Drilldown: Medicines

None (1) · Indomethacin (1) · Tramadol (1)

Botox (1) · Indocin (oral, IV, suppository), Tivorbex (low-dose), Indo-Lemmon (1) · Ultram (IR), Ultram ER, ConZip ER (1)

neuromuscular blocker (presynaptic) (1) · Neurotoxin (1) · potent non-selective)]] (1) · weak μ-agonist with serotonin/norepinephrine reuptake inhibition)]] (1) · [[:Category:Analgesics|Analgesic]] (2) · [[: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)

None (2) · Cleaves SNAP-25 protein in presynaptic motor and autonomic nerve terminals, blocking acetylcholine release; in chronic migraine, hypothesized to inhibit peripheral sensitization of trigeminovascular nociceptors (1)

Chronic migraine (≥15 headache days/month), cervical dystonia, blepharospasm, hyperhidrosis, overactive bladder, urinary incontinence, strabismus, spasticity, cosmetic problems (1) · '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"', '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-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)

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) · Chronic migraine (PREEMPT protocol): 155 units divided across 31 sites in 7 head/neck muscle groups every 12 weeks (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)

50, 100, or 200 unit vials of lyophilized powder for reconstitution (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)

195 units/treatment for chronic migraine; max varies by problem (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)

Intramuscular (PREEMPT injections for migraine) (1) · intravenous (PDA closure only) (1) · Oral (2) · rectal (1)

1–2 weeks for muscle effects; preventive migraine benefit accrues over 12-week cycles (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

4-5 hours'"`UNIQ--ref-00000026-QINU`"' (1) · Tissue half-life not formally measured; clinical effect ~12 weeks (1) · Tramadol 6-7 hours; M1 active metabolite 7-9 hours'"`UNIQ--ref-0000001D-QINU`"' (1)

Local (intramuscular) (1) · ~100% (oral)'"`UNIQ--ref-00000027-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) · Category C; limited data (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)

Rx; black-box warning for distant spread of toxin effect (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)