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Medicines > fda max : 4 mg/d (schizophrenia); 3 mg/d (AD agitation); 3 mg/d (MDD adjunct) or 5 mg/d or Indication-specific

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classes:
5HT1A activity than aripiprazole (1) · 5HT2A (1) · Atypical antipsychotic (1) · D2/5HT1A partial agonist with stronger α1A (1) · high-potency)]] (2) · narrow-spectrum)]] (1) · with mineralocorticoid activity)]] (1) · [[:Category:5-alpha-reductase_inhibitors|5α-reductase inhibitor]] (1) · [[:Category:Androgen_modulators|Androgen modulator]] (1) · [[:Category:Antifungals|Antifungal]] (1) · [[:Category:Antihyperglycemic_agents|Antihyperglycemic agent]] (1) · [[:Category:Beta-lactam_antibiotics|β-lactam antibiotic]] (1) · [[:Category:BPH_treatments|Benign prostatic hyperplasia treatment]] (1) · [[:Category:Corticosteroids|Corticosteroid]] (6) · [[:Category:DPP-4_inhibitors|DPP-4 inhibitor]] (1) · [[:Category:Glucocorticoids|Glucocorticoid (intermediate-acting)]] (3) · [[:Category:Glucocorticoids|Glucocorticoid (long-acting (2) · [[:Category:Glucocorticoids|Glucocorticoid (short-acting (1) · [[:Category:Hormonal_contraceptives|Hormonal contraceptive (Depo)]] (1) · [[:Category:Hormonal_contraceptives|Hormonal contraceptive]] (1) · [[:Category:Immunosuppressants|Immunosuppressant]] (3) · [[:Category:Incretin_modulators|Incretin pathway modulator]] (1) · [[:Category:Penicillins|Penicillin (natural (1) · [[:Category:Polyene_antifungals|Polyene antifungal]] (1) · [[:Category:Progestins|Progestin (synthetic progestogen)]] (1) · [[:Category:Progestogens|Progestin (synthetic progestogen)]] (1) · [[:Category:Sex_hormones|Sex hormone]] (2) · [[:Category:Topical_corticosteroids|Topical corticosteroid (high-to-super-high potency depending on ester)]] (1) · [[:Category:Topical_corticosteroids|Topical corticosteroid]] (1)
mechanism:
None (7) · 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) · '"`UNIQ--vote-00000860-QINU`"' Activates the glucocorticoid receptor to broadly remodel inflammatory, immune, and metabolic transcription. Unlike prednisone, it does not require hepatic activation, making it the preferred oral choice in severe hepatic dysfunction'"`UNIQ--ref-00000861-QINU`"'. (1) · '"`UNIQ--vote-000008BE-QINU`"' Preferred over prednisone in advanced hepatic dysfunction where hepatic 11β-HSD1 activation is impaired. Liquid formulations are the workhorse pediatric oral corticosteroid for asthma and croup'"`UNIQ--ref-000008BF-QINU`"'. (1) · '"`UNIQ--vote-00000D11-QINU`"' Same mechanistic family as amphotericin B but with prohibitive systemic toxicity at therapeutic doses, hence restriction to topical and luminal-gut indications. No clinically meaningful resistance after decades of use'"`UNIQ--ref-00000D12-QINU`"'. (1) · '"`UNIQ--vote-00001014-QINU`"' Activates the glucocorticoid receptor to broadly remodel inflammatory, immune, and metabolic transcription. The dipropionate, valerate, and augmented dipropionate ester forms determine topical potency (high to super-high)'"`UNIQ--ref-00001015-QINU`"'. (1) · '"`UNIQ--vote-000013EE-QINU`"' Higher-dose Aygestin (5 mg) achieves more reliable ovulation suppression and is used for endometriosis and DUB. POP requires strict daily timing because the 24-hour cervical-mucus effect window is narrower than COC'"`UNIQ--ref-000013EF-QINU`"'. (1)
uses:
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-0000052E-QINU`"', '"`UNIQ--vote-0000052F-QINU`"', '"`UNIQ--vote-00000530-QINU`"' (1) · '"`UNIQ--vote-00000661-QINU`"', '"`UNIQ--vote-00000662-QINU`"', '"`UNIQ--vote-00000663-QINU`"', '"`UNIQ--vote-00000664-QINU`"', '"`UNIQ--vote-00000665-QINU`"' (1) · '"`UNIQ--vote-00000862-QINU`"', '"`UNIQ--vote-00000863-QINU`"', '"`UNIQ--vote-00000864-QINU`"', '"`UNIQ--vote-00000865-QINU`"', '"`UNIQ--vote-00000866-QINU`"' (1) · '"`UNIQ--vote-000008C0-QINU`"', '"`UNIQ--vote-000008C1-QINU`"', '"`UNIQ--vote-000008C2-QINU`"', '"`UNIQ--vote-000008C3-QINU`"' (1) · '"`UNIQ--vote-00000ACD-QINU`"', '"`UNIQ--vote-00000ACE-QINU`"', '"`UNIQ--vote-00000ACF-QINU`"', '"`UNIQ--vote-00000AD0-QINU`"' (1) · '"`UNIQ--vote-00000D13-QINU`"', '"`UNIQ--vote-00000D14-QINU`"', '"`UNIQ--vote-00000D15-QINU`"', '"`UNIQ--vote-00000D16-QINU`"' (1) · '"`UNIQ--vote-00000E23-QINU`"', '"`UNIQ--vote-00000E