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Medicines (732)

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: Plant Medicine

or Tryptamine

or [[:Category:Analgesics|Analgesic]]

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None (26) · ''Areca catechu'' (the nut); ''Piper betle'' (the leaf) (1) · ''Brugmansia'' spp., Angel's trumpet, ''borrachero'', ''toé'' (1) · ''Camellia sinensis'' (formerly ''Thea sinensis'') (1) · ''Catha edulis''. Chat, qat, the Flower of Paradise (1) · ''Coffea arabica'', ''Coffea canephora'' (robusta) (1) · ''Cola nitida'', ''Cola acuminata'' (1) · ''Erythroxylum coca'', ''E. novogranatense'' (1) · ''Ilex paraguariensis'' (1) · ''Ilex vomitoria'' (1) · ''Mimosa tenuiflora''. Jurema preta, tepescohuite (1) · ''Paullinia cupana'' (1) · ''Sophora secundiflora''. Texas mountain laurel, frijolillo (1) · ''Theobroma cacao'' (1) · Advil, Motrin, IBU, Caldolor (IV), NeoProfen (neonatal IV) (1) · Aleve (OTC), Naprosyn (Rx), Anaprox (Rx), Naprelan (ER), EC-Naprosyn (enteric-coated), Vimovo (with esomeprazole) (1) · Bayer, Ecotrin, Bufferin, St. Joseph (low-dose 81 mg), Excedrin (with acetaminophen and caffeine) (1) · Celebrex (oral capsules), Elyxyb (oral solution, for acute migraine) (1) · Deadly nightshade (1) · Henbane, black henbane (1) · Imitrex (oral, injectable, nasal), Tosymra (nasal spray), Onzetra Xsail (nasal powder), Zembrace SymTouch (low-dose autoinjector), Sumavel DosePro (needle-free SC) (1) · Indocin (oral, IV, suppository), Tivorbex (low-dose), Indo-Lemmon (1) · Mandrake (1) · Maxalt (tablet), Maxalt-MLT (orally disintegrating tablet) (1) · Mobic, Vivlodex (lower-dose capsules), Anjeso (IV) (1) · MS Contin (ER), Kadian (ER), Avinza (ER), Roxanol (IR oral solution), Duramorph (epidural / IT), Astramorph (IV), Infumorph (intrathecal pump), MorphaBond (IR abuse-deterrent) (1) · Nurtec ODT (1) · OxyContin (ER), Roxicodone (IR), Oxaydo (IR abuse-deterrent), Xtampza ER (abuse-deterrent ER) (1) · Reed canary grass (1) · The ayahuasca vine, ''yagé'', ''caapi'', ''mariri'' (1) · Ultram (IR), Ultram ER, ConZip ER (1) · Voltaren (IR oral, topical gel), Cataflam (potassium IR), Cambia (oral powder, migraine), Zorvolex (low-dose), Pennsaid (topical 2% solution), Flector (transdermal patch), Solaraze (3% gel for actinic keratosis) (1) · Wormwood, absinthe, la Fée Verte, the Green Muse (1)

