Drilldown: Medicines

None (3) · Indomethacin (1) · Tramadol (1) · Valacyclovir (1)

Belsomra (1) · Dayvigo (1) · Indocin (oral, IV, suppository), Tivorbex (low-dose), Indo-Lemmon (1) · Quviviq (1) · Ultram (IR), Ultram ER, ConZip ER (1) · Valtrex (1)

Dual orexin receptor antagonist (DORA) (3) · potent non-selective)]] (1) · the first approved (1) · weak μ-agonist with serotonin/norepinephrine reuptake inhibition)]] (1) · [[:Category:Analgesics|Analgesic]] (2) · [[:Category:Anti-herpesvirus_agents|Anti-herpesvirus agent]] (1) · [[:Category:Antivirals|Antiviral]] (1) · [[:Category:NSAIDs|Non-steroidal anti-inflammatory (NSAID (1) · [[:Category:Nucleoside_analogs|Nucleoside analog (prodrug)]] (1) · [[:Category:Opioid analgesics|Opioid analgesic (atypical (1) · [[:Category:Schedule IV controlled substances|Schedule IV controlled substance]] (1)

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-000005D0-QINU`"' Selectivity comes from the viral-kinase-only initial phosphorylation step, which is why uninfected cells generate minimal active drug'"`UNIQ--ref-000005D1-QINU`"'. Dose-adjust by renal function; rare crystalline nephropathy with rapid IV acyclovir. (1)

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-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-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"' (1) · '"`UNIQ--vote-000005D2-QINU`"', '"`UNIQ--vote-000005D3-QINU`"', '"`UNIQ--vote-000005D4-QINU`"', '"`UNIQ--vote-000005D5-QINU`"' (1)

10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (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) · 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) · Initial genital herpes 1 g PO BID × 10 days; recurrent 500 mg BID × 3 days; suppression 500 mg-1 g PO daily; zoster 1 g TID × 7 days (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)

25 mg, 50 mg tablets (1) · 5 mg, 10 mg tablets (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (1) · 500 mg, 1 g tablets (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)

10 mg/d (1) · 20 mg/d (1) · 200 mg/day (typical adult oral) (1) · 3 g/d (zoster) (1) · 400 mg/day (IR, adult); 300 mg/day (ER); 300 mg/day in elderly >75 years (1) · 50 mg/d (1)

intravenous (PDA closure only) (1) · Oral (6) · rectal (1)

30-60 minutes (IR) (1) · 30-60 minutes (oral); rapid relief in acute gout (1) · Symptom relief within 24-48 hours (1) · ~30 min (3)

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

4-5 hours'"`UNIQ--ref-00000026-QINU`"' (1) · Tramadol 6-7 hours; M1 active metabolite 7-9 hours'"`UNIQ--ref-00000024-QINU`"' (1) · ~12 hours (1) · ~17-19 hours (longer than daridorexant) (1) · ~3 hours (acyclovir, the active metabolite); longer in renal impairment'"`UNIQ--ref-000005D6-QINU`"' (1) · ~8 hours (shorter than suvorexant and lemborexant) (1)

~100% (oral)'"`UNIQ--ref-00000027-QINU`"' (1) · ~44% (1) · ~55% bioavailability of acyclovir after valacyclovir oral (vs ~20% from oral acyclovir directly)'"`UNIQ--ref-000005D7-QINU`"' (1) · ~62% (1) · ~75% (IR, rises with multi-dose administration due to saturable first-pass)'"`UNIQ--ref-00000025-QINU`"' (1) · ~82% (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 data; avoid (3) · Widely used in pregnancy when antiviral indicated; reassuring registry data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

Rx, Schedule IV (US) (3) · [[USLegal:Prescription only|Rx-only]] in US (2) · [[USLegal:Schedule IV|Schedule IV controlled substance]] in US (federally scheduled 2014); some states schedule higher'"`UNIQ--ref-00000026-QINU`"' (1)