24-QINU`"', '"`UNIQ--vote-00000E25-QINU`"', '"`UNIQ--vote-00000E26-QINU`"', '"`UNIQ--vote-00000E27-QINU`"', '"`UNIQ--vote-00000E28-QINU`"', '"`UNIQ--vote-00000E29-QINU`"', '"`UNIQ--vote-00000E2A-QINU`"' (1) · '"`UNIQ--vote-00000F1B-QINU`"', '"`UNIQ--vote-00000F1C-QINU`"', '"`UNIQ--vote-00000F1D-QINU`"', '"`UNIQ--vote-00000F1E-QINU`"', '"`UNIQ--vote-00000F1F-QINU`"' (1) · '"`UNIQ--vote-00001016-QINU`"', '"`UNIQ--vote-00001017-QINU`"', '"`UNIQ--vote-00001018-QINU`"', '"`UNIQ--vote-00001019-QINU`"' (1) · '"`UNIQ--vote-0000117B-QINU`"' (1) · '"`UNIQ--vote-000013F0-QINU`"', '"`UNIQ--vote-000013F1-QINU`"', '"`UNIQ--vote-000013F2-QINU`"', '"`UNIQ--vote-000013F3-QINU`"', '"`UNIQ--vote-000013F4-QINU`"' (1) · '"`UNIQ--vote-00001414-QINU`"', '"`UNIQ--vote-00001415-QINU`"', '"`UNIQ--vote-00001416-QINU`"', '"`UNIQ--vote-00001417-QINU`"', '"`UNIQ--vote-00001418-QINU`"' (1)
starting dose:
None (1) · 5 mg PO daily for BPH; 1 mg PO daily for androgenetic alopecia (1) · 5 mg PO once daily (no renal dose adjustment, unlike sitagliptin) (1) · Antenatal: Celestone Soluspan 12 mg IM q24h × 2 doses; topical: pea-sized amount BID; intra-articular varies by joint (1) · Contraception: Depo-Provera 150 mg IM every 13 weeks; Depo-SubQ 104 mg SC every 12-13 weeks; oral cycling: 5-10 mg PO daily ×5-10 days for amenorrhea (1) · Indication-specific: 0.5-9 mg PO/IV daily for inflammation; 4 mg IV q6h for cerebral edema; 40 mg PO once weekly in MM; 6 mg PO/IV daily ×10 days for severe COVID-19; 0.6 mg/kg PO single dose for croup (max 16 mg) (1) · Oral: 4-6 mL (400,000-600,000 units) suspension QID swish-and-swallow; topical: BID-QID; vaginal tablet 1 daily for 2 weeks (1) · Pediatric 1-2 mg/kg/d (max 60 mg) PO for asthma exacerbation; adult dosing similar to prednisone milligram-for-milligram (~1:1 potency) (1) · Physiologic replacement 15-25 mg/d divided (e.g., 10 mg AM, 5 mg noon, 5 mg afternoon); stress dose 50-100 mg IV q6-8h; adrenal crisis 100 mg IV then 50-100 mg q6h; topical 0.5-2.5% applied 2-4×/d (1) · PO Medrol Dosepak (5-day taper from 24 mg to 4 mg) is the prototypic short-course outpatient regimen; IV pulse 1 g daily for 3-5 days for MS relapse; intra-articular 4-80 mg per joint q1-5 weeks (1) · POP: 0.35 mg PO daily continuously (no placebo week); high-dose 5 mg Aygestin for amenorrhea/endometriosis 5-10 mg/d (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) · Topical 0.025-0.5% cream/ointment BID; intra-articular 5-40 mg per joint q3-6 months; intranasal Nasacort 110 mcg/spray, 2 sprays/nostril daily; oral paste 0.1% to lesion 2-3×/d (1)
fda max: (Click arrow to add another value)
pregnancy:
None (1) · '''Pregnant individuals should not handle crushed/broken tablets''' (skin absorption risk); can cause hypospadias in male fetus. Not used in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Contraindicated in known pregnancy (Aygestin); the 0.35 mg POP is not teratogenic and does not need to be discontinued before conception planning.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Contraindicated in known pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe in pregnancy (no systemic absorption).<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; switch to insulin where feasible.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Penicillin G is the only fully effective syphilis treatment in pregnancy; penicillin-allergic pregnant patients require desensitization.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Topical/intranasal generally low-risk; intra-articular and high-dose injection: weigh risk individually.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Use when benefits outweigh; small association with oral clefts debated.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Use when benefits outweigh; small association with oral clefts in first trimester debated.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Use when benefits outweigh; widely used at physiologic doses for adrenal insufficiency.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Used in antenatal lung maturation (24-34 weeks gestation; 6 mg IM q12h × 4 doses); broader use weighs benefits against fetal HPA suppression.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

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