None (12) · 5-HT2A agonist (15) · 5-HT2A agonist; 5-HT3 antagonist (1) · 5-HT2A agonist; minor psilocybin mushroom alkaloid (1) · 5-HT2A agonist; primarily auditory effects (1) · 5-HT2A agonist; sigma-1 agonist (1) · Active alkaloid is cytisine, a nicotinic acetylcholine receptor agonist. NOT a classical 5-HT2A psychedelic. (1) · Active principle is thujone, a GABA-A antagonist (the opposite of most CNS depressants). Also present in cooking sage (''Salvia officinalis''), tansy, and ''Thuja'' cedars. (1) · Caffeine (1.5–2%) + theobromine + kolanin (a glycoside). (1) · Caffeine (highest of the ''Ilex'' genus) plus saponins that produce ritual vomiting at high doses. (1) · Caffeine (sometimes called 'mateine' historically, though chemically identical), theobromine, theophylline, plus polyphenols. (1) · Caffeine + theophylline + L-theanine. L-theanine (an amino acid unique to tea) modulates glutamate and produces an 'alpha-wave' calming overlay on caffeine's stimulation, hence tea's reputation as a 'cleaner' stimulant than coffee. (1) · Caffeine is a non-selective adenosine A1/A2A receptor antagonist; also weak PDE inhibition. Beans contain theobromine (3,7-DMX) and theophylline (1,3-DMX) in smaller amounts. (1) · Contains the β-carboline alkaloids harmine, harmaline, and tetrahydroharmine, reversible monoamine oxidase inhibitors (RIMAs) that allow oral DMT to reach the brain. (1) · Contains varying amounts of DMT, 5-MeO-DMT, bufotenine, and gramine depending on strain and growing conditions. (1) · Highest natural caffeine content of any plant (2–7% by dry weight, ~2–4× coffee). Caffeine is bound to tannins, producing a slower release than pure coffee caffeine. (1) · Monoamine releasing agent; 5-HT2A agonist; MAO inhibitor (1) · Potent 5-HT2A agonist; sigma-1 agonist (1) · Primary alkaloid is (S)-(-)-cathinone, a phenylpropanolamine close kin to amphetamine. Releases dopamine and norepinephrine. Also contains cathine (=norpseudoephedrine) and norephedrine. (1) · Primary alkaloid is arecoline, a muscarinic agonist (M1, M2, M3, M4) and partial agonist at nicotinic receptors. Produces alertness, salivation, sweating, mild euphoria. (1) · Primary alkaloid is cocaine, a tropane that blocks reuptake of dopamine and norepinephrine (and serotonin). At low oral doses from leaf chewing, the slow release favors NE-mediated alertness over DA-mediated euphoria. (1) · Primary alkaloid is theobromine (3,7-dimethylxanthine), with minor caffeine. Also contains phenethylamine, anandamide (an endogenous cannabinoid), tryptophan (serotonin precursor), and flavanols. The combined effect is mild stimulation + mood elevation. (1) · Prodrug of 4-HO-DET; 5-HT2A agonist (1) · Prodrug of 4-HO-DiPT; 5-HT2A agonist (1) · Prodrug of 4-HO-MET; 5-HT2A agonist (1) · Prodrug of 4-HO-MiPT; 5-HT2A agonist (1) · Prodrug of psilocin; 5-HT2A agonist (1) · Root bark contains ~1% N,N-dimethyltryptamine (DMT) and related tryptamines. Oral activity requires MAOI co-administration. (1) · Tropane alkaloids: hyoscyamine (dominant; the racemic form is atropine), scopolamine. Competitive muscarinic antagonism. (1) · Tropane alkaloids: hyoscyamine, scopolamine, atropine, apoatropine. (1) · Tropane alkaloids: hyoscyamine, scopolamine, in higher seed concentrations than belladonna or datura. (1) · Tropane alkaloids: scopolamine (dominant), hyoscyamine, atropine. Competitive antagonism at muscarinic acetylcholine receptors. (1) · '"`UNIQ--vote-00000019-QINU`"' Once-daily dosing is a clinical advantage over short-half-life NSAIDs'"`UNIQ--ref-0000001A-QINU`"'. (1)

