Side Effects

Constipation, drowsiness, upset stomach, tiredness, weight gain, blurred vision, or dry mouth may occur. If any of these effects persist or worsen, tell your doctor promptly.

Dizziness or lightheadedness may occur, especially when you first start or increase your dose of this drug. Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position.

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Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: restlessness/constant need to move, shakiness (tremor), mental/mood changes (such as increased anxiety, depression, thoughts of suicide), difficulty swallowing, constipation with persistent abdominal pain, persistent nausea/vomiting, loss of appetite, yellowing eyes/skin, interrupted breathing during sleep, trouble urinating.

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Get medical help right away if you have any very serious side effects, including: fainting, seizure, severe dizziness.

This medication may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

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This drug may also cause significant weight gain and a rise in your blood cholesterol (or triglyceride) levels. These effects, along with diabetes, may increase your risk for developing heart disease. Discuss the risks and benefits of treatment with your doctor. (See also Notes section.)

Quetiapine may rarely cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any unusual/uncontrolled movements (especially of the face, lips, mouth, tongue, arms or legs).

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This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, signs of kidney problems (such as change in the amount of urine).

Quetiapine may increase a certain natural substance (prolactin) made by your body. For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor right away.

Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.

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A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

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Precautions

Before taking quetiapine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: eye cataracts, liver disease, low white blood cell count (including history of low white blood cell count caused by medications), seizure disorder, trouble swallowing, thyroid problems, stomach/intestinal blockage (such as severe constipation, bowel obstruction), stomach/intestines that are not moving (such as ileus), personal or family history of diabetes, personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol), heart disease, high blood pressure, high cholesterol/triglyceride levels, breathing trouble during sleep (sleep apnea), difficulty urinating (for example, due to enlarged prostate).

This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Quetiapine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using quetiapine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills“) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using quetiapine safely.

This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Children may be at higher risk for certain side effects while taking this medication, such as increased blood pressure or increased prolactin (see also Side Effects section). Talk with the doctor about the risks and benefits.

Older adults may be more sensitive to the side effects of this drug, especially drowsiness, dizziness, lightheadedness, and QT prolongation (see above). Drowsiness, dizziness, and lightheadedness can increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop symptoms including muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away.

Since untreated mental/mood problems (such as schizophrenia, bipolar disorder, depression) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.

This medication passes into breast milk and may have undesirable effects on a nursing infant. Tell the doctor right away if your baby develops symptoms such as muscle stiffness or shakiness, unusual sleepiness, or difficulty feeding. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Many drugs besides quetiapine may affect the heart rhythm (QT prolongation), including amiodarone, moxifloxacin, procainamide, quinidine, sotalol, thioridazine, among others.

Other medications can affect the removal of quetiapine from your body, which may affect how quetiapine works. Examples include azole antifungals (such as itraconazole, ketoconazole), rifamycins (such as rifampin), drugs used to treat seizures (such as phenytoin), among others.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

This medication may interfere with certain laboratory tests (including urine tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, loss of consciousness.

Notes

Do not share this medication with others.

Keep all regular medical and psychiatric appointments. Laboratory and/or medical tests (such as blood sugar, blood pressure, cholesterol levels, eye exams, weight, blood counts) should be performed before you start treatment, periodically to monitor your progress, or to check for side effects. Consult your doctor for more details.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.Information last revised May 2020.

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Description

Common use

        Seroquel is an oral antipsychotic (neuroleptic) medication used for treating schizophrenia and acute manic episodes associated with bipolar I disorder. It shows more affinity with serotonin receptors (5-HT2) than with dopamine receptors D1 and D2 in the brain. It also active toward the alpha 1 adrenoreceptor and less active toward alpha 2 adrenoreceptor. Duration of binding with 5-HT2-serotonin and D2 dopamine receptors is less than 12 hours. Mechanism of Quetiapine action is unknown. Though it is supposed that the therapeutic effect is mediated through a combination of dopamine type 2 (D2) and serotonin type 2 (5HT2) receptor antagonism. This medication is used to treat acute and chronic psychosis also ones in patients with schizophrenia.

