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Drilldown: Medicines

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Medicines > duration: 4-6 hours & pregnancy : Not studied in human pregnancy; no approved clinical use in any population or None

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generic:
Codeine / Acetaminophen (1) · Psilocybin (1)
brand:
COMP360 (Compass Pathways, investigational synthesized clinical formulation) (1) · Tylenol with Codeine #3 (30 mg codeine), Tylenol #4 (60 mg codeine), Capital with Codeine, Phenaphen with Codeine (1)
classes:
weak)]] (1) · [[:Category:Classical Psychedelics (Serotonergic)|Serotonergic psychedelic]] (1) · [[:Category:Fixed-dose_combinations|Fixed-dose combination]] (1) · [[:Category:Non-opioid_analgesics|Non-opioid analgesic (acetaminophen)]] (1) · [[:Category:Opioid_analgesics|Opioid analgesic (codeine (1) · [[:Category:Psychedelics|Psychedelic]] (1) · [[:Category:Schedule_III_controlled_substances|Schedule III controlled substance]] (1) · [[:Category:Tryptamines|Tryptamine]] (1)
mechanism:
Prodrug to [[Psilocin|psilocin]] (4-hydroxy-N,N-dimethyltryptamine), a partial agonist at the [[Receptor:5-HT2A|5-HT2A]] serotonin receptor; the action that defines the classical-psychedelic mechanism (1) · '"`UNIQ--vote-00001513-QINU`"' The combination with acetaminophen provides additive non-opioid analgesia and lowers required codeine dose. CYP2D6 PGx is one of the most clinically actionable in current pharmacology; CPIC supports genotype-guided opioid selection'"`UNIQ--ref-00001514-QINU`"'. (1)
uses:
(investigational) '"`UNIQ--vote-000000EF-QINU`"', '"`UNIQ--vote-000000F0-QINU`"', '"`UNIQ--vote-000000F1-QINU`"', '"`UNIQ--vote-000000F2-QINU`"', '"`UNIQ--vote-000000F3-QINU`"' (1) · '"`UNIQ--vote-00001515-QINU`"', '"`UNIQ--vote-00001516-QINU`"' (1)
starting dose:
1-2 tablets (15-60 mg codeine, 300-600 mg acetaminophen) PO every 4-6 hours as needed (1) · Modern clinical-trial standard: 25 mg synthesized psilocybin, single oral dose with psychological support (1)
preparations:
Codeine/acetaminophen 15/300 (#2 historical), 30/300 (#3), 60/300 (#4) mg tablets; 12/120 mg/5 mL elixir (1) · Synthesized psilocybin capsules (COMP360 and other investigational formulations); dried whole [[Psilocybe|Psilocybe]] mushrooms (variable potency, no legal supply chain in most jurisdictions); psilocybin truffles (Psilocybe sclerotia, legal in the Netherlands) (1)
fda max:
Acetaminophen 4 g/d absolute; codeine 240-360 mg/d typical practical limit (1) · Not FDA-approved; clinical-trial protocols use up to 30 mg in adult investigational dosing (1)
routes:
Oral (2)
onset:
20-45 min subjective onset; psilocin formation from psilocybin requires intestinal and hepatic alkaline phosphatase (1) · 30-60 minutes (1)
duration: (Click arrow to add another value)
halflife:
Codeine 2.5-3.5 hours; acetaminophen 1-3 hours'"`UNIQ--ref-00001517-QINU`"' (1) · Psilocin: ~2-3 h; psilocybin itself is a prodrug, dephosphorylated within minutes of absorption (1)
bioavailability:
Codeine ~60% (oral); acetaminophen 85-98%'"`UNIQ--ref-00001518-QINU`"' (1) · Oral bioavailability of psilocin from administered psilocybin approximately 50% (1)
pregnancy: (Click arrow to add another value)
legal:
None (1) · [[USLegal:Schedule III|Schedule III controlled substance]] in US. '''Contraindicated in children <12''' for any indication and in any age post-tonsillectomy/adenoidectomy (FDA 2017 black-box advisory)'"`UNIQ--ref-00001519-QINU`"' (1)

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