Drilldown: Medicines
Use the filters below to narrow your results.
generic:
brand:
classes:
Dual orexin receptor antagonist (DORA) (3) ·
the first approved (1) ·
[[:Category:Acetylcholinesterase inhibitors|Acetylcholinesterase inhibitor]] (1) ·
[[:Category:Anti-dementia medicines|Anti-dementia medicine]] (1) ·
[[:Category:Antidepressants|Antidepressant]] (3) ·
[[:Category:Anxiolytics|Anxiolytic]] (2) ·
[[:Category:Expectorants|Expectorant]] (1) ·
[[:Category:Mucolytics|Mucolytic]] (1) ·
[[:Category:SSRIs|Selective serotonin reuptake inhibitor (SSRI)]] (3)
mechanism:
None (3) ·
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) ·
'"`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-0000104D-QINU`"' Adequate hydration is at least as important as the drug in producing the expectorant effect clinically. Used in combination with dextromethorphan, decongestants, or antihistamines in many proprietary OTC cold preparations. (1)
uses:
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-00000017-QINU`"', '"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-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`"' (2) ·
'"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"', '"`UNIQ--vote-00000026-QINU`"', '"`UNIQ--vote-00000027-QINU`"', '"`UNIQ--vote-00000028-QINU`"', '"`UNIQ--vote-00000029-QINU`"', '"`UNIQ--vote-0000002A-QINU`"' (1) ·
'"`UNIQ--vote-0000104E-QINU`"', '"`UNIQ--vote-0000104F-QINU`"' (1)
starting dose:
10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) ·
10 mg PO once daily; titrate to 20 mg/day after 1-2 weeks if needed (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) ·
200-400 mg PO q4h (IR); 600-1200 mg PO q12h (Mucinex 12-Hour ER) (1) ·
25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate (1) ·
5 mg PO at bedtime; may increase to 10 mg if inadequate (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) ·
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)
preparations:
100, 200, 400 mg IR tablets; 600 mg, 1200 mg Mucinex ER tablets; many liquid formulations and combination products with dextromethorphan, pseudoephedrine, antihistamines (1) ·
25 mg, 50 mg tablets (1) ·
5 mg, 10 mg tablets (1) ·
5 mg, 10 mg, 15 mg, 20 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)
fda max:
'''20 mg/day in adults >60 years''' per FDA's 2011-2012 QT-prolongation warning; 40 mg/day in adults ≤60 (1) ·
10 mg/d (1) ·
2.4 g/d (1) ·
20 mg/d (1) ·
20 mg/day (adult); 10 mg/day in elderly and in hepatic impairment (1) ·
23 mg/day (1) ·
50 mg/d (1) ·
50 mg/day (IR); 62.5 mg/day (CR); 60 mg/day (OCD) (1)
routes:
onset:
30 minutes (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) ·
Cognitive effect emerges gradually over weeks to months; ceiling effect at the therapeutic dose (1) ·
~30 min (3)
duration: (Click arrow to add another value)
halflife:
27-32 hours'"`UNIQ--ref-00000026-QINU`"' (1) ·
~1 hour'"`UNIQ--ref-00001050-QINU`"' (1) ·
~12 hours (1) ·
~17-19 hours (longer than daridorexant) (1) ·
~21 hours (with nonlinear pharmacokinetics from CYP2D6 autoinhibition)'"`UNIQ--ref-0000002B-QINU`"' (1) ·
~35 hours'"`UNIQ--ref-00000026-QINU`"' (1) ·
~70 hours (long, supports once-daily dosing without peak-trough variation)'"`UNIQ--ref-0000001B-QINU`"' (1) ·
~8 hours (shorter than suvorexant and lemborexant) (1)
bioavailability:
pregnancy:
None (1) ·
'''Among the least preferred SSRIs in pregnancy.''' Observational signal for cardiac malformations (atrial and ventricular septal defects) with first-trimester exposure, and the most severe neonatal adaptation syndrome of any SSRI with third-trimester exposure'"`UNIQ--ref-0000002D-QINU`"' (1) ·
Generally considered acceptable.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited data; avoid (3) ·
Limited human data; rarely indicated in pregnancy given the patient population.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Observational signal for persistent pulmonary hypertension of the newborn (small absolute risk) and neonatal adaptation syndrome with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1)
legal:
OTC in US (1) ·
Rx, Schedule IV (US) (3) ·
[[USLegal:Prescription only|Rx-only]] in US (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)
Showing below up to 8 results in range #1 to #8.