Quetiapine | Side Effects, Dosage, Uses & More
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Generic Name:

quetiapine, Oral tablet

All Brands

  • Seroquel
SECTION 1 of 5

Highlights for quetiapine

Oral tablet
1

Quetiapine is used to treat schizophrenia, bipolar disorder, or major depression.

2

This drug comes in the form of a tablet you take by mouth. There are two versions of the tablet. The immediate-release version is released into the bloodstream right away. The extended-release version is slowly released into your bloodstream over time.

3

Quetiapine is available as the brand-name drugs Seroquel (immediate-release tablet) and Seroquel XR (extended-release tablet). The immediate-release form is also available as a generic drug.

4

The more common side effects of this drug include drowsiness, dry mouth, headache, weakness, constipation, or dizziness.

5

In some cases, quetiapine can cause serious side effects. These can include a condition called neuroleptic malignant syndrome, movements you can’t control, seizures, or suicide. They can also include death in seniors with dementia.

IMPORTANT INFORMATION

FDA Warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Increased risk of death for seniors with dementia warning. Quetiapine can help reduce symptoms of psychosis in people with schizophrenia. However, it’s not approved for treating psychosis in seniors with dementia (a brain disorder that causes memory loss). Drugs such as quetiapine raise the risk of death in seniors who have dementia. (With psychosis, a person loses contact with reality. They may have symptoms that include hallucinations, which means seeing or hearing things that aren’t there. They also include delusions, which are false beliefs about what’s happening.)

Increased risk of suicidal thoughts and behaviors warning. During the first few months of treatment, quetiapine may increase suicidal thoughts or actions in some children, teenagers, and young adults. People at higher risk include those with depression or bipolar illness, or who have already experienced suicidal thoughts or actions. People with a family history of these conditions are also at higher risk. Patients of all ages who are started on antidepressant treatment should be monitored for new or worsening suicidal thoughts or behaviors.

Neuroleptic malignant syndrome (NMS)

NMS is a rare but very serious condition that can occur in people who take antipsychotic drugs such as quetiapine. NMS can cause death and must be treated in a hospital. Symptoms can include high fever, excessive sweating, rigid muscles, confusion, or changes in breathing, heartbeat, or blood pressure. If you become very ill with these symptoms, call 9-1-1 right away.

Metabolic changes

Quetiapine can cause changes in the way your body functions. You may have hyperglycemia (high blood sugar), increased cholesterol and triglycerides (fats in the blood), or weight gain. High blood sugar can occur in people with or without diabetes. Symptoms can include feeling very thirsty or hungry, needing to urinate more than usual, feeling weak or tired, or having fruity-smelling breath. Your doctor will monitor you for these metabolic changes.

Tardive dyskinesia

Quetiapine can cause tardive dyskinesia. This is a serious condition that causes movements of the face, tongue, or other body parts that you can’t control. Tardive dyskinesia may not go away even if you stop taking quetiapine. It may also start after you stop taking this drug.

What is quetiapine?

Quetiapine is a prescription drug. It comes in the form of a tablet you take by mouth. There are two versions of the tablet. The immediate-release version is released into the bloodstream right away. The extended-release version is slowly released into your bloodstream over time.

Quetiapine is available as the brand-name drugs Seroquel (immediate-release tablet) and Seroquel XR (extended-release tablet). The immediate-release tablet is also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. Talk to your doctor to see if the generic version will work for you.

Quetiapine may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Quetiapine is used to treat the symptoms of schizophrenia, bipolar disorder, or depression.

More Details

How it works

Quetiapine belongs to a class of drugs called atypical antipsychotics.

More Details

Why it's used

Quetiapine is used to treat the symptoms of schizophrenia, bipolar disorder, or depression.

  • Schizophrenia. This condition causes altered thinking or perception. People may have hallucinations (hearing or seeing things that don’t exist) or delusions (false beliefs about reality). These symptoms can be very scary for the person and cause emotions or behavior that may not be considered appropriate.
  • Bipolar I disorder. This condition causes intense mood episodes that lead to drastic changes in behavior. These episodes may include mania (an overly joyful or excited state), depression (an extremely hopeless or sad state), or a mixture of both. Extreme changes in activity and behavior occur with these mood episodes.

