Comprehensive medication guide to Seroquel 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 extended-release on most commercial and Medicare Part D plans, typically covered at Tier 1 or Tier 2. Brand-name Seroquel XR may require prior authorization or step therapy to generic first.
Estimated Cash Pricing
$30–$65 retail for a 30-day supply of generic quetiapine XR; as low as $5–$10 per month with GoodRx or SingleCare coupons. Brand-name Seroquel XR costs $400–$800+ per month without a savings card.
Medfinder Findability Score
82/100
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Seroquel XR (quetiapine fumarate extended-release) is an atypical antipsychotic (second-generation antipsychotic) in the dibenzothiazepine chemical class. Originally developed by AstraZeneca and now distributed in the U.S. by Cheplapharm Arzneimittel GmbH, it is available both as brand-name Seroquel XR and as widely available generic quetiapine fumarate extended-release tablets.
Seroquel XR is FDA-approved for schizophrenia (adults and adolescents 13+), bipolar I disorder (manic episodes, depressive episodes, and long-term maintenance in adults), and as an adjunct to antidepressants for major depressive disorder in adults. It is also widely used off-label for generalized anxiety disorder, PTSD, and insomnia.
Seroquel XR tablets come in five strengths: 50 mg, 150 mg, 200 mg, 300 mg, and 400 mg. They are taken once daily in the evening, without food or with a light meal of approximately 300 calories. Tablets must be swallowed whole — crushing or splitting destroys the extended-release mechanism.
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Quetiapine XR works through a multi-receptor pharmacological profile. Its primary antipsychotic action comes from blocking dopamine D2 receptors — particularly in the mesolimbic pathway — which reduces excessive dopamine signaling responsible for psychotic symptoms like hallucinations and delusions. Quetiapine's "fast-off" dissociation from D2 receptors explains its low risk of extrapyramidal side effects compared to older antipsychotics.
Seroquel XR also blocks serotonin 5-HT2A receptors, histamine H1 receptors (causing sedation), and alpha-1 adrenergic receptors (causing orthostatic hypotension). Its active metabolite, norquetiapine, inhibits norepinephrine reuptake and partially activates 5-HT1A receptors — mechanisms that account for its antidepressant and anxiolytic effects.
The extended-release formulation uses a hydrophilic matrix to release quetiapine gradually over 24 hours, enabling once-daily dosing with lower peak plasma concentrations and reduced peak sedation compared to the immediate-release formulation.
50 mg — extended-release tablet
Starting dose for elderly patients; used in bipolar depression titration
150 mg — extended-release tablet
Lower maintenance dose; used in MDD adjunct therapy
200 mg — extended-release tablet
Mid-range maintenance dose
300 mg — extended-release tablet
Common maintenance dose for bipolar depression and MDD adjunct
400 mg — extended-release tablet
Higher dose for schizophrenia and bipolar mania
As of 2026, Seroquel XR (quetiapine fumarate extended-release) is not listed on the FDA Drug Shortage Database or the ASHP shortage tracker. Generic quetiapine XR is produced by multiple manufacturers and is generally available nationwide. However, localized pharmacy-level stock gaps are common — particularly for high-demand strengths like 50 mg and 300 mg at chain pharmacies.
Stock gaps occur because chain pharmacies source generics from preferred wholesale suppliers under exclusive contracts. When a supplier backlogs on a specific strength, the chain has nothing to dispense. Independent pharmacies often have stock when chains don't, as they use different wholesalers. The medication exists nationally — it just isn't at every pharmacy at all times.
If you're struggling to find your quetiapine XR, medfinder calls pharmacies near you to check which ones have your specific strength in stock and texts you the results — eliminating the need to call pharmacies yourself.
Seroquel XR (quetiapine) is not a controlled substance, which means any licensed prescriber with standard DEA registration can prescribe it — without special scheduling authorization or PDMP requirements. This significantly broadens the pool of providers who can manage this medication.
Because quetiapine XR is not a controlled substance, telehealth prescribing is fully available without in-person visit requirements. Multiple psychiatry telehealth platforms offer evaluation and prescribing via video consultation, providing access for patients in areas with limited local psychiatric services.
