Comprehensive medication guide to Quetiapine XR including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic quetiapine XR on most commercial and Medicare Part D plans (Tier 1–2); brand-name Seroquel XR may require prior authorization or sit on a higher tier.
Estimated Cash Pricing
$30–$65 retail for generic quetiapine XR (30-day supply); as low as $2–$10 with GoodRx or SingleCare coupons at participating pharmacies.
Medfinder Findability Score
72/100
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Quetiapine XR (extended-release quetiapine fumarate) is a second-generation atypical antipsychotic sold under the brand name Seroquel XR by AstraZeneca, and available as generic quetiapine extended-release from multiple manufacturers. The "XR" designation refers to its extended-release delivery system, which allows for once-daily dosing compared to the twice-daily immediate-release formulation.
Quetiapine XR is FDA-approved for schizophrenia in adults and adolescents 13+, bipolar I disorder (manic episodes, depressive episodes, and maintenance) in adults and children 10+, and as an adjunctive treatment for major depressive disorder (MDD) in adults — the MDD indication being specific to the XR formulation, approved by the FDA in 2009.
It is available in 50 mg, 150 mg, 200 mg, 300 mg, and 400 mg extended-release tablets. The medication should be taken once daily in the evening, without food or with only a light meal, and tablets must be swallowed whole.
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Quetiapine XR works by blocking multiple receptor types in the brain. Its primary actions are antagonism of dopamine D2 receptors (reducing overactive dopamine signaling associated with psychosis) and serotonin 5-HT2A receptors (contributing to antidepressant effects and reducing extrapyramidal side effects). It also antagonizes histamine H1 receptors — causing its characteristic sedation — and alpha-1 adrenergic receptors, which can cause orthostatic hypotension.
Quetiapine's active metabolite, norquetiapine (N-desalkylquetiapine), has distinct pharmacological properties including norepinephrine reuptake inhibition and 5-HT1A partial agonism — properties it shares with antidepressant medications. These norquetiapine-mediated effects are believed to contribute significantly to quetiapine's effectiveness in bipolar depression and MDD augmentation.
The XR formulation uses a hydrophilic matrix technology that releases quetiapine gradually over 24 hours, providing more stable blood levels and less peak sedation compared to the immediate-release formulation. Quetiapine is metabolized primarily by the CYP3A4 liver enzyme, making drug interactions with CYP3A4 inhibitors and inducers clinically significant.
50 mg — extended-release tablet
Starting dose for several indications; also used for titration
150 mg — extended-release tablet
Common maintenance dose for MDD adjunctive therapy and anxiety (off-label)
200 mg — extended-release tablet
Common maintenance dose for bipolar disorder and schizophrenia
300 mg — extended-release tablet
Target dose for bipolar depression; common for schizophrenia
400 mg — extended-release tablet
Higher dose for schizophrenia and bipolar mania; maximum for many patients
In the United States, quetiapine XR is generally available from multiple generic manufacturers, and the FDA has not listed an active nationwide shortage as of 2026. However, localized stocking gaps are real — particularly for the 150 mg extended-release strength, which is stocked by fewer pharmacies due to lower prescribing volume. Not every pharmacy carries every strength, and smaller independent pharmacies may stock only the most common doses.
Internationally, quetiapine XR has experienced more significant supply challenges. The UK, EU, and Australia all reported active shortages of extended-release quetiapine between 2024 and early 2025, with the UK's MHRA issuing a supply notification for all XR strengths in February 2025 and Australia's TGA reporting limited availability of several strengths into 2025.
If you're having trouble locating your Quetiapine XR dose, medfinder calls local pharmacies on your behalf to find which ones have your specific strength in stock, then texts you the results. No hold music, no runaround.
Quetiapine XR is not a controlled substance, which means any licensed prescriber in the United States can prescribe it without DEA scheduling requirements or special state prescription monitoring protocols. This makes it widely accessible compared to many other psychiatric medications.
Common prescriber types include:
Psychiatrists (most common for higher-dose use in schizophrenia and bipolar disorder)
Primary care physicians and internal medicine doctors
Nurse practitioners (NPs) and physician assistants (PAs) with mental health scope
Pediatric psychiatrists (for adolescents and children with FDA-approved indications)
Neurologists (less common; may prescribe for neuropsychiatric conditions)
Telehealth prescribing is widely available for quetiapine XR since it is not a controlled substance. Platforms such as Talkiatry, Cerebral, and Brightside can evaluate patients and prescribe quetiapine XR without requiring an in-person visit in most states. This is particularly valuable for patients in rural areas or those with limited access to in-person psychiatric care.
