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Medicines (732)

Medicines > classes

: Opioid

or [[:Category:Migraine prophylactics|Migraine prophylactic]]

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7-Hydroxymitragynine (1) · Acetylfentanyl (1) · Alfentanil (1) · Amitriptyline (hydrochloride) (1) · Butorphanol (1) · Carfentanil (1) · Codeine (2) · Desomorphine (1) · Dextropropoxyphene (1) · Diacetylmorphine (1) · Dihydrocodeine (1) · Ethylmorphine (1) · Fentanyl (1) · Hydrocodone (1) · Hydromorphone (1) · Kratom (1) · Levorphanol (1) · Meperidine (1) · Mitragynine (1) · Nalbuphine (1) · Nortriptyline (hydrochloride) (1) · O-Desmethyltramadol (1) · Oxymorphone (1) · Papaverine (1) · Pentazocine (1) · Remifentanil (1) · Sufentanil (1) · Tapentadol (1) · Thebaine (1) · Tianeptine (1) · Timolol (maleate) (1) · Topiramate (1) · U-47700 (1)

None (12) · (multiple, generic dominant) (1) · Alfenta (1) · Darvon (1) · Demerol (1) · Dilaudid (1) · Duragesic (1) · Elavil (US brand discontinued; generic widely available), Endep, Tryptizol (1) · Heroin (1) · Krokodil (1) · Nubain (1) · Nucynta (1) · O-DSMT (1) · Opana (1) · Pamelor (US brand discontinued; generic widely available), Aventyl (1) · Stablon (1) · Stadol (1) · Sufenta (1) · Talwin (1) · Timoptic (ophthalmic), Timoptic-XE (gel-forming once-daily), Istalol (once-daily 0.5%), Betimol; Blocadren (oral, discontinued in many markets); combination eye drops Combigan (with brimonidine), Cosopt (with dorzolamide) (1) · Topamax (IR), Trokendi XR, Qudexy XR, Eprontia (oral solution); component of Qsymia (with phentermine) (1) · Ultiva (1) · Vicodin (1)

None (3) · Active metabolite of tramadol; mu-opioid agonist (1) · Extremely potent mu-opioid receptor agonist (1) · Highly potent mu-opioid receptor agonist (1) · Kappa agonist; mu antagonist (1) · Kappa agonist; mu partial agonist (1) · Kappa agonist; mu partial agonist/antagonist (1) · Mitragynine/7-hydroxymitragynine; mu-opioid partial agonist (1) · Mu-opioid agonist; modulates glutamate AMPA receptors (1) · Mu-opioid agonist; norepinephrine reuptake inhibitor (1) · Mu-opioid receptor agonist (4) · Mu-opioid receptor agonist; fentanyl analogue (1) · Mu-opioid receptor agonist; prodrug (metabolized to morphine) (1) · Mu-opioid receptor agonist; sodium channel blocker (1) · Mu/kappa/delta agonist; NMDA antagonist (1) · Opioid receptor partial agonist/antagonist; toxic alkaloid (1) · Partial mu-opioid receptor agonist; alpha-2 agonist (1) · Phosphodiesterase inhibitor; calcium channel blocker (1) · Potent mu-opioid receptor agonist (6) · Prodrug of morphine; mu-opioid receptor agonist (1) · Prodrug; converted to [[Morphine|morphine]] by [[Enzyme:CYP2D6|CYP2D6]] for analgesic action. (1) · Selective mu-opioid receptor agonist (1) · Ultra-short-acting mu-opioid agonist (1) · '"`UNIQ--vote-00000019-QINU`"' Therapeutic plasma-level monitoring is standard practice for TCAs given the narrow therapeutic index and the established plasma-level-efficacy correlation. CYP2D6 substrate; CPIC PGx guidance applies for dose individualization'"`UNIQ--ref-0000001A-QINU`"'. (1)

