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Medicines > fda max

: Indication-specific

or No fixed maximum; titrated to TSH target

& legal: [[USLegal:Prescription only|Rx-only]] in US

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Betamethasone (valerate, dipropionate, sodium phosphate, acetate) (1) · Dexamethasone (1) · Levothyroxine (1) · Methylprednisolone (1) · Nystatin (1) · Penicillin G (benzylpenicillin; potassium, sodium, benzathine, procaine salts) (1) · Prednisolone (and prednisolone sodium phosphate, acetate, etc.) (1) · Thyroid (desiccated) (1)

Armour Thyroid, NP Thyroid, Nature-Throid, WP Thyroid (1) · Bicillin L-A (benzathine), Bicillin C-R (combination procaine + benzathine), Pfizerpen (potassium IV) (1) · Celestone (oral/injectable), Diprolene/Diprosone (topical), Luxiq (foam), Celestone Soluspan (depot IM) (1) · Decadron (historical), Dexpak (taper pack), Hemady, Ozurdex (intravitreal) (1) · Medrol (oral), Solu-Medrol (IV/IM), Depo-Medrol (depot injection) (1) · Mycostatin, Nystop, Nyamyc, Bio-Statin (1) · Prelone, Pediapred, Orapred ODT, Millipred, Veripred (1) · Synthroid, Levoxyl, Tirosint, Unithroid, Euthyrox (1)

high-potency)]] (2) · narrow-spectrum)]] (1) · [[:Category:Antifungals|Antifungal]] (1) · [[:Category:Beta-lactam_antibiotics|β-lactam antibiotic]] (1) · [[:Category:Corticosteroids|Corticosteroid]] (4) · [[:Category:Glucocorticoids|Glucocorticoid (intermediate-acting)]] (2) · [[:Category:Glucocorticoids|Glucocorticoid (long-acting (2) · [[:Category:Hormone_replacement|Hormone replacement]] (2) · [[:Category:Immunosuppressants|Immunosuppressant]] (3) · [[:Category:Penicillins|Penicillin (natural (1) · [[:Category:Polyene_antifungals|Polyene antifungal]] (1) · [[:Category:Thyroid_hormones|Thyroid hormone]] (2) · [[:Category:Topical_corticosteroids|Topical corticosteroid (high-to-super-high potency depending on ester)]] (1)

None (2) · Synthetic T4 (thyroxine); peripherally deiodinated to T3 (triiodothyronine), the active hormone. '"`UNIQ--vote-00000031-QINU`"' Narrow therapeutic index; brand-to-generic switches can shift TSH and require re-titration'"`UNIQ--ref-00000032-QINU`"'. (1) · '"`UNIQ--vote-00000016-QINU`"' Brand-to-brand and lot-to-lot variability in T3:T4 ratio is greater than with synthetic levothyroxine, which is why endocrine guidelines prefer the synthetic'"`UNIQ--ref-00000017-QINU`"'. (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)

None (1) · 1.6 mcg/kg/d in young healthy adults; 25-50 mcg/d in elderly or cardiac disease, titrated by TSH at 6-8 weeks (1) · 30 mg PO daily (1/2 grain); titrate by TSH at 6-8 weeks; 60 mg desiccated thyroid is approximately equivalent to 88-100 mcg levothyroxine (1) · Antenatal: Celestone Soluspan 12 mg IM q24h × 2 doses; topical: pea-sized amount BID; intra-articular varies by joint (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) · 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)

0.5, 0.75, 1, 1.5, 2, 4, 6 mg tablets; oral solution; 4, 10, 20, 100 mg/mL IV; intravitreal implant (Ozurdex) (1) · 0.6 mg/5 mL oral solution; Celestone Soluspan 6 mg/mL IM/IA (mix of sodium phosphate + acetate); 0.05% and 0.1% topical cream/ointment/lotion/foam (various salts); augmented betamethasone 0.05% (super-high potency) (1) · 100,000 units/mL oral suspension; 500,000 unit tablets; 100,000 units/g cream, ointment, powder; vaginal tablets (1) · 15, 30, 60, 90, 120, 180, 240, 300 mg tablets (1/4 to 5 grains; 1 grain = 60 mg) (1) · 2, 4, 8, 16, 32 mg oral tablets; 40, 125, 500, 1000 mg IV vials; Depo-Medrol 20, 40, 80 mg/mL IM depot (1) · 25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200, 300 mcg tablets; oral capsule and IV/IM also available (1) · 5 mg tablets; 5 mg/5 mL, 10 mg/5 mL, 15 mg/5 mL oral solutions (sweetened pediatric); 5 mg/5 mL syrup; ophthalmic 0.12%, 1% suspensions and 1% solution (1) · Bicillin L-A 600,000; 1.2M; 2.4M U IM; aqueous crystalline (Pfizerpen) 5M, 20M U IV; procaine 600,000 U/mL IM (1)

