Drilldown: Medicines
Medicines > fda max 
:
10 mg/d or
50 mg/d or
Indication-specific; renal clearance limits tolerable cumulative dosing
:
10 mg/d or
50 mg/d or
Indication-specific; renal clearance limits tolerable cumulative dosing Use the filters below to narrow your results.
generic:
brand:
classes:
Anxiolytic (1) ·
Benzodiazepine (1) ·
Dual orexin receptor antagonist (DORA) (2) ·
hydroxide)]] (1) ·
torsades)]] (1) ·
Triazolobenzodiazepine (1) ·
[[:Category:Antacids|Antacid (hydroxide)]] (1) ·
[[:Category:Antianginals|Antianginal]] (1) ·
[[:Category:Antiarrhythmics|Antiarrhythmic (IV sulfate (1) ·
[[:Category:Antihyperglycemic_agents|Antihyperglycemic agent]] (1) ·
[[:Category:Antihypertensives|Antihypertensive]] (1) ·
[[:Category:Beta-3_agonists|β3 adrenergic agonist]] (1) ·
[[:Category:Calcium_channel_blockers|Calcium channel blocker]] (1) ·
[[:Category:Cholesterol_absorption_inhibitors|Cholesterol absorption inhibitor]] (1) ·
[[:Category:Electrolyte_replacements|Electrolyte replacement]] (1) ·
[[:Category:Heart_failure_medications|Heart failure medication]] (1) ·
[[:Category:Lipid-lowering_agents|Lipid-lowering agent]] (1) ·
[[:Category:Osmotic_laxatives|Osmotic laxative (citrate (1) ·
[[:Category:Overactive_bladder_medications|Overactive bladder medication]] (1) ·
[[:Category:SGLT2_inhibitors|SGLT2 inhibitor]] (1)
mechanism:
None (4) ·
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) ·
GABA-A positive allosteric modulator'"`UNIQ--ref-00000067-QINU`"' '"`UNIQ--vote-00000068-QINU`"' (1) ·
'"`UNIQ--vote-00000073-QINU`"' The long half-life gives smooth, once-daily BP control with low rebound. CYP3A4 substrate; pedal edema is the characteristic, dose-related, non-fluid-overload side effect'"`UNIQ--ref-00000074-QINU`"'. (1) ·
'"`UNIQ--vote-00001302-QINU`"' Renally cleared; accumulation in advanced CKD can produce neuromuscular and cardiac depression. Hypomagnesemia frequently co-exists with hypokalemia and is often the reason refractory potassium loss does not correct until magnesium is repleted. (1)
uses:
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-00000069-QINU`"', '"`UNIQ--vote-0000006A-QINU`"', '"`UNIQ--vote-0000006B-QINU`"' (1) ·
'"`UNIQ--vote-00000075-QINU`"', '"`UNIQ--vote-00000076-QINU`"', '"`UNIQ--vote-00000077-QINU`"' (1) ·
'"`UNIQ--vote-0000044C-QINU`"', '"`UNIQ--vote-0000044D-QINU`"', '"`UNIQ--vote-0000044E-QINU`"', '"`UNIQ--vote-0000044F-QINU`"' (1) ·
'"`UNIQ--vote-0000054E-QINU`"', '"`UNIQ--vote-0000054F-QINU`"', '"`UNIQ--vote-00000550-QINU`"', '"`UNIQ--vote-00000551-QINU`"' (1) ·
'"`UNIQ--vote-00000C4C-QINU`"', '"`UNIQ--vote-00000C4D-QINU`"' (1) ·
'"`UNIQ--vote-00001303-QINU`"', '"`UNIQ--vote-00001304-QINU`"', '"`UNIQ--vote-00001305-QINU`"', '"`UNIQ--vote-00001306-QINU`"', '"`UNIQ--vote-00001307-QINU`"', '"`UNIQ--vote-00001308-QINU`"', '"`UNIQ--vote-00001309-QINU`"' (1)
starting dose:
0.25 mg (1) ·
10 mg PO once daily in the morning; 5 mg starting in heart failure (1) ·
10 mg PO once daily, with or without food (1) ·
2.5-5 mg PO once daily; titrate to 10 mg/d (1) ·
25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate (1) ·
25 mg PO once daily; titrate to 50 mg after 4-8 weeks if needed (1) ·
