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: Antidepressant

or [[:Category:Lipid-lowering_agents|Lipid-lowering agent]]

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Agomelatine (1) · Amoxapine (1) · Atorvastatin (1) · Clomipramine (1) · Desipramine (1) · Duloxetine (1) · Evolocumab (1) · Ezetimibe (1) · Fenofibrate (1) · Icosapent ethyl (eicosapentaenoic acid ethyl ester, EPA-EE) (1) · Imipramine (1) · Isocarboxazid (1) · Levomilnacipran (1) · Lovastatin (1) · Maprotiline (1) · Milnacipran (1) · Moclobemide (1) · Nefazodone (1) · Niacin (nicotinic acid, vitamin B3) (1) · Omega-3-acid ethyl esters (1) · Phenelzine (1) · Pravastatin (1) · Protriptyline (1) · Reboxetine (1) · Rosuvastatin (1) · Sertraline (1) · Simvastatin (1) · Tianeptine (1) · Tranylcypromine (1) · Trimipramine (1)

None (1) · Altoprev (ER), Mevacor (discontinued US); mostly generic (1) · Anafranil (1) · Aurorix (1) · Crestor, Ezallor (1) · Cymbalta, Drizalma Sprinkle, Irenka, Yentreve (1) · Edronax (1) · Fetzima (1) · Lipitor (1) · Lovaza, Omtryg (1) · Ludiomil (1) · Marplan (1) · Nardil (1) · Niaspan (ER, Rx), Niacor (IR, Rx); huge OTC presence (1) · Norpramin (1) · Parnate (1) · Pravachol (1) · Repatha (1) · Savella (1) · Serzone (1) · Stablon (1) · Surmontil (1) · Tofranil (1) · Tricor, Lipofen, Antara, Fenoglide, Lofibra, Triglide, Trilipix (fenofibric acid) (1) · Valdoxan (1) · Vascepa (1) · Vivactil (1) · Zetia (1) · Zocor (1) · Zoloft (1)

None (7) · Irreversible non-selective MAO inhibitor (3) · Melatonin receptor agonist; 5-HT2C antagonist (1) · Mu-opioid agonist; modulates glutamate AMPA receptors (1) · Potent serotonin reuptake inhibitor; also NRI (1) · Reversible inhibitor of MAO-A (1) · Selective norepinephrine reuptake inhibitor (3) · Serotonin and norepinephrine reuptake inhibitor (3) · Serotonin reuptake inhibitor and 5-HT2A antagonist (1) · Serotonin–norepinephrine reuptake inhibition (balanced) (1) · Serotonin–norepinephrine reuptake inhibitor (2) · TrkB/BDNF'"`UNIQ--ref-00000084-QINU`"' '"`UNIQ--vote-00000085-QINU`"' (1) · Weak SRI; primarily H1/D2/alpha antagonist (1) · '"`UNIQ--vote-0000004E-QINU`"' The EPA+DHA mix is biochemically and clinically distinct from icosapent ethyl'"`UNIQ--ref-0000004F-QINU`"'. (1) · '"`UNIQ--vote-000000F7-QINU`"' Minimal CYP3A4 dependence (CYP2C9 minor) reduces drug-drug interactions; transport in and out of hepatocytes is largely via OATP1B1, making SLCO1B1 PGx genotype the most clinically actionable marker for statin-associated myopathy'"`UNIQ--ref-000000F8-QINU`"'. (1) · '"`UNIQ--vote-000003D1-QINU`"' SLCO1B1 polymorphism affects exposure but is most clinically actionable for simvastatin'"`UNIQ--ref-000003D2-QINU`"'. (1) · '"`UNIQ--vote-000004A9-QINU`"' Modest HDL rise; LDL effects mixed. Renally cleared; combination with statin carries elevated myopathy risk (greater for gemfibrozil than fenofibrate, but caution still warranted)'"`UNIQ--ref-000004AA-QINU`"'. (1)

