Drilldown: Medicines
Medicines > fda max 
:
1 capsule BID (40 mg DXM / 20 mg quinidine per day) or
10 mg/d (adults) or
Titrated to glucose; no fixed maximum
:
1 capsule BID (40 mg DXM / 20 mg quinidine per day) or
10 mg/d (adults) or
Titrated to glucose; no fixed maximum Use the filters below to narrow your results.
generic:
brand:
classes:
None (1) ·
[[:Category:Antiasthmatic_agents|Antiasthmatic]] (1) ·
[[:Category:Antihistamines|Antihistamine]] (2) ·
[[:Category:H1_receptor_antagonists|Histamine H1 receptor antagonist (second-generation)]] (2) ·
[[:Category:Insulins|Insulin]] (2) ·
[[:Category:Leukotriene_receptor_antagonists|Leukotriene receptor antagonist]] (1) ·
[[:Category:Mealtime_insulins|Mealtime (bolus) insulin]] (2) ·
[[:Category:Rapid-acting_insulins|Rapid-acting insulin analog]] (2)
mechanism:
None (2) ·
'"`UNIQ--vote-00000391-QINU`"' Minimal CYP metabolism; mostly renally cleared unchanged. Cetirizine is the active racemate; levocetirizine is the active R-enantiomer marketed separately'"`UNIQ--ref-00000392-QINU`"'. (1) ·
'"`UNIQ--vote-00000584-QINU`"' Binds the same insulin receptor as endogenous insulin with comparable mitogenic-to-metabolic ratio. Ultra-rapid formulations (Lyumjev) add treprostinil and citrate to accelerate absorption further'"`UNIQ--ref-00000585-QINU`"'. (1) ·
'"`UNIQ--vote-0000061E-QINU`"' Less reliably anticholinergic than first-generation H1s; minimal antiemetic effect. Desloratadine (Clarinex) is the active enantiomer-of-metabolite version marketed as a Rx alternative. (1) ·
'"`UNIQ--vote-00001580-QINU`"' First FDA-approved treatment for PBA. The 10 mg quinidine daily dose is far below antiarrhythmic levels but sufficient to nearly fully inhibit CYP2D6, the basis of the combination's pharmacokinetic rationale'"`UNIQ--ref-00001581-QINU`"'. (1)
uses:
'"`UNIQ--vote-0000015B-QINU`"', '"`UNIQ--vote-0000015C-QINU`"', '"`UNIQ--vote-0000015D-QINU`"' (1) ·
'"`UNIQ--vote-00000393-QINU`"', '"`UNIQ--vote-00000394-QINU`"', '"`UNIQ--vote-00000395-QINU`"' (1) ·
'"`UNIQ--vote-00000586-QINU`"', '"`UNIQ--vote-00000587-QINU`"', '"`UNIQ--vote-00000588-QINU`"' (1) ·
'"`UNIQ--vote-000005EF-QINU`"', '"`UNIQ--vote-000005F0-QINU`"', '"`UNIQ--vote-000005F1-QINU`"' (1) ·
'"`UNIQ--vote-0000061F-QINU`"', '"`UNIQ--vote-00000620-QINU`"' (1) ·
'"`UNIQ--vote-00001582-QINU`"' (1)
starting dose:
1 capsule (20/10 mg dextromethorphan/quinidine) PO once daily × 7 days, then 1 capsule BID (1) ·
10 mg PO once daily (1) ·
10 mg PO once daily (5 mg in older adults or if sedation occurs) (1) ·
10 mg PO once daily in the evening (adults); 4-5 mg in children (1) ·
SC 4-6 units (or 1 unit per 10-15 g carbs) at meals; titrate to postprandial glucose (1) ·
SC 4-6 units (or 1 unit per 10-15 g carbs) at meals; titrate to postprandial glucose. Typical total daily dose 0.5-1 U/kg/d split between basal and prandial coverage in T1DM (1)
preparations:
10 mg tablets; 4 mg, 5 mg chewables; 4 mg granules (1) ·
10 mg tablets; 5 mg ODT and chewables; 1 mg/mL oral syrup; combo Claritin-D (with pseudoephedrine, behind-counter) (1) ·
100 U/mL (Humalog, Admelog, Lyumjev) vials, pens, cartridges; 200 U/mL Humalog KwikPen (1) ·
