Drilldown: Medicines

None (4) · Famotidine (1) · Hydrochlorothiazide (1)

Belsomra (1) · Botox (1) · Dayvigo (1) · Microzide; mostly prescribed generically (1) · Pepcid, Pepcid AC, Pepcid Complete (1) · Quviviq (1)

Dual orexin receptor antagonist (DORA) (3) · neuromuscular blocker (presynaptic) (1) · Neurotoxin (1) · the first approved (1) · [[:Category:Antihypertensives|Antihypertensive]] (1) · [[:Category:Antisecretory_agents|Gastric acid suppressant]] (1) · [[:Category:H2_receptor_antagonists|Histamine H2 receptor antagonist]] (1) · [[:Category:Thiazide_diuretics|Thiazide diuretic]] (1)

None (1) · 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) · 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-00000138-QINU`"' Decreases urinary calcium (used in stone prevention); raises serum uric acid, glucose, and lipids modestly; non-anion-gap hypokalemic metabolic alkalosis is the characteristic electrolyte pattern'"`UNIQ--ref-00000139-QINU`"'. (1) · '"`UNIQ--vote-00000255-QINU`"' Less potent and shorter-acting than PPIs but with faster on-effect; suitable for on-demand acid suppression. Largely renally cleared; dose-adjust in renal impairment to avoid CNS effects (confusion in elderly)'"`UNIQ--ref-00000256-QINU`"'. (1)

Chronic migraine (≥15 headache days/month), cervical dystonia, blepharospasm, hyperhidrosis, overactive bladder, urinary incontinence, strabismus, spasticity, cosmetic problems (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-0000013A-QINU`"', '"`UNIQ--vote-0000013B-QINU`"', '"`UNIQ--vote-0000013C-QINU`"', '"`UNIQ--vote-0000013D-QINU`"' (1) · '"`UNIQ--vote-00000257-QINU`"', '"`UNIQ--vote-00000258-QINU`"', '"`UNIQ--vote-00000259-QINU`"', '"`UNIQ--vote-0000025A-QINU`"' (1)

10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · 12.5-25 mg PO once daily (1) · 20 mg PO twice daily, or 40 mg at bedtime (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) · Chronic migraine (PREEMPT protocol): 155 units divided across 31 sites in 7 head/neck muscle groups every 12 weeks (1)

10 mg, 20 mg, 40 mg tablets; chewables; 40 mg/5 mL oral suspension; 10 mg/mL IV (1) · 12.5 mg capsules; 12.5, 25, 50 mg tablets (1) · 25 mg, 50 mg tablets (1) · 5 mg, 10 mg tablets (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (1) · 50, 100, or 200 unit vials of lyophilized powder for reconstitution (1)

10 mg/d (1) · 160 mg/d (Zollinger-Ellison); 80 mg/d for routine indications (1) · 195 units/treatment for chronic migraine; max varies by problem (1) · 20 mg/d (1) · 50 mg/d (1) · 50 mg/d (hypertension); up to 200 mg/d (edema) (1)

Intramuscular (PREEMPT injections for migraine) (1) · IV (1) · Oral (5)

1 hour PO; minutes IV (1) · 1–2 weeks for muscle effects; preventive migraine benefit accrues over 12-week cycles (1) · Diuresis at 2 hours; antihypertensive effect within days, max at 3-4 weeks (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:

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2.5-3.5 hours; longer in renal impairment'"`UNIQ--ref-0000025B-QINU`"' (1) · 6-15 hours'"`UNIQ--ref-0000013E-QINU`"' (1) · Tissue half-life not formally measured; clinical effect ~12 weeks (1) · ~12 hours (1) · ~17-19 hours (longer than daridorexant) (1) · ~8 hours (shorter than suvorexant and lemborexant) (1)

40-45% (oral; not significantly affected by food)'"`UNIQ--ref-0000025C-QINU`"' (1) · 65-75% (oral)'"`UNIQ--ref-0000013F-QINU`"' (1) · Local (intramuscular) (1) · ~44% (1) · ~62% (1) · ~82% (1)

None (1) · Category C; limited data (1) · Generally considered safe; widely used. Cleared in lactation at low levels.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data; avoid (3)

OTC (10-20 mg) and [[USLegal:Prescription only|Rx-only]] (higher doses) in US (1) · Rx, Schedule IV (US) (3) · Rx; black-box warning for distant spread of toxin effect (1) · [[USLegal:Prescription only|Rx-only]] in US (1)