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Medicines > fda max

: 400 mg/d

or 750 mg/d

or None

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None (237)

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Research material (131) · Classic Psychedelic (70) · Stimulant (43) · Opioid (29) · Sedative-Hypnotic (29) · Phenethylamine (26) · Tryptamine (26) · Botanical (23) · Benzodiazepine (22) · Anticonvulsant (19) · Dissociative (19) · Plant Medicine (19) · Antidepressant (18) · Antiparkinsonian (16) · Antipsychotic (16) · Empathogen (16) · Analgesic (15) · Neuroleptic (15) · Cathinone (14)

Other values:

5-HT2A agonist (27) · GABAA positive allosteric modulator (22) · None (12) · Monoamine releasing agent (11) · CB1/CB2 agonist (7) · Potent mu-opioid receptor agonist (6) · Sodium channel blocker (6) · Dopamine/norepinephrine reuptake inhibitor (5) · GABAA potentiator; NMDA antagonist (5) · Phenothiazine D2 antagonist (5) · Potent 5-HT2A agonist (5) · 5-HT1B/1D agonist (4) · LSD analogue; 5-HT2A agonist (4) · Mu-opioid receptor agonist (4) · Muscarinic receptor antagonist (4) · Prodrug of LSD; 5-HT2A agonist (4) · Selective norepinephrine reuptake inhibitor (4)

None (414) · 0.5–1 oz (10–30 g) ground for psychoactive effect; far smaller for culinary use (1) · 25–50 mg BID (tartrate); 25–100 mg daily (succinate); 12.5 mg daily in HFrEF (1) · 400 mg PO/IV once daily (1) · 50 mg PO BID; titrate to 100-200 mg BID; pill-in-pocket 200-300 mg PO single dose for AF conversion (1) · 500-750 mg PO/IV once daily (1) · A ''marduuf'' bundle (~50 g fresh leaves) chewed over a couple of hours (1) · A measured pour of absinthe diluted 5:1 with cold water over sugar (the louche ritual) (1) · Acute mania: 300 mg PO TID (immediate-release) or 900 mg PO once daily (extended-release Lithobid); titrate based on serum levels to target 0.8-1.2 mEq/L. Maintenance: target 0.6-0.8 mEq/L. All dosing guided by serum lithium levels drawn at the 12-hour post-dose standardized trough. (1) · One cup (~40–60 mg caffeine; about half of brewed coffee) (1) · One cup (~80–145 mg caffeine for brewed; 60–100 mg for instant) (1)

None (399) · 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) · 400 mg tablets; 400 mg/250 mL IV; 0.5% ophthalmic solution (1) · 50, 100, 150 mg tablets (1) · A ''betel quid'': areca nut slice + betel leaf + slaked lime (calcium hydroxide) ± tobacco ± spices, chewed (1) · Acid/base extraction of fresh young grass for tryptamines; combined with an MAOI (1) · Bark/woody stem decocted with a DMT-source plant (''Psychotria viridis'', ''Diplopterys cabrerana'') to make ayahuasca (1) · Bright red seeds, traditionally ingested or smoked. Highly toxic, narrow margin between active and lethal (1) · Dried leaves and twigs, infused in a gourd (''mate'') and drunk through a metal straw (''bombilla'') (1) · Dried leaves, infused. Six major processings: white, green, yellow, oolong, black, pu-erh (1) · Dried leaves; absinthe liqueur (120–160 proof, with hyssop, lemon balm, fennel, anise, sometimes Acorus calamus) (1) · Fermented and roasted seeds, ground. Mexican tradition: drunk with chili, cornmeal, achiote. European tradition: with sugar and milk (1) · Flowers or leaves infused or smoked. Highly variable potency; narrow toxic margin (1) · Fresh leaves and tender twigs chewed; degrades on drying (1) · Fresh nuts chewed; also dried and powdered (1) · Ground dried seed (nutmeg) or fruit aril (mace); occasionally infused (1) · Leaves and seeds, traditionally smoked or infused. Possibly the original Pythia oracle plant (1) · Leaves chewed with a pinch of slaked lime (the lime converts cocaine HCl to freebase for buccal absorption); also drunk as tea (''mate de coca'') (1) · Leaves, berries, root. Historically: belladonna cigarettes ("Asthmador") OTC in US until the 1970s (1) · Parotid-gland venom expressed onto a glass plate, dried into a shellac-like resin, vaporized and inhaled (1) · Roasted beans, ground; brewed (drip, French press, espresso, cold brew, percolated) (1) · Roasted seeds ground to powder, mixed with water; commercial syrups and energy drinks (1) · Root bark acid/base-extracted for DMT; or as the resurrected ''jurema preta'' brew (decocted with an MAOI such as ''Peganum harmala'') (1) · Root, traditionally carved into ''mannikens'' or infused into wine (1) · Tartrate: 25, 50, 100 mg tabs; 1 mg/mL IV. Succinate ER: 25, 50, 100, 200 mg. (1) · Toasted leaves and twigs decocted to a near-black concentrate (1)

None (392) · buccal); refined cocaine has its own profile (1) · IM (1) · inhalation (2) · Inhalation (vaporized) (1) · insufflated (1) · IV (4) · Oral (25) · Oral (buccal absorption) (1) · Oral (buccal) (1) · Oral (leaf (1) · Oral (with MAOI) (2) · Oral only. No parenteral lithium formulation exists for clinical use. (1) · PR (1) · smoked (extracted DMT) (1) · topical (1) · topical ophthalmic (2) · transdermal (1)

