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Medicines > classes : Classic Psychedelic or Opioid or [[:Category:Skeletal muscle relaxants|Skeletal muscle relaxant]]

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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None (81) · (multiple, generic dominant) (1) · Alfenta (1) · Darvon (1) · Delysid (historical, Sandoz, withdrawn 1965) (1) · Demerol (1) · Dilaudid (1) · Dolophine (1) · Duragesic (1) · Heroin (1) · Krokodil (1) · Nubain (1) · Nucynta (1) · O-DSMT (1) · Opana (1) · Stablon (1) · Stadol (1) · Suboxone (1) · Sufenta (1) · Talwin (1) · Ultiva (1) · Valium (oral, IV/IM, rectal), Diastat (rectal gel for breakthrough seizures), Valtoco (nasal spray for breakthrough seizures), Libervant (buccal film) (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 (101) · Mild to moderate pain; cough suppression (low-dose). (1) · '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"' (1)
starting dose:
None (101) · Adult: 15–60 mg every 4 hours as needed. (1) · Anxiety: 2-10 mg PO 2-4 times daily. Alcohol withdrawal: 10-20 mg PO/IV every 4-6 hours, symptom-triggered. Status epilepticus: 5-10 mg IV. Breakthrough seizures: Diastat rectal 0.2-0.5 mg/kg or Valtoco intranasal 5-20 mg (1)
preparations:
None (101) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1) · Tablets 2, 5, 10 mg; oral solution 1, 5 mg/mL; injection 5 mg/mL; Diastat rectal gel 2.5, 5, 10, 20 mg; Valtoco nasal spray 5, 7.5, 10 mg/dose; Libervant buccal film (1)
fda max:
None (101) · 360 mg/day (1) · 40 mg/day (oral, anxiety) (1)
routes:
None (100) · buccal (1) · IM (1) · intranasal (1) · IV (1) · Oral (2) · PO (only formulation marketed in the US). (1) · rectal (1)
onset:
None (100) · 15-60 minutes (oral); 1-5 minutes (IV); 4-10 minutes (rectal or intranasal) (1) · 30–60 min (PO) (1) · 30–60 minutes (1)
duration:
None (100) · 4–6 hours (1) · 6-24 hours (parent); much longer when accounting for the long-lived active metabolites (1) · 8–12 hours (1)
halflife:
None (100) · 2.5–3 hours (1) · 3–5 hours (1) · Diazepam 20-50 hours; '''N-desmethyldiazepam (nordazepam) 30-200 hours''' is the major active metabolite and accumulates substantially with chronic dosing'"`UNIQ--ref-00000026-QINU`"' (1)
bioavailability:
None (100) · 70–90% (oral) (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1) · ~93% (oral); ~90% (rectal)'"`UNIQ--ref-00000027-QINU`"' (1)
pregnancy:
None (100) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1) · Not established (1) · Some signal for cleft palate with first-trimester exposure (debated); neonatal sedation and withdrawal with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (100) · Schedule I (United States) (1) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1) · [[USLegal:Schedule IV|Schedule IV controlled substance]] in US. Carries the benzodiazepine class '''Boxed Warning''' for risk of fatal respiratory depression, coma, and death when combined with opioids'"`UNIQ--ref-00000028-QINU`"' (1)

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