Quetiapine can be used to treat symptoms in adults who have depressive episodes or manic episodes caused by bipolar I disorder. For these cases, it can be used alone or with the drugs lithium or divalproex. It can also be used with lithium or divalproex for long-term treatment of bipolar I disorder. Quetiapine can be used in children ages 10–17 years old to treat manic episodes caused by bipolar I disorder.

  • Major depression. For this condition, quetiapine is used as an add-on treatment for people already taking antidepressant drugs. It’s used when your doctor decides that one antidepressant alone is not enough to treat your depression.

How it works

Quetiapine belongs to a class of drugs called atypical antipsychotics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

It isn’t known exactly how this drug works. However, it’s thought that it helps regulate the amount of certain chemicals (dopamine and serotonin) in your brain to control your condition.

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SECTION 2 of 5

quetiapine Side Effects

Oral tablet

More common side effects

The side effects for this drug vary slightly based on the drug form.

  • Seroquel (immediate-release tablets)

    • The more common side effects can include:
      • dry mouth
      • dizziness
      • pain in the abdomen (stomach area)
      • constipation
      • nausea
      • vomiting
      • weight gain
      • increased appetite
      • sore throat
      • trouble moving
      • rapid heartbeat
      • weakness

    If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

  • Seroquel XR (extended-release tablets)

    • The more common side effects of Seroquel XR can include:
      • dry mouth
      • constipation
      • dizziness
      • increased appetite
      • upset stomach
      • tiredness
      • stuffy nose
      • trouble moving

    If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Suicidal thoughts or actions

  • Neuroleptic malignant syndrome. Symptoms can include:

    • high fever
    • excessive sweating
    • rigid muscles
    • confusion
    • changes in your breathing, heartbeat, and blood pressure
  • Hyperglycemia (high blood sugar). Symptoms can include:

    • extreme thirst
    • frequent urination
    • severe hunger
    • weakness or tiredness
    • upset stomach
    • confusion
    • fruity-smelling breath 
  • Increased cholesterol and triglycerides (high fat levels in your blood)

  • Weight gain

  • Tardive dyskinesia. Symptoms can include:

    • movements you can’t control in your face, tongue, or other body parts
  • Orthostatic hypotension (decreased blood pressure when rising too quickly after sitting or lying down). Symptoms can include:

    • lightheadedness
    • fainting
    • dizziness
  • Increases in blood pressure in children and teenagers

  • Low white blood cell count. Symptoms can include:

    • fever
    • infection
  • Cataracts. Symptoms can include:

    • clouding of the lens of your eye
    • blurry vision
    • loss of vision
  • Seizures

  • Abnormal thyroid levels (shown in tests your doctor can do)

  • Increases in blood prolactin levels. Symptoms can include:

    • breast enlargement (in men and women)
    • milky discharge from nipple of breast (in women)
    • erectile dysfunction
    • absence of menstrual period
  • Increased body temperature

  • Trouble swallowing

  • Risk of death from stroke in seniors with dementia

Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Quetiapine may cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

quetiapine May Interact with Other Medications

Oral tablet

Quetiapine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

Quetiapine can cause drowsiness. The use of drinks that contain alcohol raises your risk of this side effect. If you drink alcohol, talk to your doctor about whether this drug is safe for you.

Medications that might interact with this drug

Drugs you should not use with quetiapine

Do not take these drugs with quetiapine. Doing so can cause dangerous effects in the body. Examples of these drugs include:

  • Anti-arrhythmic drugs such as quinidine, procainamide, amiodarone or sotalol. You may have heart rhythm problems that could cause sudden death.
  • Antipsychotic drugs such as ziprasidone, chlorpromazine, or thioridazine. You may have heart rhythm problems that could cause sudden death.
  • Antibiotics such as gatifloxacin or moxifloxacin. You may have heart rhythm problems that could cause sudden death.
  • Pentamidine. You may have heart rhythm problems that could cause sudden death.
  • Methadone. You may have heart rhythm problems that could cause sudden death.

