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: Sedative-Hypnotic

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Bromazolam (1) · Bupropion / Naltrexone (1) · Butalbital / Acetaminophen / Caffeine (1) · Butalbital / Aspirin / Caffeine (1) · Clonazolam (1) · Codeine / Acetaminophen (1) · Deschloroetizolam (1) · Diclazepam (1) · Estazolam (1) · Eszopiclone (1) · Ethchlorvynol (1) · Flualprazolam (1) · Flubromazepam (1) · Flubromazolam (1) · Flunitrazepam (1) · Flunitrazolam (1) · Flurazepam (1) · Gaboxadol (1) · GHB (1) · Glutethimide (1) · Lormetazepam (1) · Methaqualone (1) · Midazolam (1) · Nifoxipam (1) · Nitrazepam (1) · Olanzapine / Fluoxetine (1) · Oxycodone / Acetaminophen (1) · Oxycodone / Aspirin (1) · Pentobarbital (1) · Quazepam (1) · Ramelteon (1) · Secobarbital (1) · Sumatriptan / Naproxen (1) · Tasimelteon (1) · Temazepam (1) · Triazolam (1) · Zaleplon (1) · Zopiclone (1)

None (9) · (none, never marketed) (1) · Contrave (US), Mysimba (EU) (1) · Dalmane (1) · Doral (1) · Doriden (1) · Fioricet, Esgic; with codeine as Fioricet with Codeine (Schedule III) (1) · Fiorinal; with codeine as Fiorinal with Codeine (Schedule III) (1) · Halcion (1) · Hetlioz (1) · Imovane (1) · Lunesta (1) · Mogadon (1) · Nembutal (1) · Percocet, Endocet, Roxicet, Tylox, Primlev (1) · Percodan (1) · Placidyl (1) · ProSom (1) · Quaalude (1) · Restoril (1) · Rohypnol (1) · Rozerem (1) · Seconal (1) · Sonata (1) · Symbyax (1) · THIP (1) · Treximet (1) · Tylenol with Codeine #3 (30 mg codeine), Tylenol #4 (60 mg codeine), Capital with Codeine, Phenaphen with Codeine (1) · Versed (1) · Xyrem (1)

None (5) · Extremely potent GABAA positive allosteric modulator (1) · GABAA positive allosteric modulator (15) · GABAA positive allosteric modulator (non-benzodiazepine) (3) · GABAA positive allosteric modulator; very long half-life (1) · GABAA potentiator (1) · GABAA potentiator and direct activator (2) · GABAB agonist; GHB receptor agonist (1) · Melatonin receptor agonist (2) · Positive allosteric modulator of the GABAA receptor at the benzodiazepine binding site; increases frequency of Cl− channel opening, producing anxiolytic, sedative, hypnotic, anticonvulsant, and skeletal-muscle relaxant effects. (1) · Selective GABAA agonist (extrasynaptic delta subunit) (1) · '"`UNIQ--vote-000014DD-QINU`"' The combination is the most-prescribed opioid analgesic in the US for moderate-to-severe acute pain. CPIC PGx guidance addresses CYP2D6-driven exposure variation'"`UNIQ--ref-000014DE-QINU`"'. (1) · '"`UNIQ--vote-000014F7-QINU`"' Falling out of favor for acute pain due to aspirin's GI bleeding and antiplatelet effects compared with acetaminophen-opioid combinations; still used in selected indications'"`UNIQ--ref-000014F8-QINU`"'. (1) · '"`UNIQ--vote-00001513-QINU`"' The combination with acetaminophen provides additive non-opioid analgesia and lowers required codeine dose. CYP2D6 PGx is one of the most clinically actionable in current pharmacology; CPIC supports genotype-guided opioid selection'"`UNIQ--ref-00001514-QINU`"'. (1) · '"`UNIQ--vote-00001549-QINU`"' Metabolic effects (weight gain, dyslipidemia, glucose dysregulation) dominate the long-term tolerability profile; routine metabolic monitoring is standard'"`UNIQ--ref-0000154A-QINU`"'. (1) · '"`UNIQ--vote-000015CE-QINU`"' The dual-mechanism design exploits the inflammatory component of migraine that triptan monotherapy does not fully address. Risk of serotonin syndrome with SSRIs/SNRIs is theoretical but generally not seen clinically at triptan doses'"`UNIQ--ref-000015CF-QINU`"'. (1)

