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Apixaban (1) · Azelastine (1) · Citalopram (1) · Dextromethorphan / Quinidine (1) · Donepezil (1) · Doxycycline (1) · Escitalopram (1) · Flecainide (1) · Fluorouracil (5-FU) (1) · Icosapent ethyl (eicosapentaenoic acid ethyl ester, EPA-EE) (1) · Ofloxacin (1) · Oseltamivir (1) · Paroxetine (HCl; mesylate as Pexeva) (1) · Riboflavin (vitamin B2) (1) · Ticagrelor (1) · Tretinoin (all-trans retinoic acid, ATRA) (1)

Aricept (oral), Adlarity (transdermal patch) (1) · Astelin, Astepro (intranasal); Optivar (ophthalmic); with fluticasone as Dymista (1) · Brilinta (1) · Celexa (1) · Efudex (topical), Carac (topical), Fluoroplex (topical); generic IV (1) · Eliquis (1) · Floxin (oral, US brand discontinued); Ocuflox (ophthalmic); Floxin Otic (otic) (1) · Lexapro (1) · Many generics/OTC (1) · Nuedexta (1) · Paxil (IR), Paxil CR (controlled-release), Brisdelle (low-dose for menopausal vasomotor symptoms), Pexeva (paroxetine mesylate) (1) · Retin-A, Renova, Atralin, Avita, Tretin-X, Refissa, Altreno; Vesanoid (oral, APL) (1) · Tambocor (US brand discontinued) (1) · Tamiflu (1) · Vascepa (1) · Vibramycin, Doryx, Oracea, Adoxa, Monodox, Acticlate (1)

None (8) · '"`UNIQ--vote-0000001D-QINU`"' CYP2C19 + CYP3A4 metabolism, with CPIC PGx guidance: poor CYP2C19 metabolizers have ~3-fold higher exposure and benefit from a lower starting dose; ultrarapid metabolizers may have inadequate response'"`UNIQ--ref-0000001E-QINU`"'. (2) · '"`UNIQ--vote-000001F6-QINU`"' CYP3A4 (primary) and P-glycoprotein substrate; strong dual inhibitors or inducers materially shift exposure. Reversal: andexanet alfa for life-threatening bleeding; 4F-PCC commonly used off-label when andexanet unavailable'"`UNIQ--ref-000001F7-QINU`"'. (1) · '"`UNIQ--vote-0000113A-QINU`"' Concomitant β-blocker or CCB is required when used for AF to prevent 1:1 atrial flutter conduction (flecainide can slow atrial rate to a level where AV conduction allows dangerous ventricular rates). CYP2D6 substrate'"`UNIQ--ref-0000113B-QINU`"'. (1) · '"`UNIQ--vote-0000124C-QINU`"' The 400 mg/d dose for migraine prophylaxis is supported by randomized trials (Schoenen 1998) and remains a low-risk evidence-based supplement option. Characteristic bright-yellow urine fluorescence with high-dose oral supplementation. (1) · '"`UNIQ--vote-000013B1-QINU`"' Topical application minimizes systemic antihistaminic burden; the characteristic bitter taste with nasal use (drainage to oropharynx) is the main tolerability issue'"`UNIQ--ref-000013B2-QINU`"'. (1) · '"`UNIQ--vote-000014BC-QINU`"' Topical ophthalmic and otic formulations remain widely used in ENT and ophthalmology. Subject to all fluoroquinolone-class restrictions (tendinitis/rupture, peripheral neuropathy, QT prolongation)'"`UNIQ--ref-000014BD-QINU`"'. (1) · '"`UNIQ--vote-00001580-QINU`"' First FDA-approved treatment for PBA. The 10 mg quinidine daily dose is far below antiarrhythmic levels but sufficient to nearly fully inhibit CYP2D6, the basis of the combination's pharmacokinetic rationale'"`UNIQ--ref-00001581-QINU`"'. (1)

