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None (7) · Kappa agonist; mu antagonist (1) · Kappa agonist; mu partial agonist (1) · Kappa agonist; mu partial agonist/antagonist (1) · Mu-opioid agonist; norepinephrine reuptake inhibitor (1) · Mu-opioid receptor agonist (4) · Mu-opioid receptor agonist; NMDA antagonist (1) · Mu-opioid receptor agonist; prodrug (metabolized to morphine) (1) · Mu-opioid receptor agonist; sodium channel blocker (1) · Mu/kappa/delta agonist; NMDA antagonist (1) · Partial mu-opioid agonist; kappa antagonist (1) · Phosphodiesterase inhibitor; calcium channel blocker (1) · Potent mu-opioid receptor agonist (3) · Prodrug; converted to [[Morphine|morphine]] by [[Enzyme:CYP2D6|CYP2D6]] for analgesic action. (1) · '"`UNIQ--vote-0000004E-QINU`"' The EPA+DHA mix is biochemically and clinically distinct from icosapent ethyl'"`UNIQ--ref-0000004F-QINU`"'. (1) · '"`UNIQ--vote-000000F7-QINU`"' Minimal CYP3A4 dependence (CYP2C9 minor) reduces drug-drug interactions; transport in and out of hepatocytes is largely via OATP1B1, making SLCO1B1 PGx genotype the most clinically actionable marker for statin-associated myopathy'"`UNIQ--ref-000000F8-QINU`"'. (1) · '"`UNIQ--vote-000003D1-QINU`"' SLCO1B1 polymorphism affects exposure but is most clinically actionable for simvastatin'"`UNIQ--ref-000003D2-QINU`"'. (1) · '"`UNIQ--vote-000004A9-QINU`"' Modest HDL rise; LDL effects mixed. Renally cleared; combination with statin carries elevated myopathy risk (greater for gemfibrozil than fenofibrate, but caution still warranted)'"`UNIQ--ref-000004AA-QINU`"'. (1)

None (17) · 10 mg PO once daily, with or without food (1) · 10-20 mg PO once daily (1) · 10-20 mg PO once daily (5 mg in Asian ancestry, elderly, hypothyroidism, or strong CYP/SLCO1B1 interactions) (1) · 10-20 mg PO once daily in the evening (40 mg starting allowed for high CV risk) (1) · 140 mg SC every 2 weeks OR 420 mg SC monthly (3 consecutive injections 5 minutes apart due to volume) (1) · 2 g PO BID with meals (4 g/d total) (1) · 20 mg PO once daily with the evening meal; titrate to 40-80 mg/d (1) · 4 g PO daily (as 4 x 1 g capsules once daily, or 2 capsules BID) (1) · 40 mg PO once daily (10-20 mg in elderly, hepatic impairment, or strong drug interactions) (1) · Adult: 15–60 mg every 4 hours as needed. (1) · Niaspan ER 500 mg PO at bedtime, titrate weekly to 1-2 g/d; flushing-protective aspirin 30-60 minutes before dose; pellagra replacement 100-500 mg/d (1) · Varies by salt form and brand; e.g., Tricor 145 mg PO daily; reduce to 48 mg in renal impairment (1)

None (17) · 0.5 g, 1 g capsules (1) · 1 g soft gelatin capsules containing ~465 mg EPA + ~375 mg DHA as ethyl esters (1) · 10 mg tablet; also as fixed-dose combinations with simvastatin (Vytorin) and atorvastatin (Liptruzet, withdrawn US 2015 but generics exist) (1) · 10 mg, 20 mg, 40 mg, 80 mg tablets (2) · 10, 20, 40 mg tablets; 20, 40, 60 mg ER tablets (1) · 140 mg/mL single-use prefilled syringe and SureClick autoinjector; Pushtronex 420 mg/3.5 mL on-body infusor (1) · 5, 10, 20, 40 mg tablets (1) · 5, 10, 20, 40, 80 mg tablets; 4 mg/mL oral suspension (1) · Multiple non-bioequivalent fenofibrate and fenofibric acid formulations: 48-200 mg (1) · OTC IR niacin 50-500 mg tablets; Niaspan ER 500, 750, 1000 mg tablets; "no-flush" niacin (inositol hexaniacinate, lacks evidence) (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1)

None (17) · 10 mg/d (1) · 2 g/d (Niaspan); higher off-label use historical (1) · 360 mg/day (1) · 4 g/d (2) · 40 mg/d (rarely needed; 40 mg restricted to patients not at goal on 20 mg) (1) · 40 mg/d standard; 80 mg/d restricted to patients tolerating 80 mg for ≥12 months without myopathy (post-SEARCH 2011 FDA restriction) (1) · 420 mg/month (1) · 80 mg/d (2) · 80 mg/d (40 mg/d if combined with diltiazem, verapamil, danazol; lower limits with various interactions) (1) · Formulation-specific (e.g., 145 mg/d Tricor, 200 mg/d Lipofen) (1)

