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Medicines (732)

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: Analgesic

or Sedative-hypnotic

or [[:Category:Schedule II controlled substances|Schedule II controlled substance]]

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Codeine (2)

None (14) · (multiple, generic dominant) (1) · (none, never marketed) (1) · Dalmane (1) · Darvon (1) · Demerol (1) · Dilaudid (1) · Dolophine, Methadose, Diskets (oral dispersible tablets for OTPs) (1) · Doral (1) · Doriden (1) · Duragesic (1) · Halcion (1) · Hetlioz (1) · Imovane (1) · Lunesta (1) · Mogadon (1) · MS Contin (ER), Kadian (ER), Avinza (ER), Roxanol (IR oral solution), Duramorph (epidural / IT), Astramorph (IV), Infumorph (intrathecal pump), MorphaBond (IR abuse-deterrent) (1) · Nembutal (1) · Nubain (1) · Nucynta (1) · Opana (1) · OxyContin (ER), Roxicodone (IR), Oxaydo (IR abuse-deterrent), Xtampza ER (abuse-deterrent ER) (1) · Placidyl (1) · ProSom (1) · Quaalude (1) · Restoril (1) · Rohypnol (1) · Rozerem (1) · Seconal (1) · Sonata (1) · Stadol (1) · Talwin (1) · THIP (1) · Versed (1) · Vicodin (1) · Vyvanse, Elvanse (EU) (1) · Xyrem (1)

None (5) · Extremely potent GABAA positive allosteric modulator (1) · GABAA positive allosteric modulator (15) · GABAA positive allosteric modulator (non-benzodiazepine) (3) · GABAA positive allosteric modulator; very long half-life (1) · GABAA potentiator (1) · GABAA potentiator and direct activator (2) · GABAB agonist; GHB receptor agonist (1) · Kappa agonist; mu antagonist (1) · Kappa agonist; mu partial agonist (1) · Kappa agonist; mu partial agonist/antagonist (1) · Melatonin receptor agonist (2) · Mu-opioid agonist; norepinephrine reuptake inhibitor (1) · Mu-opioid receptor agonist (4) · Mu-opioid receptor agonist; prodrug (metabolized to morphine) (1) · Mu-opioid receptor agonist; sodium channel blocker (1) · Mu/kappa/delta agonist; NMDA antagonist (1) · Phosphodiesterase inhibitor; calcium channel blocker (1) · Positive allosteric modulator of the GABAA receptor at the benzodiazepine binding site; increases frequency of Cl− channel opening, producing anxiolytic, sedative, hypnotic, anticonvulsant, and skeletal-muscle relaxant effects. (1) · Potent mu-opioid receptor agonist (3) · Prodrug; converted to [[Morphine|morphine]] by [[Enzyme:CYP2D6|CYP2D6]] for analgesic action. (1) · Selective GABAA agonist (extrasynaptic delta subunit) (1) · '"`UNIQ--vote-00000013-QINU`"' Once converted, dextroamphetamine acts by displacing dopamine and norepinephrine from presynaptic vesicles via VMAT-2 and reversing DAT and NET transport, the shared mechanism of all amphetamine-class agents'"`UNIQ--ref-00000014-QINU`"'. (1)

None (45) · ADHD: 30 mg PO once daily in the morning; titrate by 10-20 mg weekly to clinical effect. Binge-eating disorder: 30 mg/day, titrate to 50-70 mg/day (1) · Adult: 15–60 mg every 4 hours as needed. (1) · IR opioid-naive: 5-10 mg PO every 4-6 hours as needed. ER opioid-naive: '''10 mg PO every 12 hours (lowest available)'''; titrate slowly to clinical effect (1) · IR oral: 15-30 mg every 4 hours as needed. ER opioid-naive: 15-30 mg every 12 hours. IV/IM/SC: 2-10 mg every 3-4 hours. Epidural / intrathecal: see surgical or palliative-care protocols (1) · No medical dose. Active recreational doses reported in the 0.5–1.5 mg range (similar potency to alprazolam). (1)

None (44) · Capsules 10, 20, 30, 40, 50, 60, 70 mg; chewable tablets 10, 20, 30, 40, 50, 60 mg (1) · Illicit tablets ("bars"), powders, blotter, occasionally solutions. No pharmaceutical product exists. (1) · IR tablets 15, 30 mg; oral solution 10 mg/5 mL, 20 mg/mL, 100 mg/5 mL (concentrated); suppositories; ER tablets and capsules in multiple strengths; injectable 0.5-50 mg/mL (1) · IR tablets 5, 7.5, 10, 15, 20, 30 mg; IR oral solution 5 mg/5 mL; concentrated solution 20 mg/mL; OxyContin ER tablets 10, 15, 20, 30, 40, 60, 80 mg; Xtampza ER capsules (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1) · Tablets 5, 10, 40 mg (40 mg dispersible restricted to OTPs); oral concentrate 10 mg/mL; oral solution 1, 2, 10 mg/mL; injection 10 mg/mL (1)