None (29) · Adult: 15–60 mg every 4 hours as needed. (1) · Depression (rarely used now): 25-75 mg PO at bedtime, titrate to 150 mg/day. Neuropathic pain / migraine prophylaxis: 10-25 mg at bedtime, titrate by 10-25 mg weekly to 50-100 mg/day. Elderly: 10 mg at bedtime (Beers-list cautions apply) (1) · Depression: 25 mg PO TID-QID or 75 mg at bedtime, titrate to 75-150 mg/day. Neuropathic pain: 10-25 mg at bedtime, titrate to 50-100 mg/day. Elderly: 10 mg at bedtime (Beers-list cautions, though less than amitriptyline) (1) · Migraine: 25 mg PO at bedtime, titrate by 25 mg weekly to target 100 mg/day divided BID. Seizures: 25-50 mg/day, titrate weekly to 200-400 mg/day divided BID (1) · Ophthalmic: 1 drop 0.5% in affected eye(s) BID (or once daily for XE / Istalol). Oral hypertension: 10 mg PO BID, titrate to 60 mg/day. Migraine prophylaxis: 10 mg BID, titrate to 30 mg/day (1)

None (29) · Capsules 10, 25, 50, 75 mg; oral solution 10 mg/5 mL (1) · IR tablets 25, 50, 100, 200 mg; sprinkle capsules 15, 25 mg; Trokendi XR capsules 25, 50, 100, 200 mg; Qudexy XR capsules; Eprontia oral solution 25 mg/mL (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1) · Tablets 10, 25, 50, 75, 100, 150 mg (1) · Tablets 5, 10, 20 mg; ophthalmic solution 0.25%, 0.5%; ophthalmic gel-forming solution 0.25%, 0.5% (Timoptic-XE) (1)

None (29) · 150 mg/day; therapeutic plasma-level monitoring recommended (target 50-150 ng/mL window) (1) · 1600 mg/day (theoretical seizure dosing); practical use 400 mg/day for seizures, 100-200 mg/day for migraine prophylaxis (1) · 300 mg/day (historical hospitalized inpatient depression); 150 mg/day outpatient typical ceiling (1) · 360 mg/day (1) · 60 mg/day (oral, hypertension); 0.5% BID (ophthalmic) (1)

None (29) · ophthalmic (1) · Oral (4) · PO (only formulation marketed in the US). (1)

None (29) · 30–60 min (PO) (1) · Anticonvulsant effect within days at therapeutic level; migraine prophylaxis effect emerges over 2-3 months (1) · BP effect within hours (oral); IOP reduction within 30 minutes, full effect 1-2 weeks (ophthalmic) (1) · Pain and migraine prophylaxis effect 1-4 weeks; antidepressant effect 4-6 weeks (1) · Sleep effect from first dose; analgesic and migraine-prophylaxis effect 1-4 weeks; antidepressant effect 4-6 weeks (1)

None (29) · 12 hours (oral BID); 24 hours (Timoptic-XE) (1) · 12-24 hours (IR BID); 24 hours (ER once-daily) (1) · 24 hours (HS dosing) (2) · 4–6 hours (1)

None (29) · 18-44 hours'"`UNIQ--ref-00000020-QINU`"' (1) · 2.5–3 hours (1) · Amitriptyline 10-50 hours (highly variable); nortriptyline active metabolite 18-44 hours'"`UNIQ--ref-00000026-QINU`"' (1) · ~21 hours'"`UNIQ--ref-00000028-QINU`"' (1) · ~4 hours (oral)'"`UNIQ--ref-0000001B-QINU`"' (1)

None (29) · ~50% (oral); systemic absorption from ophthalmic application is clinically meaningful via nasolacrimal drainage'"`UNIQ--ref-0000001C-QINU`"' (1) · ~50% (oral)'"`UNIQ--ref-00000021-QINU`"' (1) · ~50% (oral)'"`UNIQ--ref-00000027-QINU`"' (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1) · ~80% (oral)'"`UNIQ--ref-00000029-QINU`"' (1)

None (29) · '''Substantial teratogenic risk''' including cleft lip/palate, hypospadias, and growth restriction (pregnancy registry data clear); effective contraception and pre-pregnancy counseling are required in reproductive-age patients'"`UNIQ--ref-0000002A-QINU`"' (1) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1) · Limited human data; β-blocker class effects include fetal growth restriction and neonatal bradycardia/hypoglycemia.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Older agent with substantial use experience; observational signals not clearly causal.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · TCA class signal; limited human data specific to nortriptyline.[[[Pharmacopedia:Citation needed|citation needed]]] (1)

None (29) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1) · [[USLegal:Prescription only|Rx-only]] in US (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000022-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000028-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance'"`UNIQ--ref-0000002B-QINU`"' (1)