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Drilldown: Medicines

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

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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None (81) · (multiple, generic dominant) (1) · Alfenta (1) · Darvon (1) · Delysid (historical, Sandoz, withdrawn 1965) (1) · Demerol (1) · Dilaudid (1) · Dolophine (1) · Duragesic (1) · Heroin (1) · Krokodil (1) · Mysoline (1) · Nubain (1) · Nucynta (1) · O-DSMT (1) · Opana (1) · Stablon (1) · Stadol (1) · Suboxone (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 (101) · Mild to moderate pain; cough suppression (low-dose). (1) · '"`UNIQ--vote-00000015-QINU`"', '"`UNIQ--vote-00000016-QINU`"' (1)
starting dose:
None (101) · Adult: 15–60 mg every 4 hours as needed. (1) · Seizures: 100-125 mg PO at bedtime x 3 days, then BID, then TID, escalating to 750-1500 mg/day. Essential tremor: 25-50 mg PO at bedtime, titrate slowly to 250-750 mg/day (1)
preparations:
None (101) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1) · Tablets 50, 250 mg (1)
fda max:
None (101) · 2 g/day (seizures); typically much lower for essential tremor (1) · 360 mg/day (1)
routes:
None (100) · Oral (2) · PO (only formulation marketed in the US). (1)
onset:
None (100) · 30–60 min (PO) (1) · 30–60 minutes (1) · Anticonvulsant effect emerges with slow titration over weeks; tremor effect over weeks (1)
duration:
None (100) · 4–6 hours (1) · 8–12 hours (1) · BID-TID dosing (1)
halflife:
None (100) · 2.5–3 hours (1) · 3–5 hours (1) · Primidone 5-15 hours; '''phenobarbital active metabolite 50-150 hours'''; PEMA (phenylethylmalonamide) active metabolite 16 hours'"`UNIQ--ref-00000017-QINU`"' (1)
bioavailability:
None (100) · 70–90% (oral) (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1) · ~90% (oral)'"`UNIQ--ref-00000018-QINU`"' (1)
pregnancy:
None (100) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1) · Not established (1) · Substantial teratogenic signal (barbiturate class effects including neonatal withdrawal and hemorrhagic disease of newborn).<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:Prescription only|Rx-only]] in US. '''Federally non-controlled despite being a barbiturate''', a paradoxical situation given that its primary active metabolite phenobarbital is Schedule IV'"`UNIQ--ref-00000019-QINU`"' (1)

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