Seroquel XR Warnings and Precautions

Prior to starting a new medication, it is important to be aware of the potential risks. Seroquel XR warnings and precautions include an increased risk of developing diabetes, the possibility of the drug causing a life-threatening condition called neuroleptic malignant syndrome (NMS), and the safety of taking the drug when pregnant or breastfeeding. Also, certain people should avoid the medication completely, such as those who are allergic to any of the ingredients in Seroquel XR.

Seroquel XR: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Seroquel XR® (quetiapine 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 Seroquel XR Warnings and Precautions

Some warnings and precautions to be aware of with Seroquel XR include:
 
  • The U.S. Food and Drug Administration (FDA) has issued a special warning (a "black box warning") about the use of Seroquel 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 Seroquel XR, are more likely to die (of various causes) than those who were not treated with these types of medications. Seroquel XR is not approved to treat dementia, and caution should be used before using Seroquel XR in elderly people with dementia.

 

  • Even though Seroquel XR is not classified as an antidepressant, the FDA has required Seroquel XR to carry the special antidepressant and suicide warning, since Seroquel 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.

 

  • Seroquel 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 Seroquel 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 Seroquel XR to make sure your diabetes is not becoming more severe (see Seroquel and Diabetes).
     
  • Seroquel XR can cause a life-threatening condition called neuroleptic malignant syndrome (NMS). Some symptoms of NMS include:

 

    • A high fever
    • Stiff muscles
    • Confusion
    • An irregular pulse or blood pressure
    • A fast heart rate (tachycardia)
    • Sweating
    • Irregular heart rhythms (arrhythmias). 
Tell your healthcare provider right away if you think you might have NMS.
  • Seroquel 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 Seroquel XR.

 

  • Seroquel XR can cause a potentially dangerous change in the heart rhythm known as QT prolongation. Combining Seroquel 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.

  

  • Seroquel 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).
     
  • Seroquel XR can cause tardive dyskinesia, a condition involving unusual and uncontrollable body or facial movements. The condition can become permanent (even if Seroquel 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 Seroquel XR.
     
  • Seroquel XR can cause cataracts (an eye condition). It is recommended that all people taking Seroquel XR have their eyes checked for cataracts every six months.
     
  • Seroquel XR may increase the risk of seizures. Before starting Seroquel XR, tell your healthcare provider if you have epilepsy or a history of seizures.
     
  • Seroquel 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 Seroquel XR.
     
  • Seroquel 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, Seroquel 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.
     
  • Seroquel 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.
     
  • Seroquel 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 Seroquel XR during pregnancy (see Seroquel and Pregnancy).
     
  • Seroquel 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 Seroquel XR (see Seroquel and Breastfeeding for more information).
     
  • Generally, alcohol should be avoided while taking Seroquel XR (see Alcohol and Seroquel).
     
  • Seroquel XR can interact with certain other medications (see Seroquel XR Drug Interactions).
 
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