None (18) · 10 mg PO once daily, with or without food (1) · 10-20 mg PO once daily (1) · 10-20 mg PO once daily (5 mg in Asian ancestry, elderly, hypothyroidism, or strong CYP/SLCO1B1 interactions) (1) · 10-20 mg PO once daily in the evening (40 mg starting allowed for high CV risk) (1) · 140 mg SC every 2 weeks OR 420 mg SC monthly (3 consecutive injections 5 minutes apart due to volume) (1) · 2 g PO BID with meals (4 g/d total) (1) · 20 mg PO once daily with the evening meal; titrate to 40-80 mg/d (1) · 25 mg (1) · 4 g PO daily (as 4 x 1 g capsules once daily, or 2 capsules BID) (1) · 40 mg PO once daily (10-20 mg in elderly, hepatic impairment, or strong drug interactions) (1) · Niaspan ER 500 mg PO at bedtime, titrate weekly to 1-2 g/d; flushing-protective aspirin 30-60 minutes before dose; pellagra replacement 100-500 mg/d (1) · Varies by salt form and brand; e.g., Tricor 145 mg PO daily; reduce to 48 mg in renal impairment (1)

None (18) · 0.5 g, 1 g capsules (1) · 1 g soft gelatin capsules containing ~465 mg EPA + ~375 mg DHA as ethyl esters (1) · 10 mg tablet; also as fixed-dose combinations with simvastatin (Vytorin) and atorvastatin (Liptruzet, withdrawn US 2015 but generics exist) (1) · 10 mg, 20 mg, 40 mg, 80 mg tablets (2) · 10, 20, 40 mg tablets; 20, 40, 60 mg ER tablets (1) · 140 mg/mL single-use prefilled syringe and SureClick autoinjector; Pushtronex 420 mg/3.5 mL on-body infusor (1) · 25 mg, 50 mg, 100 mg tablets; oral concentrate 20 mg/mL (1) · 5, 10, 20, 40 mg tablets (1) · 5, 10, 20, 40, 80 mg tablets; 4 mg/mL oral suspension (1) · Multiple non-bioequivalent fenofibrate and fenofibric acid formulations: 48-200 mg (1) · OTC IR niacin 50-500 mg tablets; Niaspan ER 500, 750, 1000 mg tablets; "no-flush" niacin (inositol hexaniacinate, lacks evidence) (1)

None (18) · 10 mg/d (1) · 2 g/d (Niaspan); higher off-label use historical (1) · 200 mg/d (1) · 4 g/d (2) · 40 mg/d (rarely needed; 40 mg restricted to patients not at goal on 20 mg) (1) · 40 mg/d standard; 80 mg/d restricted to patients tolerating 80 mg for ≥12 months without myopathy (post-SEARCH 2011 FDA restriction) (1) · 420 mg/month (1) · 80 mg/d (2) · 80 mg/d (40 mg/d if combined with diltiazem, verapamil, danazol; lower limits with various interactions) (1) · Formulation-specific (e.g., 145 mg/d Tricor, 200 mg/d Lipofen) (1)

None (17) · Oral (12) · Subcutaneous (1)

None (17) · Anxiolysis classically 3-4 weeks, continuing improvement to 8-12 weeks (1) · LDL lowering at 1 week, max by 4 weeks (1) · LDL lowering at 2 weeks, max by 4 weeks (3) · LDL lowering at 2 weeks, max by 4 weeks; cardiovascular benefit months to years (1) · LDL lowering within 2 weeks (1) · LDL reduction ~50-60% from baseline at 1-2 weeks (1) · Lipid changes 4-8 weeks (1) · Mood: 2–4 weeks. Pain: often within 1–2 weeks. (1) · Triglyceride lowering at 2-4 weeks; max at 8 weeks (1) · Triglyceride lowering at 4-8 weeks (1) · Triglyceride lowering at 4-8 weeks; CV benefit emerges over months (1)

None (17) · 12 hours (1) · 2-4 weeks per dose (1) · 24 hours (6) · 24 hours (evening dosing aligns with overnight HMG-CoA reductase peak) (1) · 24-48 hours per dose (1) · Chronic daily dosing (1) · Daily dosing (1) · Long (1)

