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Medicines (732)

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Ascorbic acid (vitamin C) (1) · Bisacodyl (1) · Brimonidine (1) · Cefuroxime (axetil oral, sodium IV) (1) · Ciprofloxacin (1) · Citalopram (1) · Docusate (sodium or calcium) (1) · Donepezil (1) · Escitalopram (1) · Ketotifen (1) · Lactulose (1) · Loperamide (1) · Metronidazole (1) · Paroxetine (HCl; mesylate as Pexeva) (1) · Polyethylene glycol 3350 (PEG 3350) (1)

Alphagan P (ophthalmic glaucoma), Mirvaso (topical rosacea) (1) · Aricept (oral), Adlarity (transdermal patch) (1) · Ceftin (oral), Zinacef (IV) (1) · Celexa (1) · Cipro, Cipro XR, Ciloxan (ophthalmic) (1) · Colace (sodium), Surfak (calcium); many generics OTC (1) · Dulcolax, Correctol, Bisac-Evac (1) · Flagyl, Metrocream, Metrogel, Metrogel-Vaginal, Noritate (1) · Generic; huge OTC presence (1) · Imodium, Imodium A-D (1) · Kristalose, Constulose, Generlac, Enulose (1) · Lexapro (1) · MiraLAX (OTC), GlycoLax, GoLYTELY (with electrolytes for bowel prep), CoLyte, MoviPrep, NuLYTELY (1) · Paxil (IR), Paxil CR (controlled-release), Brisdelle (low-dose for menopausal vasomotor symptoms), Pexeva (paroxetine mesylate) (1) · Zaditor, Alaway (ophthalmic, OTC); Zaditen (systemic, outside US) (1)

None (10) · '"`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-00001067-QINU`"' Chronic use is associated with cathartic colon (colonic dilation, loss of haustration), hypokalemia, and laxative dependence; reserved for short-term use or bowel prep with breaks between courses'"`UNIQ--ref-00001068-QINU`"'. (1) · '"`UNIQ--vote-00001284-QINU`"' Systemic oral ketotifen (available outside US) has historical use for asthma adjunct therapy via the same dual mechanism, but oral use produces sedation and weight gain — the topical ophthalmic application largely avoids both'"`UNIQ--ref-00001285-QINU`"'. (1) · '"`UNIQ--vote-0000132D-QINU`"' Electrolyte-balanced bowel-prep formulations are designed to be iso-osmotic with plasma so the volume passes through without net fluid or electrolyte shifts, the basis of their safety for whole-bowel evacuation. (1)

10 mg PO once daily; titrate to 20 mg/day after 1-2 weeks if needed (1) · 100-200 mg PO once or twice daily; pediatric weight-based (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) · 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) · 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) · 5-15 mg PO once at bedtime; 10 mg PR for faster effect; bowel prep regimens use higher single doses (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) · Constipation: 15-30 mL PO daily (titrate to 1-2 soft stools/day); hepatic encephalopathy: 20-30 g (30-45 mL) PO/PR every 1-2 hours acutely until soft stools, then BID-QID to target 2-3 soft stools/day (1) · Constipation: 17 g (one capful) PO daily dissolved in 4-8 oz fluid; bowel prep: 4 L of PEG-electrolyte solution split-dose evening before and morning of procedure (1) · General supplementation 75-90 mg/d (RDA); scurvy treatment 100-1000 mg/d for several weeks; megadose claims unsupported (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) · 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)

0.025%, 0.035% ophthalmic solutions (1) · 0.1%, 0.15%, 0.2% ophthalmic solutions; 0.33% topical gel; combinations with timolol (Combigan) and brinzolamide (Simbrinza) (1) · 10 g/15 mL solution (Constulose); 10 g, 20 g powder packets (Kristalose) (1) · 100, 250, 500, 1000 mg tablets, chewables, gummies, effervescent; IV (specialty) (1) · 125, 250, 500 mg tablets; 125 mg/5 mL, 250 mg/5 mL suspension; 750 mg, 1.5 g IV vials (1) · 17 g (OTC) and 14 g (Rx) powder packets; 238, 510, 527 g bottles; PEG-electrolyte preparations 4 L (GoLYTELY, NuLYTELY) (1) · 2 mg capsules and tablets; 1 mg/5 mL oral solution; combined with simethicone (Imodium Multi-Symptom) (1) · 250, 500 mg tablets; 750 mg ER; 500 mg/100 mL IV; 0.75-1% topical gel/cream; 0.75% vaginal gel; suppository (1) · 250, 500, 750 mg IR tablets; 500, 1000 mg ER tablets (XR); 250, 500 mg/5 mL oral suspension; 200, 400 mg IV; 0.3% ophthalmic solution and ointment; 0.2% otic (1) · 5 mg enteric-coated tablets; 10 mg rectal suppositories; OTC and Rx (1) · 50, 100, 250 mg capsules; 50 mg/5 mL syrup; OTC (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)