Interactions that increase your risk of side effects
  • Increased side effects from other drugs: Taking quetiapine with certain medications raises your risk of side effects from those drugs. Examples of these drugs include:
    • Benzodiazepines such as alprazolam, clonazepam, diazepam, chlordiazepoxide or lorazepam. You may have increased drowsiness.
    • Muscle relaxants such as baclofen, cyclobenzaprine, methocarbamol, tizanidine, carisoprodol, or metaxalone. You may have increased drowsiness.
    • Pain medications such as morphine, oxycodone, fentanyl, hydrocodone, tramadol, or codeine. You may have increased drowsiness.
    • Antihistamines such as hydroxyzine, diphenhydramine, chlorpheniramine, or brompheniramine. You may have increased drowsiness.
    • Sedative/hypnotics such as zolpidem, temazepam, quetiapine, or eszopiclone. You may have increased drowsiness.
    • Barbiturates such as phenobarbital. You may have increased drowsiness.
    • Antihypertensives such as amlodipine, lisinopril, losartan, or metoprolol. Your blood pressure may be lowered even more.
  • Increased side effects from quetiapine: Taking quetiapine with certain medications raises your risk of side effects from quetiapine. This is because the amount of quetiapine in your body may be increased. Examples of these drugs include:
    • Antifungal drugs such as ketoconazole or itraconazole. Your doctor may decrease your quetiapine dosage.
    • HIV drugs such as indinavir or ritonavir. Your doctor may decrease your quetiapine dosage.
    • Antidepressants such as nefazodone or fluoxetine. Your doctor may decrease your quetiapine dosage.

Interactions that can make your drugs less effective
  • When quetiapine is less effective: When quetiapine is used with certain drugs, it may not work as well to treat your condition. This is because the amount of quetiapine in your body may be decreased. Examples of these drugs include:
    • Anticonvulsants such as phenytoin, fosphenytoin, oxcarbazepine, or carbamazepine. Your doctor may increase your quetiapine dose.
    • Rifampin. Your doctor may increase your quetiapine dose.
    • St. John’s wort. Your doctor may increase your quetiapine dose.
  • When other drugs are less effective: When certain drugs are used with quetiapine, they may not work as well. This is because the amount of these drugs in your body may be decreased. Examples of these drugs include:
    • Parkinson’s disease medications such as levodopa, pramipexole, or ropinirole. Quetiapine may block the effects of your Parkinson’s medications. This may cause an increase in your symptoms of Parkinson’s disease.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Quetiapine warnings
blood sugar warning
People with diabetes or high blood sugar

Quetiapine may increase your blood sugar levels, which can worsen your condition. Extremely high blood sugar may lead to coma or death. If you have diabetes or risk factors of diabetes (such as being overweight or having a family history of diabetes), talk with your doctor. They should check your blood sugar before and during treatment with quetiapine.

blood fat warning
People with hyperlipidemia (high fat levels in the blood)

Quetiapine may further increase the levels of fat (cholesterol and triglycerides) in your blood. High fat levels raise your risk of heart attack and stroke. These high levels typically don’t cause symptoms. Therefore, your doctor may check your blood cholesterol and triglycerides during treatment with quetiapine.

blood pressure warning
People with low or high blood pressure

Quetiapine may worsen your high or low blood pressure. It may also increase blood pressure in children and teenagers. Your doctor should monitor your blood pressure while you take quetiapine.

cell count warning
People with a low white blood cell count

Quetiapine may lower your low white blood cell count even more. Your doctor should monitor your white blood cell count often during your first few months of treatment. This can help make sure that quetiapine is not decreasing your white blood cell count.

cataract warning
People with cataracts (clouding of the lens of the eye)

Quetiapine may worsen your cataracts. Your doctor will monitor you for changes in your cataracts. They will examine your eyes when you start treatment and every 6 months during treatment.

seizure warning
People with seizures

Seizures have occurred in patients with or without epilepsy while taking quetiapine. Quetiapine may make it harder to control seizures in people with epilepsy. Your doctor should monitor you for an increase in seizures while taking this drug.

hypothyroidism warning
People with hypothyroidism (low thyroid level)

Quetiapine may lower thyroid hormone levels and worsen your existing condition. Your doctor should monitor your blood thyroid hormone levels before and during treatment with this drug.

