Drilldown: Medicines

Indomethacin (1) · Melatonin (N-acetyl-5-methoxytryptamine) (1) · Tramadol (1)

Indocin (oral, IV, suppository), Tivorbex (low-dose), Indo-Lemmon (1) · Multiple OTC dietary supplement formulations (1) · Ultram (IR), Ultram ER, ConZip ER (1)

potent non-selective)]] (1) · weak μ-agonist with serotonin/norepinephrine reuptake inhibition)]] (1) · [[:Category:Analgesics|Analgesic]] (2) · [[:Category:Chronobiotics|Chronobiotic (circadian phase regulator)]] (1) · [[:Category:Melatonin receptor agonists|Melatonin receptor agonist]] (1) · [[:Category:NSAIDs|Non-steroidal anti-inflammatory (NSAID (1) · [[:Category:Opioid analgesics|Opioid analgesic (atypical (1) · [[:Category:Schedule IV controlled substances|Schedule IV controlled substance]] (1) · [[:Category:Sleep aids|Sleep aid]] (1)

None (3)

'"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"', '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"' (1) · '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-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)

0.5-3 mg PO 30-60 minutes before bedtime. Some patients respond to micro-doses (0.3 mg) without additional benefit at higher doses. For circadian phase shifting, timing relative to dim-light melatonin onset matters more than absolute dose (1) · Acute gout: 50 mg PO TID until symptom relief, then taper; maximum 200 mg/day for 3-5 days. Rheumatoid arthritis / osteoarthritis: 25-50 mg PO BID-TID. Patent ductus arteriosus: 0.2 mg/kg IV, then 0.1-0.2 mg/kg every 12-24 hours for 2 doses (1) · IR: 25-50 mg PO every 4-6 hours as needed, titrate as tolerated. ER: 100 mg PO once daily, titrate by 100 mg every 5 days (1)

Capsules 25, 50 mg; ER capsules 75 mg; oral suspension 25 mg/5 mL; suppositories 50 mg; injection 1 mg/vial (PDA closure) (1) · IR tablets 50 mg; ER tablets 100, 200, 300 mg (Ultram ER, ConZip); oral solution 5 mg/mL; combination products with acetaminophen (Ultracet) (1) · OTC tablets, sublingual tablets, gummies, liquid, extended-release tablets and capsules; common strengths 0.5, 1, 3, 5, 10 mg (1)

200 mg/day (typical adult oral) (1) · 400 mg/day (IR, adult); 300 mg/day (ER); 300 mg/day in elderly >75 years (1) · Not formally established (dietary supplement); doses above ~3-5 mg show no additional efficacy but increase next-day sedation risk (1)

intravenous (PDA closure only) (1) · Oral (3) · rectal (1) · sublingual (1)

30-60 minutes (immediate-release oral) (1) · 30-60 minutes (IR) (1) · 30-60 minutes (oral); rapid relief in acute gout (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

30-50 minutes (short)'"`UNIQ--ref-00000021-QINU`"' (1) · 4-5 hours'"`UNIQ--ref-00000026-QINU`"' (1) · Tramadol 6-7 hours; M1 active metabolite 7-9 hours'"`UNIQ--ref-0000001D-QINU`"' (1)

~100% (oral)'"`UNIQ--ref-00000027-QINU`"' (1) · ~15% (oral; highly variable due to extensive and variable first-pass metabolism)'"`UNIQ--ref-00000022-QINU`"' (1) · ~75% (IR, rises with multi-dose administration due to saturable first-pass)'"`UNIQ--ref-0000001E-QINU`"' (1)

Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning; contraindicated from 30 weeks (risk of premature ductus arteriosus closure, which is paradoxically the basis of the neonatal PDA-closure indication)'"`UNIQ--ref-00000028-QINU`"' (1) · Chronic third-trimester exposure produces neonatal opioid withdrawal syndrome and respiratory depression at delivery.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited human data; endogenous hormone, but supplemental pharmacological doses are not well characterized in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

[[USLegal:Over-the-counter|OTC]] dietary supplement in the US ('''not FDA-regulated as a medicine'''; multiple studies show OTC products contain 50-470% of labeled melatonin content); [[USLegal:Prescription only|Rx-only]] in the EU and UK (1) · [[USLegal:Prescription only|Rx-only]] in US (1) · [[USLegal:Schedule IV|Schedule IV controlled substance]] in US (federally scheduled 2014); some states schedule higher'"`UNIQ--ref-0000001F-QINU`"' (1)