None (41) · 200-400 mg PO every 4-6 hours as needed. OTC max 1200 mg/day without provider direction; prescription max 3200 mg/day divided (1) · 5-10 mg PO at migraine onset; may repeat after 2 hours, maximum 30 mg/24 hours (1) · 7.5 mg PO once daily; titrate to 15 mg daily if needed. Vivlodex 5 mg PO once daily, max 10 mg (1) · A ''marduuf'' bundle (~50 g fresh leaves) chewed over a couple of hours (1) · A measured pour of absinthe diluted 5:1 with cold water over sugar (the louche ritual) (1) · Acute gout: 50 mg PO TID until symptom relief, then taper; maximum 200 mg/day for 3-5 days. Rheumatoid arthritis / osteoarthritis: 25-50 mg PO BID-TID. Patent ductus arteriosus: 0.2 mg/kg IV, then 0.1-0.2 mg/kg every 12-24 hours for 2 doses (1) · Acute migraine: 75 mg PO at onset, maximum one dose per 24 hours. Preventive: 75 mg PO every other day (1) · Antiplatelet: 81 mg PO once daily. Acute MI/stroke: 162-325 mg chewed. Analgesic: 325-650 mg PO every 4-6 hours as needed (1) · IR opioid-naive: 5-10 mg PO every 4-6 hours as needed. ER opioid-naive: '''10 mg PO every 12 hours (lowest available)'''; titrate slowly to clinical effect (1) · IR oral 50 mg PO TID or 75 mg BID. Voltaren 1% gel: apply 2-4 g to affected area QID. Pennsaid 2%: 40 drops to knee BID. Flector patch: every 12 hours (1) · IR oral: 15-30 mg every 4 hours as needed. ER opioid-naive: 15-30 mg every 12 hours. IV/IM/SC: 2-10 mg every 3-4 hours. Epidural / intrathecal: see surgical or palliative-care protocols (1) · IR: 25-50 mg PO every 4-6 hours as needed, titrate as tolerated. ER: 100 mg PO once daily, titrate by 100 mg every 5 days (1) · One cup (~40–60 mg caffeine; about half of brewed coffee) (1) · One cup (~80–145 mg caffeine for brewed; 60–100 mg for instant) (1) · Oral: 50-100 mg at migraine onset, may repeat in 2 hours if needed. SC: 6 mg, may repeat in 1 hour. Nasal: 5-20 mg per nostril, may repeat in 2 hours (1) · Osteoarthritis: 200 mg PO once daily or 100 mg BID. Rheumatoid arthritis: 100-200 mg PO BID. Acute pain: 400 mg loading, then 200 mg every 12 hours (1) · OTC: 220 mg PO every 8-12 hours, max 660 mg/24h. Rx: 250-500 mg PO BID. Acute gout: 750 mg loading then 250 mg every 8 hours (1)

