Nuedexta: Difference between revisions
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MDElliottMD (talk | contribs) parser-claude batch MedTemplate pre-fill, mind-medicine combination |
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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 | | 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" />. | ||
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