Seroquel interactions: Alcohol, medications, and other factors

Seroquel comes in two forms: Seroquel oral tablets and Seroquel XR extended-release* oral tablets. Both forms are prescribed for:

• schizophrenia in adults and adolescents ages 13 years and older
• manic episodes of bipolar I disorder in adults and children ages 10 years and older
• depressive episodes of bipolar I in adults
• maintenance (long-term) treatment of bipolar I in adults

Seroquel XR is also prescribed for:

• mixed episodes of bipolar I in adults
• major depressive disorder in adults

An interaction occurs when one substance causes another substance to have a different effect than expected.

Both forms of Seroquel have the same interactions. In this article, we refer to both forms as Seroquel.

To learn more about Seroquel’s interactions, keep reading. For additional information about Seroquel, including details about its uses, see this article.

* “Extended-release” means the drug is slowly released into your body over a long period of time.

Seroquel interactions with other medications  

Before you start treatment with Seroquel, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Seroquel interacts with supplements, herbs, or vitamins, see the “Seroquel and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Seroquel. Keep in mind that this table doesn’t include all drugs that may interact with Seroquel. Some of these interactions are described in detail just below in “Drug interactions in depth.”

When to avoid Seroquel

In some cases, factors or conditions could prevent your doctor from prescribing Seroquel due to the risk of harm. These are known as contraindications. The contraindications of Seroquel include:

Having had an allergic reaction to Seroquel or any of its ingredients

If you have had an allergic reaction to Seroquel or any of its ingredients, your doctor will likely not prescribe Seroquel. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Seroquel, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Seroquel.

Seroquel interaction with alcohol

There aren’t any known interactions between Seroquel and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Seroquel treatment.

This is because drinking alcohol while taking the drug may worsen some of Seroquel’s side effects. For example, you may experience:

• sleepiness
• dizziness
• nausea
• vomiting
• headache

If you consume alcohol during Seroquel treatment, these side effects may be more likely to occur.

Alcohol can also worsen the condition you’re receiving Seroquel to treat. For example, if you have a mental health condition such as depression or bipolar disorder, drinking alcohol may worsen your symptoms.

If you have questions about drinking alcohol while taking Seroquel, talk with your doctor.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Seroquel.

Blood pressure medications

Blood pressure medications are commonly prescribed to lower high blood pressure. It’s not uncommon for doctors to prescribe Seroquel to treat mental health conditions in people taking blood pressure medications.

Interaction result: Taking Seroquel with blood pressure medications can raise your risk of orthostatic hypotension. Orthostatic hypotension is a drop in blood pressure that happens upon getting up from sitting or lying down. It can cause dizziness or fainting, and can lead to falls.

Interaction explained: Seroquel and blood pressure medications can both sometimes cause orthostatic hypotension. Taking these drugs together can increase the risk or severity of this side effect.

Examples of blood pressure medications: Here are some blood pressure medications that may interact with Seroquel:

• furosemide (Lasix)
• hydrochlorothiazide (Microzide)
• lisinopril (Zestril, others)
• losartan (Cozaar)
• metoprolol (Lopressor, others)

Steps you or your doctor may take: If your doctor prescribes Seroquel with a blood pressure medication, they may prescribe a Seroquel dosage that’s lower than usual. They may also increase your Seroquel dosage more slowly than usual when you start treatment.

If you take Seroquel with a blood pressure medication, take extra care when changing positions until you know how the combination affects you. For example, when getting out of bed in the morning, sit on the edge of the bed for a while before standing up. Then hold onto something when standing up in case you feel dizzy.

If you often feel dizzy, lightheaded, or faint while taking Seroquel with a blood pressure medication, talk with your doctor. They may need to adjust the dose of your medications.

If you have questions about taking Seroquel with blood pressure medications, talk with your doctor or pharmacist.

Benzodiazepines

Benzodiazepines are used to treat anxiety and insomnia. It’s not uncommon for doctors to prescribe Seroquel with a benzodiazepine for certain mental health conditions.

Interaction result: Taking Seroquel with a benzodiazepine can raise your risk of sleepiness.

Interaction explained: Seroquel and benzodiazepines can both cause sleepiness. Taking them together can raise the risk or severity of this side effect.

