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Medicines > mechanism: None & bioavailability : 100% (IV) or ~50% (oral)'"`UNIQ--ref-00000021-QINU`"'

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generic:
None (3) · Atenolol (1)
brand:
Kisunla (1) · Leqembi (1) · Tenormin (1) · Zulresso (1)
classes:
Anti-amyloid beta (Aβ) monoclonal antibody (2) · GABA-A positive allosteric modulator (1) · Neuroactive steroid (1) · targets protofibrils (1) · targets pyroglutamated Aβ in plaques (1) · [[:Category:Antihypertensives|Antihypertensive]] (1) · [[:Category:Beta blockers|Beta blocker (cardioselective β1)]] (1)
mechanism: (Click arrow to add another value)
uses:
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) · Postpartum depression (PPD) in adults (1) · '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"' (1)
starting dose:
10 mg/kg IV every 2 weeks (1) · 25-50 mg PO once daily; titrate to 100 mg/day (1) · 700 mg IV q4w × 3 doses, then 1400 mg IV q4w; may discontinue when amyloid PET shows clearance (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)
preparations:
100 mg/20 mL vial, single-use (1) · 200 mg/2 mL, 500 mg/5 mL vials for IV infusion (1) · 350 mg/20 mL vial for IV infusion (1) · Tablets 25, 50, 100 mg (1)
fda max:
10 mg/kg q2w (1) · 100-200 mg/day depending on indication (1) · 1400 mg q4w (1) · Single 60-hour course (1)
routes:
Intravenous (continuous infusion in a REMS-certified facility) (1) · IV infusion (60 min) every 2 weeks; outpatient or infusion-center setting (1) · IV infusion every 4 weeks (1) · Oral (1)
onset:
Amyloid PET clearance within months; cognitive benefit over 18 months (1) · Antidepressant effect within hours of infusion start; sustained at 30 days (1) · BP effect within hours; full effect over 1-2 weeks (1) · Slowing of cognitive decline over 18 months (modest effect, ~27% relative slowing) (1)
duration:
24 hours (once-daily dosing supported by long elimination) (1) · Ongoing dosing (1) · Single infusion course (1) · Treatment can be discontinued upon achieving amyloid clearance (1)
halflife:
6-9 hours (substantially longer in renal impairment due to renal elimination)'"`UNIQ--ref-00000020-QINU`"' (1) · ~12.1 days (1) · ~5-7 days (1) · ~9 hours (terminal) (1)
bioavailability: (Click arrow to add another value)
pregnancy:
'''Documented fetal growth restriction with chronic exposure'''; avoid in pregnancy if alternative β-blockers are appropriate. The β-blocker most consistently associated with intrauterine growth concerns'"`UNIQ--ref-00000022-QINU`"' (1) · Limited data (2) · Medicine is structurally identical to endogenous allopregnanolone; pregnancy considerations relate to breastfeeding during/after infusion. Limited data; brief interruption of breastfeeding considered (1)
legal:
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) · [[USLegal:Prescription only|Rx-only]] in US (1)
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