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Medicines > classes : Benzodiazepine or Research material or None

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generic:
brand:
None (135) · (none, never marketed) (1) · Dalmane (1) · Doral (1) · Halcion (1) · ketalar (1) · Laudanum, Dropizol (1) · Lexotan (1) · Librium (1) · Lithobid (1) · Mogadon (1) · Nuedexta (1) · O-DSMT (1) · Onfi (1) · ProSom (1) · Restoril (1) · Rohypnol (1) · Serax (1) · Tranxene (1) · Ultracet, Tramacet (1) · Versed (1) · Xanax (1)
classes: (Click arrow to add another value)
mechanism:
5-HT2A agonist (26) · GABAA positive allosteric modulator (21) · Monoamine releasing agent (9) · 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) · Cathinone analogue; monoamine reuptake inhibitor (2) · Dopamine and norepinephrine reuptake inhibitor (2) · NMDA antagonist (2) · Prodrug of GHB (2)
uses:
None (150) · Antimanic, Antidepressive, Antisuicide (1) · No approved medical problem. Encountered as a designer/research benzodiazepine and, increasingly, as an adulterant in illicit opioid supplies. (1) · Pain, cough, disquiet (1) · '"`UNIQ--vote-00000069-QINU`"', '"`UNIQ--vote-0000006A-QINU`"', '"`UNIQ--vote-0000006B-QINU`"' (1) · '"`UNIQ--vote-0000152F-QINU`"' (1) · '"`UNIQ--vote-00001582-QINU`"' (1)
starting dose:
None (152) · 0.25 mg (1) · 1 capsule (20/10 mg dextromethorphan/quinidine) PO once daily × 7 days, then 1 capsule BID (1) · 2 tablets (75 mg tramadol / 650 mg acetaminophen) PO every 4-6 hours as needed; maximum 8 tablets/day for ≤5 days (1) · No medical dose. Active recreational doses reported in the 0.5–1.5 mg range (similar potency to alprazolam). (1)
preparations:
None (152) · 0.25 mg, 0.5 mg, 1 mg, 2 mg tablets (immediate-release and orally disintegrating); 0.5 mg, 1 mg, 2 mg, 3 mg extended-release tablets; 1 mg/mL oral concentrate (1) · 20 mg dextromethorphan HBr / 10 mg quinidine sulfate capsules (1) · Illicit tablets ("bars"), powders, blotter, occasionally solutions. No pharmaceutical product exists. (1) · Tramadol/acetaminophen 37.5/325 mg tablets (1)
fda max:
None (152) · 1 capsule BID (40 mg DXM / 20 mg quinidine per day) (1) · 10 mg/d (1) · 8 tablets/d (300 mg tramadol / 2600 mg acetaminophen); 5-day duration limit per label (1) · N/A (never approved) (1)
routes:
None (152) · intranasal; rectal and IV reported. (1) · Oral (4) · sublingual (1)
onset:
None (152) · 30-60 min (immediate-release); 1-2 h (extended-release) (1) · 30-60 minutes (1) · PBA episode reduction within 1-2 weeks (1) · ~20–40 min PO; faster sublingual/intranasal. (1)
duration:
None (152) · 12 hours (1) · 4-6 hours (1) · 6 h (immediate-release); ~11 h (extended-release) (1) · 6–10 h subjective; full pharmacologic effect considerably longer. (1)
halflife:
None (152) · 11-13 h (immediate-release); 11-16 h (extended-release) (1) · Dextromethorphan substantially prolonged by quinidine's CYP2D6 inhibition (typical extensive metabolizers see ~10× higher AUC); quinidine ~6-8 hours'"`UNIQ--ref-00001583-QINU`"' (1) · Estimated ~12–17 h (some sources cite up to ~21 h); active metabolites prolong effect. (1) · Tramadol ~5-7 hours (M1 metabolite ~9 hours); acetaminophen 1-3 hours'"`UNIQ--ref-00001530-QINU`"' (1)
bioavailability:
None (152) · 80-90% oral (1) · Increased substantially via CYP2D6 inhibition'"`UNIQ--ref-00001584-QINU`"' (1) · Not formally characterized in humans. (1) · Tramadol ~75% (oral); acetaminophen 85-98%'"`UNIQ--ref-00001531-QINU`"' (1)
pregnancy:
None (152) · 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) · Avoid; neonatal opioid withdrawal documented.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Category D'"`UNIQ--ref-0000006C-QINU`"' (1) · Limited data; quinidine has been used in pregnancy as antiarrhythmic.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (153) · Schedule IV (US) (1) · [[USLegal:Prescription only|Rx-only]] in US. Caution with QT-prolonging medicines (quinidine itself is class IA antiarrhythmic, and the dose here, though sub-antiarrhythmic, still contributes to QT)'"`UNIQ--ref-00001585-QINU`"' (1) · [[USLegal:Schedule IV|Schedule IV controlled substance]] in US (tramadol was reclassified from non-controlled to Schedule IV in 2014 after recognition of dependence risk) (1)

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