Drilldown: Medicines

Brimonidine (1) · Dorzolamide (1) · Esomeprazole (1) · Levofloxacin (1) · Pantoprazole (1)

Alphagan P (ophthalmic glaucoma), Mirvaso (topical rosacea) (1) · Levaquin (US brand discontinued); generic and ophthalmic Quixin/Iquix (1) · Nexium, Nexium 24HR (OTC) (1) · Protonix (1) · Trusopt; with timolol as Cosopt (1)

[[:Category:Alpha-2_agonists|Alpha-2 adrenergic agonist]] (1) · [[:Category:Antibacterials|Antibacterial]] (1) · [[:Category:Antisecretory_agents|Gastric acid suppressant]] (2) · [[:Category:Carbonic_anhydrase_inhibitors|Carbonic anhydrase inhibitor (topical)]] (1) · [[:Category:Fluoroquinolones|Fluoroquinolone antibiotic]] (1) · [[:Category:Glaucoma_medications|Glaucoma medication]] (2) · [[:Category:Ocular_hypotensive_agents|Ocular hypotensive agent]] (2) · [[:Category:Proton_pump_inhibitors|Proton pump inhibitor (PPI)]] (2)

None (3) · '"`UNIQ--vote-00000117-QINU`"' Compared with omeprazole, pantoprazole has a more linear pharmacokinetic profile and is metabolized predominantly via CYP2C19 with CYP3A4 contribution; less CYP2C19-driven drug interaction with clopidogrel than omeprazole'"`UNIQ--ref-00000118-QINU`"'. (1) · '"`UNIQ--vote-000008E1-QINU`"' Like omeprazole, it is an acid-activated prodrug that covalently and irreversibly binds the H+/K+ ATPase. CYP2C19 PGx remains clinically relevant for both'"`UNIQ--ref-000008E2-QINU`"'. (1)

'"`UNIQ--vote-00000119-QINU`"', '"`UNIQ--vote-0000011A-QINU`"', '"`UNIQ--vote-0000011B-QINU`"', '"`UNIQ--vote-0000011C-QINU`"' (1) · '"`UNIQ--vote-000008E3-QINU`"', '"`UNIQ--vote-000008E4-QINU`"', '"`UNIQ--vote-000008E5-QINU`"', '"`UNIQ--vote-000008E6-QINU`"', '"`UNIQ--vote-000008E7-QINU`"' (1) · '"`UNIQ--vote-00000B08-QINU`"', '"`UNIQ--vote-00000B09-QINU`"' (1) · '"`UNIQ--vote-00000CEF-QINU`"', '"`UNIQ--vote-00000CF0-QINU`"', '"`UNIQ--vote-00000CF1-QINU`"', '"`UNIQ--vote-00000CF2-QINU`"', '"`UNIQ--vote-00000CF3-QINU`"', '"`UNIQ--vote-00000CF4-QINU`"' (1) · '"`UNIQ--vote-000010CE-QINU`"', '"`UNIQ--vote-000010CF-QINU`"', '"`UNIQ--vote-000010D0-QINU`"' (1)

1 drop in affected eye(s) TID (monotherapy); BID with timolol (Cosopt) (1) · 20-40 mg PO once daily, 30-60 minutes before breakfast (1) · 40 mg PO or IV once daily (1) · 500-750 mg PO/IV once daily (1) · Ophthalmic 1 drop in affected eye(s) TID; topical Mirvaso 0.33% gel applied to face daily (1)

0.1%, 0.15%, 0.2% ophthalmic solutions; 0.33% topical gel; combinations with timolol (Combigan) and brinzolamide (Simbrinza) (1) · 2% ophthalmic solution (Trusopt); 2%/0.5% fixed combination with timolol (Cosopt, Cosopt PF) (1) · 20 mg, 40 mg delayed-release tablets; 40 mg IV vial; oral suspension 40 mg/packet (1) · 20, 40 mg delayed-release capsules; 2.5, 5, 10, 20, 40 mg oral suspension packets; 20, 40 mg IV (1) · 250, 500, 750 mg tablets; 25 mg/mL oral solution; 25 mg/mL IV (premix bags 250, 500, 750 mg); 0.5%, 1.5% ophthalmic solutions (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:

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IV (3) · Oral (3) · Topical ophthalmic (3) · topical skin (1)

2-3 hours per dose; full acid suppression after 3-5 days (1) · Acid suppression within hours; full effect after 3-5 days of dosing (1) · Hours (1) · IOP lowering at 1 hour; max at 2-3 hours (1) · IOP lowering at 2 hours; max at 4 hours (1)

24 hours (1) · 24+ hours (irreversible enzyme binding) (1) · 24-72 hours per dose (irreversible enzyme binding) (1) · 8-12 hours (1) · 8-12 hours (TID dosing needed) (1)

~1 hour (plasma); pharmacodynamic effect persists 24+ hours'"`UNIQ--ref-0000011D-QINU`"' (1) · ~1.5 hours (plasma); pharmacodynamic effect 24+ hours via target turnover'"`UNIQ--ref-000008E8-QINU`"' (1) · ~3 hours'"`UNIQ--ref-000010D1-QINU`"' (1) · ~4 months in erythrocytes (carbonic anhydrase binding in red cells; not relevant to topical IOP duration)'"`UNIQ--ref-00000B0A-QINU`"' (1) · ~6-8 hours'"`UNIQ--ref-00000CF5-QINU`"' (1)

Topical with measurable systemic absorption (small CA inhibition observed clinically with chronic use)'"`UNIQ--ref-00000B0B-QINU`"' (1) · Topical; clinically meaningful systemic absorption can produce systemic α2 effects (somnolence, hypotension), especially in children'"`UNIQ--ref-000010D2-QINU`"' (1) · ~64-90% (oral; increases at higher doses and with multi-day dosing)'"`UNIQ--ref-000008E9-QINU`"' (1) · ~77% (oral; not affected by food or antacids)'"`UNIQ--ref-0000011E-QINU`"' (1) · ~99% (oral; matched 1:1 IV-to-PO conversion)'"`UNIQ--ref-00000CF6-QINU`"' (1)

'''Avoid in pregnancy where alternatives exist''' (animal cartilage toxicity; class-wide concern).<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 in obstetric reflux.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data; weigh against alternatives.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Widely used in obstetric reflux; reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

OTC (20 mg, 14-day course) and [[USLegal:Prescription only|Rx-only]] (higher and longer durations) in US (1) · [[USLegal:Prescription only|Rx-only]] in US (3) · [[USLegal:Prescription only|Rx-only]] in US. Carries the same fluoroquinolone-class '''Boxed Warnings''' as ciprofloxacin: tendinitis/tendon rupture (especially elderly, corticosteroid co-use), peripheral neuropathy, CNS effects, worsening of myasthenia gravis'"`UNIQ--ref-00000CF7-QINU`"' (1)