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Precautions and Warnings With Quetiapine XR

It is important to know the precautions and warnings with quetiapine XR to ensure a safe treatment process. For example, quetiapine XR can cause difficulty swallowing or increase your risk of seizures. In addition, the drug can cause serious conditions, such as neuroleptic malignant syndrome (NMS) and tardive dyskinesia. People who are allergic to any of the ingredients used to make quetiapine XR should not take the medication.

Quetiapine XR: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking quetiapine XR (Seroquel XR®) if you have:
Also, let your healthcare provider know if you:
  • Are pregnant or thinking of becoming pregnant
  • Are breastfeeding
  • Drink alcohol.
You should also tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Some Precautions and Warnings With Quetiapine XR

Some warnings and precautions to be aware of with quetiapine XR include:
  • The U.S. Food and Drug Administration (FDA) has issued a special warning (a "black box warning") about the use of quetiapine XR in elderly people with psychosis or dementia (a condition involving confusion; disorientation; and a loss of memory, intellect, and judgment). Elderly people with dementia (Alzheimer's disease is the most common form of dementia) who are treated with antipsychotics, including quetiapine XR, are more likely to die (of various causes) than those who were not treated with these types of medications. Quetiapine XR is not approved to treat dementia, and caution should be used before using quetiapine XR in elderly people with dementia.


  • Even though quetiapine XR is not classified as an antidepressant, the FDA has required quetiapine XR to carry the special antidepressant and suicide warning, since quetiapine XR is used to treat depression and bipolar depression. Antidepressants may increase the risk of suicidal thinking or behavior in children, teenagers, and adults (see Depression and Suicide for more information). Therefore, if you notice any changes in symptoms or new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include anxiety, hostility, agitation, panic, restlessness, hallucinations, extreme hyperactivity, and suicidal thinking or behavior. 


  • Quetiapine XR can cause an increase in blood sugar levels and can increase the risk of developing diabetes. Tell your healthcare provider if you develop signs of diabetes while taking quetiapine XR. Possible signs of diabetes can include an increase in thirst, urination, or hunger. If you have diabetes, your blood sugar should be monitored carefully and regularly during treatment with quetiapine XR to make sure your diabetes is not becoming more severe (see Seroquel and Diabetes).
  • Quetiapine XR can cause a life-threatening condition called neuroleptic malignant syndrome (NMS). Some symptoms of NMS include:
o A high fever
o Stiff muscles
o Confusion
o An irregular pulse or blood pressure
o A fast heart rate (tachycardia)
o Sweating
o Irregular heart rhythms (arrhythmias). 
Tell your healthcare provider right away if you think you might have NMS.
  • Quetiapine XR can cause a drop in blood pressure when going from a sitting or lying position to standing (known medically as orthostatic hypotension). This can cause a person to faint or to have lightheadedness or dizziness. Tell your healthcare provider if you have any of these symptoms when standing. Orthostatic hypotension can be especially dangerous in people with heart disease or congestive heart failure (CHF).


  • Quetiapine XR can cause low white blood cells, which can be dangerous. If you already have low white blood cells (or have experienced a white blood cell drop due to a medication in the past), your healthcare provider should check your white blood cell count during the first few months you take quetiapine XR. 


  • Quetiapine XR can cause tardive dyskinesia, a condition involving unusual and uncontrollable body or facial movements. The condition can become permanent (even if quetiapine XR is stopped). The best way to prevent it from becoming permanent is to tell your healthcare provider right away if you notice any abnormal movements (including abnormal movements of the tongue) while taking quetiapine XR.
  • Quetiapine XR can cause cataracts (an eye condition). It is recommended that all people taking quetiapine XR have their eyes checked for cataracts every six months.
  • Quetiapine XR may increase the risk of seizures. Before starting quetiapine XR, tell your healthcare provider if you have epilepsy or a history of seizures.
  • Quetiapine XR can cause an underactive thyroid (hypothyroidism), high liver enzymes, high cholesterol, or high triglycerides. It is probably a good idea to have your thyroid, triglycerides, liver enzymes, and cholesterol checked (using a blood test) regularly while taking quetiapine XR.


  • Quetiapine XR can cause a potentially dangerous change in the heart rhythm known as QT prolongation. Combining Quetiapine XR with other QT-prolonging medications increases this risk. People with low blood potassium levels, low blood magnesium levels, congestive heart failure, or certain arrhythmias have a higher risk for this problem. 


  • Quetiapine XR can cause high levels of the hormone prolactin. Let your healthcare provider know if you develop signs of high prolactin, such as breast enlargement or breast discharge.
  • Very rarely, quetiapine XR can cause priapism (a painful erection of the penis that does not go away). Because this is a medical emergency, seek medical care immediately in order to prevent permanent damage to the penis.
  • Quetiapine XR can cause difficultly swallowing, which can lead to inhalation of food (which can cause pneumonia). Tell your healthcare provider if you notice any problems swallowing.
  • Quetiapine XR is considered a pregnancy Category C medication. This means that it may not be safe to take during pregnancy. Be sure to talk with your healthcare provider about the risks and benefits of using quetiapine XR during pregnancy (see Seroquel and Pregnancy).
  • Quetiapine XR passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about using quetiapine XR (see Seroquel and Breastfeeding for more information).
  • Generally, alcohol should be avoided while taking quetiapine XR (see Alcohol and Seroquel).
  • Quetiapine XR can interact with certain other medications (see Drug Interactions With Quetiapine XR).
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