Drilldown: Medicines

None (3) · Bisoprolol (1) · Memantine ER / Donepezil (1) · Nebivolol (1) · Testosterone (1)

AndroGel, Testim, Axiron, Fortesta (gels); Androderm (patch); Aveed (IM); Striant (buccal); Natesto (nasal); Jatenzo, Tlando (oral undecanoate) (1) · Belsomra (1) · Bystolic (1) · Dayvigo (1) · Namzaric (1) · Quviviq (1) · Zebeta (1)

Androgen / Anabolic Steroid (1) · Beta Blocker (2) · Cardioselective (β1) (1) · Cardioselective (β1) + vasodilator (1) · Combined cholinesterase inhibitor + NMDA antagonist (1) · Dual orexin receptor antagonist (DORA) (3) · the first approved (1)

None (1) · Competitive antagonist at OX1R and OX2R. Faster receptor association/dissociation kinetics than suvorexant (~16 sec dissociation vs ~57 sec) hypothesized to support sleep onset, with sufficient duration for maintenance. (1) · Competitive antagonist at OX1R and OX2R. First-in-class DORA. Receptor dissociation slower than lemborexant or daridorexant. (1) · Donepezil: reversible AChE inhibitor, increases synaptic acetylcholine. Memantine: uncompetitive low-affinity NMDA receptor antagonist, dampens pathological glutamate overactivation while preserving normal synaptic signaling. Targets two distinct mechanisms in Alzheimer's. (1) · Endogenous androgen binding to androgen receptors; mediates male secondary sex characteristics, anabolism, libido, erythropoiesis, and CNS effects on mood/energy/aggression. Aromatized peripherally to estradiol; reduced to DHT. (1) · Highly β1-selective adrenergic antagonist. Greater selectivity than metoprolol or atenolol. (1) · The d-enantiomer is a highly β1-selective antagonist; the l-enantiomer triggers endothelial nitric-oxide–mediated vasodilation. Unique among beta blockers for this NO mechanism. (1)

Insomnia (sleep onset and/or maintenance) in adults (FDA-approved August 2014). Also studied for insomnia in mild-moderate Alzheimer disease. (1) · Insomnia (sleep onset and/or maintenance) in adults (FDA-approved Dec 2019) (1) · Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022) (1) · '"`UNIQ--vote-00000468-QINU`"' (1) · '"`UNIQ--vote-0000059D-QINU`"' (1) · '"`UNIQ--vote-00000636-QINU`"', '"`UNIQ--vote-00000637-QINU`"', '"`UNIQ--vote-00000638-QINU`"' (1) · '"`UNIQ--vote-00000758-QINU`"', '"`UNIQ--vote-00000759-QINU`"', '"`UNIQ--vote-0000075A-QINU`"' (1)

10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · 2.5–5 mg daily (HTN); 1.25 mg daily (HFrEF, slow titration) (1) · 25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate (1) · 5 mg daily (1) · 5 mg PO at bedtime; may increase to 10 mg if inadequate (1) · For patients already stable on memantine 28 mg/d + donepezil 10 mg/d, switch to one capsule daily of equivalent strength (1) · Formulation-dependent. Gels: 40–50 mg topically daily. Cypionate/enanthate IM: 50–100 mg weekly. Undecanoate IM: 750 mg q10w. Patch: 4 mg/d. (1)

2.5, 5, 10, 20 mg tabs (1) · 25 mg, 50 mg tablets (1) · 5 mg, 10 mg tablets (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (1) · 5, 10 mg tabs (1) · 7/10, 14/10, 21/10, 28/10 mg ER capsules (memantine ER / donepezil) (1) · Gels, patches, IM cypionate/enanthate/undecanoate, buccal tabs, nasal gel, oral undecanoate, subcutaneous pellets (1)

10 mg/d (1) · 20 mg/d (2) · 28/10 mg/d (1) · 40 mg/d (1) · 50 mg/d (1) · Formulation-dependent (1)

buccal (1) · IM (1) · nasal (1) · Oral (5) · Oral (capsule whole or opened/sprinkled on applesauce) (1) · oral (undecanoate only) (1) · Topical (gel/patch) (1)

1–2 h (2) · Component effects accumulate over weeks (1) · Hours (transdermal); days (IM esters) (1) · ~30 min (3)

None · 24 hours · 4-6 hours · 12 hours · 6-8 hours · Daily dosing · 8-12 hours · 12-24 hours · Hours · Hours per application · 24 hours (HS dosing) · 24 hours (once-daily dosing) · 24 h · N/A · N/A (replacement) · Variable · ~7-8 hours · 3-5 hours · 4-6 hours (IR); 24 hours (ER) · 6-12 hours

Other values:

Search

9–12 h (1) · Highly variable by formulation; native T is hours (1) · ~10 h (CYP2D6 extensive metabolizers); up to 31 h (poor metabolizers) (1) · ~12 hours (1) · ~17-19 hours (longer than daridorexant) (1) · ~60–80 h (memantine); ~70 h (donepezil) (1) · ~8 hours (shorter than suvorexant and lemborexant) (1)

Oral non-undecanoate has essentially zero bioavailability (hepatic first-pass) (1) · ~100% both components (1) · ~12% (extensive metabolizers); ~96% (poor metabolizers) (1) · ~44% (1) · ~62% (1) · ~82% (1) · ~90% (low first-pass) (1)

Category C (2) · Category X, contraindicated; teratogenic (virilization of female fetus) (1) · Limited data; avoid (3) · Not relevant (geriatric problem) (1)

Rx, Schedule IV (US) (3) · Rx-only in US (3) · Schedule III (DEA, US) (1)