Drilldown: Medicines

Bisoprolol (1) · Guanfacine (1) · Memantine ER / Donepezil (1) · Nebivolol (1)

Bystolic (1) · Intuniv (extended-release), Tenex (immediate-release) (1) · Namzaric (1) · Zebeta (1)

Beta Blocker (2) · Cardioselective (β1) (1) · Cardioselective (β1) + vasodilator (1) · Combined cholinesterase inhibitor + NMDA antagonist (1) · [[:Category:ADHD medicines|ADHD medicine]] (1) · [[:Category:Alpha-2 adrenergic agonists|Alpha-2 adrenergic agonist]] (1) · [[:Category:Antihypertensives|Antihypertensive (historical)]] (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) · 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) · '"`UNIQ--vote-00000019-QINU`"' Sedation and hypotension are the dose-limiting effects; gradual titration and bedtime or split dosing mitigate both. Abrupt discontinuation can precipitate rebound hypertension, particularly with long-standing use'"`UNIQ--ref-0000001A-QINU`"'. (1)

'"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"' (1) · '"`UNIQ--vote-00000468-QINU`"' (1) · '"`UNIQ--vote-0000059D-QINU`"' (1) · '"`UNIQ--vote-00000636-QINU`"', '"`UNIQ--vote-00000637-QINU`"', '"`UNIQ--vote-00000638-QINU`"' (1)

2.5–5 mg daily (HTN); 1.25 mg daily (HFrEF, slow titration) (1) · 5 mg daily (1) · For patients already stable on memantine 28 mg/d + donepezil 10 mg/d, switch to one capsule daily of equivalent strength (1) · Intuniv ER 1 mg PO once daily; titrate by 1 mg/week as tolerated to clinical response (1)

2.5, 5, 10, 20 mg tabs (1) · 5, 10 mg tabs (1) · 7/10, 14/10, 21/10, 28/10 mg ER capsules (memantine ER / donepezil) (1) · Extended-release tablets 1, 2, 3, 4 mg (Intuniv); immediate-release tablets 1, 2 mg (Tenex) (1)

20 mg/d (1) · 28/10 mg/d (1) · 40 mg/d (1) · 7 mg/day in children and adolescents; weight-based ceiling (~0.12 mg/kg/day) applies in smaller patients (1)

Oral (3) · Oral (capsule whole or opened/sprinkled on applesauce) (1)

1–2 h (2) · Component effects accumulate over weeks (1) · Gradual; full clinical effect over 2-4 weeks of titration (1)

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:

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9–12 h (1) · ~10 h (CYP2D6 extensive metabolizers); up to 31 h (poor metabolizers) (1) · ~17-18 hours (Intuniv ER); ~17 hours (immediate-release)'"`UNIQ--ref-00000020-QINU`"' (1) · ~60–80 h (memantine); ~70 h (donepezil) (1)

~100% both components (1) · ~12% (extensive metabolizers); ~96% (poor metabolizers) (1) · ~58% (extended-release); ~80% (immediate-release)'"`UNIQ--ref-00000021-QINU`"' (1) · ~90% (low first-pass) (1)

Category C (2) · Limited human data. Animal studies show fetal effects at maternally toxic doses; use only if benefits justify the potential risk.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Not relevant (geriatric problem) (1)

Rx-only in US (3) · [[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, which is a meaningful contrast to the psychostimulant alternatives for ADHD'"`UNIQ--ref-00000022-QINU`"' (1)