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Medicines > duration : 6-8 hours or Daily dosing or N/A (replacement)

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classes:
5HT1A activity than aripiprazole (1) · 5HT2A (1) · 5HT2A/D2 antagonist with proposed differential pre/post-synaptic D2 activity (1) · Atypical antipsychotic (2) · D2/5HT1A partial agonist with stronger α1A (1) · low-trapping) (1) · Multimodal antidepressant: SERT inhibitor + 5HT1A agonist + 5HT1B partial agonist + 5HT3/5HT7 antagonist (1) · narrow-spectrum)]] (1) · NMDA receptor antagonist (uncompetitive (1) · non-stimulant ADHD agent (1) · Selective 5HT2A inverse agonist (with weaker 5HT2C inverse agonism) (1) · Selective norepinephrine reuptake inhibitor (NRI) with 5HT1A partial agonism (1) · Serotonin partial agonist reuptake inhibitor (SPARI) (1) · [[:Category:Antibacterials|Antibacterial]] (2) · [[:Category:Antihistamines|First-generation antihistamine]] (1) · [[:Category:Anxiolytics|Anxiolytic]] (1) · [[:Category:Azo_dyes|Azo dye]] (1) · [[:Category:B-vitamins|B-vitamin]] (2) · [[:Category:Benzodiazepines|Benzodiazepine]] (1) · [[:Category:Beta-lactam_antibiotics|β-lactam antibiotic]] (2) · [[:Category:Cephalosporins|Cephalosporin (first-generation)]] (1) · [[:Category:Hematinics|Hematinic]] (3) · [[:Category:Iron_supplements|Iron supplement]] (1) · [[:Category:Lincosamides|Lincosamide antibiotic]] (1) · [[:Category:Lipid-lowering_agents|Lipid-lowering agent]] (1) · [[:Category:Loop_diuretics|Loop diuretic]] (1) · [[:Category:Macrolide_antibiotics|Macrolide antibiotic]] (1) · [[:Category:Omega-3_fatty_acids|Omega-3 fatty acid]] (1) · [[:Category:Orexigenics|Appetite-promoting medicine (orexigenic)]] (1) · [[:Category:Penicillins|Penicillin (natural (1) · [[:Category:Prokinetics|Prokinetic (off-label)]] (1) · [[:Category:Schedule IV controlled substances|Schedule IV controlled substance]] (1) · [[:Category:Serotonin antagonists|Serotonin 5-HT2 antagonist]] (1) · [[:Category:Urinary_analgesics|Urinary tract analgesic]] (1) · [[:Category:Vitamins|Vitamin]] (2)
uses:
ADHD in children (6+), adolescents, and adults (FDA-approved 2021 for pediatric, 2022 for adult) (1) · Hallucinations and delusions associated with Parkinson's disease psychosis (PDP). Investigational for psychosis in other dementias and as augmentation for depression. (1) · Investigational for major depressive disorder; trials underway (phase 3 mixed results) (1) · Major depressive disorder in adults (FDA-approved 2011) (1) · Major depressive disorder in adults (FDA-approved 2013). Notable for evidence of cognitive benefit (processing speed) that distinguishes it from other antidepressants. (1) · Schizophrenia (FDA-approved 2015). Adjunctive treatment of major depressive disorder (2015). '''Agitation associated with dementia due to Alzheimer disease''' (FDA-approved May 2023, first agent specifically approved for this problem). Investigational for PTSD (combined with sertraline). (1) · Schizophrenia (FDA-approved Dec 2019). Bipolar depression as monotherapy or adjunct to lithium/valproate (FDA-approved Dec 2021). (1) · '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"', '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"' (1) · '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"' (1) · '"`UNIQ--vote-00000050-QINU`"' (1) · '"`UNIQ--vote-000004ED-QINU`"', '"`UNIQ--vote-000004EE-QINU`"', '"`UNIQ--vote-000004EF-QINU`"', '"`UNIQ--vote-000004F0-QINU`"', '"`UNIQ--vote-000004F1-QINU`"' (1) · '"`UNIQ--vote-0000059A-QINU`"', '"`UNIQ--vote-0000059B-QINU`"' (1) · '"`UNIQ--vote-000005B3-QINU`"', '"`UNIQ--vote-000005B4-QINU`"', '"`UNIQ--vote-000005B5-QINU`"', '"`UNIQ--vote-000005B6-QINU`"' (1) · '"`UNIQ--vote-00000607-QINU`"', '"`UNIQ--vote-00000608-QINU`"', '"`UNIQ--vote-00000609-QINU`"', '"`UNIQ--vote-0000060A-QINU`"' (1) · '"`UNIQ--vote-00000B42-QINU`"', '"`UNIQ--vote-00000B43-QINU`"', '"`UNIQ--vote-00000B44-QINU`"', '"`UNIQ--vote-00000B45-QINU`"' (1) · '"`UNIQ--vote-00000D38-QINU`"', '"`UNIQ--vote-00000D39-QINU`"', '"`UNIQ--vote-00000D3A-QINU`"', '"`UNIQ--vote-00000D3B-QINU`"', '"`UNIQ--vote-00000D3C-QINU`"', '"`UNIQ--vote-00000D3D-QINU`"' (1) · '"`UNIQ--vote-00000E71-QINU`"', '"`UNIQ--vote-00000E72-QINU`"', '"`UNIQ--vote-00000E73-QINU`"', '"`UNIQ--vote-00000E74-QINU`"', '"`UNIQ--vote-00000E75-QINU`"' (1) · '"`UNIQ--vote-00000FB3-QINU`"', '''adjunctive only''' (does not treat the underlying infection) (1) · '"`UNIQ--vote-0000143C-QINU`"', '"`UNIQ--vote-0000143D-QINU`"', '"`UNIQ--vote-0000143E-QINU`"', '"`UNIQ--vote-0000143F-QINU`"', '"`UNIQ--vote-00001440-QINU`"', '"`UNIQ--vote-00001441-QINU`"' (1)