None (29) · 1 tablet (4.8355 mg oxycodone / 325 mg aspirin) PO every 6 hours as needed (1) · 1 tablet (85/500 mg sumatriptan/naproxen) PO at migraine onset; may repeat after 2 hours if needed; maximum 2 tablets per 24 hours (1) · 1-2 capsules (50 mg butalbital / 325 mg acetaminophen / 40 mg caffeine each) PO every 4 hours as needed; maximum 6 capsules/d (1) · 1-2 capsules (50 mg butalbital / 325 mg aspirin / 40 mg caffeine each) PO every 4 hours as needed; maximum 6 capsules/d (1) · 1-2 tablets (15-60 mg codeine, 300-600 mg acetaminophen) PO every 4-6 hours as needed (1) · 5 mg / 325 mg PO every 4-6 hours as needed; total acetaminophen <3 g/d (1) · 6/25 mg PO once daily in the evening; titrate within range 3/25 to 18/75 mg by clinical response and tolerability (1) · No medical dose. Active recreational doses reported in the 0.5–1.5 mg range (similar potency to alprazolam). (1) · Week 1: 1 tablet (8/90 mg) PO morning; week 2: 1 tablet AM + 1 PM; week 3: 2 AM + 1 PM; week 4 onward: 2 AM + 2 PM (32 mg naltrexone / 360 mg bupropion/d) (1)

None (29) · 4.8355 mg oxycodone / 325 mg aspirin tablets (1) · 50/325/40 mg capsules (1) · 50/325/40 mg capsules and tablets; oral solution (1) · 8 mg naltrexone / 90 mg bupropion ER tablets (titration-pack design) (1) · 85 mg sumatriptan / 500 mg naproxen sodium tablets; lower-dose 10/60 mg pediatric (Treximet pediatric) (1) · Capsules: 3/25, 6/25, 6/50, 12/25, 12/50 mg olanzapine/fluoxetine (1) · Codeine/acetaminophen 15/300 (#2 historical), 30/300 (#3), 60/300 (#4) mg tablets; 12/120 mg/5 mL elixir (1) · Illicit tablets ("bars"), powders, blotter, occasionally solutions. No pharmaceutical product exists. (1) · Oxycodone/acetaminophen 2.5/325, 5/325, 7.5/325, 10/325 mg tablets; 5/325 mg/5 mL solution (1)

None (29) · 18 mg olanzapine / 75 mg fluoxetine per day (1) · 2 tablets per 24 hours; ≤4 days per month to avoid medicine-overuse headache (1) · 32 mg naltrexone / 360 mg bupropion per day (1) · 6 capsules/d (300 mg butalbital, 1950 mg acetaminophen, 240 mg caffeine) (1) · 6 capsules/d (300 mg butalbital, 1950 mg aspirin, 240 mg caffeine) (1) · Acetaminophen 4 g/d absolute (3 g/d conservative); oxycodone titrated to effect (1) · Acetaminophen 4 g/d absolute; codeine 240-360 mg/d typical practical limit (1) · Aspirin GI/bleeding-limited; oxycodone titrated to effect (1) · N/A (never approved) (1)

None (29) · intranasal; rectal and IV reported. (1) · Oral (9) · sublingual (1)

None (29) · 10-30 minutes (1) · 15-30 minutes (1) · 30-60 minutes (3) · Headache relief at 30-60 minutes (1) · Modest appetite suppression within weeks; weight loss over months (1) · Mood improvement at 1-3 weeks; full effect 4-6 weeks (1) · ~20–40 min PO; faster sublingual/intranasal. (1)

None (29) · 12 hours (BID dosing required) (1) · 24 hours (1) · 4-6 hours (5) · 4-8 hours (1) · 6–10 h subjective; full pharmacologic effect considerably longer. (1)

