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Medicines > fda max : 40 mg/d (rarely needed; 40 mg restricted to patients not at goal on 20 mg) or 50 mg/d & routes: Oral

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generic:
None (1) · Mirabegron (1) · Rosuvastatin (1)
brand:
Crestor, Ezallor (1) · Myrbetriq (1) · Quviviq (1)
classes:
Dual orexin receptor antagonist (DORA) (1) · [[:Category:Beta-3_agonists|β3 adrenergic agonist]] (1) · [[:Category:Lipid-lowering_agents|Lipid-lowering agent]] (1) · [[:Category:Overactive_bladder_medications|Overactive bladder medication]] (1) · [[:Category:Statins|Statin]] (1)
mechanism:
None (2) · '"`UNIQ--vote-000000F7-QINU`"' Minimal CYP3A4 dependence (CYP2C9 minor) reduces drug-drug interactions; transport in and out of hepatocytes is largely via OATP1B1, making SLCO1B1 PGx genotype the most clinically actionable marker for statin-associated myopathy'"`UNIQ--ref-000000F8-QINU`"'. (1)
uses:
Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022) (1) · '"`UNIQ--vote-000000F9-QINU`"', '"`UNIQ--vote-000000FA-QINU`"', '"`UNIQ--vote-000000FB-QINU`"' (1) · '"`UNIQ--vote-00000C4C-QINU`"', '"`UNIQ--vote-00000C4D-QINU`"' (1)
starting dose:
10-20 mg PO once daily (5 mg in Asian ancestry, elderly, hypothyroidism, or strong CYP/SLCO1B1 interactions) (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)
preparations:
25 mg, 50 mg tablets (1) · 25, 50 mg ER tablets; 8 mg/mL granules for oral suspension (Myrbetriq Granules, pediatric) (1) · 5, 10, 20, 40 mg tablets (1)
fda max: (Click arrow to add another value)
routes: (Click arrow to add another value)
onset:
LDL lowering at 1 week, max by 4 weeks (1) · Symptom improvement within weeks (1) · ~30 min (1)
duration:
24 hours (2) · ~7-8 hours (1)
halflife:
~19 hours'"`UNIQ--ref-000000FC-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) · ~20% (oral; hydrophilic, minimal CYP metabolism, mostly excreted unchanged in bile)'"`UNIQ--ref-000000FD-QINU`"' (1) · ~62% (1)
pregnancy:
Limited data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data; avoid (1) · Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021. Use individualized.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
Rx, Schedule IV (US) (1) · [[USLegal:Prescription only|Rx-only]] in US (2)

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