Examples of benzodiazepine drugs: Here are some benzodiazepines that may interact with Seroquel:

• alprazolam (Xanax)
• diazepam (Valium)
• lorazepam (Ativan)

Steps you or your doctor may take: If your doctor prescribes Seroquel with a benzodiazepine, they may prescribe a dose of one or both drugs that’s lower than usual. Don’t take a higher dosage of either drug than your doctor prescribes.

If you take Seroquel with a benzodiazepine, tell your doctor if it makes you feel very sleepy or drowsy. Your doctor may need to adjust the dose of your medications.

If you have questions about taking Seroquel with benzodiazepines, talk with your doctor or pharmacist.

Certain antibiotics

Antibiotics are used to treat bacterial infections. Your doctor may prescribe antibiotics if you have an infection while you are taking Seroquel. However, some antibiotics can interact with Seroquel.

Interaction result: Taking certain antibiotics with Seroquel can raise your risk of Seroquel side effects, especially QT prolongation. This condition can cause dangerous and even life threatening irregular heartbeats.

Interaction explained: In rare cases, Seroquel can cause QT prolongation. Certain antibiotics can also cause this side effect. Taking Seroquel with these antibiotics can increase the risk or severity of this side effect.

Some other antibiotics slow the action of an enzyme that helps clear Seroquel from your body, called cytochrome p450 3A4 (CYP3A4). Taking these antibiotics with Seroquel can make Seroquel build up in your body, which can increase the risk or severity of Seroquel side effects, including QT prolongation.

Examples of antibiotic drugs: Here are some antibiotics that may interact with Seroquel:

• azithromycin (Z-Pak, others)
• clarithromycin
• erythromycin (Erytab, others)
• moxifloxacin (Avelox)

Steps you or your doctor may take: Your doctor will likely avoid prescribing the antibiotics listed above with Seroquel. If you have a bacterial infection, your doctor will usually prescribe an antibiotic that doesn’t interact with Seroquel.

If your doctor prescribes one of the antibiotics listed above with Seroquel, they may lower your Seroquel dosage temporarily. They may also monitor you more closely. For example, they may order electrocardiograms (ECGs) to check your heart rhythm.

Tell your doctor right away if you have symptoms of QT prolongation while taking these drugs together. These can include heart palpitations, dizziness, and fainting.

Seroquel and other interactions

Seroquel may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Seroquel.

Seroquel interactions with supplements

Before you start treatment with Seroquel, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Seroquel interactions with herbs

Doctors will typically recommend you avoid taking St. John’s wort with Seroquel. St. John’s wort is an herbal supplement that may be used to treat depression and other conditions.

St. John’s wort may speed up the activity of an enzyme in your body called cytochrome P450 3A4 (CYP3A4). This enzyme helps break down Seroquel.

By speeding up this enzyme, St. John’s wort can cause Seroquel to break down more quickly, which may lead to a low level of Seroquel in your system. If the level of Seroquel in your system is too low, the drug may not work to treat your condition.

Your doctor may be able to suggest a treatment option other than St. John’s wort.

Seroquel interactions with vitamins 

There are no specific reports of vitamins interacting with Seroquel. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Seroquel.

Seroquel interactions with food

Grapefruit and grapefruit juice can interact with Seroquel. Specifically, grapefruit products can stop your body from breaking down Seroquel as well as usual. This raises the level of Seroquel in your body, which increases your risk of side effects from Seroquel. Due to this risk, your doctor may recommend not consuming grapefruit or grapefruit juice while taking the drug.

Seroquel interactions with vaccines

There aren’t any known interactions between Seroquel and vaccines. Talk to your doctor or pharmacist to see whether you’re due for any vaccines.

Seroquel interactions with lab tests

Seroquel isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

SEROQUEL INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Seroquel.

Using cannabis or cannabis products while taking Seroquel can stop your body breaking down Seroquel as well as usual. This can make Seroquel build up in your body, which can raise your risk of Seroquel side effects.

Both cannabis and Seroquel can also cause sleepiness. This means that using cannabis while taking Seroquel can increase the risk or severity of sleepiness.

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 U.S. states to varying degrees.

