Drilldown: Medicines

None (7) · Lactated Ringer's solution (1)

Aduhelm (1) · Kisunla (1) · Lactated Ringer's Injection (Baxter, B. Braun, ICU Medical); Hartmann's solution (intl.) (1) · Leqembi (1) · Rexulti (1) · Sunosi (1) · Vyepti (1) · Zulresso (1)

5HT1A activity than aripiprazole (1) · 5HT2A (1) · Anti-amyloid beta (Aβ) monoclonal antibody (3) · Anti-CGRP ligand monoclonal antibody (1) · Atypical antipsychotic (1) · D2/5HT1A partial agonist with stronger α1A (1) · GABA-A positive allosteric modulator (1) · Neuroactive steroid (1) · Norepinephrine-dopamine reuptake inhibitor (NDRI) (1) · targets protofibrils (1) · targets pyroglutamated Aβ in plaques (1) · wake-promoting agent (1) · [[:Category:Crystalloid_IV_fluids|Crystalloid IV fluid]] (1) · [[:Category:Electrolyte_replacements|Electrolyte replacement]] (1)

None (3) · Human IgG1 monoclonal antibody targeting aggregated forms of amyloid-β (Aβ), soluble oligomers and insoluble fibrils. Reduces Aβ plaque burden on PET imaging via Fc-mediated microglial clearance. Whether plaque reduction translates to clinical benefit is the core controversy. (1) · Humanized IgG1 monoclonal antibody binding CGRP peptide; IV infusion enables fastest onset of any CGRP mAb (1) · Partial agonist at D2 and 5HT1A. Antagonist at 5HT2A, α1A, α1B, α2C. More potent 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism (relative to D2 partial agonism) than aripiprazole, proposed to reduce akathisia and enhance affective/cognitive effects. (1) · Selective dopamine and norepinephrine reuptake inhibitor (DAT and NET inhibition). Unlike amphetamine, does not significantly release monoamines, pure reuptake inhibition. (1) · '"`UNIQ--vote-00000086-QINU`"' Calcium content is a relative contraindication for co-administration with citrated blood products through the same line'"`UNIQ--ref-00000087-QINU`"'. (1)

Alzheimer disease (FDA accelerated approval June 2021; '''withdrawn from market January 2024''' by manufacturer Biogen). At time of approval indicated for MCI or mild dementia stage of AD. (1) · Alzheimer disease (MCI or mild dementia stage), FDA-approved July 2024 (1) · Alzheimer disease (MCI or mild dementia stage); FDA accelerated approval Jan 2023 → traditional approval July 2023 (1) · Excessive daytime sleepiness in adults with narcolepsy or obstructive sleep apnea (OSA) (1) · Postpartum depression (PPD) in adults (1) · Preventive treatment of migraine in adults (1) · Schizophrenia (FDA-approved 2015). Adjunctive treatment of major depressive disorder (2015). '''Agitation associated with dementia due to Alzheimer disease''' (FDA-approved May 2023, first agent specifically approved for this problem). Investigational for PTSD (combined with sertraline). (1) · '"`UNIQ--vote-00000088-QINU`"', '"`UNIQ--vote-00000089-QINU`"', '"`UNIQ--vote-0000008A-QINU`"', '"`UNIQ--vote-0000008B-QINU`"' (1)

10 mg/kg IV every 2 weeks (1) · 100 mg IV every 3 months; may increase to 300 mg IV every 3 months (1) · 700 mg IV q4w × 3 doses, then 1400 mg IV q4w; may discontinue when amyloid PET shows clearance (1) · Narcolepsy: 75 mg PO once daily upon awakening, titrate every 3 days. OSA: 37.5 mg PO once daily, titrate. (1) · Schizophrenia: 1 mg PO daily × 4 days, then 2 mg daily × 3 days, then 4 mg daily. MDD adjunct: 0.5-1 mg daily, increase to 2 mg max. AD agitation: 0.5 mg daily, titrate to 2-3 mg daily. (1) · Single 60-hour continuous IV infusion: 30 mcg/kg/h × 4h → 60 mcg/kg/h × 20h → 90 mcg/kg/h × 28h → 60 mcg/kg/h × 4h → 30 mcg/kg/h × 4h (1) · Volume titrated to clinical status; typical adult bolus 500-1000 mL, then reassess (1) · Was 1 mg/kg IV q4w × 2, then 3 mg/kg × 2, then 6 mg/kg × 2, then 10 mg/kg q4w (1)