None (26) · A ''betel quid'': areca nut slice + betel leaf + slaked lime (calcium hydroxide) ± tobacco ± spices, chewed (1) · Acid/base extraction of fresh young grass for tryptamines; combined with an MAOI (1) · Bark/woody stem decocted with a DMT-source plant (''Psychotria viridis'', ''Diplopterys cabrerana'') to make ayahuasca (1) · Bright red seeds, traditionally ingested or smoked. Highly toxic, narrow margin between active and lethal (1) · Capsules 25, 50 mg; ER capsules 75 mg; oral suspension 25 mg/5 mL; suppositories 50 mg; injection 1 mg/vial (PDA closure) (1) · Capsules 50, 100, 200, 400 mg; Elyxyb oral solution 25 mg/mL (1) · Dried leaves and twigs, infused in a gourd (''mate'') and drunk through a metal straw (''bombilla'') (1) · Dried leaves, infused. Six major processings: white, green, yellow, oolong, black, pu-erh (1) · Dried leaves; absinthe liqueur (120–160 proof, with hyssop, lemon balm, fennel, anise, sometimes Acorus calamus) (1) · Fermented and roasted seeds, ground. Mexican tradition: drunk with chili, cornmeal, achiote. European tradition: with sugar and milk (1) · Flowers or leaves infused or smoked. Highly variable potency; narrow toxic margin (1) · Fresh leaves and tender twigs chewed; degrades on drying (1) · Fresh nuts chewed; also dried and powdered (1) · IR tablets 15, 30 mg; oral solution 10 mg/5 mL, 20 mg/mL, 100 mg/5 mL (concentrated); suppositories; ER tablets and capsules in multiple strengths; injectable 0.5-50 mg/mL (1) · IR tablets 25, 50 mg; ER tablets 100 mg; Cataflam IR 50 mg; Zorvolex 18, 35 mg; Voltaren gel 1%; Pennsaid 2% topical solution; Flector transdermal patch; Solaraze 3% gel; Cambia oral powder 50 mg (1) · IR tablets 5, 7.5, 10, 15, 20, 30 mg; IR oral solution 5 mg/5 mL; concentrated solution 20 mg/mL; OxyContin ER tablets 10, 15, 20, 30, 40, 60, 80 mg; Xtampza ER capsules (1) · IR tablets 50 mg; ER tablets 100, 200, 300 mg (Ultram ER, ConZip); oral solution 5 mg/mL; combination products with acetaminophen (Ultracet) (1) · Leaves and seeds, traditionally smoked or infused. Possibly the original Pythia oracle plant (1) · Leaves chewed with a pinch of slaked lime (the lime converts cocaine HCl to freebase for buccal absorption); also drunk as tea (''mate de coca'') (1) · Leaves, berries, root. Historically: belladonna cigarettes ("Asthmador") OTC in US until the 1970s (1) · Oral tablets 25, 50, 100 mg; SC injection 4, 6 mg autoinjector; needle-free SC 6 mg (Sumavel); nasal spray 5, 20 mg; nasal powder 22 mg (Onzetra Xsail); low-dose autoinjector 3 mg (Zembrace SymTouch) (1) · Orally disintegrating tablet 75 mg (1) · OTC tablets 220 mg; Rx tablets 250, 375, 500 mg; ER tablets 375, 500, 750 mg (Naprelan); oral suspension 125 mg/5 mL; enteric-coated tablets (EC-Naprosyn) (1) · Roasted beans, ground; brewed (drip, French press, espresso, cold brew, percolated) (1) · Roasted seeds ground to powder, mixed with water; commercial syrups and energy drinks (1) · Root bark acid/base-extracted for DMT; or as the resurrected ''jurema preta'' brew (decocted with an MAOI such as ''Peganum harmala'') (1) · Root, traditionally carved into ''mannikens'' or infused into wine (1) · Tablets 200, 400, 600, 800 mg; capsules 200 mg; oral suspension 100 mg/5 mL; chewable tablets 100 mg; injection 100 mg/mL (Caldolor) (1) · Tablets 5, 10 mg; ODT (Maxalt-MLT) 5, 10 mg (1) · Tablets 7.5, 15 mg (Mobic); capsules 5, 10 mg (Vivlodex); oral suspension 7.5 mg/5 mL; injection 30 mg/mL (Anjeso) (1) · Tablets 81 (low-dose), 325, 500, 650 mg; chewable 81 mg; enteric-coated tablets; effervescent tablets; suppositories (1) · Toasted leaves and twigs decocted to a near-black concentrate (1)

None (45) · 15 mg/day (oral); 30 mg IV once daily (Anjeso) (1) · 150 mg/day (oral); use lowest effective dose for shortest duration per FDA NSAID class guidance (1) · 1500 mg/day (Rx); 660 mg/24h (OTC, without provider direction) (1) · 200 mg/day (oral); 12 mg/day (SC); 40 mg/day (nasal spray); 44 mg/day (Onzetra) (1) · 200 mg/day (typical adult oral) (1) · 30 mg/24 hours (1) · 3200 mg/day (Rx); 1200 mg/day (OTC, without provider direction) (1) · 400 mg/day (IR, adult); 300 mg/day (ER); 300 mg/day in elderly >75 years (1) · 400 mg/day for chronic indications; higher for short-term acute pain (1) · 4000 mg/day (analgesic) (1) · 75 mg per dose; one dose per 24 hours (acute); one dose every other day (preventive) (1) · No fixed ceiling; titrate to clinical effect and tolerability with CDC opioid prescribing guidance constraints on morphine-milligram-equivalent (MME) totals (2)

None (42) · 1-2 hours for migraine relief (1) · 10 minutes (SC); 15-30 minutes (nasal); 30-60 minutes (oral) (1) · 10-30 minutes (IR) (1) · 15–30 min (2) · 30 minutes for migraine relief (1) · 30-60 minutes (2) · 30-60 minutes (IR) (1) · 30-60 minutes (oral) (1) · 30-60 minutes (oral); rapid relief in acute gout (1) · 30-60 minutes (oral); slower for topical (1) · 5-10 minutes (IV); 30 minutes (oral IR); slower for ER and rectal (1) · Analgesic effect within hours; full anti-inflammatory effect over 1-2 weeks (1) · Antiplatelet effect within 30-60 minutes; analgesic effect 30-60 minutes (1) · ~15–30 min (1)

