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Medicines > classes : Anti-amyloid beta (Aβ) monoclonal antibody or Antiparkinsonian or Research material

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generic:
None (3)
brand:
None (131) · (none, never marketed) (1) · Aduhelm (1) · Akineton (1) · Apokyn (1) · Artane (1) · Azilect (1) · Cogentin (1) · Comtan (1) · Dostinex (1) · Eldepryl (1) · Kisunla (1) · Leqembi (1) · Neupro (1) · O-DSMT (1) · Ongentys (1) · Parlodel (1) · Sinemet (1) · Symmetrel (1) · Tasmar (1) · Xadago (1)
classes: (Click arrow to add another value)
mechanism:
5-HT2A agonist (26) · Monoamine releasing agent (9) · GABAA positive allosteric modulator (8) · CB1/CB2 agonist (7) · Dopamine/norepinephrine reuptake inhibitor (5) · Potent 5-HT2A agonist (5) · LSD analogue; 5-HT2A agonist (4) · Prodrug of LSD; 5-HT2A agonist (4) · Serotonin/norepinephrine/dopamine releasing agent (3) · None (2) · Cathinone analogue; monoamine reuptake inhibitor (2) · Dopamine and norepinephrine reuptake inhibitor (2) · Irreversible selective MAO-B inhibitor (2) · NMDA antagonist (2) · Prodrug of GHB (2)
uses:
None (147) · Alzheimer disease (FDA accelerated approval June 2021; '''withdrawn from market January 2024''' by manufacturer Biogen).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) · No approved medical problem. Encountered as a designer/research benzodiazepine and, increasingly, as an adulterant in illicit opioid supplies. (1)
starting dose:
None (147) · 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) · No medical dose. Active recreational doses reported in the 0.5–1.5 mg range (similar potency to alprazolam). (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 (147) · 200 mg/2 mL, 500 mg/5 mL vials for IV infusion (1) · 350 mg/20 mL vial for IV infusion (1) · Illicit tablets ("bars"), powders, blotter, occasionally solutions. No pharmaceutical product exists. (1) · Was: 170 mg/1.7 mL, 300 mg/3 mL vials for IV infusion (1)
fda max:
None (147) · 10 mg/kg q2w (1) · 1400 mg q4w (1) · N/A (never approved) (1) · Withdrawn 2024 (1)
routes:
None (147) · intranasal; rectal and IV reported. (1) · IV infusion (60 min) every 2 weeks; outpatient or infusion-center setting (1) · IV infusion every 4 weeks (2) · Oral (1) · sublingual (1)
onset:
None (147) · 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) · ~20–40 min PO; faster sublingual/intranasal. (1)
duration:
None (147) · 6–10 h subjective; full pharmacologic effect considerably longer. (1) · Ongoing dosing (1) · Treatment can be discontinued upon achieving amyloid clearance (1) · Withdrawn (1)
halflife:
None (147) · Estimated ~12–17 h (some sources cite up to ~21 h); active metabolites prolong effect. (1) · ~12.1 days (1) · ~25 days (1) · ~5-7 days (1)
bioavailability:
None (147) · 100% (IV) (3) · Not formally characterized in humans. (1)
pregnancy:
None (147) · 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) · Discontinued/withdrawn (1) · Limited data (2)
legal:
None (148) · Rx; ARIA monitoring required (1) · Rx; REMS-like program for ARIA monitoring (1) · Withdrawn from US market January 2024 (1)

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