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Medicines > classes : Classic Psychedelic or Dissociative or [[:Category:Catecholamines|Catecholamine]]

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generic:
brand:
None (86) · Delysid (historical, Sandoz, withdrawn 1965) (1) · DXM (1) · DXO (1) · EpiPen, EpiPen Jr, Auvi-Q, Adrenaclick, Symjepi; many generic (1) · Spravato (1)
classes: (Click arrow to add another value)
mechanism:
5-HT2A agonist (26) · Potent 5-HT2A agonist (5) · LSD analogue; 5-HT2A agonist (4) · Prodrug of LSD; 5-HT2A agonist (4) · NMDA antagonist (3) · Contains LSA (2) · Contains mescaline (2) · NMDA antagonist; sigma receptor agonist (2)
uses:
None (89) · Treatment-resistant depression (TRD) in adults, as adjunct to oral antidepressant (FDA-approved March 2019). Depressive symptoms in adults with MDD with acute suicidal ideation or behavior (FDA-approved Aug 2020). (1) · '"`UNIQ--vote-00000E4C-QINU`"', '"`UNIQ--vote-00000E4D-QINU`"', '"`UNIQ--vote-00000E4E-QINU`"', '"`UNIQ--vote-00000E4F-QINU`"', '"`UNIQ--vote-00000E50-QINU`"', '"`UNIQ--vote-00000E51-QINU`"' (1)
starting dose:
None (89) · Anaphylaxis IM 0.3-0.5 mg (adult) into lateral thigh, repeat q5-15 minutes prn; pediatric 0.01 mg/kg IM (max 0.3 mg, max 0.5 mg in adolescents); cardiac arrest 1 mg IV/IO q3-5 minutes; severe asthma neb 0.1 mg/kg up to 5 mg; never IV bolus for anaphylaxis outside critical care (1) · Induction (TRD): 56 mg intranasal twice weekly × 4 weeks. Maintenance: 56-84 mg once weekly × 4 weeks, then 56-84 mg every 1-2 weeks. For acute suicidality: 84 mg twice weekly × 4 weeks. Administered under medical supervision in REMS-certified site. (1)
preparations:
None (89) · 28 mg/device (each dose uses 2 devices) (1) · Auto-injectors 0.15 mg (Jr/pediatric), 0.3 mg (adult); 1 mg/mL (1:1,000) ampules for IM/SC use; 0.1 mg/mL (1:10,000) for IV use; 2.25% racemic nebulizer (1)
fda max:
None (89) · 84 mg per session (1) · Indication-specific; ACLS no fixed cumulative ceiling (1)
routes:
None (88) · endotracheal (legacy ACLS (1) · IM (1) · intracardiac (historical only) (1) · Intranasal (under direct medical supervision) (1) · IV (1) · nebulized (1) · not preferred) (1) · Oral (1) · SC (less common) (1)
onset:
None (88) · 30–60 minutes (1) · IM: 5-10 minutes; IV: seconds; nebulized: 5-10 minutes (1) · Within hours of first administration (1)
duration:
None (88) · 5-15 minutes (1) · 8–12 hours (1) · Acute effect ~24 hours; cumulative effect builds with repeated dosing (1)
halflife:
None (88) · 3–5 hours (1) · ~2 minutes'"`UNIQ--ref-00000E52-QINU`"' (1) · ~7-12 hours (1)
bioavailability:
None (88) · 70–90% (oral) (1) · IM/SC ~100%; oral negligible (extensive first-pass and gut metabolism — hence the no-oral route)'"`UNIQ--ref-00000E53-QINU`"' (1) · ~48% intranasal (1)
pregnancy:
None (88) · Avoid; may cause fetal harm (1) · Not established (1) · Used in life-threatening obstetric anaphylaxis without hesitation; benefits clearly outweigh.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (88) · Rx, Schedule III (US). REMS program required. (1) · Schedule I (United States) (1) · [[USLegal:Prescription only|Rx-only]] in US (1)

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