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: Opioid

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Codeine (2)

Other values:

5-HT2A agonist (26) · Monoamine releasing agent (9) · GABAA positive allosteric modulator (8) · CB1/CB2 agonist (7) · Potent mu-opioid receptor agonist (6) · Dopamine/norepinephrine reuptake inhibitor (5) · Potent 5-HT2A agonist (5) · LSD analogue; 5-HT2A agonist (4) · Mu-opioid receptor agonist (4) · Prodrug of LSD; 5-HT2A agonist (4) · Serotonin/norepinephrine/dopamine releasing agent (3) · Cathinone analogue; monoamine reuptake inhibitor (2) · Dopamine and norepinephrine reuptake inhibitor (2) · NMDA antagonist (2) · Prodrug of GHB (2)

Other values:

None (158) · Mild to moderate pain; cough suppression (low-dose). (1) · No approved medical problem. Encountered as a designer/research benzodiazepine and, increasingly, as an adulterant in illicit opioid supplies. (1)

None (158) · Adult: 15–60 mg every 4 hours as needed. (1) · No medical dose. Active recreational doses reported in the 0.5–1.5 mg range (similar potency to alprazolam). (1)

None (157) · Illicit tablets ("bars"), powders, blotter, occasionally solutions. No pharmaceutical product exists. (1) · Lithium carbonate: immediate-release capsules (150 mg, 300 mg, 600 mg) and tablets (300 mg); extended-release tablets (300 mg, 450 mg). Lithium citrate: oral solution (8 mEq/5 mL, equivalent to 300 mg lithium carbonate per 5 mL) for patients unable to swallow tablets. (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1)

None (157) · 360 mg/day (1) · N/A (never approved) (1) · No defined absolute maximum; dosing is guided by serum level monitoring. Levels above 1.5 mEq/L carry increasing toxicity risk. Levels consistently above 1.2 mEq/L are generally not maintained in clinical practice.'"`UNIQ--ref-00000052-QINU`"' (1)

None (157) · intranasal; rectal and IV reported. (1) · Oral (2) · PO (only formulation marketed in the US). (1) · sublingual (1)

None (157) · 30–60 min (PO) (1) · Antimanic effects begin within 5-7 days of reaching therapeutic serum levels, with full response often requiring 2-3 weeks. For acute mania, a neuroleptic is typically added for rapid sedation while lithium takes effect.'"`UNIQ--ref-00000053-QINU`"' (1) · ~20–40 min PO; faster sublingual/intranasal. (1)

None (158) · 4–6 hours (1) · 6–10 h subjective; full pharmacologic effect considerably longer. (1)

None (157) · 2.5–3 hours (1) · Approximately 18-24 hours after acute administration; may extend to 36-48 hours with chronic dosing as tissue compartments equilibrate. Serum trough levels should be drawn 12 hours after the last dose for accurate interpretation.'"`UNIQ--ref-00000055-QINU`"' (1) · Estimated ~12–17 h (some sources cite up to ~21 h); active metabolites prolong effect. (1)

None (158) · Not formally characterized in humans. (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1)

None (158) · Avoid. Benzodiazepines are associated with neonatal sedation, floppy-infant syndrome, and withdrawal; teratogenic signal weak but non-zero. Designer benzo with no safety data, assume worst-case. (1) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1)

None (158) · Not a controlled substance in the United States, European Union, United Kingdom, Canada, or Australia. Prescription-only in all of these jurisdictions due to the narrow therapeutic index and the need for serum monitoring. No abuse potential has been identified. (1) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1)

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