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Drilldown: Medicines

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Medicines > classes : Dissociative or Stimulant or gut-restricted)]]

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generic:
brand:
None (59) · Benzedrex (1) · DXM (1) · DXO (1) · Imodium, Imodium A-D (1) · Spravato (1)
classes: (Click arrow to add another value)
mechanism:
Monoamine releasing agent (8) · Dopamine/norepinephrine reuptake inhibitor (5) · NMDA antagonist (3) · None (2) · 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) · 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) · '"`UNIQ--vote-00000FCF-QINU`"', '"`UNIQ--vote-00000FD0-QINU`"', '"`UNIQ--vote-00000FD1-QINU`"' (1)
starting dose:
None (62) · 4 mg PO initially, then 2 mg after each loose stool, '''not to exceed 16 mg/d''' (8 mg OTC); chronic-use lower (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) · 2 mg capsules and tablets; 1 mg/5 mL oral solution; combined with simethicone (Imodium Multi-Symptom) (1) · 28 mg/device (each dose uses 2 devices) (1)
fda max:
None (62) · 16 mg/d (8 mg/d OTC) (1) · 84 mg per session (1)
routes:
None (62) · Intranasal (under direct medical supervision) (1) · Oral (1)
onset:
None (62) · 30-60 minutes (1) · Within hours of first administration (1)
duration:
None (62) · 8-12 hours (1) · Acute effect ~24 hours; cumulative effect builds with repeated dosing (1)
halflife:
None (62) · ~7-12 hours (1) · ~9-14 hours'"`UNIQ--ref-00000FD2-QINU`"' (1)
bioavailability:
None (62) · ~0.3% (oral; extensive first-pass via CYP3A4 and P-glycoprotein-mediated efflux at the intestinal and blood-brain barriers limit systemic and CNS exposure at therapeutic doses)'"`UNIQ--ref-00000FD3-QINU`"' (1) · ~48% intranasal (1)
pregnancy:
None (62) · Avoid; may cause fetal harm (1) · Generally considered acceptable when needed.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (62) · OTC in US (1) · Rx, Schedule III (US). REMS program required. (1)

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