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Medicines > classes : Stimulant or [[:Category:Calcium_supplements|Calcium supplement]] or dissociative

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generic:
brand:
None (59) · Benzedrex (1) · DXM (1) · DXO (1) · Spravato (1) · Tums, Caltrate, Os-Cal, Citracal; many generics (1)
classes: (Click arrow to add another value)
mechanism:
Monoamine releasing agent (8) · Dopamine/norepinephrine reuptake inhibitor (5) · NMDA antagonist (3) · None (2) · Cathinone analogue; monoamine reuptake inhibitor (2) · Dopamine and norepinephrine reuptake inhibitor (2) · NMDA antagonist; sigma receptor agonist (2) · Norepinephrine–dopamine reuptake inhibitor (2)
uses:
None (62) · Treatment-resistant depression (TRD) in adults, as adjunct to oral antidepressant (FDA-approved March 2019). Depressive symptoms in adults with MDD with acute suicidal ideation or behavior (FDA-approved Aug 2020). (1) · '"`UNIQ--vote-000012B7-QINU`"', '"`UNIQ--vote-000012B8-QINU`"', '"`UNIQ--vote-000012B9-QINU`"', '"`UNIQ--vote-000012BA-QINU`"', '"`UNIQ--vote-000012BB-QINU`"' (1)
starting dose:
None (62) · Induction (TRD): 56 mg intranasal twice weekly × 4 weeks. Maintenance: 56-84 mg once weekly × 4 weeks, then 56-84 mg every 1-2 weeks. For acute suicidality: 84 mg twice weekly × 4 weeks. Administered under medical supervision in REMS-certified site. (1) · Oral: 1000-1500 mg elemental calcium/day in divided doses for supplementation; IV gluconate 1 g (4.65 mEq) over 5-10 min for hyperkalemia or symptomatic hypocalcemia (1)
preparations:
None (62) · 28 mg/device (each dose uses 2 devices) (1) · Carbonate 200, 400, 500, 600 mg elemental tablets and chewables; citrate 200, 250, 315 mg elemental; gluconate 1 g (94 mg elemental, 4.65 mEq) IV; chloride 1 g (270 mg elemental, 13.6 mEq) IV (1)
fda max:
None (62) · 84 mg per session (1) · ~2500 mg elemental/d combined diet + supplements (chronic; UL) (1)
routes:
None (62) · Intranasal (under direct medical supervision) (1) · IV (gluconate or chloride for acute use) (1) · Oral (1)
onset:
None (62) · Acute: minutes (IV); chronic: bone effect over months (1) · Within hours of first administration (1)
duration:
None (62) · Acute effect ~24 hours; cumulative effect builds with repeated dosing (1) · Variable (1)
halflife:
None (62) · Not meaningfully described (electrolyte) (1) · ~7-12 hours (1)
bioavailability:
None (62) · Carbonate ~30-40% (best with food and acid); citrate ~24% (absorbable without acid; preferred in achlorhydria, PPI use, post-bariatric) (1) · ~48% intranasal (1)
pregnancy:
None (62) · Avoid; may cause fetal harm (1) · Routinely supplemented in pregnancy; needs higher in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (62) · OTC (oral supplements) and [[USLegal:Prescription only|Rx-only]] (IV) in US (1) · Rx, Schedule III (US). REMS program required. (1)

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