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Medicines > classes : Anti-amyloid beta (Aβ) monoclonal antibody or Anticonvulsant or Opioid

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generic:
None (3) · Codeine (2)
brand:
None (12)
classes: (Click arrow to add another value)
mechanism:
Potent mu-opioid receptor agonist (6) · Mu-opioid receptor agonist (4) · None (2) · Sodium channel blocker (2)
uses:
None (48) · Alzheimer disease (FDA accelerated approval June 2021; '''withdrawn from market January 2024''' by manufacturer Biogen). At time of approval indicated for MCI or mild dementia stage of AD. (1) · 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) · Mild to moderate pain; cough suppression (low-dose). (1)
starting dose:
None (48) · 10 mg/kg IV every 2 weeks (1) · 700 mg IV q4w × 3 doses, then 1400 mg IV q4w; may discontinue when amyloid PET shows clearance (1) · Adult: 15–60 mg every 4 hours as needed. (1) · Was 1 mg/kg IV q4w × 2, then 3 mg/kg × 2, then 6 mg/kg × 2, then 10 mg/kg q4w (1)
preparations:
None (48) · 200 mg/2 mL, 500 mg/5 mL vials for IV infusion (1) · 350 mg/20 mL vial for IV infusion (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1) · Was: 170 mg/1.7 mL, 300 mg/3 mL vials for IV infusion (1)
fda max:
None (48) · 10 mg/kg q2w (1) · 1400 mg q4w (1) · 360 mg/day (1) · Withdrawn 2024 (1)
routes:
None (48) · IV infusion (60 min) every 2 weeks; outpatient or infusion-center setting (1) · IV infusion every 4 weeks (2) · PO (only formulation marketed in the US). (1)
onset:
None (48) · 30–60 min (PO) (1) · Amyloid PET clearance within months; cognitive benefit over 18 months (1) · PET Aβ reduction over months (1) · Slowing of cognitive decline over 18 months (modest effect, ~27% relative slowing) (1)
duration:
None (48) · 4–6 hours (1) · Ongoing dosing (1) · Treatment can be discontinued upon achieving amyloid clearance (1) · Withdrawn (1)
halflife:
None (48) · 2.5–3 hours (1) · ~12.1 days (1) · ~25 days (1) · ~5-7 days (1)
bioavailability:
None (48) · 100% (IV) (3) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1)
pregnancy:
None (48) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1) · Discontinued/withdrawn (1) · Limited data (2)
legal:
None (48) · Rx; ARIA monitoring required (1) · Rx; REMS-like program for ARIA monitoring (1) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1) · Withdrawn from US market January 2024 (1)

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