None (29) · Butalbital ~35 hours (long; cumulative effects with frequent use); acetaminophen 1-3 hours; caffeine 3-7 hours'"`UNIQ--ref-0000159F-QINU`"' (1) · Butalbital ~35 hours; aspirin (acetyl group) ~15 minutes, salicylate 2-3 hours; caffeine 3-7 hours'"`UNIQ--ref-000015B7-QINU`"' (1) · Codeine 2.5-3.5 hours; acetaminophen 1-3 hours'"`UNIQ--ref-00001517-QINU`"' (1) · Estimated ~12–17 h (some sources cite up to ~21 h); active metabolites prolong effect. (1) · Naltrexone ~4 hours (6β-naltrexol metabolite ~13 hours); bupropion ~21 hours'"`UNIQ--ref-00001568-QINU`"' (1) · Olanzapine ~30 hours; fluoxetine 1-4 days (norfluoxetine 7-15 days)'"`UNIQ--ref-0000154D-QINU`"' (1) · Oxycodone 3-5 hours; acetaminophen 1-3 hours'"`UNIQ--ref-000014E2-QINU`"' (1) · Oxycodone 3-5 hours; aspirin (acetyl group) 15-20 minutes, salicylate 2-3 hours at therapeutic doses'"`UNIQ--ref-000014FA-QINU`"' (1) · Sumatriptan ~2.5 hours; naproxen 12-15 hours'"`UNIQ--ref-000015D1-QINU`"' (1)

None (29) · Butalbital well-absorbed; aspirin 50-75%; caffeine ~100%'"`UNIQ--ref-000015B8-QINU`"' (1) · Butalbital well-absorbed; caffeine ~100%; acetaminophen 85-98%'"`UNIQ--ref-000015A0-QINU`"' (1) · Codeine ~60% (oral); acetaminophen 85-98%'"`UNIQ--ref-00001518-QINU`"' (1) · Naltrexone ~5% (oral, extensive first-pass to 6β-naltrexol); bupropion ER ~87%'"`UNIQ--ref-00001569-QINU`"' (1) · Not formally characterized in humans. (1) · Olanzapine 60% (oral); fluoxetine high (oral)'"`UNIQ--ref-0000154E-QINU`"' (1) · Oxycodone 60-87%; aspirin 50-75%'"`UNIQ--ref-000014FB-QINU`"' (1) · Sumatriptan ~15% (oral; substantial first-pass); naproxen ~95%'"`UNIQ--ref-000015D2-QINU`"' (1) · ~60-87% oxycodone (high and predictable, less CYP-genotype-dependent than codeine or hydrocodone); 85-98% acetaminophen'"`UNIQ--ref-000014E3-QINU`"' (1)

None (30) · 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; aspirin teratogenicity concerns plus opioid neonatal withdrawal.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Avoid; NSAID-class restriction after 20 weeks (FDA 2020) and limited triptan pregnancy data.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Avoided; barbiturate + aspirin teratogenicity and bleeding concerns.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Contraindicated in pregnancy (FDA label).[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Generally avoided; barbiturate exposure in late pregnancy can produce neonatal withdrawal and respiratory depression.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Limited data; fluoxetine has reassuring data but olanzapine carries metabolic-syndrome and gestational diabetes signals.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Limited use in pregnancy; chronic third-trimester opioid exposure produces neonatal opioid withdrawal syndrome and respiratory depression at delivery.[[[Pharmacopedia:Citation needed|citation needed]]] (1)

None (32) · [[USLegal:Prescription only|Rx-only]] in US. Carries the '''antidepressant Boxed Warning''' for suicidality in children/adolescents/young adults and the atypical-neuroleptic '''Boxed Warning''' for increased mortality in elderly dementia patients'"`UNIQ--ref-0000154F-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. NSAID-class '''Boxed Warning''' for CV thrombotic events and GI bleeding; triptans contraindicated in coronary artery disease, peripheral vascular disease, uncontrolled hypertension, and recent ergot or MAOI use'"`UNIQ--ref-000015D3-QINU`"' (1) · [[USLegal:Schedule III|Schedule III controlled substance]] in US (Fiorinal is scheduled federally; Fioricet with acetaminophen is unscheduled federally despite identical butalbital content, a regulatory quirk) (1) · [[USLegal:Schedule III|Schedule III controlled substance]] in US. '''Contraindicated in children <12''' for any indication and in any age post-tonsillectomy/adenoidectomy (FDA 2017 black-box advisory)'"`UNIQ--ref-00001519-QINU`"' (1) · [[USLegal:Schedule II|Schedule II controlled substance]] in US (1) · [[USLegal:Schedule II|Schedule II controlled substance]] in US. Acetaminophen content limited to ≤325 mg per dosage unit (FDA 2014) (1)