Drilldown/Medicines

None (1) · Amitriptyline (hydrochloride) (1) · Calcium (carbonate, citrate, gluconate, chloride salts) (1) · Doxepin (hydrochloride) (1) · Ivermectin (1) · Magnesium (oxide, citrate, sulfate, hydroxide, gluconate, chloride salts) (1) · Mirtazapine (1) · Nortriptyline (hydrochloride) (1)

Elavil (US brand discontinued; generic widely available), Endep, Tryptizol (1) · Mag-Ox, Slow-Mag, MagCitrate, Milk of Magnesia (hydroxide); IV sulfate generic (1) · Pamelor (US brand discontinued; generic widely available), Aventyl (1) · Remeron (US brand discontinued; generic widely available), Remeron SolTab (ODT) (1) · Sinequan (oral antidepressant, US brand discontinued), Silenor (low-dose for insomnia), Prudoxin / Zonalon (topical cream) (1) · Stromectol (oral, generic), Sklice (lice, topical), Soolantra (rosacea, topical 1%) (1) · Sunosi (1) · Tums, Caltrate, Os-Cal, Citracal; many generics (1)

hydroxide)]] (1) · Norepinephrine-dopamine reuptake inhibitor (NDRI) (1) · secondary amine)]] (1) · torsades)]] (1) · wake-promoting agent (1) · [[:Category:Antacids|Antacid (carbonate)]] (1) · [[:Category:Antacids|Antacid (hydroxide)]] (1) · [[:Category:Antiarrhythmics|Antiarrhythmic (IV sulfate (1) · [[:Category:Antidepressants|Antidepressant]] (4) · [[:Category:Antihistamines|Antihistamine (potent H1)]] (1) · [[:Category:Antiparasitics|Antiparasitic]] (1) · [[:Category:Calcium_supplements|Calcium supplement]] (1) · [[:Category:Electrolyte_replacements|Electrolyte replacement]] (2) · [[:Category:Macrocyclic_lactones|Macrocyclic lactone (avermectin)]] (1) · [[:Category:Migraine prophylactics|Migraine prophylactic]] (2) · [[:Category:Neuropathic pain medicines|Neuropathic pain medicine]] (2) · [[: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)

None (5) · Selective dopamine and norepinephrine reuptake inhibitor (DAT and NET inhibition). Unlike amphetamine, does not significantly release monoamines, pure reuptake inhibition. (1) · '"`UNIQ--vote-00000019-QINU`"' Therapeutic plasma-level monitoring is standard practice for TCAs given the narrow therapeutic index and the established plasma-level-efficacy correlation. CYP2D6 substrate; CPIC PGx guidance applies for dose individualization'"`UNIQ--ref-0000001A-QINU`"'. (1) · '"`UNIQ--vote-00001302-QINU`"' Renally cleared; accumulation in advanced CKD can produce neuromuscular and cardiac depression. Hypomagnesemia frequently co-exists with hypokalemia and is often the reason refractory potassium loss does not correct until magnesium is repleted. (1)

Excessive daytime sleepiness in adults with narcolepsy or obstructive sleep apnea (OSA) (1) · '"`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-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-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)

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) · 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) · Narcolepsy: 75 mg PO once daily upon awakening, titrate every 3 days. OSA: 37.5 mg PO once daily, titrate. (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)

3 mg tablets (Stromectol); 0.5% topical lotion (Sklice); 1% topical cream (Soolantra) (1) · 75 mg, 150 mg tablets (1) · Capsules 10, 25, 50, 75 mg; oral solution 10 mg/5 mL (1) · Capsules 10, 25, 50, 75, 100, 150 mg; oral concentrate 10 mg/mL; Silenor tablets 3, 6 mg; topical cream 5% (Prudoxin, Zonalon) (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) · Oxide 400, 500 mg tablets (240, 300 mg elemental); citrate 100, 150, 200 mg tablets; hydroxide oral suspension 400 mg/5 mL; sulfate IV 500 mg/mL ampules (1) · Tablets 10, 25, 50, 75, 100, 150 mg (1) · Tablets 7.5, 15, 30, 45 mg; orally disintegrating tablets (SolTab) 15, 30, 45 mg (1)

150 mg/d (1) · 150 mg/day; therapeutic plasma-level monitoring recommended (target 50-150 ng/mL window) (1) · 300 mg/day (depression, hospitalized); 150 mg/day outpatient; 6 mg/day for insomnia (1) · 300 mg/day (historical hospitalized inpatient depression); 150 mg/day outpatient typical ceiling (1) · 45 mg/day (1) · Indication-specific; renal clearance limits tolerable cumulative dosing (1) · Single 200-400 mcg/kg per dose for systemic indications (1) · ~2500 mg elemental/d combined diet + supplements (chronic; UL) (1)

IV (1) · IV (gluconate or chloride for acute use) (1) · Oral (8) · topical (2)

Acute: minutes (IV); chronic: bone effect over months (1) · Hours to days (1) · Oral: hours; IV: minutes (1) · Pain and migraine prophylaxis effect 1-4 weeks; antidepressant effect 4-6 weeks (1) · Sleep effect from first dose; analgesic and migraine-prophylaxis effect 1-4 weeks; antidepressant effect 4-6 weeks (1) · Sleep effect from first dose; antidepressant effect over 1-4 weeks (2) · ~30-60 min (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:

Search

18-44 hours'"`UNIQ--ref-00000020-QINU`"' (1) · 20-40 hours'"`UNIQ--ref-00000023-QINU`"' (1) · Amitriptyline 10-50 hours (highly variable); nortriptyline active metabolite 18-44 hours'"`UNIQ--ref-00000026-QINU`"' (1) · Not meaningfully described (electrolyte) (1) · Not meaningfully described (electrolyte; renally cleared) (1) · ~15 hours (parent); nordoxepin active metabolite ~30 hours'"`UNIQ--ref-00000020-QINU`"' (1) · ~16-18 hours'"`UNIQ--ref-00001092-QINU`"' (1) · ~7.1 hours (1)

Carbonate ~30-40% (best with food and acid); citrate ~24% (absorbable without acid; preferred in achlorhydria, PPI use, post-bariatric) (1) · Highly salt-dependent: citrate ~25-30%; oxide ~4% (limited and causes osmotic diarrhea); chloride ~12% (1) · ~30% (oral)'"`UNIQ--ref-00000021-QINU`"' (1) · ~50% (oral)'"`UNIQ--ref-00000021-QINU`"' (1) · ~50% (oral)'"`UNIQ--ref-00000027-QINU`"' (1) · ~50% (oral; substantial first-pass)'"`UNIQ--ref-00000024-QINU`"' (1) · ~60% (oral; substantially increased with high-fat meal)'"`UNIQ--ref-00001093-QINU`"' (1) · ~95% (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; pregnancy exposure registry available (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)

OTC (oral salts) and [[USLegal:Prescription only|Rx-only]] (IV) in US (1) · OTC (oral supplements) and [[USLegal:Prescription only|Rx-only]] (IV) in US (1) · Rx, Schedule IV (US) (1) · [[USLegal:Prescription only|Rx-only]] in US (the veterinary preparations are not for human use) (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000022-QINU`"' (2) · [[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000025-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`"' (1)