1 capsule (20/10 mg dextromethorphan/quinidine) PO once daily × 7 days, then 1 capsule BID (1) · 10 mg PO once daily; titrate to 20 mg/day after 1-2 weeks if needed (1) · 100 mg PO BID; rickettsial 200 mg/d; doxy-PEP 200 mg within 72 hours after condomless sex (1) · 2 g PO BID with meals (4 g/d total) (1) · 20 mg PO once daily; titrate to 40 mg/day after 1 week if tolerated. Elderly (>60) and hepatic impairment: 20 mg/day ceiling (1) · 5 mg PO once daily at bedtime; titrate to 10 mg/day after 4-6 weeks. Severe Alzheimer disease: may escalate to 23 mg/day. Adlarity patch: 5 or 10 mg/day applied weekly (1) · 50 mg PO BID; titrate to 100-200 mg BID; pill-in-pocket 200-300 mg PO single dose for AF conversion (1) · ACS/PCI: 180 mg PO loading dose, then 90 mg PO BID for 12 months; long-term post-MI: 60 mg BID (1) · Intranasal 0.1% or 0.15%: 1-2 sprays/nostril BID; ophthalmic 0.05%: 1 drop in each eye BID (1) · MDD/GAD: 20 mg PO once daily. Panic disorder: 10 mg titrating to 40 mg. OCD: 20 mg titrating to 40-60 mg. CR: 25 mg/day. Brisdelle: 7.5 mg at bedtime for hot flashes (1) · Migraine prophylaxis: 400 mg PO daily; deficiency replacement 5-30 mg/d (1) · NVAF: 5 mg PO BID (2.5 mg BID if 2 of 3: age ≥80, weight ≤60 kg, serum creatinine ≥1.5 mg/dL); acute VTE: 10 mg BID for 7 days, then 5 mg BID (1) · Oral 200-400 mg BID; ophthalmic 1-2 drops in affected eye(s) q2-4h initially, then taper; otic 5-10 drops in affected ear BID (1) · Topical: 0.5-5% cream/solution to lesions BID × 2-4 weeks; systemic IV: regimen-specific in cancer chemotherapy (1) · Topical: pea-sized amount to dry face at bedtime, building from 2-3×/week to nightly as tolerated; oral APL: 45 mg/m²/d in divided doses (1) · Treatment: 75 mg PO BID × 5 days (adult); pediatric weight-based; prophylaxis: 75 mg PO once daily × 7-10 days (1)

0.1%, 0.15% intranasal spray; 0.05% ophthalmic solution; combination Dymista (azelastine 0.137 mg + fluticasone 50 mcg/spray) (1) · 0.5 g, 1 g capsules (1) · 0.5% (Carac), 1% (Fluoroplex), 5% (Efudex) topical creams/solutions; 50 mg/mL IV (1) · 2.5 mg, 5 mg tablets (1) · 20 mg dextromethorphan HBr / 10 mg quinidine sulfate capsules (1) · 200, 300, 400 mg tablets (mostly generic now); 0.3% ophthalmic solution; 0.3% otic solution (1) · 25, 50, 100, 250, 400 mg tablets; OTC (1) · 30, 45, 75 mg capsules; 6 mg/mL oral suspension (1) · 50 mg, 75 mg, 100 mg, 150 mg tablets and capsules; delayed-release; suspension; IV (1) · 50, 100, 150 mg tablets (1) · 60, 90 mg tablets (1) · IR tablets 10, 20, 30, 40 mg; CR tablets 12.5, 25, 37.5 mg; oral suspension 10 mg/5 mL; Brisdelle capsules 7.5 mg (1) · Oral tablets 5, 10, 23 mg; ODT 5, 10 mg; Adlarity transdermal patch 5, 10 mg/day (weekly application) (1) · Tablets 10, 20, 40 mg; oral solution 10 mg/5 mL (1) · Tablets 5, 10, 20 mg; oral solution 1 mg/mL (1) · Topical 0.01-0.1% creams, gels, micropsheres, lotions; oral 10 mg capsules (Vesanoid) (1)

'''20 mg/day in adults >60 years''' per FDA's 2011-2012 QT-prolongation warning; 40 mg/day in adults ≤60 (1) · 1 capsule BID (40 mg DXM / 20 mg quinidine per day) (1) · 10 mg BID for the first 7 days of acute VTE; otherwise 5 mg BID (1) · 150 mg/d (treatment) (1) · 2 sprays/nostril BID (1) · 20 mg/day (adult); 10 mg/day in elderly and in hepatic impairment (1) · 23 mg/day (1) · 4 g/d (1) · 400 mg/d (1) · 50 mg/day (IR); 62.5 mg/day (CR); 60 mg/day (OCD) (1) · 800 mg/d (1) · 90 mg BID (acute year); 60 mg BID (chronic post-MI) (1) · No strict ceiling for water-soluble vitamin; UL not set (1) · Topical: nightly; oral APL: 45 mg/m²/d (1) · Topical: nightly; systemic: regimen-specific (1) · ~200 mg/d for most indications; higher doses for severe infections (1)

Intranasal (1) · IV (2) · IV (rare) (1) · ophthalmic (1) · Oral (13) · oral (APL only) (1) · otic (1) · Topical (2) · topical ophthalmic (1) · transdermal (1)

15 minutes (1) · AF conversion within hours of single PO dose (1) · Antidepressant effect emerges over 1-2 weeks (1) · Antidepressant effect emerges over 1-2 weeks; full clinical effect 4-6 weeks (1) · Antidepressant effect over 1-2 weeks; full clinical effect 4-6 weeks (1) · Antiplatelet effect within 30 minutes of loading dose (faster than clopidogrel) (1) · Cognitive effect emerges gradually over weeks to months; ceiling effect at the therapeutic dose (1) · Hours (2) · Migraine effect after 1-3 months of daily use (1) · PBA episode reduction within 1-2 weeks (1) · Peak anticoagulant effect 3-4 hours (1) · Symptom shortening detectable within 24-48 hours of starting (small absolute benefit; ~1 day reduction in symptom duration) (1) · Topical: inflammation, erythema, crusting at 2 weeks; complete response weeks to months after course (1) · Topical: irritation within days; acne improvement 6-12 weeks; oral APL response within days (1) · Triglyceride lowering at 4-8 weeks; CV benefit emerges over months (1)