heart problem warning
People with heart problems

Quetiapine may lower blood pressure and may worsen conditions in people with a history of certain heart problems. These include heart attack, angina (chest pain), coronary artery disease, heart failure, or heart rhythm problems. Talk with your doctor about whether this drug is safe for

liver warning
People with liver problems

Quetiapine is mainly broken down in the body by the liver. As a result, people with liver problems may have increased blood levels of this drug. This raises the risk of side effects from this drug.

pregnancy warning
Pregnant women

Quetiapine is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

breast feeding warning
Women who are breast feeding

Quetiapine may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

senior warning
For seniors

The kidneys and livers of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

children warning
For children
  • Schizophrenia
    • Episodes: This medication hasn’t been studied in children for this purpose. It shouldn’t be used in people younger than 13 years.
    • Maintenance: This medication hasn’t been studied in children for this purpose. It shouldn’t be used in people younger than 18 years.
  • Bipolar I mania
    • Episodes: This medication hasn’t been studied in children for this purpose. It shouldn’t be used in people younger than 10 years.
    • Maintenance: This medication hasn’t been studied in children for this purpose. It shouldn’t be used in people younger than 18 years.
  • Bipolar disorder, depressive episodes: This medication hasn’t been studied in children for this purpose. It shouldn’t be used in people younger than 18 years. 
  • Major depressive disorder treated with antidepressants: This medication hasn’t been studied in children for this purpose. It shouldn’t be used in people younger than 18 years.
call your doctor
When to call the doctor

Call your doctor if:

  • You become pregnant while taking this drug.
  • Your condition gets worse while you take this drug.
allergy warning
Allergies

Quetiapine can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take quetiapine (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Schizophrenia

Generic: Quetiapine

Form: Immediate-release oral tablet
Strengths: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, and 400 mg

Brand: Seroquel

Form: Immediate-release oral tablet
Strengths: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, and 400 mg

Brand: Seroquel XR

Form: Extended-release oral tablet
Strengths: 50 mg, 150 mg, 200 mg, 300 mg, and 400 mg
Adult dosage (ages 18–64 years)

Immediate-release tablets

  • Typical starting dosage:
  • Day 1: 25 mg twice daily.
  • Days 2 and 3: Your doctor will increase your dose by 25–50 mg. The total dosage should be taken two or three times daily.
  • Day 4: 300–400 mg daily, taken in 2 or 3 divided doses.
    • Dosage increases:
    • Your doctor may further increase your dosage not more often than every two days. The increase would be 25–50 mg added to your previous dose. The total dosage would be taken twice daily.
    • The recommended dosage range is 150–750 mg per day.
      • Maintenance dosage: Your doctor may keep you on this medication to help control symptoms on an ongoing basis. The dosage range for maintenance use is 400–800 mg per day, taken in 2 or 3 divided doses.
      • Maximum dosage: 800 mg per day, taken in 2 or 3 divided doses.

Extended-release tablets

  • Typical starting dosage: 300 mg once per day.
  • Dosage increases: Your doctor may increase your dose every day by no more than 300 mg once per day. The recommended dosage range is 400–800 mg once per day.
  • Maximum dosage: 800 mg per day.

Schizophrenia episodes

Child dosage (ages 13–17 years)

Immediate-release tablets

  • Typical starting dosage:
    • Day 1: 25 mg twice daily.
    • Day 2: 100 mg per day, taken in divided doses twice daily.
    • Day 3: 200 mg per day, taken in divided doses twice daily.
    • Day 4: 300 mg per day, taken in divided doses twice daily.
    • Day 5: 400 mg per day, taken in divided doses twice daily.
  • Dosage increases: Your doctor may further increase your dose by no more than 100 mg per day. The recommended dosage range is 400–800 mg per day, taken in 2 or 3 divided doses.
  • Maximum dose: 800 mg per day, taken in 2 or 3 divided doses.

Extended-release tablets

  • Typical starting dosage:
    • Day 1: 50 mg once daily.
    • Day 2: 100 mg once daily.
    • Day 3: 200 mg once daily.
    • Day 4: 300 mg once daily.
    • Day 5: 400 mg once daily.
  • Dosage increases: Your doctor may further increase your dose within the recommended dosage range of 400–800 mg once per day.
  • Maximum dosage: 800 mg once per day.
Child dosage (ages 0–12 years)

It has not been confirmed that quetiapine is safe and effective to use for this purpose in people younger than 13 years.

