effects or alter the effectiveness of either medication
2. Antihypertensives: May enhance the hypotensive effect of Seroquel XR
3. Lithium: May increase the risk of neurotoxicity
4. Metformin: May affect blood glucose levels
5. Bronchodilators, cold/allergy medicines, and medications for overactive bladder, Parkinson’s disease, or gastrointestinal issues may also interact with Seroquel XR.

Inform your healthcare provider about all medications, including over-the-counter drugs, vitamins, and herbal supplements, before starting Seroquel XR. Your doctor may need to adjust dosages or monitor you more closely for side effects when using Seroquel XR with other medications.

Sources and references:

1. https://www.drugs.com/drug-interactions/quetiapine,seroquel.html
2. https://www.drugs.com/drug-interactions/quetiapine,seroquel-xr.html
3. https://www.medicalnewstoday.com/articles/drugs-seroquel-interactions
4. https://www.drugs.com/drug-interactions/quetiapine.html
5. https://www.rxlist.com/seroquel-xr-drug.htm
6. https://www.rxlist.com/seroquel-drug.htm
7. https://www.healthline.com/health/drugs/seroquel-interactions
8. https://www.drugs.com/mtm/seroquel-xr.html