16-22 hours'"`UNIQ--ref-0000047D-QINU`"' (1) · 27-32 hours'"`UNIQ--ref-00000026-QINU`"' (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) · ~0.5-2 hours (oral)'"`UNIQ--ref-00000BA3-QINU`"' (1) · ~1-2 hours plasma (riboflavin itself); FAD/FMN tissue cofactors are continuous (1) · ~10-20 minutes systemically (rapid hepatic and erythrocyte dihydropyrimidine dehydrogenase clearance)'"`UNIQ--ref-000011BE-QINU`"' (1) · ~12 hours'"`UNIQ--ref-000001FB-QINU`"' (1) · ~14 hours (adults); longer in elderly and renal impairment'"`UNIQ--ref-0000113F-QINU`"' (1) · ~21 hours (with nonlinear pharmacokinetics from CYP2D6 autoinhibition)'"`UNIQ--ref-0000002B-QINU`"' (1) · ~22 hours; longer 54 hours (desmethylazelastine, active metabolite)'"`UNIQ--ref-000013B6-QINU`"' (1) · ~35 hours'"`UNIQ--ref-00000026-QINU`"' (1) · ~6-10 hours (oseltamivir carboxylate, the active metabolite)'"`UNIQ--ref-00000E94-QINU`"' (1) · ~7 hours (parent); ~9 hours (active AR-C124910XX metabolite, accounts for ~30-40% of activity)'"`UNIQ--ref-00000C92-QINU`"' (1) · ~70 hours (long, supports once-daily dosing without peak-trough variation)'"`UNIQ--ref-0000001B-QINU`"' (1) · ~89 hours (EPA, the active metabolite)'"`UNIQ--ref-000013D1-QINU`"' (1) · ~9 hours'"`UNIQ--ref-000014C3-QINU`"' (1)

Highly variable due to saturable first-pass metabolism'"`UNIQ--ref-0000002C-QINU`"' (1) · Increased substantially via CYP2D6 inhibition'"`UNIQ--ref-00001584-QINU`"' (1) · Intranasal ~40% systemic; ophthalmic minimal'"`UNIQ--ref-000013B7-QINU`"' (1) · Substantially improved with high-fat meal; take with food'"`UNIQ--ref-000013D2-QINU`"' (1) · Topical: minimal systemic absorption (oral systemic 5-FU not used due to poor and variable absorption)'"`UNIQ--ref-000011BF-QINU`"' (1) · Topical: minimal systemic absorption with normal skin; oral: variable, induced metabolism with repeated dosing'"`UNIQ--ref-00000BA4-QINU`"' (1) · ~100% (oral)'"`UNIQ--ref-0000001C-QINU`"' (1) · ~36% (oral)'"`UNIQ--ref-00000C93-QINU`"' (1) · ~50% (oral; not significantly affected by food)'"`UNIQ--ref-000001FC-QINU`"' (1) · ~50-60% (oral; food enhances) (1) · ~75% (oral, as the active carboxylate after hepatic esterase activation)'"`UNIQ--ref-00000E95-QINU`"' (1) · ~80% (oral)'"`UNIQ--ref-00000027-QINU`"' (2) · ~90% (oral)'"`UNIQ--ref-00001140-QINU`"' (1) · ~95% (oral)'"`UNIQ--ref-000014C4-QINU`"' (1) · ~95% (oral; reduced by dairy, antacids, iron via divalent-cation chelation, though less than for tetracycline itself)'"`UNIQ--ref-0000047E-QINU`"' (1)

OTC (Astepro 0.15%) and [[USLegal:Prescription only|Rx-only]] (other intranasal, ophthalmic, Dymista) in US (1) · OTC in US (1) · [[USLegal:Prescription only|Rx-only]] in US (7) · [[USLegal:Prescription only|Rx-only]] in US. '''Contraindicated in structural heart disease''' — CAST trial (1989) showed increased mortality from class IC agents in patients with prior MI; modern use is limited to structurally normal hearts'"`UNIQ--ref-00001141-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' for bleeding risk and against aspirin maintenance doses above 100 mg/d (reduces ticagrelor efficacy, per PLATO subgroup analysis)'"`UNIQ--ref-00000C94-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000028-QINU`"' (2) · [[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-0000002E-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the same fluoroquinolone-class '''Boxed Warnings''' as ciprofloxacin/levofloxacin'"`UNIQ--ref-000014C5-QINU`"' (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)