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Drilldown: Medicines

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Medicines > generic: None & fda max : 10 mg/d or 2 tablets/day (dextromethorphan 90 mg / bupropion 210 mg)

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generic: (Click arrow to add another value)
brand:
Auvelity (dextromethorphan/bupropion ER) (1) · Dayvigo (1)
classes:
Dual orexin receptor antagonist (DORA) (1) · NMDA receptor antagonist + sigma-1 agonist + NDRI (combination) (1)
mechanism:
None (1) · Competitive antagonist at OX1R and OX2R. Faster receptor association/dissociation kinetics than suvorexant (~16 sec dissociation vs ~57 sec) hypothesized to support sleep onset, with sufficient duration for maintenance. (1)
uses:
Insomnia (sleep onset and/or maintenance) in adults (FDA-approved Dec 2019) (1) · Major depressive disorder in adults (FDA-approved August 2022) (1)
starting dose:
1 tablet (dextromethorphan 45 mg / bupropion 105 mg) PO daily × 3 days, then increase to 1 tablet BID (1) · 5 mg PO at bedtime; may increase to 10 mg if inadequate (1)
preparations:
5 mg, 10 mg tablets (1) · Dextromethorphan 45 mg + bupropion 105 mg ER tablets (1)
fda max: (Click arrow to add another value)
routes:
Oral (2)
onset:
Significant antidepressant response by week 1 in trials (faster than monoaminergic antidepressants which take 4-6 weeks) (1) · ~30 min (1)
duration:
Sustained with twice-daily dosing (1) · ~7-8 hours (1)
halflife:
Dextromethorphan ~22 h (when CYP2D6 inhibited); bupropion ~21 h (1) · ~17-19 hours (longer than daridorexant) (1)
bioavailability:
Not formally characterized for the combination (1) · ~44% (1)
pregnancy:
Limited data; avoid (2)
legal:
Rx (1) · Rx, Schedule IV (US) (1)

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