Seroquel (quetiapine) is a prescription drug used in adults and certain children to treat schizophrenia, bipolar disorder, and depression. Seroquel can interact with some supplements and other medications, such as alprazolam and metoprolol.
Note: Seroquel is available as an oral tablet and as an extended-release oral tablet called Seroquel XR. (With extended release, the drug is slowly released into your body over a long period of time.) This article uses the term “Seroquel” to refer to both forms. The interactions of Seroquel and Seroquel XR are expected to be the same.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Before you start taking Seroquel, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Seroquel interacts with herbs or vitamins and supplements, see the “Are there other interactions with Seroquel?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Seroquel. Keep in mind that this table does not include all drugs that may interact with Seroquel. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| blood pressure medications | • furosemide (Lasix) • lisinopril (Zestril, others) • metoprolol (Lopressor, others) | can increase the risk of orthostatic hypotension (sudden drop in blood pressure when you stand up) |
| benzodiazepines | • alprazolam (Xanax) • diazepam (Valium) • lorazepam (Ativan) | can increase the risk of sleepiness |
| opioids | • hydrocodone (Hysingla ER) • oxycodone (Oxycontin, others) • tramadol (Ultram, others) | can increase the risk of sleepiness |
| anticholinergics | • oxybutynin (Oxytrol) • solifenacin (Vesicare) • tiotropium (Spiriva) | can increase the risk of digestive side effects (such as constipation) from Seroquel and the anticholinergic |
| drugs that can cause long QT syndrome (an abnormal heart rhythm) | • amiodarone (Pacerone) • haloperidol (Haldol) • citalopram (Celexa) | can increase the risk of long QT syndrome |
| certain antibiotics | • azithromycin (Z-Pak, others) • clarithromycin • moxifloxacin (Avelox) | can increase the risk of side effects from Seroquel |
| certain antifungals | • itraconazole (Sporanox) • ketoconazole • posaconazole (Noxafil) | can increase the risk of side effects from Seroquel |
| certain HIV drugs | • cobicistat (Tybost) • nelfinavir (Viracept) • ritonavir (Norvir) | can increase the risk of side effects from Seroquel |
| certain seizure medications | • carbamazepine (Tegretol, others) • phenobarbital (Seizalam) • phenytoin (Dilantin) | can make Seroquel less effective |
| rifampin (Rifadin, Rimactane) | — | can make Seroquel less effective |
Certain health conditions or other factors could raise your risk of harm if you take Seroquel. In such cases, your doctor may not prescribe Seroquel for you. These are known as contraindications. Seroquel has one contraindication, which is described below.
If you’ve had an allergic reaction: If you’ve had an allergic reaction to Seroquel or any of its ingredients, your doctor likely won’t prescribe Seroquel for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Seroquel is not known to interact with alcohol. But Seroquel and alcohol can cause some similar side effects, such as sleepiness and dizziness. So you may be more likely to experience these side effects if you drink alcohol during your Seroquel treatment. Your doctor may recommend limiting the amount of alcohol you consume when taking Seroquel.
Drinking alcohol may also worsen symptoms of the mental health condition you’re taking Seroquel to treat.
If you have questions about drinking alcohol while taking Seroquel, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Seroquel.
Interaction with blood pressure medications
Seroquel can interact with blood pressure medications, which are used to treat high blood pressure.
Examples of blood pressure medications medications include:
What could happen
Seroquel and blood pressure medications can both cause orthostatic hypotension (sudden drop in blood pressure when you stand up that can cause dizziness). So taking these drugs together can raise your risk of this side effect.
If you’re dehydrated, you may have a higher risk of orthostatic hypotension if you take Seroquel with blood pressure medications.
What you can do
If you take Seroquel with a blood pressure medication, your doctor may prescribe a lower dosage of either drug. You should not take a higher dose of either medication than your doctor prescribes.
If you take Seroquel and a blood pressure medication together, take extra care when standing up until you know how this combination of drugs affects you. For example, after waking up, sit on the edge of your bed for a while before standing up.