None (42) · '''Antiplatelet effect lasts the platelet's lifetime (~7-10 days)''' due to irreversible COX-1 acetylation; analgesic 4-6 hours (1) · 12-24 hours (1) · 2-4 hours; headache recurrence rate ~20-30% within 24 hours (1) · 24 hours (once-daily dosing supported by long half-life) (1) · 2–4 h (1) · 3-5 hours (IR); 8-24 hours (ER); 12-24 hours (epidural / intrathecal) (1) · 3–4 h (1) · 3–5 h (subjective) (1) · 4-6 hours (1) · 4-6 hours (IR); 12 hours (ER) (1) · 4-6 hours (IR); 24 hours (ER) (2) · 4-6 hours; headache recurrence is common (1) · 6-8 hours (IR oral); 12-24 hours (ER) (1) · 8-12 hours (the long-duration feature relative to ibuprofen) (1) · ~48 hours of headache freedom (1)

None (44) · Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)'"`UNIQ--ref-00000022-QINU`"' (1) · Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)'"`UNIQ--ref-00000028-QINU`"' (1) · Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)'"`UNIQ--ref-0000002B-QINU`"' (3) · Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning; contraindicated from 30 weeks (risk of premature ductus arteriosus closure, which is paradoxically the basis of the neonatal PDA-closure indication)'"`UNIQ--ref-00000028-QINU`"' (1) · Chronic third-trimester exposure produces neonatal opioid withdrawal syndrome and respiratory depression at delivery.[[[Pharmacopedia:Citation needed|citation needed]]] (3) · Limit to <200 mg/d (~2 cups brewed) (1) · Limited human data.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Limited human data; pregnancy registry data have been broadly reassuring across the triptan class.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Limited human data; pregnancy registry data have been broadly reassuring relative to baseline malformation rates.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Low-dose (81 mg) safe and indicated for preeclampsia prophylaxis after 12 weeks in high-risk patients per USPSTF; high-dose aspirin avoid third trimester due to premature ductus arteriosus closure and bleeding risk (1)

None (40) · Currently legal in most jurisdictions with thujone limits (1) · Leaves legal in Bolivia, Peru, Colombia; cocaine internationally controlled (1) · Plant unrestricted; pharmaceutical atropine Rx-only (1) · Schedule I in US since 1993 (despite traditional use elsewhere); legal in Ethiopia, Kenya, Yemen, Somalia, Djibouti (1) · Unrestricted (food) (1) · [[USLegal:Over-the-counter|OTC]] in the US at ≤200 mg per tablet / ≤1200 mg/day; [[USLegal:Prescription only|Rx-only]] at higher strengths and indications (1) · [[USLegal:Over-the-counter|OTC]] in US at all standard strengths (1) · [[USLegal:Over-the-counter|OTC]] in US at ≤220 mg/tablet and ≤660 mg/day; [[USLegal:Prescription only|Rx-only]] at higher strengths (1) · [[USLegal:Prescription only|Rx-only]] for oral and most topical formulations in US; Voltaren Arthritis Pain 1% gel switched to [[USLegal:Over-the-counter|OTC]] in 2020 (1) · [[USLegal:Prescription only|Rx-only]] in US (6) · [[USLegal:Schedule II|Schedule II controlled substance]] in US; WHO essential medicine'"`UNIQ--ref-00000022-QINU`"' (1) · [[USLegal:Schedule II|Schedule II controlled substance]] in US'"`UNIQ--ref-0000001F-QINU`"' (1) · [[USLegal:Schedule IV|Schedule IV controlled substance]] in US (federally scheduled 2014); some states schedule higher'"`UNIQ--ref-0000001F-QINU`"' (1)