None (17) · Oral (10) · PO (only formulation marketed in the US). (1) · Subcutaneous (1)

None (17) · 30–60 min (PO) (1) · LDL lowering at 1 week, max by 4 weeks (1) · LDL lowering at 2 weeks, max by 4 weeks (3) · LDL lowering at 2 weeks, max by 4 weeks; cardiovascular benefit months to years (1) · LDL lowering within 2 weeks (1) · LDL reduction ~50-60% from baseline at 1-2 weeks (1) · Lipid changes 4-8 weeks (1) · Triglyceride lowering at 2-4 weeks; max at 8 weeks (1) · Triglyceride lowering at 4-8 weeks (1) · Triglyceride lowering at 4-8 weeks; CV benefit emerges over months (1)

None (17) · 12 hours (1) · 2-4 weeks per dose (1) · 24 hours (6) · 24 hours (evening dosing aligns with overnight HMG-CoA reductase peak) (1) · 24-48 hours per dose (1) · 4–6 hours (1) · Daily dosing (1)

None (17) · 14 hours (parent); 20-30 hours including active ortho- and para-hydroxylated metabolites'"`UNIQ--ref-0000001B-QINU`"' (1) · 2.5–3 hours (1) · Not well characterized; tissue incorporation over weeks'"`UNIQ--ref-00000051-QINU`"' (1) · ~1 hour (IR niacin); ER formulations extend functional duration'"`UNIQ--ref-00001038-QINU`"' (1) · ~11-17 days'"`UNIQ--ref-0000147F-QINU`"' (1) · ~19 hours'"`UNIQ--ref-000000FC-QINU`"' (1) · ~2 hours (parent and active β-hydroxy acid metabolite); pharmacodynamic effect lasts 24 hours via target turnover'"`UNIQ--ref-0000017A-QINU`"' (1) · ~2-3 hours (parent); pharmacodynamic effect 24 hours via target turnover'"`UNIQ--ref-000003D5-QINU`"' (1) · ~2-4 hours (parent and active β-hydroxy acid metabolite); pharmacodynamic effect 24 hours via target turnover'"`UNIQ--ref-00000807-QINU`"' (1) · ~20 hours (fenofibric acid, the active metabolite)'"`UNIQ--ref-000004AD-QINU`"' (1) · ~22 hours (parent + active glucuronide)'"`UNIQ--ref-00000450-QINU`"' (1) · ~89 hours (EPA, the active metabolite)'"`UNIQ--ref-000013D1-QINU`"' (1)

None (17) · <5% (extensive hepatic first-pass; food enhances absorption of IR, hence the evening-meal dosing)'"`UNIQ--ref-00000808-QINU`"' (1) · <5% (extensive hepatic first-pass; statin pharmacology is hepatocellular, not systemic)'"`UNIQ--ref-0000017B-QINU`"' (1) · High (oral; food enhances)'"`UNIQ--ref-00001039-QINU`"' (1) · Improved with food'"`UNIQ--ref-00000052-QINU`"' (1) · Increased with food (varies by formulation; the micronized and nanocrystal forms are less food-dependent)'"`UNIQ--ref-000004AE-QINU`"' (1) · Substantially improved with high-fat meal; take with food'"`UNIQ--ref-000013D2-QINU`"' (1) · Variable (oral; rapidly conjugated to active glucuronide; food does not affect)'"`UNIQ--ref-00000451-QINU`"' (1) · ~14% (extensive hepatic first-pass)'"`UNIQ--ref-0000001C-QINU`"' (1) · ~17% (oral; food slightly reduces absorption)'"`UNIQ--ref-000003D6-QINU`"' (1) · ~20% (oral; hydrophilic, minimal CYP metabolism, mostly excreted unchanged in bile)'"`UNIQ--ref-000000FD-QINU`"' (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1) · ~72% from SC depot'"`UNIQ--ref-00001480-QINU`"' (1)

None (17) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1) · Limited data.[[[Pharmacopedia:Citation needed|citation needed]]] (2) · Limited data; generally avoided particularly in combination with statin.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Limited data; generally avoided unless triglyceride pancreatitis risk is high.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Limited human data[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Pharmacologic doses generally avoided in pregnancy; vitamin doses fine.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021. Use individualized.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021. Use individualized; lactation generally avoided.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021.[[[Pharmacopedia:Citation needed|citation needed]]] (3)

None (17) · OTC (low-dose, dietary supplement) and [[USLegal:Prescription only|Rx-only]] (Niaspan ER) in US (1) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1) · [[USLegal:Prescription only|Rx-only]] in US (10)