Quetiapine is used alone or together with other medicines to treat bipolar disorder (depressive and manic episodes) and schizophrenia. Quetiapine extended-release tablet is also used together with other antidepressants to treat major depressive disorder. This medicine should not be used to treat behavioral problems in older adult patients who have dementia or Alzheimer disease. Quetiapine is an antipsychotic medicine that works in the brain.

This medicine is available only with your doctor's prescription.

Take this medicine exactly as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine should come with a Medication Guide. Read and follow the instructions carefully. Read it again each time you refill your prescription in case there is new information. Ask your doctor if you have any questions.

Quetiapine tablets may be taken with or without food on a full or empty stomach. However, if your doctor tells you to take it a certain way, take it as directed.

Swallow the extended-release tablets whole. Do not break, crush, or chew it. It is best to take this medicine without food or with a light meal (approximately 300 calories).

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Chills

cold sweats

confusion

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

sleepiness or unusual drowsiness

Less common

Black, tarry stools

blurred vision

changes in patterns and rhythms of speech

chest pain

cough

drooling

fever

inability to move the eyes

inability to sit still

increased blinking or spasms of the eyelid

lip smacking or puckering

loss of balance control

mask-like face

muscle aches

need to keep moving

painful or difficult urination

puffing of the cheeks

rapid or worm-like movements of the tongue

restlessness

shakiness in the legs, arms, hands, or feet

shuffling walk

slowed movements

slurred speech

sore throat

sores, ulcers, or white spots on the lips or in the mouth

sticking out of the tongue

stiffness of the arms or legs

sweating

swelling of the face, arms, hands, feet, or lower legs

swollen glands

trembling and shaking of the hands and fingers

trouble with breathing, speaking, or swallowing

uncontrolled chewing movements

uncontrolled movements of the arms and legs

uncontrolled twisting movements of the neck, trunk, arms, or legs

unusual bleeding or bruising

unusual facial expressions

unusual tiredness or weakness

Rare

Dry, puffy skin

fast, pounding, or irregular heartbeat

loss of appetite

menstrual changes

unusual secretion of milk (in females)

weight gain

Incidence not known

Aching or discomfort in the lower legs or sensation of crawling in the legs

agitation

bed-wetting

blistering, peeling, or loosening of the skin

bloating

bluish lips or skin

chest discomfort

constipation

dark urine

decreased awareness or responsiveness

decreased urine output

depression

diarrhea

difficulty breathing

difficulty in passing urine (dribbling)

difficulty swallowing

dizziness

faintness

general feeling of tiredness or weakness

headache

hives, itching, skin rash

hoarseness

increased thirst

indigestion

irritability

joint or muscle pain

light-colored stools

loss of consciousness

lower back or side pain

muscle cramps, spasms, stiffness, or twitching

nausea

painful or prolonged erection of the penis

painful urination

pains in the stomach, side, or abdomen, possibly radiating to the back

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

red skin lesions, often with a purple center

red, irritated eyes

seizures

severe constipation

severe sleepiness

severe vomiting

sore throat

stomach pain, continuing

tightness in the chest

tingling of the hands or feet

unusual bleeding or bruising unusual drowsiness, dullness, or feeling of sluggishness

unusual weight gain or loss

upper right abdominal pain

vomiting

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Abnormal vision

belching

decreased appetite

decreased strength and energy

heartburn

increased appetite

increased muscle tone

increased sweating

indigestion

sneezing

stomach discomfort or upset

stuffy or runny nose

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects. You may also need to have your eyes tested on a regular basis.

This medicine may add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using quetiapine.

For some patients, this medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed and have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you, especially if they are new or are getting worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive illness) or has tried to commit suicide.

Quetiapine may cause drowsiness, trouble with thinking, trouble with controlling body movements, or trouble with your vision (especially during the first week of use), which may lead to falls, fractures, or other injuries. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or urination. If you have diabetes, the results of your urine or blood sugar tests may change. Check your blood sugar closely and talk with your doctor if you have any questions.

Check with your doctor right away if you have convulsions (seizures), difficulty breathing, a fast heartbeat, high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.

Quetiapine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
Avoid contact sports or other situations where bruising or injury could occur.
This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

Quetiapine may increase your cholesterol and fats in the blood. If this condition occurs, your doctor may give you medicine to lower the cholesterol and fats in the blood.

This medicine may increase your weight. Your doctor may need to check your weight on a regular basis while you are using this medicine.

You will need to have your blood pressure measured before starting this medicine and while you are using it. If you notice any changes to your recommended blood pressure, call your doctor right away. If you have questions about this, talk to your doctor.

This medicine can cause changes in your heart rhythm, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects. Contact your doctor right away if you have symptoms of heart rhythm problems, such as a fast, pounding, or uneven heartbeat.

Quetiapine may make it more difficult for your body to cool down. It might reduce how much you sweat. Your body could get too hot if you do not sweat enough. If your body gets too hot, you might feel dizzy, weak, tired, or confused. You might vomit or have an upset stomach. Do not get too hot while you are exercising. Avoid places that are very hot. Call your doctor if you are too hot and can not cool down.

Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This will decrease the chance of having withdrawal symptoms such as nausea, vomiting, insomnia, dizziness, irritability, or headache.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests (eg, urine drug screens) may be affected by this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.