'''20 mg/day in adults >60 years''' per FDA's 2011-2012 QT-prolongation warning; 40 mg/day in adults ≤60 (1) · 1 drop per eye q8-12h (1) · 1 g/d (oral); 6 g/d (IV) (1) · 16 mg/d (8 mg/d OTC) (1) · 20 mg/day (adult); 10 mg/day in elderly and in hepatic impairment (1) · 23 mg/day (1) · 30 mg/d for short-term use (1) · 50 mg/day (IR); 62.5 mg/day (CR); 60 mg/day (OCD) (1) · Indication-specific; bowel prep regimens reach 4 L cumulative (1) · Indication-specific; HE may require high-volume dosing (1) · TID per eye (1) · UL 2000 mg/d in adults (1) · ~1500 mg/d (oral); 1200 mg/d (IV) (1) · ~4 g/d (severe systemic infection) (1) · ~500 mg/d typical (1)

especially in acute HE) (1) · IM (1) · IV (4) · Oral (13) · otic (1) · rectal (2) · rectal (enema (1) · topical (1) · topical ophthalmic (3) · topical skin (1) · transdermal (1) · vaginal (1)

1-3 days (1) · 30-60 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) · Constipation: 1-3 days; bowel prep: 1-3 hours after starting (1) · Constipation: 24-48 hours; HE: ammonia reduction within hours of stool production (1) · Days for symptom improvement in scurvy (1) · Hours (3) · IOP lowering at 1 hour; max at 2-3 hours (1) · PO 6-12 hours; PR 15-60 minutes (1) · Within minutes (1)

27-32 hours'"`UNIQ--ref-00000026-QINU`"' (1) · 4 hours'"`UNIQ--ref-00000938-QINU`"' (1) · 6-8 hours'"`UNIQ--ref-00000BEB-QINU`"' (1) · Not meaningfully described (1) · Not meaningfully described (negligible systemic absorption) (1) · Not meaningfully described for ophthalmic use'"`UNIQ--ref-00001287-QINU`"' (1) · Not meaningfully described — lactulose is not significantly absorbed (1) · Variable; effect dependent on local intestinal action rather than systemic kinetics'"`UNIQ--ref-0000106B-QINU`"' (1) · ~1.5 hours'"`UNIQ--ref-00000FF9-QINU`"' (1) · ~10-20 days (steady-state body pool); single dose plasma ~2 hours (1) · ~21 hours (with nonlinear pharmacokinetics from CYP2D6 autoinhibition)'"`UNIQ--ref-0000002B-QINU`"' (1) · ~3 hours'"`UNIQ--ref-000010D1-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) · ~9-14 hours'"`UNIQ--ref-00000FD2-QINU`"' (1)

<0.1% systemic absorption (PEG 3350 is too large to absorb intact) (1) · <3% systemic absorption (the basis of the safety and mechanism)'"`UNIQ--ref-00000F5E-QINU`"' (1) · Highly variable due to saturable first-pass metabolism'"`UNIQ--ref-0000002C-QINU`"' (1) · Local action; minimal systemic effect (1) · Low systemic absorption (enteric coating delivers drug to colon)'"`UNIQ--ref-0000106C-QINU`"' (1) · Topical with minimal systemic absorption'"`UNIQ--ref-00001288-QINU`"' (1) · Topical; clinically meaningful systemic absorption can produce systemic α2 effects (somnolence, hypotension), especially in children'"`UNIQ--ref-000010D2-QINU`"' (1) · ~0.3% (oral; extensive first-pass via CYP3A4 and P-glycoprotein-mediated efflux at the intestinal and blood-brain barriers limit systemic and CNS exposure at therapeutic doses)'"`UNIQ--ref-00000FD3-QINU`"' (1) · ~100% (oral)'"`UNIQ--ref-0000001C-QINU`"' (1) · ~37% (oral, as axetil prodrug; food modestly improves absorption)'"`UNIQ--ref-00000FFA-QINU`"' (1) · ~70% (oral; reduced by divalent cations — antacids, iron, calcium, dairy)'"`UNIQ--ref-00000939-QINU`"' (1) · ~70-90% at typical doses; saturable at high doses (>500 mg) (1) · ~80% (oral)'"`UNIQ--ref-00000027-QINU`"' (2) · ~80% (oral)'"`UNIQ--ref-00000BEC-QINU`"' (1)

None (1) · OTC (MiraLAX) and [[USLegal:Prescription only|Rx-only]] (electrolyte solutions for bowel prep) in US (1) · OTC in US (5) · [[USLegal:Prescription only|Rx-only]] in US (5) · [[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)