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Drilldown: Medicines

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Medicines > classes : Analgesic or Dissociative or Empathogen

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generic:
Codeine (2)
brand:
None (38) · (multiple, generic dominant) (1) · Darvon (1) · Demerol (1) · Dilaudid (1) · Dolophine (1) · Duragesic (1) · DXM (1) · DXO (1) · Nubain (1) · Nucynta (1) · Opana (1) · Spravato (1) · Stadol (1) · Suboxone (1) · Talwin (1) · Vicodin (1)
classes: (Click arrow to add another value)
mechanism:
None (1) · Active metabolite of DXM; NMDA antagonist (1) · Contains salvinorin A (1) · Kappa agonist; mu antagonist (1) · Kappa agonist; mu partial agonist (1) · Kappa agonist; mu partial agonist/antagonist (1) · Kappa-opioid agonist; NMDA antagonist; SERT/DAT/NET inhibitor (1) · Kappa-opioid receptor agonist (1) · MAO inhibitor; monoamine releasing agent (1) · MAO inhibitor; serotonin releasing agent (1) · Monoamine releasing agent (3) · Monoamine releasing agent; 5-HT2A agonist (1) · Monoamine releasing agent; serotonergic at higher doses (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) · NMDA antagonist (3) · NMDA antagonist; endogenous opioid releaser (1) · NMDA antagonist; fluorinated ketamine analogue (1) · NMDA antagonist; kappa-opioid agonist (1) · NMDA antagonist; ketamine analogue (1) · NMDA antagonist; more stimulating than PCP (1) · NMDA antagonist; opioid agonist (1) · NMDA antagonist; potent opioid agonist (1) · NMDA antagonist; SERT inhibitor; sigma-1 agonist (1) · NMDA antagonist; sigma receptor agonist (2) · NMDA antagonist; sigma receptor agonist; dopaminergic (1) · NMDA antagonist; sigma-1 agonist; serotonin reuptake inhibitor (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) · Serotonin releasing agent (2) · Serotonin releasing agent; 5-HT2A agonist (3) · Serotonin/dopamine/norepinephrine releasing agent; 5-HT2A agonist (1) · Serotonin/norepinephrine/dopamine releasing agent (3)
uses:
None (52) · Mild to moderate pain; cough suppression (low-dose). (1) · Treatment-resistant depression (TRD) in adults, as adjunct to oral antidepressant (FDA-approved March 2019). Depressive symptoms in adults with MDD with acute suicidal ideation or behavior (FDA-approved Aug 2020). (1)
starting dose:
None (52) · Adult: 15–60 mg every 4 hours as needed. (1) · Induction (TRD): 56 mg intranasal twice weekly × 4 weeks. Maintenance: 56-84 mg once weekly × 4 weeks, then 56-84 mg every 1-2 weeks. For acute suicidality: 84 mg twice weekly × 4 weeks. Administered under medical supervision in REMS-certified site. (1)
preparations:
None (52) · 28 mg/device (each dose uses 2 devices) (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1)
fda max:
None (52) · 360 mg/day (1) · 84 mg per session (1)
routes:
None (52) · Intranasal (under direct medical supervision) (1) · PO (only formulation marketed in the US). (1)
onset:
None (52) · 30–60 min (PO) (1) · Within hours of first administration (1)
duration:
None (52) · 4–6 hours (1) · Acute effect ~24 hours; cumulative effect builds with repeated dosing (1)
halflife:
None (52) · 2.5–3 hours (1) · ~7-12 hours (1)
bioavailability:
None (52) · ~48% intranasal (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1)
pregnancy:
None (52) · Avoid; may cause fetal harm (1) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1)
legal:
None (52) · Rx, Schedule III (US). REMS program required. (1) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1)

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