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Medicines > classes : Classic Psychedelic or Opioid or [[:Category:Antimanic medicines|Antimanic]]

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generic:
Codeine (2)
brand:
None (81) · (multiple, generic dominant) (1) · Alfenta (1) · Darvon (1) · Delysid (historical, Sandoz, withdrawn 1965) (1) · Demerol (1) · Dilaudid (1) · Duragesic (1) · Heroin (1) · Krokodil (1) · Lithobid (extended-release); Eskalith (discontinued in US); Carbolith (Canada); Priadel (UK); Camcolit (UK) (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:
5-HT2A agonist (26) · Potent mu-opioid receptor agonist (6) · Potent 5-HT2A agonist (5) · LSD analogue; 5-HT2A agonist (4) · Mu-opioid receptor agonist (4) · Prodrug of LSD; 5-HT2A agonist (4) · Contains LSA (2) · Contains mescaline (2)
uses:
None (100) · Mild to moderate pain; cough suppression (low-dose). (1)
starting dose:
None (100) · Adult: 15–60 mg every 4 hours as needed. (1)
preparations:
None (99) · Lithium carbonate: immediate-release capsules (150 mg, 300 mg, 600 mg) and tablets (300 mg); extended-release tablets (300 mg, 450 mg). Lithium citrate: oral solution (8 mEq/5 mL, equivalent to 300 mg lithium carbonate per 5 mL) for patients unable to swallow tablets. (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1)
fda max:
None (99) · 360 mg/day (1) · No defined absolute maximum; dosing is guided by serum level monitoring. Levels above 1.5 mEq/L carry increasing toxicity risk. Levels consistently above 1.2 mEq/L are generally not maintained in clinical practice.'"`UNIQ--ref-00000052-QINU`"' (1)
routes:
None (98) · Oral (2) · PO (only formulation marketed in the US). (1)
onset:
None (98) · 30–60 min (PO) (1) · 30–60 minutes (1) · Antimanic effects begin within 5-7 days of reaching therapeutic serum levels, with full response often requiring 2-3 weeks. For acute mania, a neuroleptic is typically added for rapid sedation while lithium takes effect.'"`UNIQ--ref-00000053-QINU`"' (1)
duration:
None (99) · 4–6 hours (1) · 8–12 hours (1)
halflife:
None (98) · 2.5–3 hours (1) · 3–5 hours (1) · Approximately 18-24 hours after acute administration; may extend to 36-48 hours with chronic dosing as tissue compartments equilibrate. Serum trough levels should be drawn 12 hours after the last dose for accurate interpretation.'"`UNIQ--ref-00000055-QINU`"' (1)
bioavailability:
None (99) · 70–90% (oral) (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1)
pregnancy:
None (99) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1) · Not established (1)
legal:
None (98) · Not a controlled substance in the United States, European Union, United Kingdom, Canada, or Australia. Prescription-only in all of these jurisdictions due to the narrow therapeutic index and the need for serum monitoring. No abuse potential has been identified. (1) · Schedule I (United States) (1) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1)

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