Drilldown: Medicines

None (2) · Cetirizine (1) · Enalapril (and enalaprilat IV) (1) · Fluoxetine (1) · Loratadine (1) · Metoclopramide (1) · Montelukast (1) · Nebivolol (1) · Olmesartan (medoxomil) (1) · Prazosin (1)

Benicar (1) · Bystolic (1) · Claritin, Alavert, Tavist ND (1) · Minipress (1) · Prozac (1) · Reglan, Gimoti (intranasal), Metozolv ODT (1) · Rexulti (1) · Singulair (1) · Vasotec, Vasotec IV, Epaned (1) · Viibryd (1) · Zyrtec, Zyrtec-D (1)

5HT1A activity than aripiprazole (1) · 5HT2A (1) · Alpha-1 Adrenergic Antagonist (1) · Atypical antipsychotic (1) · Beta Blocker (1) · Cardioselective (β1) + vasodilator (1) · D2/5HT1A partial agonist with stronger α1A (1) · Serotonin partial agonist reuptake inhibitor (SPARI) (1) · [[:Category:ACE_inhibitors|ACE inhibitor]] (1) · [[:Category:Angiotensin_receptor_blockers|Angiotensin receptor blocker (ARB)]] (1) · [[:Category:Antiasthmatic_agents|Antiasthmatic]] (1) · [[:Category:Antidepressants|Antidepressant]] (1) · [[:Category:Antiemetics|Antiemetic]] (1) · [[:Category:Antihistamines|Antihistamine]] (2) · [[:Category:Antihypertensives|Antihypertensive]] (2) · [[:Category:Anxiolytics|Anxiolytic]] (1) · [[:Category:Dopamine_D2_antagonists|Dopamine D2 antagonist]] (1) · [[:Category:H1_receptor_antagonists|Histamine H1 receptor antagonist (second-generation)]] (2) · [[:Category:Leukotriene_receptor_antagonists|Leukotriene receptor antagonist]] (1) · [[:Category:Prokinetics|Prokinetic]] (1) · [[:Category:Selective Serotonin Reuptake Inhibitors (SSRIs)|SSRI]] (1)

None (5) · Partial agonist at D2 and 5HT1A. Antagonist at 5HT2A, α1A, α1B, α2C. More potent 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism (relative to D2 partial agonism) than aripiprazole, proposed to reduce akathisia and enhance affective/cognitive effects. (1) · Selective alpha-1 adrenergic receptor antagonist. Lowers peripheral vascular resistance via vasodilation; in the CNS, blunts noradrenergic hyperarousal thought to drive trauma-related nightmares. (1) · The d-enantiomer is a highly β1-selective antagonist; the l-enantiomer triggers endothelial nitric-oxide–mediated vasodilation. Unique among beta blockers for this NO mechanism. (1) · TrkB/BDNF'"`UNIQ--ref-00000047-QINU`"' '"`UNIQ--vote-00000048-QINU`"' (1) · '"`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-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)

Major depressive disorder in adults (FDA-approved 2011) (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) · '"`UNIQ--vote-00000049-QINU`"', '"`UNIQ--vote-0000004A-QINU`"', '"`UNIQ--vote-0000004B-QINU`"' (1) · '"`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-0000056B-QINU`"' (1) · '"`UNIQ--vote-0000059D-QINU`"' (1) · '"`UNIQ--vote-000005D0-QINU`"', '"`UNIQ--vote-000005D1-QINU`"', '"`UNIQ--vote-000005D2-QINU`"' (1) · '"`UNIQ--vote-0000061F-QINU`"', '"`UNIQ--vote-00000620-QINU`"' (1) · '"`UNIQ--vote-00000B81-QINU`"', '"`UNIQ--vote-00000B82-QINU`"', '"`UNIQ--vote-00000B83-QINU`"' (1) · '"`UNIQ--vote-00000EF4-QINU`"', '"`UNIQ--vote-00000EF5-QINU`"', '"`UNIQ--vote-00000EF6-QINU`"', '"`UNIQ--vote-00000EF7-QINU`"', '"`UNIQ--vote-00000EF8-QINU`"' (1)

1 mg at bedtime (PTSD nightmares); 1 mg BID–TID (HTN) (1) · 10 mg (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) · 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/IV/IM QID, '''not to exceed 12 weeks''' (tardive dyskinesia risk); intranasal Gimoti 15 mg BID (1) · 20 mg PO once daily; titrate to 40 mg/d after 2 weeks if needed (1) · 5 mg daily (1) · 5-10 mg PO once daily (2.5 mg if on diuretic or in heart failure); titrate to 10-20 mg BID for HFrEF (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)

0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg tablets (1) · 1, 2, 5 mg caps (1) · 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) · 10 mg, 20 mg, 40 mg caps (1) · 10 mg, 20 mg, 40 mg tablets (1) · 2.5, 5, 10, 20 mg tablets; 1 mg/mL oral solution (Epaned); 1.25 mg/mL IV (enalaprilat) (1) · 2.5, 5, 10, 20 mg tabs (1) · 5 mg, 10 mg tablets; 5 mg, 10 mg chewables; 1 mg/mL oral syrup; OTC (1) · 5, 10 mg tablets; 5 mg/5 mL solution; 5 mg/mL IV; 15 mg/spray intranasal (1) · 5, 20, 40 mg tablets (1)

