Drilldown: Medicines
Medicines > classes 
:
[[:Category:Antihypertensives|Antihypertensive]] or
[[:Category:Hormone_replacement|Hormone replacement]]
& routes:
IV
:
[[:Category:Antihypertensives|Antihypertensive]] or
[[:Category:Hormone_replacement|Hormone replacement]]
& routes:
IV Use the filters below to narrow your results.
generic:
brand:
Apresoline (historical); mostly generic; combination with isosorbide dinitrate marketed as BiDil for self-identified Black patients with HFrEF (1) ·
Calan, Calan SR, Verelan, Verelan PM, Isoptin SR (1) ·
Cardizem, Tiazac, Cartia XT, Dilacor XR, Taztia XT, Matzim LA (1) ·
Cytomel (oral), Triostat (IV) (1) ·
Synthroid, Levoxyl, Tirosint, Unithroid, Euthyrox (1) ·
Vasotec, Vasotec IV, Epaned (1)
classes: (Click arrow to add another value)
mechanism:
None (4) ·
Synthetic T4 (thyroxine); peripherally deiodinated to T3 (triiodothyronine), the active hormone. '"`UNIQ--vote-00000031-QINU`"' Narrow therapeutic index; brand-to-generic switches can shift TSH and require re-titration'"`UNIQ--ref-00000032-QINU`"'. (1) ·
'"`UNIQ--vote-0000063C-QINU`"' Avoid in HFrEF (negative inotropy). CYP3A4 substrate AND moderate inhibitor — interacts substantially with statins (especially simvastatin), tacrolimus, cyclosporine, and many other CYP3A4 substrates'"`UNIQ--ref-0000063D-QINU`"'. (1)
uses:
'"`UNIQ--vote-00000017-QINU`"', '"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"' (1) ·
'"`UNIQ--vote-00000033-QINU`"', '"`UNIQ--vote-00000034-QINU`"', '"`UNIQ--vote-00000035-QINU`"' (1) ·
'"`UNIQ--vote-0000063E-QINU`"', '"`UNIQ--vote-0000063F-QINU`"', '"`UNIQ--vote-00000640-QINU`"', '"`UNIQ--vote-00000641-QINU`"' (1) ·
'"`UNIQ--vote-00000683-QINU`"', '"`UNIQ--vote-00000684-QINU`"', '"`UNIQ--vote-00000685-QINU`"', '"`UNIQ--vote-00000686-QINU`"' (1) ·
'"`UNIQ--vote-00000A66-QINU`"', '"`UNIQ--vote-00000A67-QINU`"', '"`UNIQ--vote-00000A68-QINU`"', '"`UNIQ--vote-00000A69-QINU`"', '"`UNIQ--vote-00000A6A-QINU`"' (1) ·
'"`UNIQ--vote-00000B81-QINU`"', '"`UNIQ--vote-00000B82-QINU`"', '"`UNIQ--vote-00000B83-QINU`"' (1)
starting dose:
1.6 mcg/kg/d in young healthy adults; 25-50 mcg/d in elderly or cardiac disease, titrated by TSH at 6-8 weeks (1) ·
5-10 mg PO once daily (2.5 mg if on diuretic or in heart failure); titrate to 10-20 mg BID for HFrEF (1) ·
ER 180-240 mg PO once daily; IR 30 mg PO QID; IV 0.25 mg/kg over 2 min for acute rate control, then 5-15 mg/h infusion (1) ·
Hypothyroidism: 5-25 mcg PO daily (start low, titrate slowly); myxedema coma: 5-20 mcg IV q4-12h with T4 loading (1) ·
IR 80-120 mg PO TID; ER 180-240 mg PO daily; IV 2.5-5 mg over 2 min for SVT termination (under monitoring); cluster prophylaxis up to 480-960 mg/d in divided doses (1) ·
PO 10 mg QID; IV 5-10 mg every 20-30 minutes for hypertensive emergency (1)
preparations:
10, 25, 50, 100 mg tablets; 20 mg/mL IV (1) ·
2.5, 5, 10, 20 mg tablets; 1 mg/mL oral solution (Epaned); 1.25 mg/mL IV (enalaprilat) (1) ·
25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200, 300 mcg tablets; oral capsule and IV/IM also available (1) ·
5, 25, 50 mcg tablets (Cytomel); 10 mcg/mL IV (Triostat) (1) ·
IR 30, 60, 90, 120 mg tablets; multiple ER capsules and tablets 60-420 mg; IV 5 mg/mL (1) ·
IR 40, 80, 120 mg tablets; SR/ER 100-360 mg; IV 2.5 mg/mL (1)
fda max:
routes: (Click arrow to add another value)
onset:
BP effect 1 hour; max at 4-6 hours (1) ·
Hours (faster than T4); peak biologic activity 24-48 hours (1) ·
IV: 1-3 minutes (SVT termination); PO IR: 30-60 minutes; ER: hours (1) ·
IV: 3-7 minutes (rate control); PO IR: 30-60 minutes; ER: hours (1) ·
IV: 5-20 minutes; PO: 30-60 minutes (1) ·
TSH normalization 4-8 weeks; symptomatic improvement weeks to months (1)
duration:
halflife:
3-4.5 hours (IR); 5-7 hours (ER; effective duration 24 hours via formulation)'"`UNIQ--ref-00000642-QINU`"' (1) ·
3-7 hours (IR); functional 24 hours (ER)'"`UNIQ--ref-00000A6B-QINU`"' (1) ·
3-7 hours (slow acetylators) vs 1-3 hours (rapid acetylators) via NAT2 polymorphism'"`UNIQ--ref-00000687-QINU`"' (1) ·
~1 day (much shorter than T4's ~7 days)'"`UNIQ--ref-0000001A-QINU`"' (1) ·
~11 hours (enalaprilat, the active metabolite)'"`UNIQ--ref-00000B84-QINU`"' (1) ·
~7 days (euthyroid); longer in hypothyroidism (~9-10 days), shorter in hyperthyroidism'"`UNIQ--ref-00000036-QINU`"' (1)
bioavailability:
40-80% (oral); reduced by food, calcium, iron, PPIs, fiber; take fasting with water'"`UNIQ--ref-00000037-QINU`"' (1) ·
~20-35% (oral; extensive first-pass via CYP3A4 with R/S enantiomer differences)'"`UNIQ--ref-00000A6C-QINU`"' (1) ·
~25-50% (oral; substantial first-pass via NAT2 acetylation, phenotype-dependent)'"`UNIQ--ref-00000688-QINU`"' (1) ·
~40% (oral; extensive first-pass via CYP3A4)'"`UNIQ--ref-00000643-QINU`"' (1) ·
~60% (oral; food does not affect absorption)'"`UNIQ--ref-00000B85-QINU`"' (1) ·
~95% (oral)'"`UNIQ--ref-0000001B-QINU`"' (1)
pregnancy:
'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, skull hypoplasia, hypotension. Stop on detection'"`UNIQ--ref-00000B86-QINU`"' (1) ·
First-line in pregnancy; dose typically increased 25-30% due to estrogen-driven rise in TBG and fetal demand. Lactation safe at physiologic doses.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited data; alternative antihypertensives generally preferred. Crosses placenta.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited data; labetalol/nifedipine generally preferred. Crosses placenta.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
One of the historically preferred IV agents for severe hypertension in pregnancy alongside labetalol and nifedipine.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
T4 (levothyroxine) is the first-line in pregnancy; T3 is rarely needed.'"`UNIQ--ref-0000001C-QINU`"' (1)
Showing below up to 6 results in range #1 to #6.