0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg tablets (1) · 100 mg/20 mL vial, single-use (1) · 100 mg/mL vial for IV infusion (1) · 200 mg/2 mL, 500 mg/5 mL vials for IV infusion (1) · 250, 500, 1000 mL IV bags. Composition per liter: Na+ 130 mEq, K+ 4 mEq, Ca2+ 3 mEq, Cl- 109 mEq, lactate 28 mEq (1) · 350 mg/20 mL vial for IV infusion (1) · 75 mg, 150 mg tablets (1) · Was: 170 mg/1.7 mL, 300 mg/3 mL vials for IV infusion (1)

10 mg/kg q2w (1) · 1400 mg q4w (1) · 150 mg/d (1) · 300 mg/quarter (1) · 4 mg/d (schizophrenia); 3 mg/d (AD agitation); 3 mg/d (MDD adjunct) (1) · No fixed maximum; titrated to clinical endpoints (1) · Single 60-hour course (1) · Withdrawn 2024 (1)

Intravenous (continuous infusion in a REMS-certified facility) (1) · Intravenous infusion (1) · IV (1) · IV infusion (60 min) every 2 weeks; outpatient or infusion-center setting (1) · IV infusion every 4 weeks (2) · Oral (2)

Amyloid PET clearance within months; cognitive benefit over 18 months (1) · Antidepressant effect within hours of infusion start; sustained at 30 days (1) · Effect demonstrated within 24 hours in some patients (1) · Immediate intravascular expansion (1) · PET Aβ reduction over months (1) · Slowing of cognitive decline over 18 months (modest effect, ~27% relative slowing) (1) · Weeks for psychosis/depression; AD agitation benefit emerges over weeks (1) · ~30-60 min (1)

3-month dosing interval (1) · Daily dosing (1) · Ongoing dosing (1) · Roughly 20-30% remains intravascular at 1 hour (1) · Single infusion course (1) · Treatment can be discontinued upon achieving amyloid clearance (1) · Withdrawn (1) · ~9 hours (1)

Not applicable (electrolyte solution) (1) · ~12.1 days (1) · ~25 days (1) · ~27 days (1) · ~5-7 days (1) · ~7.1 hours (1) · ~9 hours (terminal) (1) · ~91 hours (1)

None · 100% (IV) · ~100% from subcutaneous depot · ~80% (oral)'"`UNIQ--ref-00000027-QINU`"' · 70–90% (oral) · ~100% (oral)'"`UNIQ--ref-0000001C-QINU`"' · ~50% (oral)'"`UNIQ--ref-00000021-QINU`"' · ~95% · '''Saturable''' via the LAT-1 amino-acid transporter, producing nonlinear pharmacokinetics: ~60% at 300 mg single dose, falling to ~35% at 1200 mg single dose'"`UNIQ--ref-0000002A-QINU`"' · 10-20% (oral; reduced by food, calcium, antacids, PPIs, tea/coffee; enhanced by ascorbate) · 100% (IV); essentially complete (oral) · 100% (IV); rapidly neutralized by gastric acid (oral) · 16-21% capsule, 25% suspension (oral; iron and antacids reduce absorption substantially)'"`UNIQ--ref-000009E5-QINU`"' · 25 mg: ~29%; 50 mg: ~35%; food reduces absorption'"`UNIQ--ref-00000C4F-QINU`"' · 30-40% (oral; increases with repeated dosing as gastric pH rises)'"`UNIQ--ref-000000DF-QINU`"' · 40-45% (oral; not significantly affected by food)'"`UNIQ--ref-0000025C-QINU`"' · 40-80% (oral); reduced by food, calcium, iron, PPIs, fiber; take fasting with water'"`UNIQ--ref-00000037-QINU`"' · 42-58% (oral; dose-dependent)'"`UNIQ--ref-00000AEF-QINU`"' · 50-60% (oral; decreased with food, but food given anyway for GI tolerance)'"`UNIQ--ref-00000019-QINU`"' · 60-70% PO at low doses; saturable at high doses (parenteral routes preferred above 15-25 mg/week)'"`UNIQ--ref-000007C9-QINU`"'

Other values:

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Discontinued/withdrawn (1) · Limited data (2) · Limited data; avoid (1) · Limited data; National Pregnancy Registry available (1) · Limited data; pregnancy exposure registry available (1) · Medicine is structurally identical to endogenous allopregnanolone; pregnancy considerations relate to breastfeeding during/after infusion. Limited data; brief interruption of breastfeeding considered (1) · Standard resuscitation fluid in pregnancy (1)

Rx (2) · Rx, Schedule IV (US) (1) · Rx; ARIA monitoring required (1) · Rx; REMS program required (excessive sedation/loss of consciousness during infusion) (1) · Rx; REMS-like program for ARIA monitoring (1) · Withdrawn from US market January 2024 (1) · [[USLegal:Prescription only|Rx-only]] in US (1)