IA (1) · IM (4) · IM (benzathine (1) · intra-articular (2) · intrathecal (rare and controversial) (1) · intrathecal (rare) (1) · intravitreal (1) · IV (3) · IV (aqueous crystalline); '''NEVER IV for benzathine — fatal cardiopulmonary events reported''' (1) · IV (prednisolone sodium phosphate) (1) · ophthalmic (1) · Oral (6) · Oral (topical action; minimal systemic absorption) (1) · procaine) (1) · topical (2) · vaginal (1)

Hours (3) · IV pulse: hours; PO: hours; intra-articular: days (1) · IV: minutes; IM benzathine: depot levels last weeks (1) · Symptom relief within days (1) · TSH normalization 4-8 weeks (1) · TSH normalization 4-8 weeks; symptomatic improvement weeks to months (1)

Biologic 12-36 hours (intermediate-acting) (1) · Biologic 12-36 hours (intermediate-acting); Depo-Medrol depot weeks (1) · Biologic 36-54 hours (long-acting) (1) · Biologic 36-72 hours (long-acting) (1) · Hours per application (1) · IM benzathine: 3-4 weeks of detectable levels (1) · Steady-state at 4-6 weeks (2)

Aqueous crystalline ~30 minutes; benzathine effective ~3 weeks via depot release'"`UNIQ--ref-00001419-QINU`"' (1) · Not meaningfully described (not systemically absorbed)'"`UNIQ--ref-00000D17-QINU`"' (1) · Plasma 2-3 hours; biologic ~18-36 hours'"`UNIQ--ref-00000867-QINU`"' (1) · Plasma 2-3 hours; biologic ~18-36 hours'"`UNIQ--ref-000008C4-QINU`"' (1) · Plasma ~3-4.5 hours; biologic ~36-72 hours'"`UNIQ--ref-00000E2B-QINU`"' (1) · Plasma ~5 hours; biologic ~36-54 hours'"`UNIQ--ref-0000101A-QINU`"' (1) · T4 ~7 days; T3 ~1 day'"`UNIQ--ref-0000001A-QINU`"' (1) · ~7 days (euthyroid); longer in hypothyroidism (~9-10 days), shorter in hyperthyroidism'"`UNIQ--ref-00000036-QINU`"' (1)

40-80% (oral); reduced by food, calcium, iron, PPIs, fiber; take fasting with water'"`UNIQ--ref-00000037-QINU`"' (1) · Acid-labile; not effective orally (oral form available outside US as penicillin G salts but penicillin V is preferred for oral use)'"`UNIQ--ref-0000141A-QINU`"' (1) · Essentially zero systemic absorption from oral or topical routes — the topical-action-only profile is the basis of its safety'"`UNIQ--ref-00000D18-QINU`"' (1) · Oral ~70%; depot IM provides sustained release over weeks'"`UNIQ--ref-0000101B-QINU`"' (1) · Variable; reduced by food, calcium, iron, PPIs'"`UNIQ--ref-0000001B-QINU`"' (1) · ~70% (oral)'"`UNIQ--ref-000008C5-QINU`"' (1) · ~80% (oral)'"`UNIQ--ref-00000E2C-QINU`"' (1) · ~80-99% (oral)'"`UNIQ--ref-00000868-QINU`"' (1)

None (1) · First-line in pregnancy; dose typically increased 25-30% due to estrogen-driven rise in TBG and fetal demand. Lactation safe at physiologic doses.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Generally considered safe in pregnancy (no systemic absorption).[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Penicillin G is the only fully effective syphilis treatment in pregnancy; penicillin-allergic pregnant patients require desensitization.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Synthetic levothyroxine is the standard-of-care in pregnancy; desiccated thyroid use in pregnancy is not well studied.'"`UNIQ--ref-0000001C-QINU`"' (1) · Use when benefits outweigh; small association with oral clefts debated.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Use when benefits outweigh; small association with oral clefts in first trimester debated.[[[Pharmacopedia:Citation needed|citation needed]]] (1) · Used in antenatal lung maturation (24-34 weeks gestation; 6 mg IM q12h × 4 doses); broader use weighs benefits against fetal HPA suppression.[[[Pharmacopedia:Citation needed|citation needed]]] (1)

Showing below up to 8 results in range #1 to #8.

B

Betamethasone

D