100 U/mL (NovoLog, Fiasp) vials, pens, cartridges (1) ·
20 mg dextromethorphan HBr / 10 mg quinidine sulfate capsules (1) ·
5 mg, 10 mg tablets; 5 mg, 10 mg chewables; 1 mg/mL oral syrup; OTC (1)
fda max: (Click arrow to add another value)
routes:
onset:
1-3 hours (slower onset than cetirizine; symptom relief somewhat less) (1) ·
30-60 minutes (1) ·
Bronchodilation within 1-2 hours; full controller effect 1-2 weeks (1) ·
PBA episode reduction within 1-2 weeks (1) ·
SC: 5-15 minutes (Fiasp 2.5 minutes earlier on average) (1) ·
SC: 5-15 minutes; ultra-rapid Lyumjev faster (1)
duration:
halflife:
2.7-5.5 hours'"`UNIQ--ref-0000015E-QINU`"' (1) ·
8-10 hours (longer in elderly and renal impairment)'"`UNIQ--ref-00000396-QINU`"' (1) ·
Dextromethorphan substantially prolonged by quinidine's CYP2D6 inhibition (typical extensive metabolizers see ~10× higher AUC); quinidine ~6-8 hours'"`UNIQ--ref-00001583-QINU`"' (1) ·
~1 hour SC'"`UNIQ--ref-00000589-QINU`"' (1) ·
~8 hours (parent); ~28 hours (desloratadine, the active metabolite, marketed separately as Clarinex)'"`UNIQ--ref-00000621-QINU`"' (1) ·
~80 minutes SC'"`UNIQ--ref-000005F2-QINU`"' (1)
bioavailability:
High (oral); not significantly affected by food'"`UNIQ--ref-00000397-QINU`"' (1) ·
High (oral; food prolongs absorption modestly)'"`UNIQ--ref-00000622-QINU`"' (1) ·
Increased substantially via CYP2D6 inhibition'"`UNIQ--ref-00001584-QINU`"' (1) ·
~100% from subcutaneous depot (2) ·
~64% (oral; not significantly affected by food)'"`UNIQ--ref-0000015F-QINU`"' (1)
pregnancy:
Generally considered safe; pregnancy registries do not show increased major malformation risk.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Generally considered safe; widely used. Levocetirizine (the R-enantiomer) is an alternative with similar safety.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Generally considered safe; widely used. Loratadine and cetirizine are the most-recommended 2nd-gen H1s in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Insulin is the preferred glucose-lowering therapy in pregnancy; aspart is widely used.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Insulin is the preferred glucose-lowering therapy in pregnancy; lispro is widely used.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited data; quinidine has been used in pregnancy as antiarrhythmic.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1)
legal:
OTC in US (2) ·
[[USLegal:Prescription only|Rx-only]] in US (1) ·
[[USLegal:Prescription only|Rx-only]] in US (some OTC formulations exist) (1) ·
[[USLegal:Prescription only|Rx-only]] in US. '''FDA Boxed Warning (2020):''' neuropsychiatric events including agitation, depression, sleep disturbance, and suicidal thoughts; benefit-risk should be reassessed regularly'"`UNIQ--ref-00000160-QINU`"'. (1) ·
[[USLegal:Prescription only|Rx-only]] in US. Caution with QT-prolonging medicines (quinidine itself is class IA antiarrhythmic, and the dose here, though sub-antiarrhythmic, still contributes to QT)'"`UNIQ--ref-00001585-QINU`"' (1)
Showing below up to 6 results in range #1 to #6.