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Drilldown: Medicines

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Medicines > classes : Dissociative or Neurotoxin or Stimulant

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generic:
None (2)
brand:
None (59) · Benzedrex (1) · Botox (1) · DXM (1) · DXO (1) · Spravato (1)
classes: (Click arrow to add another value)
mechanism:
Monoamine releasing agent (8) · Dopamine/norepinephrine reuptake inhibitor (5) · NMDA antagonist (3) · Cathinone analogue; monoamine reuptake inhibitor (2) · Dopamine and norepinephrine reuptake inhibitor (2) · NMDA antagonist; sigma receptor agonist (2) · Norepinephrine–dopamine reuptake inhibitor (2)
uses:
None (62) · Chronic migraine (≥15 headache days/month), cervical dystonia, blepharospasm, hyperhidrosis, overactive bladder, urinary incontinence, strabismus, spasticity, cosmetic problems (1) · 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)
starting dose:
None (62) · Chronic migraine (PREEMPT protocol): 155 units divided across 31 sites in 7 head/neck muscle groups every 12 weeks (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 (62) · 28 mg/device (each dose uses 2 devices) (1) · 50, 100, or 200 unit vials of lyophilized powder for reconstitution (1)
fda max:
None (62) · 195 units/treatment for chronic migraine; max varies by problem (1) · 84 mg per session (1)
routes:
None (62) · Intramuscular (PREEMPT injections for migraine) (1) · Intranasal (under direct medical supervision) (1)
onset:
None (62) · 1–2 weeks for muscle effects; preventive migraine benefit accrues over 12-week cycles (1) · Within hours of first administration (1)
duration:
None (62) · Acute effect ~24 hours; cumulative effect builds with repeated dosing (1) · ~12 weeks (1)
halflife:
None (62) · Tissue half-life not formally measured; clinical effect ~12 weeks (1) · ~7-12 hours (1)
bioavailability:
None (62) · Local (intramuscular) (1) · ~48% intranasal (1)
pregnancy:
None (62) · Avoid; may cause fetal harm (1) · Category C; limited data (1)
legal:
None (62) · Rx, Schedule III (US). REMS program required. (1) · Rx; black-box warning for distant spread of toxin effect (1)

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