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Medicines > classes : Classic Psychedelic or Opioid or [[:Category:Mood_stabilizers|Mood stabilizer]]

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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None (81) · (multiple, generic dominant) (1) · Alfenta (1) · Darvon (1) · Delysid (historical, Sandoz, withdrawn 1965) (1) · Demerol (1) · Depakote, Depakote ER, Depakene, Depacon (IV) (1) · Dilaudid (1) · Duragesic (1) · Heroin (1) · Krokodil (1) · Nubain (1) · Nucynta (1) · O-DSMT (1) · Opana (1) · Stablon (1) · Stadol (1) · Sufenta (1) · Symbyax (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 (99) · Mild to moderate pain; cough suppression (low-dose). (1) · '"`UNIQ--vote-00000977-QINU`"', '"`UNIQ--vote-00000978-QINU`"', '"`UNIQ--vote-00000979-QINU`"', '"`UNIQ--vote-0000097A-QINU`"', '"`UNIQ--vote-0000097B-QINU`"' (1) · '"`UNIQ--vote-0000154B-QINU`"', '"`UNIQ--vote-0000154C-QINU`"' (1)
starting dose:
None (99) · 6/25 mg PO once daily in the evening; titrate within range 3/25 to 18/75 mg by clinical response and tolerability (1) · Adult: 15–60 mg every 4 hours as needed. (1) · Seizures: 10-15 mg/kg/d divided BID-TID, titrate to therapeutic level (50-100 mcg/mL); bipolar mania: 750 mg/d divided, titrate (1)
preparations:
None (99) · 125, 250, 500 mg delayed-release tablets (Depakote); 250, 500 mg ER tablets (Depakote ER); 125, 250 mg sprinkle capsules; 250 mg/5 mL syrup; 500 mg IV (Depacon) (1) · Capsules: 3/25, 6/25, 6/50, 12/25, 12/50 mg olanzapine/fluoxetine (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1)
fda max:
None (99) · 18 mg olanzapine / 75 mg fluoxetine per day (1) · 360 mg/day (1) · 60 mg/kg/d (typically up to 3000 mg/d) (1)
routes:
None (98) · IV (1) · Oral (3) · PO (only formulation marketed in the US). (1) · rectal (off-label use of injection) (1)
onset:
None (98) · 30–60 min (PO) (1) · 30–60 minutes (1) · Anticonvulsant effect within days; mood-stabilizing effect 1-3 weeks (1) · Mood improvement at 1-3 weeks; full effect 4-6 weeks (1)
duration:
None (98) · 12 hours (IR); 24 hours (ER) (1) · 24 hours (1) · 4–6 hours (1) · 8–12 hours (1)
halflife:
None (98) · 2.5–3 hours (1) · 3–5 hours (1) · 9-16 hours'"`UNIQ--ref-0000097C-QINU`"' (1) · Olanzapine ~30 hours; fluoxetine 1-4 days (norfluoxetine 7-15 days)'"`UNIQ--ref-0000154D-QINU`"' (1)
bioavailability:
None (98) · 70–90% (oral) (1) · Olanzapine 60% (oral); fluoxetine high (oral)'"`UNIQ--ref-0000154E-QINU`"' (1) · ~100% (oral); highly (~90%) protein-bound, with non-linear binding above therapeutic levels (free fraction matters clinically in hypoalbuminemia)'"`UNIQ--ref-0000097D-QINU`"' (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1)
pregnancy:
None (98) · '''Contraindicated for migraine prophylaxis in pregnancy; high teratogenic risk''' (neural tube defects, craniofacial anomalies, cardiac defects, cognitive/IQ impairment); avoid in women of childbearing potential without reliable contraception when alternatives exist'"`UNIQ--ref-0000097E-QINU`"' (1) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1) · Limited data; fluoxetine has reassuring data but olanzapine carries metabolic-syndrome and gestational diabetes signals.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Not established (1)
legal:
None (98) · Schedule I (United States) (1) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries '''Boxed Warnings''' for hepatotoxicity (especially children <2 with metabolic disorders), teratogenicity, and pancreatitis'"`UNIQ--ref-0000097F-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the '''antidepressant Boxed Warning''' for suicidality in children/adolescents/young adults and the atypical-neuroleptic '''Boxed Warning''' for increased mortality in elderly dementia patients'"`UNIQ--ref-0000154F-QINU`"' (1)

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