If you feel dizzy or lightheaded when standing up, sit or lie down until the feeling passes. Then try getting up more slowly.
Tell your doctor if you have episodes of orthostatic hypotension while taking Seroquel with a blood pressure drug. They may need to adjust the dose of one of your medications.
If you have questions about taking Seroquel with blood pressure medication, talk with your doctor or pharmacist.
Interaction with benzodiazepines
Seroquel can interact with benzodiazepines, which are used to treat anxiety and sleeping problems.
Examples of these drugs include:
What could happen
Seroquel and benzodiazepines can both cause sleepiness. So taking these drugs together can raise your risk of this side effect.
What you can do
If you take Seroquel with a benzodiazepine, your doctor may prescribe a lower dosage of either drug for you. You should not take a higher dose of either medication than your doctor prescribes.
If you take Seroquel and a benzodiazepine together, tell your doctor if the combination makes you very sleepy. They may need to adjust your dosage.
If you have questions about taking Seroquel with a benzodiazepine, talk with your doctor or pharmacist.
Interaction with drugs that can cause long QT syndrome
Seroquel can interact with drugs that can cause long QT syndrome, which is a type of abnormal heart rhythm that can cause a dangerous irregular heartbeat. Many drugs, including Seroquel, can cause long QT syndrome.
Examples of other drugs that can cause this condition include:
- drugs for irregular heartbeat, such as amiodarone (Pacerone) and propafenone
- some other antipsychotics, such as haloperidol (Haldol) and chlorpromazine
- certain antibiotics, such as azithromycin (Z-Pak, others) and clarithromycin
What could happen
Taking Seroquel with other drugs that can cause long QT syndrome can raise your risk of this side effect or make it worse. This can raise your risk of having a dangerous irregular heartbeat.
Having certain conditions may also raise your risk of irregular heartbeats if you take Seroquel with other drugs that can cause long QT syndrome. Examples of these conditions include heart problems and having a low level of potassium or magnesium in your blood.
What you can do
Your doctor will likely avoid prescribing Seroquel with other drugs that can cause long QT syndrome.
If you take Seroquel with a drug that can cause this side effect, your doctor will likely monitor you more closely during treatment. For example, they may order electrocardiograms (ECGs) to check your heart rhythm. They may also order blood tests to check your potassium and magnesium levels.
Tell your doctor right away if you have symptoms of long QT syndrome. These can include heart palpitations, dizziness, and fainting.
If you have questions about taking Seroquel with other drugs that can cause long QT syndrome, talk with your doctor or pharmacist.
Seroquel may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Seroquel.
Does Seroquel interact with supplements?
Before you start taking Seroquel, talk with your doctor and pharmacist about any herbs or vitamins or supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Seroquel interactions with herbs
Seroquel can interact with St. John’s wort, which is used to ease symptoms of depression and other conditions. Taking this herb with Seroquel can lower the level of Seroquel in your body. This can make Seroquel less effective.
Your doctor will likely recommend that you avoid taking St. John’s wort during your Seroquel treatment.
Seroquel interactions with vitamins
There are currently no reports of Seroquel interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Seroquel.
Does Seroquel interact with food?
Seroquel can interact with grapefruit and grapefruit juice. Your doctor will likely recommend that you avoid eating grapefruit and drinking grapefruit juice while taking Seroquel. Grapefruit can increase the level of Seroquel in your body, which can raise your risk of side effects from Seroquel.
Does Seroquel interact with vaccines?
There are currently no reports of Seroquel interacting with vaccines. If you have questions about getting certain vaccines during your Seroquel treatment, talk with your doctor.
Does Seroquel interact with lab tests?
There are currently no reports of Seroquel interacting with lab tests. If you have questions about having certain lab tests during your treatment with Seroquel, talk with the healthcare professional ordering the test.
Does Seroquel interact with cannabis or CBD?Cannabis (commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Seroquel.
Using cannabis while taking Seroquel can increase your risk of sleepiness or worsen the sleepiness you may experience with either drug.