Schizophrenia maintenance

Child dosage (ages 0–17 years)

This medication has not been studied in children to use for this purpose. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body. Your doctor may start you at a dosage of 50 mg daily. They may later increase it, adding 50 mg to your daily dose. The dosage may be increased at a slower rate, and a lower total daily dose may be used to lessen the risk of side effects.

Special considerations

Liver disease: People with liver disease should be started on 25 mg daily. This dosage may be increased by 25–50 mg daily.

Use with drugs called CYP3A4 inhibitors: Quetiapine dosage should be decreased to one-sixth of the original dosage when given with certain drugs called CYP3A4 inhibitors. Ask your doctor or pharmacist if you’re taking a CYP3A4 inhibitor. Examples of these drugs include ketoconazole, itraconazole, indinavir, ritonavir, or nefazodone. When the CYP3A4 inhibitor is stopped, the dose of quetiapine should be increased by 6 times the previous dose.

Use with drugs called CYP3A4 inducers: Quetiapine dose should be increased by five times the original dose when given with certain drugs called CYP3A4 inducers. Ask your doctor or pharmacist if you’re taking a CYP3A4 inducer. Examples of these drugs include phenytoin, carbamazepine, rifampin, or St. John’s wort. When the CYP3A4 inducer is stopped, the dose of quetiapine should be reduced to the original dose within 7–14 days.

Warnings

If you have stopped quetiapine for more than one week, you’ll need to be restarted at a lower dosage. The dosage will then need to be increased according to the dosage schedule from when you first started the medication.

Bipolar I disorder (manic or mixed episodes)

Generic: Quetiapine

Form: Immediate-release oral tablet
Strengths: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, and 400 mg

Brand: Seroquel

Form: Immediate-release oral tablet
Strengths: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, and 400 mg

Brand: Seroquel XR

Form: Extended-release oral tablet
Strengths: 50 mg, 150 mg, 200 mg, 300 mg, and 400 mg
Adult dosage (ages 18–64 years)

Bipolar I manic or mixed episodes

Immediate-release tablets

  • Typical starting dosage:
    • Day 1: 100 mg per day, taken in divided doses twice daily.
    • Day 2: 200 mg per day, taken in divided doses twice daily.
    • Day 3: 300 mg per day, taken in divided doses twice daily.
    • Day 4: 400 mg per day, taken in divided doses twice daily.
  • Dosage increases:
    • Your doctor may further increase your dosage by no more than 200 mg per day. The recommended dosage range is 400–800 mg per day, taken in 2 or 3 divided doses.
      • Maintenance dosage: Your doctor may keep you on this medication to help control symptoms on an ongoing basis. The dosage range for maintenance use is 400–800 mg per day, taken in 2 or 3 divided doses.
  • Maximum dosage: 800 mg per day, taken in 2 or 3 divided doses.

Extended-release tablets

  • Typical starting dosage:
    • Day 1: 300 mg once per day.
    • Day 2: 600 mg once per day.
    • Day 3: 400–800 mg once per day.
  • Dosage increases: Your doctor may change your dosage within the recommended range of 400–800 mg once per day.
  • Maximum dosage: 800 mg once per day.

Bipolar I manic or mixed episodes

Child dosage (ages 10–17 years)

Immediate-release tablets

  • Typical starting dosage:
    • Day 1: 25 mg twice daily.
    • Day 2: 100 mg per day, taken in divided doses twice daily.
    • Day 3: 200 mg per day, taken in divided doses twice daily.
    • Day 4: 300 mg per day, taken in divided doses twice daily.
    • Day 5: 400 mg per day, taken in divided doses twice daily.
      • Dosage increases: Your doctor may further increase your dose by no more than 100 mg per day. The recommended dosage range is 400–600 mg per day taken in divided doses up to three times daily.
      • Maximum dosage: 600 mg per day in 2 or 3 divided doses.