No. Seroquel XR (quetiapine fumarate) is not scheduled under the U.S. Controlled Substances Act (CSA). It is a prescription-only medication but does not fall under any DEA schedule — not Schedule II, III, IV, or V. This means there are no federal restrictions on how it can be prescribed beyond a standard prescription, no PDMP check requirements, no quantity limits per DEA regulations, and no restrictions on telehealth prescribing.
Quetiapine can be prescribed by any licensed prescriber (including NPs and PAs), refilled by electronic prescription or phone, dispensed through mail-order pharmacies without restriction, and transferred between pharmacies without special procedures. This non-controlled status makes it significantly more accessible than scheduled psychiatric medications like benzodiazepines or stimulants.
The most frequently reported side effects of quetiapine XR include:
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Aripiprazole (Abilify)
Dopamine partial agonist; FDA-approved for schizophrenia, bipolar I, and MDD adjunct. Less sedating, lower metabolic risk. May cause akathisia.
Risperidone (Risperdal)
D2/5-HT2A antagonist; widely available generic. Strong antipsychotic efficacy. Higher EPS and prolactin elevation risk than quetiapine.
Olanzapine (Zyprexa)
Broad receptor profile; FDA-approved for schizophrenia and bipolar disorder. Effective but carries highest metabolic risk in class — significant weight gain.
Lurasidone (Latuda)
FDA-approved for schizophrenia and bipolar depression. Favorable metabolic profile; minimal weight gain. Must be taken with at least 350 calories for adequate absorption.
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Ketoconazole / Itraconazole (antifungals)
majorStrong CYP3A4 inhibitors that increase quetiapine levels dramatically. Reduce Seroquel XR dose to 1/6 of original dose when co-administered.
Ritonavir / Indinavir (HIV medications)
majorPotent CYP3A4 inhibitors that significantly increase quetiapine exposure. Dose reduction to 1/6 of original required.
Carbamazepine (Tegretol)
majorPowerful CYP3A4 inducer that can reduce quetiapine levels by up to 80%, potentially making it ineffective. Quetiapine dose may need to increase up to 5-fold.
Rifampin (antibiotic for TB)
majorStrong CYP3A4 inducer that markedly reduces quetiapine blood levels. Significant dose adjustment required.
Amiodarone / other QTc-prolonging drugs
majorAdditive QTc prolongation risk, increasing risk of torsades de pointes cardiac arrhythmia. Contraindicated combinations.
Sodium oxybate (GHB/Xyrem)
majorProfound additive CNS depression — sedation, respiratory depression, coma, and death reported. Avoid combination entirely.
Alcohol / CNS depressants
moderateAdditive sedation and respiratory depression. Significantly enhances quetiapine's sedating effects. Avoid or strictly limit alcohol.
St. John's Wort
moderateCYP3A4 inducer that reduces quetiapine levels, potentially causing therapeutic failure. Common supplement — patients must disclose use.
Antihypertensives
moderateAdditive alpha-1 blocking effect enhances blood pressure lowering, increasing dizziness and fall risk.
Clarithromycin / Erythromycin (antibiotics)
moderateModerate-to-strong CYP3A4 inhibitors that can increase quetiapine levels. Monitor for increased side effects during antibiotic courses.
Seroquel XR (quetiapine fumarate extended-release) is one of the most versatile and widely used psychiatric medications available, with FDA approvals spanning schizophrenia, bipolar disorder across its phases, and major depressive disorder. Its unique pharmacological profile — combining dopamine D2 blockade, serotonin 5-HT2A antagonism, and norquetiapine's antidepressant mechanisms — explains its broad efficacy across diverse psychiatric conditions.
Generic quetiapine XR is affordable ($30-$65/month retail; as low as $5-$10/month with discount programs), not a controlled substance, and generally well-stocked nationally. Stock gaps at individual pharmacies are a logistics issue, not a production failure — searching across pharmacies, especially independents, typically resolves fill problems quickly.
If you're having trouble locating your Seroquel XR prescription, medfinder can check pharmacies near you for availability without requiring you to call each one yourself. Always work with your prescriber on any medication decisions, and never stop quetiapine abruptly.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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