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Medicines > duration : 24 hours (HS dosing) or 8-12 hours or Variable

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classes:
gut-restricted)]] (1) · hydroxide)]] (1) · secondary amine)]] (1) · torsades)]] (1) · [[:Category:Alpha-2_agonists|Alpha-2 adrenergic agonist]] (1) · [[:Category:Antacids|Antacid (carbonate)]] (1) · [[:Category:Antacids|Antacid (hydroxide)]] (1) · [[:Category:Antiarrhythmics|Antiarrhythmic (IV sulfate (1) · [[:Category:Antibacterials|Antibacterial (anaerobic)]] (1) · [[:Category:Antibacterials|Antibacterial]] (1) · [[:Category:Antidepressants|Antidepressant]] (4) · [[:Category:Antidiarrheals|Antidiarrheal]] (1) · [[:Category:Antihistamines|Antihistamine (potent H1)]] (1) · [[:Category:Antiparasitics|Antiparasitic]] (1) · [[:Category:Antiprotozoals|Antiprotozoal]] (1) · [[:Category:Beta-lactam_antibiotics|β-lactam antibiotic]] (1) · [[:Category:Calcium_supplements|Calcium supplement]] (1) · [[:Category:Cephalosporins|Cephalosporin (second-generation)]] (1) · [[:Category:Electrolyte_replacements|Electrolyte replacement]] (2) · [[:Category:Fluoroquinolones|Fluoroquinolone antibiotic]] (1) · [[:Category:Glaucoma_medications|Glaucoma medication]] (1) · [[:Category:H1_receptor_antagonists|Histamine H1 receptor antagonist]] (1) · [[:Category:Macrocyclic_lactones|Macrocyclic lactone (avermectin)]] (1) · [[:Category:Mast_cell_stabilizers|Mast cell stabilizer]] (1) · [[:Category:Migraine prophylactics|Migraine prophylactic]] (2) · [[:Category:Neuropathic pain medicines|Neuropathic pain medicine]] (2) · [[:Category:Nitroimidazoles|Nitroimidazole antibiotic]] (1) · [[:Category:Ocular_hypotensive_agents|Ocular hypotensive agent]] (1) · [[:Category:Ophthalmic_antihistamines|Ophthalmic antihistamine]] (1) · [[:Category:Opioid_receptor_agonists|Peripheral opioid receptor agonist (μ-selective (1) · [[:Category:Osmotic_laxatives|Osmotic laxative (citrate (1) · [[:Category:Sleep aids|Sleep aid (off-label)]] (1) · [[:Category:Sleep aids|Sleep aid (Silenor low-dose)]] (1) · [[:Category:Tetracyclic antidepressants|Tetracyclic antidepressant]] (1) · [[:Category:Tricyclic antidepressants|Tricyclic antidepressant (TCA (1) · [[:Category:Tricyclic antidepressants|Tricyclic antidepressant (TCA)]] (2)
uses:
'"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"' (2) · '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"' (1) · '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"' (1) · '"`UNIQ--vote-00000932-QINU`"', '"`UNIQ--vote-00000933-QINU`"', '"`UNIQ--vote-00000934-QINU`"', '"`UNIQ--vote-00000935-QINU`"', '"`UNIQ--vote-00000936-QINU`"', '"`UNIQ--vote-00000937-QINU`"' (1) · '"`UNIQ--vote-00000BE3-QINU`"', '"`UNIQ--vote-00000BE4-QINU`"', '"`UNIQ--vote-00000BE5-QINU`"', '"`UNIQ--vote-00000BE6-QINU`"', '"`UNIQ--vote-00000BE7-QINU`"', '"`UNIQ--vote-00000BE8-QINU`"', '"`UNIQ--vote-00000BE9-QINU`"', '"`UNIQ--vote-00000BEA-QINU`"' (1) · '"`UNIQ--vote-00000FCF-QINU`"', '"`UNIQ--vote-00000FD0-QINU`"', '"`UNIQ--vote-00000FD1-QINU`"' (1) · '"`UNIQ--vote-00000FF3-QINU`"', '"`UNIQ--vote-00000FF4-QINU`"', '"`UNIQ--vote-00000FF5-QINU`"', '"`UNIQ--vote-00000FF6-QINU`"', '"`UNIQ--vote-00000FF7-QINU`"', '"`UNIQ--vote-00000FF8-QINU`"' (1) · '"`UNIQ--vote-0000108C-QINU`"', '"`UNIQ--vote-0000108D-QINU`"', '"`UNIQ--vote-0000108E-QINU`"', '"`UNIQ--vote-0000108F-QINU`"', '"`UNIQ--vote-00001090-QINU`"', '"`UNIQ--vote-00001091-QINU`"' (1) · '"`UNIQ--vote-000010CE-QINU`"', '"`UNIQ--vote-000010CF-QINU`"', '"`UNIQ--vote-000010D0-QINU`"' (1) · '"`UNIQ--vote-00001286-QINU`"' (1) · '"`UNIQ--vote-000012B7-QINU`"', '"`UNIQ--vote-000012B8-QINU`"', '"`UNIQ--vote-000012B9-QINU`"', '"`UNIQ--vote-000012BA-QINU`"', '"`UNIQ--vote-000012BB-QINU`"' (1) · '"`UNIQ--vote-00001303-QINU`"', '"`UNIQ--vote-00001304-QINU`"', '"`UNIQ--vote-00001305-QINU`"', '"`UNIQ--vote-00001306-QINU`"', '"`UNIQ--vote-00001307-QINU`"', '"`UNIQ--vote-00001308-QINU`"', '"`UNIQ--vote-00001309-QINU`"' (1)
