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Drilldown: Medicines

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Medicines > classes : Anticonvulsant or Neuroactive steroid or Opioid

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generic:
None (2) · Codeine (2)
brand:
None (12)
classes: (Click arrow to add another value)
mechanism:
Potent mu-opioid receptor agonist (6) · Mu-opioid receptor agonist (4) · Sodium channel blocker (2)
uses:
None (50) · Mild to moderate pain; cough suppression (low-dose). (1) · Postpartum depression (PPD) in adults (1) · Postpartum depression (PPD) in adults (FDA-approved 2023) (1)
starting dose:
None (50) · 50 mg PO once daily with fatty food in the evening × 14 days (1) · Adult: 15–60 mg every 4 hours as needed. (1) · Single 60-hour continuous IV infusion: 30 mcg/kg/h × 4h → 60 mcg/kg/h × 20h → 90 mcg/kg/h × 28h → 60 mcg/kg/h × 4h → 30 mcg/kg/h × 4h (1)
preparations:
None (50) · 100 mg/20 mL vial, single-use (1) · 20 mg, 25 mg, 30 mg capsules (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1)
fda max:
None (50) · 360 mg/day (1) · 50 mg/d × 14 d (1) · Single 60-hour course (1)
routes:
None (50) · Intravenous (continuous infusion in a REMS-certified facility) (1) · Oral (1) · PO (only formulation marketed in the US). (1)
onset:
None (50) · 30–60 min (PO) (1) · Antidepressant effect within hours of infusion start; sustained at 30 days (1) · Day 3 of dosing in trials; sustained through day 45 (1)
duration:
None (50) · 14-day course; effect persists after discontinuation in trials (1) · 4–6 hours (1) · Single infusion course (1)
halflife:
None (50) · 2.5–3 hours (1) · ~16-23 hours (1) · ~9 hours (terminal) (1)
bioavailability:
None (50) · 100% (IV) (1) · Adequate (food-dependent, must take with fatty meal) (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1)
pregnancy:
None (50) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1) · Limited data; avoid in pregnancy. Lactation: present in milk; consider risks (1) · Medicine is structurally identical to endogenous allopregnanolone; pregnancy considerations relate to breastfeeding during/after infusion. Limited data; brief interruption of breastfeeding considered (1)
legal:
None (50) · Rx, Schedule IV (US) (1) · Rx; REMS program required (excessive sedation/loss of consciousness during infusion) (1) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1)

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