Seroquel and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Seroquel. Before you take this drug, be sure to talk with your doctor about your health history. Seroquel may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Seroquel include:

• Diabetes: Seroquel can increase your blood sugar levels. If you have diabetes, Seroquel can make your blood sugar levels harder to manage. Talk with your doctor about any changes that may be needed to the monitoring and management of your diabetes during Seroquel treatment.
• High cholesterol or triglyceride levels: Seroquel can increase your cholesterol and triglyceride levels. If you already have high cholesterol or triglyceride levels, Seroquel can make them harder to manage. Your doctor will likely monitor your cholesterol and triglycerides more often while you are taking Seroquel. If needed, they may adjust your treatment plan.
• Heart conditions: Seroquel can cause certain heart problems. If you have a heart condition, Seroquel may not be safe for you. If you have a condition such as angina, past heart attack, heart failure, long QT syndrome, or a slow or irregular heartbeat, talk with your doctor about whether Seroquel is right for you.
• Electrolyte imbalance: If you have an electrolyte imbalance, such as low potassium or magnesium levels, you may have a raised risk of certain heart problems with Seroquel. Your doctor will likely prescribe medication to correct any electrolyte imbalance before you start taking Seroquel.
• High or low blood pressure: Seroquel may affect your blood pressure. If you have high or low blood pressure, talk with your doctor about whether Seroquel is safe for you. Your doctor may monitor your blood pressure more frequently while you are taking Seroquel.
• Dehydration: If you become dehydrated while taking Seroquel, you may have raised risk of certain Seroquel side effects. These include orthostatic hypotension and overheating. It’s important to drink plenty of fluids while taking Seroquel, especially in hot temperatures and when exercising heavily.
• Low white blood cell count: Seroquel can lower your white blood cell count. If you’ve had a low white blood cell count with other drugs in the past, you may have a raised risk of this side effect. If you already have a low white blood cell count, Seroquel could make it worse. Your doctor will likely monitor your white blood cell counts during treatment with Seroquel.
• Seizures: Seroquel can cause seizures in some people. If you have a condition that raises your risk of seizures, such as epilepsy, you may have a higher risk of seizures with Seroquel. Talk with your doctor about whether Seroquel is right for you.
• Hypothyroidism: If you have hypothyroidism, Seroquel could make this worse. Your doctor will likely monitor your thyroid hormone levels more often while you are taking Seroquel.
• Constipation or trouble urinating: If you have constipation or trouble urinating (for example, due to an enlarged prostate), Seroquel could make this worse. This could lead to a blockage in your intestine or being unable to empty your bladder. If you have problems with constipation or urinating, talk with your doctor about whether Seroquel is right for you.
• Liver problems: Your liver helps clear Seroquel from your body. If you have liver problems, Seroquel could build up in your body, which can raise your risk of side effects. If you have liver problems, your doctor will likely prescribe a dosage of Seroquel that’s lower than usual.
• Allergic reaction: If you’ve had an allergic reaction to Seroquel or any of its ingredients, your doctor will likely not prescribe Seroquel. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether it’s safe to use Seroquel while breastfeeding. The drug passes into breast milk in small amounts, but it’s not known what effects Seroquel may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Seroquel. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: It’s not known for sure whether Seroquel is safe to take during pregnancy. In some studies, Seroquel was not found to cause congenital anomalies (sometimes called birth defects) when taken during pregnancy. However, when taken in the last 3 months of pregnancy, antipsychotic drugs such as Seroquel may cause certain side effects in the baby after birth. These side effects can include excessive sleepiness, breathing problems, trouble feeding, and tremors. If you’re pregnant or planning to become pregnant, tell your doctor before starting Seroquel. They can advise you on the right treatment plan for you.
• Risk of suicidal thoughts and behaviors: Seroquel has a boxed warning about the increased risk of suicidal thoughts and behaviors in certain children and young adults. 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 death in certain older adults. Seroquel also has a boxed warning about the increased risk of death in older adults with psychosis related to dementia. For details, see the boxed warning at the top of this article.

Preventing interactions

You can take certain steps to help prevent interactions with Seroquel. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Seroquel label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Seroquel doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Seroquel by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today 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.