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: Opioid

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Codeine (2)

Other values:

None (144) · (multiple, generic dominant) (1) · (none, never marketed) (1) · Alfenta (1) · Darvon (1) · Demerol (1) · Dilaudid (1) · Dolophine (1) · Duragesic (1) · Heroin (1) · ketalar (1) · Krokodil (1) · Laudanum, Dropizol (1) · Lithobid (1) · Nubain (1) · Nucynta (1) · Nuedexta (1) · O-DSMT (1) · Opana (1) · Stablon (1) · Stadol (1) · Suboxone (1) · Sufenta (1) · Talwin (1) · Ultiva (1) · Ultracet, Tramacet (1) · Vicodin (1)

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 (164) · Antimanic, Antidepressive, Antisuicide (1) · 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) · Pain, cough, disquiet (1) · '"`UNIQ--vote-0000152F-QINU`"' (1) · '"`UNIQ--vote-00001582-QINU`"' (1)

None (166) · 1 capsule (20/10 mg dextromethorphan/quinidine) PO once daily × 7 days, then 1 capsule BID (1) · 2 tablets (75 mg tramadol / 650 mg acetaminophen) PO every 4-6 hours as needed; maximum 8 tablets/day for ≤5 days (1) · 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 (166) · 20 mg dextromethorphan HBr / 10 mg quinidine sulfate capsules (1) · Illicit tablets ("bars"), powders, blotter, occasionally solutions. No pharmaceutical product exists. (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1) · Tramadol/acetaminophen 37.5/325 mg tablets (1)

None (166) · 1 capsule BID (40 mg DXM / 20 mg quinidine per day) (1) · 360 mg/day (1) · 8 tablets/d (300 mg tramadol / 2600 mg acetaminophen); 5-day duration limit per label (1) · N/A (never approved) (1)

None (166) · intranasal; rectal and IV reported. (1) · Oral (3) · PO (only formulation marketed in the US). (1) · sublingual (1)

None (166) · 30-60 minutes (1) · 30–60 min (PO) (1) · PBA episode reduction within 1-2 weeks (1) · ~20–40 min PO; faster sublingual/intranasal. (1)

None (166) · 12 hours (1) · 4-6 hours (1) · 4–6 hours (1) · 6–10 h subjective; full pharmacologic effect considerably longer. (1)

None (166) · 2.5–3 hours (1) · Dextromethorphan substantially prolonged by quinidine's CYP2D6 inhibition (typical extensive metabolizers see ~10× higher AUC); quinidine ~6-8 hours'"`UNIQ--ref-00001583-QINU`"' (1) · Estimated ~12–17 h (some sources cite up to ~21 h); active metabolites prolong effect. (1) · Tramadol ~5-7 hours (M1 metabolite ~9 hours); acetaminophen 1-3 hours'"`UNIQ--ref-00001530-QINU`"' (1)

None (166) · Increased substantially via CYP2D6 inhibition'"`UNIQ--ref-00001584-QINU`"' (1) · Not formally characterized in humans. (1) · Tramadol ~75% (oral); acetaminophen 85-98%'"`UNIQ--ref-00001531-QINU`"' (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1)

None (166) · 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; neonatal opioid withdrawal documented.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1) · Limited data; quinidine has been used in pregnancy as antiarrhythmic.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1)

None (167) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1) · [[USLegal:Prescription only|Rx-only]] in US. Caution with QT-prolonging medicines (quinidine itself is class IA antiarrhythmic, and the dose here, though sub-antiarrhythmic, still contributes to QT)'"`UNIQ--ref-00001585-QINU`"' (1) · [[USLegal:Schedule IV|Schedule IV controlled substance]] in US (tramadol was reclassified from non-controlled to Schedule IV in 2014 after recognition of dependence risk) (1)

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