None · Indication-specific · 40 mg/d · 10 mg/d · 20 mg/d · 80 mg/d · 10 mg/d (adults) · 100 mg/d · 4 g/d · 400 mg/d · 40 mg/d typical; up to 240 mg/d for Zollinger-Ellison · 5 mg/d · 50 mg/d · 600 mg/d · No fixed ceiling; titrate to clinical effect and tolerability with CDC opioid prescribing guidance constraints on morphine-milligram-equivalent (MME) totals · No fixed maximum; titrated to TSH target · TID per eye · Titrated to glucose; no fixed ceiling · Titrated to glucose; no fixed maximum · '''20 mg/day in adults >60 years''' per FDA's 2011-2012 QT-prolongation warning; 40 mg/day in adults ≤60

Other values:

Search

IM (1) · intranasal (1) · IV (2) · Oral (11)

None (1) · 1-3 hours (slower onset than cetirizine; symptom relief somewhat less) (1) · 1–2 h (1) · 30-60 minutes (1) · 30–90 min (1) · 4-6 weeks for full antidepressant effect (claimed earlier onset for some patients due to 5HT1A partial agonism) (1) · BP effect 1 hour; max at 4-6 hours (1) · BP effect 1-2 weeks; max at 2-3 weeks (1) · Bronchodilation within 1-2 hours; full controller effect 1-2 weeks (1) · IV/IM 1-3 minutes; PO 30-60 minutes (1) · Weeks for psychosis/depression; AD agitation benefit emerges over weeks (1)

12-24 hours (1) · 24 h (1) · 24 hours (4) · 4-6 hours (1) · 6–8 h (1) · Daily dosing (2) · Very long (1)

1-3 days acute, 4-6 days chronic; 4-16 days for norfluoxetine'"`UNIQ--ref-0000004C-QINU`"' (1) · 2.7-5.5 hours'"`UNIQ--ref-0000015E-QINU`"' (1) · 2–3 h (1) · 5-6 hours'"`UNIQ--ref-00000EF9-QINU`"' (1) · 8-10 hours (longer in elderly and renal impairment)'"`UNIQ--ref-00000396-QINU`"' (1) · ~10 h (CYP2D6 extensive metabolizers); up to 31 h (poor metabolizers) (1) · ~11 hours (enalaprilat, the active metabolite)'"`UNIQ--ref-00000B84-QINU`"' (1) · ~13 hours'"`UNIQ--ref-0000056C-QINU`"' (1) · ~25 hours (1) · ~8 hours (parent); ~28 hours (desloratadine, the active metabolite, marketed separately as Clarinex)'"`UNIQ--ref-00000621-QINU`"' (1) · ~91 hours (1)

70–90% (oral) (1) · High (oral); not significantly affected by food'"`UNIQ--ref-00000397-QINU`"' (1) · High (oral; food prolongs absorption modestly)'"`UNIQ--ref-00000622-QINU`"' (1) · ~12% (extensive metabolizers); ~96% (poor metabolizers) (1) · ~26% (oral; prodrug hydrolyzed by intestinal esterases to active olmesartan; not affected by food)'"`UNIQ--ref-0000056D-QINU`"' (1) · ~60% (1) · ~60% (oral; food does not affect absorption)'"`UNIQ--ref-00000B85-QINU`"' (1) · ~64% (oral; not significantly affected by food)'"`UNIQ--ref-0000015F-QINU`"' (1) · ~72% (with food); much lower fasting (~36%) (1) · ~80% (oral; reduced by significant first-pass)'"`UNIQ--ref-00000EFA-QINU`"' (1) · ~95% (1)

'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, hypocalvaria, hypotension. Stop on detection'"`UNIQ--ref-0000056E-QINU`"' (1) · '''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, skull hypoplasia, hypotension. Stop on detection'"`UNIQ--ref-00000B86-QINU`"' (1) · Category C (2) · Category C'"`UNIQ--ref-0000004D-QINU`"' (1) · Generally considered safe; pregnancy registries do not show increased major malformation risk.<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. Levocetirizine (the R-enantiomer) is an alternative with similar safety.<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. Loratadine and cetirizine are the most-recommended 2nd-gen H1s in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data; National Pregnancy Registry available (1) · Limited data; weigh benefits/risks (1) · Widely used for hyperemesis gravidarum; reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

OTC in US (2) · Rx (2) · Rx-only in US (2) · [[USLegal:Prescription only|Rx-only]] in US (3) · [[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. Carries a '''Boxed Warning''' for '''tardive dyskinesia''' (irreversible movement disorder), driving the 12-week chronic-use limit'"`UNIQ--ref-00000EFB-QINU`"' (1)