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Medicines > classes : Botanical or Opioid or [[:Category:Melatonin receptor agonists|Melatonin receptor agonist]]

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generic:
Codeine (2)
brand:
None (32) · (multiple, generic dominant) (1) · Alfenta (1) · Darvon (1) · Demerol (1) · Dilaudid (1) · Duragesic (1) · Heroin (1) · Krokodil (1) · Multiple OTC dietary supplement formulations (1) · Nubain (1) · Nucynta (1) · O-DSMT (1) · Opana (1) · Stablon (1) · Stadol (1) · Sufenta (1) · Talwin (1) · Ultiva (1) · Vicodin (1)
classes: (Click arrow to add another value)
mechanism:
Potent mu-opioid receptor agonist (6) · Mu-opioid receptor agonist (4) · Contains LSA (2) · Contains mescaline (2)
uses:
None (49) · Mild to moderate pain; cough suppression (low-dose). (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 (49) · 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) · Adult: 15–60 mg every 4 hours as needed. (1)
preparations:
None (49) · OTC tablets, sublingual tablets, gummies, liquid, extended-release tablets and capsules; common strengths 0.5, 1, 3, 5, 10 mg (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1)
fda max:
None (49) · 360 mg/day (1) · Not formally established (dietary supplement); doses above ~3-5 mg show no additional efficacy but increase next-day sedation risk (1)
routes:
None (49) · Oral (1) · PO (only formulation marketed in the US). (1) · sublingual (1)
onset:
None (49) · 30-60 minutes (immediate-release oral) (1) · 30–60 min (PO) (1)
duration:
None (49) · 3-4 hours (1) · 4–6 hours (1)
halflife:
None (49) · 2.5–3 hours (1) · 30-50 minutes (short)'"`UNIQ--ref-00000021-QINU`"' (1)
bioavailability:
None (49) · ~15% (oral; highly variable due to extensive and variable first-pass metabolism)'"`UNIQ--ref-00000022-QINU`"' (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1)
pregnancy:
None (49) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (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:
None (49) · US Schedule II (single-entity); Schedule III–V (combination products by content). (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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