Nuedexta - Revision history

MDElliottMD: home-claude category backfill (parser-claude gap closure)

2026-05-23T10:43:46Z

home-claude category backfill (parser-claude gap closure)

← Older revision		Revision as of 10:43, 23 May 2026
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	== References ==		== References ==
	<references />		<references />
			[[Category:NMDA receptor antagonists]]
			[[Category:Sigma-1 receptor modulators]]
			[[Category:CYP2D6 inhibitors]]
			[[Category:Fixed-dose combinations]]

MDElliottMD: home-claude house-rule fix (terminology)

2026-05-23T04:50:58Z

home-claude house-rule fix (terminology)

← Older revision		Revision as of 04:50, 23 May 2026
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	\| bioavailability = Increased substantially via CYP2D6 inhibition<ref name="nuedexta-label" />		\| bioavailability = Increased substantially via CYP2D6 inhibition<ref name="nuedexta-label" />
	\| pregnancy = Limited data; quinidine has been used in pregnancy as antiarrhythmic.{{citation needed}}		\| pregnancy = Limited data; quinidine has been used in pregnancy as antiarrhythmic.{{citation needed}}
	\| legal = [[USLegal:Prescription only\|Rx-only]] in US. Caution with QT-prolonging ~~drugs~~ (quinidine itself is class IA antiarrhythmic, and the dose here, though sub-antiarrhythmic, still contributes to QT)<ref name="nuedexta-label" />		\| legal = [[USLegal:Prescription only\|Rx-only]] in US. Caution with QT-prolonging medicines (quinidine itself is class IA antiarrhythmic, and the dose here, though sub-antiarrhythmic, still contributes to QT)<ref name="nuedexta-label" />
	\| mechanism = <vote slug="nuedexta-mech-claim">Like the Auvelity strategy, Nuedexta uses a CYP2D6 inhibitor (quinidine here, at sub-antiarrhythmic dose) to elevate plasma dextromethorphan; sustained DXM levels engage NMDA receptor antagonism and sigma-1 receptor agonism, which reduce the involuntary emotional outbursts characteristic of pseudobulbar affect.</vote> First FDA-approved treatment for PBA. The 10 mg quinidine daily dose is far below antiarrhythmic levels but sufficient to nearly fully inhibit CYP2D6, the basis of the combination's pharmacokinetic rationale<ref name="nuedexta-label" />.		\| mechanism = <vote slug="nuedexta-mech-claim">Like the Auvelity strategy, Nuedexta uses a CYP2D6 inhibitor (quinidine here, at sub-antiarrhythmic dose) to elevate plasma dextromethorphan; sustained DXM levels engage NMDA receptor antagonism and sigma-1 receptor agonism, which reduce the involuntary emotional outbursts characteristic of pseudobulbar affect.</vote> First FDA-approved treatment for PBA. The 10 mg quinidine daily dose is far below antiarrhythmic levels but sufficient to nearly fully inhibit CYP2D6, the basis of the combination's pharmacokinetic rationale<ref name="nuedexta-label" />.
	}}		}}

MDElliottMD: parser-claude batch MedTemplate pre-fill, mind-medicine combination

2026-05-23T04:44:11Z

parser-claude batch MedTemplate pre-fill, mind-medicine combination

New page

{{MedTemplate
| generic = Dextromethorphan / Quinidine
| brand = Nuedexta
| structure =
| classes = [[:Category:NMDA_receptor_antagonists|NMDA receptor antagonist (dextromethorphan)]], [[:Category:Sigma-1_receptor_modulators|Sigma-1 receptor agonist (dextromethorphan)]], [[:Category:CYP2D6_inhibitors|CYP2D6 inhibitor (quinidine, sub-antiarrhythmic dose)]], [[:Category:Fixed-dose_combinations|Fixed-dose combination]]
| uses = <vote slug="pseudobulbar-affect-use">Pseudobulbar affect (PBA) in neurologic conditions including ALS, MS, traumatic brain injury, stroke</vote>
| starting_dose = 1 capsule (20/10 mg dextromethorphan/quinidine) PO once daily × 7 days, then 1 capsule BID
| preparations = 20 mg dextromethorphan HBr / 10 mg quinidine sulfate capsules
| fda_max = 1 capsule BID (40 mg DXM / 20 mg quinidine per day)
| pill_id =
| routes = Oral
| onset = PBA episode reduction within 1-2 weeks
| duration = 12 hours
| halflife = Dextromethorphan substantially prolonged by quinidine's CYP2D6 inhibition (typical extensive metabolizers see ~10× higher AUC); quinidine ~6-8 hours<ref name="nuedexta-label">FDA Prescribing Information, Nuedexta (dextromethorphan HBr / quinidine sulfate), Avanir/Otsuka, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021879s016lbl.pdf</ref>
| bioavailability = Increased substantially via CYP2D6 inhibition<ref name="nuedexta-label" />
| pregnancy = Limited data; quinidine has been used in pregnancy as antiarrhythmic.{{citation needed}}
| legal = [[USLegal:Prescription only|Rx-only]] in US. Caution with QT-prolonging drugs (quinidine itself is class IA antiarrhythmic, and the dose here, though sub-antiarrhythmic, still contributes to QT)<ref name="nuedexta-label" />
| mechanism = <vote slug="nuedexta-mech-claim">Like the Auvelity strategy, Nuedexta uses a CYP2D6 inhibitor (quinidine here, at sub-antiarrhythmic dose) to elevate plasma dextromethorphan; sustained DXM levels engage NMDA receptor antagonism and sigma-1 receptor agonism, which reduce the involuntary emotional outbursts characteristic of pseudobulbar affect.</vote> First FDA-approved treatment for PBA. The 10 mg quinidine daily dose is far below antiarrhythmic levels but sufficient to nearly fully inhibit CYP2D6, the basis of the combination's pharmacokinetic rationale<ref name="nuedexta-label" />.
}}

== References ==
<references />