starting dose:
0.4 mg PO daily (general prevention); 0.8-1 mg/d in pregnancy; 4 mg/d for women with prior NTD-affected pregnancy; 1 mg/d during methotrexate therapy (1) · 10 mg PO once daily × 7 days, then 20 mg × 7 days, then 40 mg as target dose (take with food) (1) · 10 mg PO once daily; may increase to 20 mg as tolerated, or decrease to 5 mg if needed (1) · 10-20 mg PO/IV once daily; titrate by clinical response. 1:1 IV to PO conversion (unlike furosemide's 1:2) (1) · 100-200 mg PO TID after meals × no more than 2 days when used with concurrent antibiotic (1) · 250-500 mg PO every 6-8 hours (1) · 250-500 mg PO QID; 7.5-12.5 mg/kg IV q6h; topical and ophthalmic per formulation (1) · 325 mg PO daily to TID (=65 mg elemental iron/tablet); alternate-day dosing is now favored by hepcidin physiology for better absorption with less GI burden (1) · 34 mg PO once daily (1) · 4 g PO daily (as 4 x 1 g capsules once daily, or 2 capsules BID) (1) · 42 mg PO once daily with food (no titration) (1) · 500 mg PO every 6 hours, or 250 mg every 6 hours for mild infections (1) · Allergy: 4 mg PO TID. Serotonin syndrome: 12 mg loading dose PO or by nasogastric tube, then 2 mg every 2 hours until clinical improvement. Appetite stimulation: 2-4 mg PO TID-QID (1) · Anxiety: 0.5-1 mg PO BID-TID. Insomnia: 1-2 mg PO at bedtime. Status epilepticus: 4 mg IV (adult), repeat after 5-10 minutes if needed. Acute agitation: 1-2 mg IM (1) · Oral 300-450 mg PO QID; IV 600-900 mg q8h; topical 1% solution/gel BID; vaginal 100 mg ovule × 3 days or 2% cream × 7 days (1) · Pediatric 6-11: 100 mg PO daily, titrate weekly to max 400 mg. Adolescent 12-17: 200 mg, max 400 mg. Adult: 200 mg, max 600 mg. (1) · Replacement: 1000 mcg IM daily for 1 week, then weekly for 4 weeks, then monthly; or 1000-2000 mcg PO daily (effective even in pernicious anemia via passive diffusion); intranasal 500 mcg weekly (1) · Schizophrenia: 1 mg PO daily × 4 days, then 2 mg daily × 3 days, then 4 mg daily. MDD adjunct: 0.5-1 mg daily, increase to 2 mg max. AD agitation: 0.5 mg daily, titrate to 2-3 mg daily. (1) · Trials use 25 mg or 50 mg PO daily (1)
duration: (Click arrow to add another value)
pregnancy:
Avoid where possible; class concerns as for other loop diuretics.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe; commonly used in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe; widely used.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (2) · Investigational (1) · Limited data (1) · Limited data; avoid (1) · Limited data; National Pregnancy Registry available (1) · Limited data; National Pregnancy Registry for Atypical Antipsychotics (1) · Limited data; not first-line in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data; weigh benefits/risks (2) · Limited human data; older agent with substantial use experience.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited human data<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Routinely supplemented in pregnancy and preconception to prevent neural tube defects.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Routinely supplemented in vegan pregnancies and pernicious anemia.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Routinely used; iron requirements rise substantially in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Some signal for cleft lip/palate with first-trimester exposure (debated); neonatal sedation and withdrawal with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

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