quetiapine (Seroquel, Seroquel XR)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Is quetiapine (Seroquel, Seroquel XR) available as a generic drug?

Yes

Do I need a prescription for quetiapine (Seroquel, Seroquel XR)?

Yes

Why is quetiapine (Seroquel, Seroquel XR) prescribed to patients?

What are the side effects of quetiapine (Seroquel, Seroquel XR)?

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What are the side effects of quetiapine (Seroquel, Seroquel XR)?

  • The most common side effects of Seroquel or Seroquel XR are
  • Possible serious side effects include
  • Other important side effects include a potentially fatal complex referred to as neuroleptic malignant syndrome (NMS), in which patients may have
  • Quetiapine frequently causes tiredness (1 in 5 patients), especially during the first 3-5 days of treatment. Because of this tiredness, care should be exercised in any activity requiring mental alertness such as operating a motor vehicle or hazardous machinery.
  • Less common side effects include seizures (1 in 125 patients) and hypothyroidism (1 in 250 patients).

Warning for people with high or low blood pressure and Seroquel or Seroquel XR

  • Seroquel or Seroquel XR can cause orthostatic hypotension (a drop in blood pressure upon standing that can lead to dizziness or fainting) especially during the first 3-5 day period of treatment, when it is restarted after temporary discontinuation, and after an increase in the dose. The risk of orthostatic hypotension is about 1 in 100 (one of every hundred patients who take quetiapine).
  • As with other antipsychotics, long-term use of quetiapine may lead to irreversible tardive dyskinesia, a neurologic disease which consists of involuntary movements of the jaw, lips, and tongue.

Warning for people with cataracts taking Seroquel or Seroquel XR

  • In animals, quetiapine has been associated with the development of cataracts, and cataracts have been reported in patients using quetiapine for prolonged periods. Although it is not clear if quetiapine was responsible for the cataracts seen in humans, eye examinations by slit-lamp (to identify cataracts before they impair vision) are recommended at the beginning of treatment and every six months during treatment. If cataracts form, treatment should be discontinued.

Warning for people with high triglycerides or cholesterol taking Seroquel or Seroquel XR

Warning for people with diabetes taking quetiapine taking Seroquel or Seroquel XR

  • There is an increased risk of hyperglycemia (high blood glucose) and diabetes-related events in patients taking atypical antipsychotics, including quetiapine. Patients should be tested during treatment for elevated blood-sugars. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.

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What is the dosage for quetiapine (Seroquel, Seroquel XR)?

  • Immediate release quetiapine usually is taken two or three times daily.
  • Extended release quetiapine is taken once daily.
  • The dose usually is increased slowly over several days or weeks to achieve the desired effect.
  • Quetiapine can be taken with or without food.
  • The initial dose for bipolar disorder is 50 mg twice daily (100 mg/day) of immediate release quetiapine. The dose can be increased by 100 mg/day to a daily dose of 400 mg/day. Most patients respond to 400-800 mg/day. Doses greater than 800 mg/d have not been studied. The starting dose is 300 mg once daily and the target dose is 400-800 mg once daily when using extended release tablets.
  • The initial dose for schizophrenia is 25 mg twice daily (50 mg/day) of immediate release tablets. The dose can be increased by 25-50 mg two or three times daily. The target dose is 300-400 mg/day in two or three doses. Patients respond to 150-750 mg/day, and doses greater than 800 mg/day have not been evaluated. The starting dose is 300 mg once daily and the target dose is 400-800 mg once daily when using extended release tablets.
  • The dose range for treating major depression is 150-300 mg/day of extended release tablets. The starting does is 50 mg in the evening for 2 days increasing to 150 mg in the evening.

Which drugs or supplements interact with quetiapine (Seroquel, Seroquel XR)?

Is quetiapine (Seroquel, Seroquel XR) safe to use during pregnancy or while breastfeeding?

  • There are no adequate studies of Seroquel and Seroquel XR in pregnant women. Studies in animals are inconsistent. Some studies suggest effects on the fetus and others show no effects. Seroquel and Seroquel XR should be used in pregnancy only if the physician feels that it is necessary and that the potential benefits justify the unknown risks.
  • Seroquel and Seroquel XR is excreted in the milk of animals during lactation. Although it is not known if it is excreted in human milk, it is recommended that women taking Seroquel and Seroquel XR not breastfeed.

What else should I know about quetiapine (Seroquel, Seroquel XR)?

What preparations of quetiapine (Seroquel, Seroquel XR) are available?
  • Tablets: 25, 50, 100, 200, 300 and 400 mg.
  • Tablet (Extended Release): 50, 150, 200, 300 and 400 mg
How should I keep quetiapine (Seroquel, Seroquel XR) stored?
  • Tablets should be stored at room temperature, 15 C to 30 C (59 F to 86 F).
How does quetiapine (Seroquel, Seroquel XR) work?
  • Although the mechanism of action of quetiapine is unknown, like other atypical anti-psychotics, it inhibits communication among nerves of the brain. It does this by blocking receptors on the nerves for several neurotransmitters, the chemicals that nerves use to communicate with each other. It is thought that its beneficial effect is due to blocking of the dopamine type 2 (D2) and serotonin type 2 (5-HT2) receptors.
When was quetiapine (Seroquel, Seroquel XR) approved by the FDA?
  • The FDA approved quetiapine in September 1997.

Reference: FDA Prescribing Information

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Summary

Seroquel and Seroquel XR (qauetiapine) is an antipsychotic drug prescribed to treat bipolar disorder and schizophrenia. Common side effects include

Drug interactions, dosage, and pregnancy and breastfeeding safety information should be reviewed prior to taking this medication.

Treatment & Diagnosis

Medications & Supplements

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See more info: quetiapine on RxList
Reviewed on 11/4/2016
References
Reference: FDA Prescribing Information

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