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ESQ uses

Pharmacological action

ESQ is an antipsychotic drug. This medication exhibits a high affinity for serotonin 5HT2-receptors compared with dopamine D1- and D2-receptors in the brain. Also ESQ has a high affinity for histamine and alpha1-receptors and a less pronounced - to the alpha2-receptors. This drug has no affinity for the m-cholinergic receptors and benzodiazepine receptors.

ESQ in the dose effectively blocking dopamine D2-receptors causing only weak catalepsy. ESQ selectively reduces the activity of mesolimbic dopamine neurons in A10-compared with A9-nigrostriatalnymi neurons involved in motor function. This medicine does not cause long raise prolactin levels.

In accordance with the results of positron emission tomography effect of ESQ on serotonin 5HT2- and dopamine D2-receptors can be extended to 12 h.


ESQ after oral administration is well absorbed from the gastrointestinal tract. Ingestion did not significantly affect the bioavailability of ESQ.

The pharmacokinetics of ESQ is linear.

Plasma protein binding is about 83%.

This medication subjected to intensive metabolism. In "in vitro" studies there was revealed that a key enzyme metabolism of ESQ is CYP3A4.

The main metabolites detected in blood plasma does not possess a pronounced pharmacological activity.

T1/2 is about 7 hours. Less than 5% of ESQ excreted unchanged in the kidneys or the intestines. Approximately 73% of metabolites excreted by the kidneys and 21% through the intestines.

The average clearance of ESQ in elderly patients is 30-50% lower than observed in patients aged 18 to 65 years.

The average plasma clearance of ESQ was approximately less than 25% in patients with severely impaired renal function (creatinine clearance less than 30 ml / min / 1.73 m2) and in patients with liver disease (alcoholic cirrhosis in the stage of compensation) but the individual clearance levels were within the limits of the healthy people.

The pharmacokinetics of ESQ do not depend on gender.


Why is ESQ prescribed?

Acute and chronic psychosis.

Dosage and administration

When use for adult the starting dose is 50 mg for elderly patients is 25 mg / day. Then gradually increase the dose according to the scheme. Depending on the clinical effect and individual sensitivity of the effective therapeutic dose can be 150-750 mg / day.

Patients with impaired liver function and / or renal starting dose is 25 mg / day. The daily dose increase should be 25-50 mg to achieve an optimal effect.

ESQ side effects, adverse reactions

CNS: headache, drowsiness, dizziness, anxiety.

Cardio-vascular system: orthostatic hypotension, tachycardia, hypertension.

Digestive system: constipation, dry mouth, dyspepsia, diarrhea, transient elevation of liver enzymes, abdominal pain.

Blood: asymptomatic leukopenia and / or neutropenia, rarely - eosinophilia.

Musculoskeletal system: myalgia.

With the respiratory system: rhinitis.

Dermatological reactions: skin rash, dry skin.

Organ of hearing: ear pain.

Genitourinary system: urinary tract infection.

Endocrine system: a slight elevation of serum cholesterol and triglycerides, a small dose-related reversible reduction in thyroid hormone levels (particularly total and free T4).

Other: asthenia, pain, weight gain, fever, chest pain.

ESQ contraindications

Hypersensitivity to ESQ.

Using during pregnancy and breastfeeding

During pregnancy and lactation ESQ use is possible in cases where the expected benefit to the mother justifies the potential risk to the fetus. It is unknown whether the allocated ESQ in breast milk.

In experimental studies in animals it was showed no mutagenic and clastogene of ESQ. Found no effect of ESQ on fertility, but you can not directly transfer the data obtained in person, because there are specific differences in hormonal control of reproduction. Category effects on the fetus by FDA is C.

Special instructions

ESQ used with careful in patients with cardiovascular diseases and other conditions associated with the risk of hypotension, especially at the beginning of treatment and the elderly, and specifying a history of seizures convulsions.

ESQ undergoes active metabolism in the liver. Patients with impaired liver and renal clearance of ESQ is reduced by approximately 25%. Thats why ESQ should be used with caution in patients with impaired liver function and / or kidneys.

This medication with careful use concurrently with drugs that prolong the interval QT (especially the elderly) with drugs that provide a depressing effect on the CNS, as well as ethanol; with potent inhibitors of isoenzyme CYP3A4 (including those with ketoconazole, erythromycin).

With the development of NMS during treatment with ESQ it should be revoked and appropriate treatment.

With prolonged use there is a risk of tardive dyskinesia. In such cases it is necessary to reduce the dose of ESQ or cancel it.

ESQ used with caution in combination with other drugs that affect the activity of the CNS, as well as with ethanol.

ESQ may cause drowsiness, so patients are not encouraged to perform tasks associated with the need to focus and speed of psychomotor reactions (including driving vehicles).

ESQ drug interactions

Simultaneous administration of ESQ with:

  • ketoconazole, erythromycin is theoretically possible to increase the concentration of ESQ in the blood plasma and the development of side effects;
  • phenytoin, carbamazepine, barbiturates, rifampicin the clearance of ESQ increases decreasing its concentration in blood plasma;
  • thioridazine may increase clearance of ESQ.

    ESQ in case of emergency / overdose

    Symptoms: drowsiness, sedation, tachycardia, hypotension.

    Treatment: symptomatic; restoration and control of upper airway patency, maintenance of adequate oxygenation and ventilation, monitoring and maintenance of the cardiovascular system.


    ESQ pharmaceutical active ingredients containing related brand and generic drugs:

    Active ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.

    ESQ available forms, composition, doses:

    Form of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
    Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
    Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.

    ESQ destination | category:

    Destination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
    Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.

    ESQ Anatomical Therapeutic Chemical codes:

    A medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.

    ESQ pharmaceutical companies:

    Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
    Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.



    2. Dailymed."QUETIAPINE FUMARATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". (accessed August 28, 2018).
    3. "quetiapine". (accessed August 28, 2018).

    Frequently asked Questions

    Can i drive or operate heavy machine after consuming ESQ?

    Depending on the reaction of the ESQ after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider ESQ not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.

    Is ESQ addictive or habit forming?

    Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.

    Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.


    Review conducted a study on ESQ, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of ESQ consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.

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    The information was verified by Dr. Arunabha Ray, MD Pharmacology

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