None (408) · 15–30 min (2) · 1–2 h (PO); immediate (IV) (1) · 20–60 min (oral) (1) · 30–60 min (1) · 30–60 minutes (1) · 45-75 min (oral) (1) · AF conversion within hours of single PO dose (1) · Hours (2) · Mood: 2–4 weeks. Pain: often within 1–2 weeks. (1) · Oral peak plasma 1-2 hours (immediate-release); 4-6 hours (extended-release). Therapeutic antimanic effect typically evident within 5-14 days of achieving target serum levels; for acute mania, a neuroleptic or benzodiazepine is usually co-administered while lithium titration proceeds. (1) · PO 1–2 h; IM 30–60 min; IV 5–20 min (1) · Seconds (1) · Slow, 2–6 h (1) · ~15–30 min (1)

None (407) · 12 hours (1) · 12–24 h (oral); decanoate IM 3–4 weeks (1) · 12–24 h or longer (1) · 24 hours (2) · 2–4 h (1) · 3–4 h (1) · 3–5 h (subjective) (1) · 4-8 h (1) · 6–12 h (tartrate); 24 h (succinate) (1) · 8–12 hours (1) · About 20 minutes (1) · Chronic daily dosing (1) · IR 3–5 h; LA/SR 6–8 h; Concerta 10–12 h; Daytrana ~9 h wear time (1) · IR 4–6 h; XR 8–12 h (1) · Lithium's mood-stabilizing benefit is prophylactic and requires continuous maintenance dosing; it is not a PRN or acute-episode-only medicine. Discontinuation is associated with high relapse rates and a potentially rebound worsening of episode frequency. (1) · ~15 min (1)

None (410) · 14–26 h (oral); ~3 weeks (decanoate) (1) · 18-36 hours at steady state; longer in elderly patients (24-60 hours) and those with renal impairment. Half-life is entirely a function of glomerular filtration rate, as lithium is exclusively renally eliminated with no hepatic metabolism.'"`UNIQ--ref-0000004C-QINU`"' (1) · 2.2 h (IR parent); ~3 h (XR parent) (1) · 2–3 h (parent compound) (1) · 3–5 hours (1) · 3–7 h (1) · 9–12 minutes (intravenous) (1) · Not well characterized (1) · ~12 hours (1) · ~12 hours'"`UNIQ--ref-00000D82-QINU`"' (1) · ~14 hours (adults); longer in elderly and renal impairment'"`UNIQ--ref-0000113F-QINU`"' (1) · ~5 h (caffeine) (2) · ~6-8 hours'"`UNIQ--ref-00000CF5-QINU`"' (1)

None (413) · 70–90% (oral) (1) · Not well characterized (1) · ~22–25% (1) · ~30% (high first-pass) (1) · ~50% (1) · ~50% (highly variable) (1) · ~60–70% (oral) (1) · ~90% (oral)'"`UNIQ--ref-00001140-QINU`"' (1) · ~90% (oral; not affected by food but reduced by divalent cations)'"`UNIQ--ref-00000D83-QINU`"' (1) · ~99% (caffeine) (1) · ~99% (oral; matched 1:1 IV-to-PO conversion)'"`UNIQ--ref-00000CF6-QINU`"' (1)

None (413) · '''Avoid in pregnancy where alternatives exist''' (animal cartilage toxicity).[[[Pharmacopedia:Citation needed|citation needed]]] (1) · '''Avoid in pregnancy where alternatives exist''' (animal cartilage toxicity; class-wide concern).[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Category C (4) · Limit to <200 mg/d (~2 cups brewed) (1) · Not established (2) · Pregnancy categories were retired by FDA in 2015. Limited reproductive data with small observational signal for cardiac malformations; risk-benefit decision, with many patients deferring ADHD treatment during pregnancy. See pregnancy_details for the full discussion. (1) · Use in fetal SVT (transplacental antiarrhythmic therapy) is established; otherwise weigh against alternatives.[[[Pharmacopedia:Citation needed|citation needed]]] (1)

None (406) · 5-MeO-DMT is Schedule I in US (since 2011); the toad itself is protected in several southwestern states (1) · Currently legal in most jurisdictions with thujone limits (1) · Leaves legal in Bolivia, Peru, Colombia; cocaine internationally controlled (1) · Plant unrestricted; pharmaceutical atropine Rx-only (1) · Rx-only (2) · Rx-only in US (1) · Schedule I (United States) (1) · Schedule I in US since 1993 (despite traditional use elsewhere); legal in Ethiopia, Kenya, Yemen, Somalia, Djibouti (1) · Schedule II (2) · Unrestricted (food) (1) · [[USLegal:DEA Schedule I|Schedule I]] (United States) (2) · [[USLegal:Prescription only|Rx-only]] in US. '''Contraindicated in structural heart disease''' — CAST trial (1989) showed increased mortality from class IC agents in patients with prior MI; modern use is limited to structurally normal hearts'"`UNIQ--ref-00001141-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the same fluoroquinolone-class '''Boxed Warnings''' as ciprofloxacin/levofloxacin'"`UNIQ--ref-00000D84-QINU`"' (1) · [[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) · [[USLegal:Prescription only|Rx-only]]. Not scheduled; no abuse potential. One of the oldest continually-used psychotropic medicines, with FDA approval dating to 1970. (1)

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