None (44) · 360 mg/day (1) · 70 mg/day (1) · N/A (never approved) (1) · No fixed ceiling; titrate to clinical effect and tolerability with CDC opioid prescribing guidance constraints on morphine-milligram-equivalent (MME) totals (2) · No formal hard ceiling; in MOUD maintenance, doses typically remain at or below 120 mg/day with higher doses reserved for documented under-treatment after careful clinical assessment (1)

None (44) · epidural (1) · IM (1) · intramuscular (1) · intranasal; rectal and IV reported. (1) · intrathecal (1) · intravenous (1) · IV (1) · Oral (4) · Oral (primary) (1) · PO (only formulation marketed in the US). (1) · rectal (1) · SC (1) · subcutaneous (1) · sublingual (1) · sublingual; rectal off-label (1)

None (44) · 1-2 hours (slower than immediate-release amphetamine because activation requires enzymatic cleavage in red blood cells) (1) · 10-30 minutes (IR) (1) · 30–60 min (PO) (1) · 5-10 minutes (IV); 30 minutes (oral IR); slower for ER and rectal (1) · Oral analgesic effect 30-60 minutes; opioid-withdrawal suppression 30 minutes (oral); IV ~10 minutes (1) · ~20–40 min PO; faster sublingual/intranasal. (1)

None (44) · 10-12 hours (smoother profile than immediate-release amphetamine salts) (1) · 3-5 hours (IR); 8-24 hours (ER); 12-24 hours (epidural / intrathecal) (1) · 4-6 hours (IR); 12 hours (ER) (1) · 4–6 hours (1) · 6–10 h subjective; full pharmacologic effect considerably longer. (1) · Analgesic effect 4-8 hours (much shorter than half-life would suggest, due to receptor kinetics); MOUD effect (opioid withdrawal suppression) 24-36 hours per single daily dose (1)

None (45) · 2.5–3 hours (1) · 3-5 hours (IR); 4.5 hours (ER)'"`UNIQ--ref-0000001D-QINU`"' (1) · Estimated ~12–17 h (some sources cite up to ~21 h); active metabolites prolong effect. (1) · Morphine 2-4 hours; morphine-6-glucuronide active metabolite 2-4 hours (longer with renal impairment)'"`UNIQ--ref-00000020-QINU`"' (1) · Parent lisdexamfetamine <1 hour; dextroamphetamine 10-12 hours after release'"`UNIQ--ref-00000017-QINU`"' (1)

None (44) · Not formally characterized in humans. (1) · ~25-40% (oral; extensive first-pass)'"`UNIQ--ref-00000021-QINU`"' (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1) · ~60-87% (oral; high and more consistent than codeine or hydrocodone, making efficacy less CYP2D6-genotype-dependent)'"`UNIQ--ref-0000001E-QINU`"' (1) · ~70-85% (oral, high relative to other opioids) (1) · ~96% after red blood cell hydrolytic cleavage releases dextroamphetamine'"`UNIQ--ref-00000018-QINU`"' (1)

None (45) · Avoid. Benzodiazepines are associated with neonatal sedation, floppy-infant syndrome, and withdrawal; teratogenic signal weak but non-zero. Designer benzo with no safety data, assume worst-case. (1) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1) · Chronic third-trimester exposure produces neonatal opioid withdrawal syndrome and respiratory depression at delivery.[[[Pharmacopedia:Citation needed|citation needed]]] (2) · Limited human data; the amphetamine class is associated with intrauterine growth restriction and neonatal withdrawal symptoms.[[[Pharmacopedia:Citation needed|citation needed]]] (1)

None (46) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1) · [[USLegal:Schedule II|Schedule II controlled substance]] in US; WHO essential medicine'"`UNIQ--ref-00000022-QINU`"' (1) · [[USLegal:Schedule II|Schedule II controlled substance]] in US'"`UNIQ--ref-00000019-QINU`"' (1) · [[USLegal:Schedule II|Schedule II controlled substance]] in US'"`UNIQ--ref-0000001F-QINU`"' (1)

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