No. Quetiapine XR (Seroquel XR and generic quetiapine extended-release) is not classified as a controlled substance under the U.S. Controlled Substances Act. It does not have a DEA schedule. Prescribers do not need DEA special registration to prescribe it, and there are no federal limits on refills or requirements for in-person visits to obtain prescriptions.
It is, however, a prescription-only medication — you cannot purchase it over the counter. Prescriptions can be issued electronically, by phone, or in person by any licensed prescriber. Telehealth prescribing is available in most states without restrictions. Prescriptions can be transferred between pharmacies without the special protocols that apply to controlled substances.
While quetiapine is not addictive in the clinical sense, abrupt discontinuation after regular use can cause withdrawal symptoms including nausea, vomiting, and insomnia. Always taper under prescriber guidance when discontinuing.
The most frequently reported side effects of Quetiapine XR include:
Somnolence/drowsiness (most common, especially early in treatment)
Dry mouth
Dizziness and orthostatic hypotension
Weight gain and increased appetite
Constipation
Headache
Serious side effects requiring prompt medical attention:
Tardive dyskinesia (potentially irreversible involuntary movements)
Neuroleptic malignant syndrome (high fever, muscle rigidity, altered consciousness)
Hyperglycemia and new-onset diabetes
Increased cholesterol and triglycerides
QT interval prolongation and cardiac arrhythmia
Agranulocytosis and leukopenia
Increased mortality in elderly patients with dementia-related psychosis (black box warning)
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Aripiprazole (Abilify)
Dopamine partial agonist; FDA-approved for schizophrenia, bipolar I, and MDD adjunct. Less sedating and lower metabolic risk than quetiapine; may cause akathisia.
Risperidone (Risperdal)
Atypical antipsychotic; strong evidence for schizophrenia and bipolar mania. Higher EPS risk and prolactin elevation compared to quetiapine; widely available as generic.
Olanzapine (Zyprexa)
Highly effective for bipolar I and schizophrenia; rapid onset for acute mania. Significant weight gain and metabolic risk; available as generic.
Lurasidone (Latuda)
FDA-approved for bipolar I depression and schizophrenia. Favorable metabolic profile with low weight gain; must be taken with food (350+ calories).
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Strong CYP3A4 inhibitors (ketoconazole, ritonavir)
majorSignificantly increase quetiapine blood levels. Reduce quetiapine dose to one-sixth of usual dose when combined.
Strong CYP3A4 inducers (carbamazepine, phenytoin, rifampin)
majorSignificantly reduce quetiapine blood levels. May require up to 5-fold dose increase; reduce back after stopping inducer.
Opioid medications (oxycodone, hydrocodone, fentanyl)
majorAdditive CNS depression with risk of profound sedation, respiratory depression, coma, and death. Avoid combination when possible.
QT-prolonging drugs (antiarrhythmics, certain antibiotics, other antipsychotics)
majorIncreased risk of QT prolongation and torsades de pointes. Avoid combinations where possible; ECG monitoring if necessary.
Alcohol
moderateAdditive CNS depression, significantly amplifying sedation and impairing coordination and judgment.
Benzodiazepines (alprazolam, lorazepam, diazepam)
moderateAdditive CNS and respiratory depression. Use with caution; monitor closely if combination is necessary.
St. John's Wort
moderateNatural CYP3A4 inducer that can significantly reduce quetiapine levels and effectiveness.
Antidiabetic medications
moderateQuetiapine-induced hyperglycemia may reduce effectiveness of diabetes medications; increased glucose monitoring required.
Quetiapine XR is a versatile and widely prescribed psychiatric medication with a strong evidence base across multiple serious mental health conditions. Its once-daily dosing, broad FDA-approved indication set, and availability as an affordable generic make it a cornerstone of psychiatric treatment for schizophrenia, bipolar disorder, and major depressive disorder. The medication requires ongoing metabolic monitoring and carries important boxed warnings regarding elderly patients with dementia and suicidality in young adults.
In the US, quetiapine XR is generally available at most major pharmacies with generic options making it quite affordable. However, localized stocking gaps — particularly for the 150 mg strength — can occur. International markets have experienced more significant supply disruptions. Patients should refill proactively and have a backup plan.
If you ever have trouble locating your Quetiapine XR dose at your pharmacy, medfinder is here to help. We call local pharmacies on your behalf and text you which ones have your medication in stock — taking the frustration out of finding your prescription.
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