Extended-release tablets

  • Typical starting dosage:
    • Day 1: 50 mg once per day.
    • Day 2: 100 mg once per day.
    • Day 3: 200 mg once per day.
    • Day 4: 300 mg once per day.
    • Day 5: 400 mg once per day.
      • Dosage increases: Your doctor may change your dose, within the recommended dosage range of 400–600 mg once per day.

Maximum dosage: 600 mg once per day.

Child dosage (ages 0–9 years)

It hasn’t been confirmed that quetiapine is safe and effective to use for this purpose in children younger than 10 years.

Bipolar I maintenance

Child dosage (ages 0–17 years)

It hasn’t been confirmed that quetiapine is safe and effective to use for this purpose in people younger than 18 years.

Senior dosage (ages 65 years and older)

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body. Your doctor may start you at a dosage of 50 mg daily. They may later increase it, adding 50 mg to your daily dose. The dosage may be increased at a slower rate, and a lower total daily dose may be used to lessen the risk of side effects.

Special considerations

Liver disease: People with liver disease should be started on 25 mg daily. This dosage may be increased by 25–50 mg daily.

Use with drugs called CYP3A4 inhibitors: Quetiapine dosage should be decreased to one-sixth of the original dosage when given with certain drugs called CYP3A4 inhibitors. Ask your doctor or pharmacist if you’re taking a CYP3A4 inhibitor. Examples of these drugs include ketoconazole, itraconazole, indinavir, ritonavir, or nefazodone. When the CYP3A4 inhibitor is stopped, the dose of quetiapine should be increased by 6 times the previous dose.

Use with drugs called CYP3A4 inducers: Quetiapine dose should be increased by five times the original dose when given with certain drugs called CYP3A4 inducers. Ask your doctor or pharmacist if you’re taking a CYP3A4 inducer. Examples of these drugs include phenytoin, carbamazepine, rifampin, or St. John’s wort. When the CYP3A4 inducer is stopped, the dose of quetiapine should be reduced to the original dose within 7–14 days.

Warnings

If you have stopped quetiapine for more than one week, you’ll need to be restarted at a lower dosage. The dosage will then need to be increased according to the dosage schedule from when you first started the medication.

Bipolar disorder (depressive episodes)

Generic: Quetiapine

Form: Immediate-release oral tablet
Strengths: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, and 400 mg

Brand: Seroquel

Form: Immediate-release oral tablet
Strengths: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, and 400 mg

Brand: Seroquel XR

Form: Extended-release oral tablet
Strengths: 50 mg, 150 mg, 200 mg, 300 mg, and 400 mg
Adult dosage (ages 18–64 years)

Immediate-release tablets 

  • Typical starting dosage:
    • Maximum dosage: 300 mg daily, taken at bedtime.
  • Day 1: 50 mg daily, taken at bedtime.
  • Day 2: 100 mg daily, taken at bedtime.
  • Day 3: 200 mg daily, taken at bedtime.
  • Day 4: 300 mg daily, taken at bedtime.

Extended-release tablets 

  • Typical starting dosage:
    • Day 1: 50 mg once daily at bedtime.
    • Day 2: 100 mg once daily at bedtime.
    • Day 3: 200 mg once daily at bedtime.
    • Day 4: 300 mg once daily at bedtime.
      • Maximum dosage: 300 mg once daily at bedtime.
Child dosage (ages 0–17 years)

It hasn’t been confirmed that quetiapine is safe and effective to use for this purpose in people younger than 18 years.

Senior dosage (ages 65 years and older)

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body. Your doctor may start you at a dosage of 50 mg daily. They may later increase it, adding 50 mg to your daily dose. The dosage may be increased at a slower rate, and a lower total daily dose may be used to lessen the risk of side effects.

Special considerations

 

Warnings

If you have stopped quetiapine for more than one week, you’ll need to be restarted at a lower dosage. The dosage will then need to be increased according to the dosage schedule from when you first started the medication.