starting dose:
15 mg PO at bedtime, titrate to 30-45 mg/day after 1-2 weeks. '''Counterintuitive dose paradox''': lower doses (7.5-15 mg) are more sedating than higher doses because H1 antihistamine effect dominates at low dose (1) · 250-500 mg PO BID × 7-14 days; IV 1.5 g q8h for serious infections (1) · 4 mg PO initially, then 2 mg after each loose stool, '''not to exceed 16 mg/d''' (8 mg OTC); chronic-use lower (1) · 500 mg PO TID × 7-10 days (most indications); 2 g single dose for trichomoniasis; 500 mg IV q8h for severe anaerobic infection; rectal 1 g BID (1) · 500-750 mg PO BID; 400 mg IV q8-12h (1) · Depression (rarely used now): 25-75 mg PO at bedtime, titrate to 150 mg/day. Neuropathic pain / migraine prophylaxis: 10-25 mg at bedtime, titrate by 10-25 mg weekly to 50-100 mg/day. Elderly: 10 mg at bedtime (Beers-list cautions apply) (1) · Depression: 25 mg PO TID-QID or 75 mg at bedtime, titrate to 75-150 mg/day. Neuropathic pain: 10-25 mg at bedtime, titrate to 50-100 mg/day. Elderly: 10 mg at bedtime (Beers-list cautions, though less than amitriptyline) (1) · Depression: 25-75 mg/day to start, titrate to 75-150 mg/day at bedtime. Insomnia (Silenor): 3 mg PO 30 minutes before bedtime, max 6 mg. Topical (Prudoxin): apply to affected area every 3-4 hours (1) · Ophthalmic 1 drop in affected eye(s) TID; topical Mirvaso 0.33% gel applied to face daily (1) · Ophthalmic 1 drop in each eye every 8-12 hours (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) · Replacement oxide 400-800 mg/d in divided doses (high diarrhea rate); citrate 200-400 mg/d (better tolerated, better absorbed); IV sulfate 1-2 g over 5-60 minutes for hypomagnesemia or torsades; eclampsia 4-6 g IV loading then 1-2 g/h (1) · Strongyloides 200 mcg/kg PO single dose; scabies 200 mcg/kg PO repeated at 7-14 days; onchocerciasis 150 mcg/kg q6-12 months (1)
duration: (Click arrow to add another value)
pregnancy:
'''Avoid in pregnancy where alternatives exist''' (animal cartilage toxicity; class-wide concern); use only when benefit clearly outweighs.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered acceptable when needed.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe (minimal systemic exposure).<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe after the first trimester; first-trimester use weighed against indication.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · IV sulfate is the cornerstone of eclampsia/preeclampsia management; oral replacement also safe.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data; risk-benefit case by case; pregnancy is not a strict contraindication in WHO mass drug administration programs.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited human data; some observational signals reassuring relative to other antidepressants.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Older agent with substantial use experience; observational signals not clearly causal.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (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) · TCA class signal; limited human data specific to doxepin.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · TCA class signal; limited human data specific to nortriptyline.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

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