5 mg PO at bedtime; may increase to 10 mg if inadequate (1) ·
Replacement oxide 400-800 mg/d in divided doses (high diarrhea rate); citrate 200-400 mg/d (better tolerated, better absorbed); IV sulfate 1-2 g over 5-60 minutes for hypomagnesemia or torsades; eclampsia 4-6 g IV loading then 1-2 g/h (1)
preparations:
0.25 mg, 0.5 mg, 1 mg, 2 mg tablets (immediate-release and orally disintegrating); 0.5 mg, 1 mg, 2 mg, 3 mg extended-release tablets; 1 mg/mL oral concentrate (1) ·
10 mg tablet; also as fixed-dose combinations with simvastatin (Vytorin) and atorvastatin (Liptruzet, withdrawn US 2015 but generics exist) (1) ·
2.5, 5, 10 mg tablets; 1 mg/mL oral suspension (1) ·
25 mg, 50 mg tablets (1) ·
25, 50 mg ER tablets; 8 mg/mL granules for oral suspension (Myrbetriq Granules, pediatric) (1) ·
5 mg, 10 mg tablets (2) ·
Oxide 400, 500 mg tablets (240, 300 mg elemental); citrate 100, 150, 200 mg tablets; hydroxide oral suspension 400 mg/5 mL; sulfate IV 500 mg/mL ampules (1)
fda max: (Click arrow to add another value)
onset:
30-60 min (immediate-release); 1-2 h (extended-release) (1) ·
BP effect within 24 hours; full effect at 1-2 weeks (long half-life) (1) ·
Glycosuria within hours; HbA1c effect at 12 weeks; CV/renal benefits over months (1) ·
LDL lowering within 2 weeks (1) ·
Oral: hours; IV: minutes (1) ·
Symptom improvement within weeks (1) ·
~30 min (2)
duration:
halflife:
11-13 h (immediate-release); 11-16 h (extended-release) (1) ·
30-50 hours'"`UNIQ--ref-00000078-QINU`"' (1) ·
Not meaningfully described (electrolyte; renally cleared) (1) ·
~12.9 hours'"`UNIQ--ref-00000552-QINU`"' (1) ·
~17-19 hours (longer than daridorexant) (1) ·
~22 hours (parent + active glucuronide)'"`UNIQ--ref-00000450-QINU`"' (1) ·
~50 hours'"`UNIQ--ref-00000C4E-QINU`"' (1) ·
~8 hours (shorter than suvorexant and lemborexant) (1)
bioavailability:
25 mg: ~29%; 50 mg: ~35%; food reduces absorption'"`UNIQ--ref-00000C4F-QINU`"' (1) ·
64-90% (oral; not affected by food)'"`UNIQ--ref-00000079-QINU`"' (1) ·
80-90% oral (1) ·
Highly salt-dependent: citrate ~25-30%; oxide ~4% (limited and causes osmotic diarrhea); chloride ~12% (1) ·
Variable (oral; rapidly conjugated to active glucuronide; food does not affect)'"`UNIQ--ref-00000451-QINU`"' (1) ·
~44% (1) ·
~62% (1) ·
~78% (oral; high-fat meal modestly reduces but is not clinically significant)'"`UNIQ--ref-00000553-QINU`"' (1)
pregnancy:
Avoid in second and third trimesters; fetal SGLT2 inhibition disrupts kidney development.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Category D'"`UNIQ--ref-0000006C-QINU`"' (1) ·
IV sulfate is the cornerstone of eclampsia/preeclampsia management; oral replacement also safe.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited data; avoid (2) ·
Limited data; case series and registries suggest no major teratogenicity but other antihypertensives (labetalol, nifedipine) are typically preferred.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited data; generally avoided particularly in combination with statin.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1)
Showing below up to 8 results in range #1 to #8.