Dosage and direction

        Seroquel should be taken twice or thrice daily with or without food with a full glass of water. Swallow the tablet whole, do not crush or chew an extended-release tablet. A daily dose of four first therapeutic days is 50 mg, 100 mg (second day), 200 mg (third day), 300 mg (fourth day). Starting from the fourth day the dosage should be adjusted to the level of effective one (which can reach 750 mg daily). In patients with liver or kidney failure, the initial dose is 25 mg/day increased gradually by 25-50 mg till the effective dose is reached. Take exactly as prescribed by your physician and do not exceed the recommended dose.

Precautions

        This medication affects the ability to the high concentration of attention so it may affect your ability to drive a car or operate machinery. Before to take Seroquel to notify your doctor if you have liver or kidney disease, heart disease, high blood pressure, heart rhythm problems, heart attack or stroke in history, a history of low white blood cell counts, a thyroid disorder, high cholesterol or triglycerides, a personal or family history of diabetes, trouble swallowing, as you may need your dosage to be adjusted or pass special safety tests for this medication.

Contraindications

        Hypersensitivity, pregnancy, breastfeeding. Seroquel should be used with cautiousness in patients with hypotension, epilepsy and epileptic seizures in history. Seroquel may contribute to the development of heart failure, pneumonia, sudden death, in older adults with conditions caused by dementia.

Possible side effect

        Seroquel antagonism of adrenergic a1 receptors may explain the orthostatic hypotension observed with this drug. Most common and frequent adverse effects of Seroquel are headache, agitation, dizziness, drowsiness, weight gain and stomach upset. Long term use of this medication may cause irreversible tardive dyskinesia, a neurologic disease which consists of involuntary movements of the jaw, lips, and tongue. Other side effects concern nervous system: headache, anxiety, fatigue, hostility, agitation, insomnia, tremors, convulsions, depression, neuroleptic malignant syndrome (hyperthermia, muscle rigidity, altered mental status, the lability of the autonomic nervous system increased activity of CPK). Adverse effects of Quetiapine for cardiovascular system are tachycardia, prolongation of the interval QT. Dryness of the oral mucosa, nausea, vomiting, abdominal pain, diarrhoea or constipation, increased activity of “liver” transaminases, pharyngitis, rhinitis may also appear. Allergic reactions such as skin rash, eosinophilia are also not excluded.

Drug interaction

        Phenytoin (Dilantin) and thioridazine (Mellaril) decrease absorption of Seroquel in intestines and decrease its effects. Seroquel interacts with narcotic pain relievers, medications for hypertension interact with and their activities add oxycodone and acetaminophen (Percocet, Roxicet, Tylox, Endocet), barbiturates, alprazolam (Xanax), clonazepam (Klonopin), ethanol, prazosin (Minipress) and terazosin (Hytrin). Toxicity of Quetiapine may increase if it is co-administered with the drugs able to influence work of cytochrome P450 which is responsible for the metabolism of Seroquel, these drugs are ketoconazole (Nizoral), itraconazole (Sporanox), fluconazole (Diflucan), erythromycin, clarithromycin (Biaxin), nefazodone (Serzone), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem, Tiazac, Dilacor).

Missed dose

        Take the missed dose as soon as you remember. If it is almost time of your next dose just skip the missed dose and return to your schedule. Do not double dose this medication to make up the missed dose.

Overdose

        If you took too much of Seroquel you may experience such symptoms: extreme drowsiness, fast heart rate, feeling light-headed, or fainting. If you suppose that took too much for this medication seeks for immediate medical help.

Storage

Store Seroquel at room temperature, 15-30 C (59-86 F) away from sunlight, moisture, children and pets.