None (17) · 14 hours (parent); 20-30 hours including active ortho- and para-hydroxylated metabolites'"`UNIQ--ref-0000001B-QINU`"' (1) · Not well characterized; tissue incorporation over weeks'"`UNIQ--ref-00000051-QINU`"' (1) · ~1 hour (IR niacin); ER formulations extend functional duration'"`UNIQ--ref-00001038-QINU`"' (1) · ~11-17 days'"`UNIQ--ref-0000147F-QINU`"' (1) · ~12 hours (1) · ~19 hours'"`UNIQ--ref-000000FC-QINU`"' (1) · ~2 hours (parent and active β-hydroxy acid metabolite); pharmacodynamic effect lasts 24 hours via target turnover'"`UNIQ--ref-0000017A-QINU`"' (1) · ~2-3 hours (parent); pharmacodynamic effect 24 hours via target turnover'"`UNIQ--ref-000003D5-QINU`"' (1) · ~2-4 hours (parent and active β-hydroxy acid metabolite); pharmacodynamic effect 24 hours via target turnover'"`UNIQ--ref-00000807-QINU`"' (1) · ~20 hours (fenofibric acid, the active metabolite)'"`UNIQ--ref-000004AD-QINU`"' (1) · ~22 hours (parent + active glucuronide)'"`UNIQ--ref-00000450-QINU`"' (1) · ~26 h (sertraline; range 13-45 h, longer in females); ~62-104 h (N-desmethylsertraline, weakly active) (1) · ~89 hours (EPA, the active metabolite)'"`UNIQ--ref-000013D1-QINU`"' (1)

None (17) · <5% (extensive hepatic first-pass; food enhances absorption of IR, hence the evening-meal dosing)'"`UNIQ--ref-00000808-QINU`"' (1) · <5% (extensive hepatic first-pass; statin pharmacology is hepatocellular, not systemic)'"`UNIQ--ref-0000017B-QINU`"' (1) · Absolute bioavailability not precisely characterized; food modestly increases exposure (1) · High (oral; food enhances)'"`UNIQ--ref-00001039-QINU`"' (1) · Improved with food'"`UNIQ--ref-00000052-QINU`"' (1) · Increased with food (varies by formulation; the micronized and nanocrystal forms are less food-dependent)'"`UNIQ--ref-000004AE-QINU`"' (1) · Substantially improved with high-fat meal; take with food'"`UNIQ--ref-000013D2-QINU`"' (1) · Variable (oral; rapidly conjugated to active glucuronide; food does not affect)'"`UNIQ--ref-00000451-QINU`"' (1) · ~14% (extensive hepatic first-pass)'"`UNIQ--ref-0000001C-QINU`"' (1) · ~17% (oral; food slightly reduces absorption)'"`UNIQ--ref-000003D6-QINU`"' (1) · ~20% (oral; hydrophilic, minimal CYP metabolism, mostly excreted unchanged in bile)'"`UNIQ--ref-000000FD-QINU`"' (1) · ~50% (highly variable) (1) · ~72% from SC depot'"`UNIQ--ref-00001480-QINU`"' (1)

None (17) · Category C (1) · Category C'"`UNIQ--ref-0000008F-QINU`"' (1) · Limited data.[[[Pharmacopedia:Citation needed|citation needed]]] (2) · Limited data; generally avoided particularly in combination with statin.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Limited data; generally avoided unless triglyceride pancreatitis risk is high.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Limited human data[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Pharmacologic doses generally avoided in pregnancy; vitamin doses fine.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021. Use individualized.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021. Use individualized; lactation generally avoided.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021.[[[Pharmacopedia:Citation needed|citation needed]]] (3)

None (17) · OTC (low-dose, dietary supplement) and [[USLegal:Prescription only|Rx-only]] (Niaspan ER) in US (1) · Rx-only (1) · Rx-only in US (1) · [[USLegal:Prescription only|Rx-only]] in US (10)