Drilldown: Medicines
Medicines > duration 
:
N/A (replacement) or
SL: 30 minutes; patch: 12-14 hours; IV continuous or
~7-8 hours
:
N/A (replacement) or
SL: 30 minutes; patch: 12-14 hours; IV continuous or
~7-8 hours Use the filters below to narrow your results.
generic:
brand:
classes:
Dual orexin receptor antagonist (DORA) (3) ·
the first approved (1) ·
[[:Category:Antianginals|Antianginal]] (1) ·
[[:Category:B-vitamins|B-vitamin]] (2) ·
[[:Category:Hematinics|Hematinic]] (3) ·
[[:Category:Iron_supplements|Iron supplement]] (1) ·
[[:Category:Nitrates|Organic nitrate]] (1) ·
[[:Category:Vasodilators|Vasodilator]] (1) ·
[[:Category:Vitamins|Vitamin]] (2)
mechanism:
None (5) ·
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)
uses:
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-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-00000C0A-QINU`"', '"`UNIQ--vote-00000C0B-QINU`"', '"`UNIQ--vote-00000C0C-QINU`"', '"`UNIQ--vote-00000C0D-QINU`"', '"`UNIQ--vote-00000C0E-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 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) ·
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) ·
5 mg PO at bedtime; may increase to 10 mg if inadequate (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) ·
SL 0.3-0.6 mg every 5 minutes up to 3 doses for acute angina (call EMS if not resolved after the third); IV infusion 5-10 mcg/min titrated; transdermal patch 0.2-0.4 mg/hr for 12-14 hours daily (nitrate-free interval prevents tolerance) (1)
preparations:
0.4, 0.8, 1 mg OTC; 1 mg Rx; 5 mg/mL injection (1) ·
100, 250, 500, 1000, 5000 mcg tablets (OTC and Rx); 1000 mcg/mL injection; intranasal spray; sublingual (1) ·
25 mg, 50 mg tablets (1) ·
325 mg tablets (65 mg elemental Fe); 220 mg/5 mL liquid (44 mg elemental Fe/5 mL); 142 mg/mL drops; OTC and Rx (1) ·
5 mg, 10 mg tablets (1) ·
5 mg, 10 mg, 15 mg, 20 mg tablets (1) ·
SL 0.3, 0.4, 0.6 mg tablets; lingual spray 0.4 mg/spray; ER 2.5-9 mg capsules; transdermal patch 0.1-0.8 mg/hr; 2% ointment; 0.4% rectal ointment; 5 mg/mL IV (1)
fda max:
routes:
IM (2) ·
intranasal (1) ·
IV (3) ·
lingual spray (1) ·
Oral (6) ·
oral ER (1) ·
rectal (1) ·
SC (2) ·
sublingual (2) ·
topical (1) ·
transdermal (1)
onset:
Hematologic response within days (1) ·
Reticulocyte response at 3-5 days; neurologic recovery weeks to months (and may be incomplete if longstanding) (1) ·
Reticulocyte response at 7-10 days; hemoglobin rise of ~1 g/dL per 3 weeks (1) ·
SL/spray: 1-3 minutes; IV: minutes; patch: 30-60 minutes (1) ·
~30 min (3)
duration: (Click arrow to add another value)
halflife:
1-3 minutes (very short)'"`UNIQ--ref-00000C0F-QINU`"' (1) ·
N/A (incorporated into hemoglobin and tissue stores) (1) ·
~0.5 hours plasma; tissue retention longer (1) ·
~12 hours (1) ·
~17-19 hours (longer than daridorexant) (1) ·
~6 days (plasma); hepatic stores last 3-5 years (1) ·
~8 hours (shorter than suvorexant and lemborexant) (1)
bioavailability:
10-20% (oral; reduced by food, calcium, antacids, PPIs, tea/coffee; enhanced by ascorbate) (1) ·
High (oral) (1) ·
Highly route-dependent: SL bypasses first-pass; oral has extensive first-pass (used only for chronic ER preparations); transdermal predictable'"`UNIQ--ref-00000C10-QINU`"' (1) ·
Oral ~1-3% via passive diffusion at high doses (independent of intrinsic factor); IM/SC ~100% (1) ·
~44% (1) ·
~62% (1) ·
~82% (1)
pregnancy:
Limited data; avoid (3) ·
Routinely supplemented in pregnancy and preconception to prevent neural tube defects.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Routinely supplemented in vegan pregnancies and pernicious anemia.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Routinely used; iron requirements rise substantially in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Used in obstetric emergencies (uterine relaxation, severe hypertension) when needed; otherwise limited routine use.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1)
Showing below up to 7 results in range #1 to #7.