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Medicines > classes : Antidepressant or [[:Category:Melatonin receptor agonists|Melatonin receptor agonist]] & routes: Oral

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generic:
Duloxetine (1) · Melatonin (N-acetyl-5-methoxytryptamine) (1) · Sertraline (1)
brand:
Cymbalta, Drizalma Sprinkle, Irenka, Yentreve (1) · Multiple OTC dietary supplement formulations (1) · Zoloft (1)
classes: (Click arrow to add another value)
mechanism:
None (1) · Serotonin–norepinephrine reuptake inhibition (balanced) (1) · TrkB/BDNF'"`UNIQ--ref-00000084-QINU`"' '"`UNIQ--vote-00000085-QINU`"' (1)
uses:
None (1) · Depression, anxiety, neuropathic pain, fibromyalgia, chronic musculoskeletal pain (1) · '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"' (1)
starting dose:
None (1) · 0.5-3 mg PO 30-60 minutes before bedtime. Some patients respond to micro-doses (0.3 mg) without additional benefit at higher doses. For circadian phase shifting, timing relative to dim-light melatonin onset matters more than absolute dose (1) · 25 mg (1)
preparations:
None (1) · 25 mg, 50 mg, 100 mg tablets; oral concentrate 20 mg/mL (1) · OTC tablets, sublingual tablets, gummies, liquid, extended-release tablets and capsules; common strengths 0.5, 1, 3, 5, 10 mg (1)
fda max:
None (1) · 200 mg/d (1) · Not formally established (dietary supplement); doses above ~3-5 mg show no additional efficacy but increase next-day sedation risk (1)
routes: (Click arrow to add another value)
onset:
30-60 minutes (immediate-release oral) (1) · Anxiolysis classically 3-4 weeks, continuing improvement to 8-12 weeks (1) · Mood: 2–4 weeks. Pain: often within 1–2 weeks. (1)
duration:
3-4 hours (1) · Chronic daily dosing (1) · Long (1)
halflife:
30-50 minutes (short)'"`UNIQ--ref-00000021-QINU`"' (1) · ~12 hours (1) · ~26 h (sertraline; range 13-45 h, longer in females); ~62-104 h (N-desmethylsertraline, weakly active) (1)
bioavailability:
Absolute bioavailability not precisely characterized; food modestly increases exposure (1) · ~15% (oral; highly variable due to extensive and variable first-pass metabolism)'"`UNIQ--ref-00000022-QINU`"' (1) · ~50% (highly variable) (1)
pregnancy:
Category C (1) · Category C'"`UNIQ--ref-0000008F-QINU`"' (1) · Limited human data; endogenous hormone, but supplemental pharmacological doses are not well characterized in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
Rx-only (1) · Rx-only in US (1) · [[USLegal:Over-the-counter|OTC]] dietary supplement in the US ('''not FDA-regulated as a medicine'''; multiple studies show OTC products contain 50-470% of labeled melatonin content); [[USLegal:Prescription only|Rx-only]] in the EU and UK (1)

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