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Drug interactions between Seroquel and Tegretol

Results for the following 2 drugs:
Seroquel (quetiapine)
Tegretol (carbamazepine)

Interactions between your selected drugs


carbamazepine ↔ quetiapine

Applies to:Tegretol (carbamazepine) and Seroquel (quetiapine)

Consumer information for this interaction is not currently available.

ADJUST DOSE: Coadministration with potent inducers of CYP450 3A4 such as carbamazepine may significantly decrease the plasma concentrations of quetiapine, which is primarily metabolized by the isoenzyme. In addition, quetiapine may increase the plasma levels and the risk of adverse effects of carbamazepine and its active epoxide metabolite. In 18 psychiatric patients receiving quetiapine 300 mg twice daily, addition of the potent CYP450 3A4 inducer carbamazepine (200 mg three times daily) decreased mean quetiapine peak plasma concentration (Cmax) and systemic exposure (AUC) by 80% and 87%, respectively, and increased oral clearance (Cl/F) by 7.5-fold compared to quetiapine administered alone.

MANAGEMENT: Increased dosages of quetiapine may be required during chronic treatment (greater than 7 to 14 days) with potent CYP450 3A4 inducers such as carbamazepine. The U.S. labeling recommends an increase of up to 5-fold of the original dosage. Further adjustments should be made based on clinical response and tolerance. The safety of dosages above 800 mg/day has not been established in clinical trials. Continued treatment at higher dosages should only be considered following careful consideration of risks and benefits. When carbamazepine is discontinued, the dosage of quetiapine should be reduced to the original level within 7 to 14 days. In addition, patients should be monitored for adverse effects associated with carbamazepine (e.g., dizziness, drowsiness, ataxia, diplopia). Some authorities suggest monitoring carbamazepine levels and adjusting the dosage accordingly when coadministered with quetiapine.


  1. Grimm SW, Richtand NM, Winter HR, Stams KR, Reele SB "Effects of cytochrome P450 3A modulators ketoconazole and carbamazepine on quetiapine pharmacokinetics." Br J Clin Pharmacol 61 (2006): 58-69
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0
View all 7 references

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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