Before you start treatment with Seroquel, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Seroquel. Before taking Seroquel, talk with your doctor about your health history. They’ll determine whether Seroquel is right for you.
Health conditions or other factors that might interact with Seroquel include:
Liver problem: If you have a liver problem, levels of Seroquel could build up in your body. This can raise your risk of side effects. Because of this, your doctor may prescribe a lower dosage of Seroquel for you.
Heart condition: If you have a heart condition, you may have a higher risk of certain heart problems with Seroquel, such as irregular heartbeat. Talk with your doctor about whether Seroquel is safe for you.
High or low blood pressure: Seroquel can affect your blood pressure. If you have high or low blood pressure, your doctor may check your blood pressure more often during your Seroquel treatment.
High cholesterol or triglycerides: If you have high cholesterol or triglyceride levels, Seroquel could make your condition worse. Your doctor may check your cholesterol and triglyceride levels more often while you’re taking Seroquel.
Diabetes: If you have diabetes, taking Seroquel could make it harder to manage your blood sugar levels. Talk with your doctor about any changes you may need to make to your diabetes monitoring and treatment plan while taking Seroquel.
Hypothyroidism: If you have hypothyroidism (underactive thyroid), Seroquel could worsen your condition. Your doctor will likely check your thyroid hormones more often while you’re taking Seroquel.
Electrolyte imbalance: If you have an electrolyte imbalance, you may have a higher risk of an irregular heartbeat while taking Seroquel. Examples of electrolyte imbalance include low levels of magnesium or potassium in your blood. Your doctor may prescribe medication to correct electrolyte imbalances before you start taking Seroquel.
Dehydration: If you become dehydrated while taking Seroquel, this can raise your risk of certain side effects from the drug. These include orthostatic hypotension and overheating. Be sure to drink plenty of fluids to help prevent dehydration, especially in hot temperatures and when exercising.
Seizures: If you have a condition that causes seizures, such as epilepsy, you may have a higher risk of seizures while taking Seroquel. Talk with your doctor about whether Seroquel is a safe option for you.
Constipation or trouble urinating: If you have constipation or trouble urinating, such as due to an enlarged prostate, Seroquel could make this worse. Talk with your doctor about whether Seroquel is right for you.
Low level of white blood cells: If you have a low white blood cell count, Seroquel could make this worse. If you’ve ever had low white blood cells caused by a medication, you may have a higher risk of this side effect with Seroquel. Your doctor will likely monitor your white blood cell counts while you’re taking Seroquel.
Pregnancy: It’s not known whether Seroquel is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Seroquel.
If you do take Seroquel while pregnant, consider enrolling in the drug’s pregnancy registry. This registry collects details about pregnancy issues reported with Seroquel. To learn more, call 866-961-2388 or visit the registry website. You can also talk with your doctor for more details.
Breastfeeding: It’s not known whether it’s safe to take Seroquel while breastfeeding. The drug passes into breast milk, but it isn’t known whether the drug may cause side effects in a child who’s breastfed. If you’re breastfeeding or planning to do so, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Seroquel or any of its ingredients, your doctor will likely not prescribe Seroquel. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Risk of death in certain older adults: Seroquel has a boxed warning about the increased risk of death in older adults with psychosis related to dementia. This is a serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous. For details, see the boxed warning at the top of this article.
Risk of suicidal thoughts and behaviors: Seroquel also has a boxed warning about the increased risk of suicidal thoughts and behaviors in certain children and young adults. For details, see the boxed warning at the top of this article.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Suicide and Crisis Lifeline at 988.
- Text HOME to the Crisis Text Line at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Taking certain steps can help you avoid interactions with Seroquel. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- other medications you take, as well as any vitamins, supplements, and herbs (they can also help you fill out a
medication list ) - what to do if you start taking a new drug during your Seroquel treatment
It’s also important to understand Seroquel’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Seroquel exactly as prescribed can also help prevent interactions.
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 another 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.