Major depression in people already taking antidepressants

Generic: Quetiapine

Form: Immediate-release oral tablet
Strengths: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, and 400 mg

Brand: Seroquel

Form: Immediate-release oral tablet
Strengths: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, and 400 mg

Brand: Seroquel XR

Form: Extended-release oral tablet
Strengths: 50 mg, 150 mg, 200 mg, 300 mg, and 400 mg
Adult dosage (ages 18–64 years)

Extended-release tablets 

  • Typical starting dosage:
    • Days 1 and 2: 50 mg once daily.
    • Day 3: 150 mg once daily.
  • Dosage increases: Your doctor may change your dosage, within the recommended range of 150–300 mg once per day.
  • Maximum dosage: 300 mg once daily.
Child dosage (ages 0–17 years)

It hasn’t been confirmed that quetiapine is safe and effective to use for this purpose in people younger than 18 years.

Senior dosage (ages 65 years and older)

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body. Your doctor may start you at a dosage of 50 mg daily. They may later increase it, adding 50 mg to your daily dose. The dosage may be increased at a slower rate, and a lower total daily dose may be used to lessen the risk of side effects.

Special considerations

Liver disease: People with liver disease should be started on 25 mg daily. This dosage may be increased by 25–50 mg daily.

Use with drugs called CYP3A4 inhibitors: Quetiapine dosage should be decreased to one-sixth of the original dosage when given with certain drugs called CYP3A4 inhibitors. Ask your doctor or pharmacist if you’re taking a CYP3A4 inhibitor. Examples of these drugs include ketoconazole, itraconazole, indinavir, ritonavir, or nefazodone. When the CYP3A4 inhibitor is stopped, the dose of quetiapine should be increased by 6 times the previous dose.

Use with drugs called CYP3A4 inducers: Quetiapine dose should be increased by five times the original dose when given with certain drugs called CYP3A4 inducers. Ask your doctor or pharmacist if you’re taking a CYP3A4 inducer. Examples of these drugs include phenytoin, carbamazepine, rifampin, or St. John’s wort. When the CYP3A4 inducer is stopped, the dose of quetiapine should be reduced to the original dose within 7–14 days.

Warnings

If you have stopped quetiapine for more than one week, you’ll need to be restarted at a lower dosage. The dosage will then need to be increased according to the dosage schedule from when you first started the medication.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Quetiapine comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your condition may get worse. If you stop taking quetiapine suddenly, you may also have trouble sleeping or trouble staying asleep, or have nausea or vomiting.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • drowsiness
  • sleepiness
  • fast heartbeat (palpitations)
  • dizziness
  • fainting

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

Your behavior or mood should improve.

Quetiapine is used for long-term treatment.

You can take immediate-release tablets with or without food

You should take quetiapine extended-release tablets without food or with a light meal (about 300 calories).

You can cut or crush quetiapine immediate-release tablets

However, you can’t cut or crush quetiapine extended-release tablets.

Store this drug carefully

  • Store quetiapine at room temperature between 59°F and 86°F (15°C and 30°C).
  • Keep this drug away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You shouldn’t need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Quetiapine can make your body less able to manage your temperature. This can cause your temperature to increase too much, leading to a condition called hyperthermia. Symptoms can include hot skin, excessive sweating, fast heartbeat, rapid breathing, and even seizures. To help prevent this:

  • Avoid getting overheated or dehydrated. Don’t over-exercise.
  • During hot weather, stay inside in a cool place if possible.
  • Stay out of the sun. Don’t wear heavy clothing.
  • Drink plenty of water.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while taking this drug. These issues include:

  • Blood sugar. Quetiapine may raise your blood sugar level. Your doctor may monitor your blood sugar from time to time, especially if you have diabetes or are at risk of diabetes.
  • Cholesterol. Quetiapine may increase the levels of fats (cholesterol and triglycerides) in your blood.  You may not have symptoms, so your doctor may check your blood cholesterol and triglycerides at the start of treatment and during treatment with quetiapine.
  • Weight. Weight gain is common in people who take quetiapine. You and your doctor should check your weight regularly.
  • Mental health and behavioral problems. You and your doctor should watch for any unusual changes in your behavior and mood. This drug can cause new mental health and behavior problems, or worsen problems you already have.
  • Thyroid hormone levels. Quetiapine may decrease thyroid hormone levels. Your doctor should monitor your thyroid hormone levels before starting treatment and throughout treatment with quetiapine.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

SECTION 5 of 5

How Much Does quetiapine Cost?

Oral tablet

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These prices represent the lowest priced national pharmacies for quetiapine on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on November 19, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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