Drilldown: Medicines

None (3) · Bisoprolol (1) · Flecainide (1) · Metoprolol (1) · Moxifloxacin (1) · Terazosin (1) · Vardenafil (1)

Avelox (oral/IV brand discontinued US); Vigamox, Moxeza (ophthalmic) (1) · Belsomra (1) · Hytrin (US brand discontinued); mostly generic (1) · Levitra, Staxyn (1) · Lopressor (tartrate), Toprol XL (succinate) (1) · Nuplazid (1) · Tambocor (US brand discontinued) (1) · Trintellix (US), Brintellix (formerly) (1) · Zebeta (1)

Beta Blocker (2) · Cardioselective (β1) (2) · Dual orexin receptor antagonist (DORA) (1) · Multimodal antidepressant: SERT inhibitor + 5HT1A agonist + 5HT1B partial agonist + 5HT3/5HT7 antagonist (1) · PDE5 Inhibitor (1) · Selective 5HT2A inverse agonist (with weaker 5HT2C inverse agonism) (1) · the first approved (1) · [[:Category:Alpha-1_blockers|Alpha-1 adrenergic blocker (non-selective)]] (1) · [[:Category:Antiarrhythmics|Antiarrhythmic (Vaughan-Williams class IC)]] (1) · [[:Category:Antibacterials|Antibacterial]] (1) · [[:Category:Antihypertensives|Antihypertensive]] (1) · [[:Category:BPH_treatments|Benign prostatic hyperplasia treatment]] (1) · [[:Category:Fluoroquinolones|Fluoroquinolone antibiotic]] (1)

None (1) · Cardioselective β1-adrenergic antagonist. Selectivity is dose-dependent and partially lost at higher doses. (1) · Competitive antagonist at OX1R and OX2R. First-in-class DORA. Receptor dissociation slower than lemborexant or daridorexant. (1) · Highly β1-selective adrenergic antagonist. Greater selectivity than metoprolol or atenolol. (1) · Selective inhibitor of PDE5. Slightly higher PDE5/PDE6 selectivity vs sildenafil (less visual side effect) but more PDE1 cross-activity (occasional QT effects at high doses). (1) · Selective inverse agonist at 5HT2A receptors with weaker activity at 5HT2C. Has no significant dopamine D2 affinity, unique among approved antipsychotics. Inverse agonism (rather than antagonism) reduces constitutive 5HT2A receptor activity below baseline. (1) · '"`UNIQ--vote-00000D7A-QINU`"' Substantial QT-interval prolongation — the most QT-prolonging fluoroquinolone — limits use in patients on other QT-prolonging agents or with electrolyte abnormalities'"`UNIQ--ref-00000D7B-QINU`"'. (1) · '"`UNIQ--vote-0000111B-QINU`"' Intraoperative floppy iris syndrome is a recognized class effect. Recently emerging evidence (observational) suggests possible Parkinson's disease risk reduction via PGK1 binding — investigational and not a clinical indication'"`UNIQ--ref-0000111C-QINU`"'. (1) · '"`UNIQ--vote-0000113A-QINU`"' Concomitant β-blocker or CCB is required when used for AF to prevent 1:1 atrial flutter conduction (flecainide can slow atrial rate to a level where AV conduction allows dangerous ventricular rates). CYP2D6 substrate'"`UNIQ--ref-0000113B-QINU`"'. (1)

Hallucinations and delusions associated with Parkinson's disease psychosis (PDP). Investigational for psychosis in other dementias and as augmentation for depression. (1) · Insomnia (sleep onset and/or maintenance) in adults (FDA-approved August 2014). Also studied for insomnia in mild-moderate Alzheimer disease. (1) · Major depressive disorder in adults (FDA-approved 2013). Notable for evidence of cognitive benefit (processing speed) that distinguishes it from other antidepressants. (1) · '"`UNIQ--vote-000004F5-QINU`"', '"`UNIQ--vote-000004F6-QINU`"', '"`UNIQ--vote-000004F7-QINU`"', '"`UNIQ--vote-000004F8-QINU`"', '"`UNIQ--vote-000004F9-QINU`"' (1) · '"`UNIQ--vote-00000636-QINU`"', '"`UNIQ--vote-00000637-QINU`"', '"`UNIQ--vote-00000638-QINU`"' (1) · '"`UNIQ--vote-00000669-QINU`"' (1) · '"`UNIQ--vote-00000D7C-QINU`"', '"`UNIQ--vote-00000D7D-QINU`"', '"`UNIQ--vote-00000D7E-QINU`"', '"`UNIQ--vote-00000D7F-QINU`"', '"`UNIQ--vote-00000D80-QINU`"', '"`UNIQ--vote-00000D81-QINU`"' (1) · '"`UNIQ--vote-0000111D-QINU`"', '"`UNIQ--vote-0000111E-QINU`"' (1) · '"`UNIQ--vote-0000113C-QINU`"', '"`UNIQ--vote-0000113D-QINU`"', '"`UNIQ--vote-0000113E-QINU`"' (1)

1 mg PO at bedtime to limit first-dose syncope; titrate weekly to 5-10 mg (1) · 10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · 10 mg PO once daily; may increase to 20 mg as tolerated, or decrease to 5 mg if needed (1) · 10 mg ~1 h before sexual activity (1) · 2.5–5 mg daily (HTN); 1.25 mg daily (HFrEF, slow titration) (1) · 25–50 mg BID (tartrate); 25–100 mg daily (succinate); 12.5 mg daily in HFrEF (1) · 34 mg PO once daily (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)

1, 2, 5, 10 mg capsules and tablets (1) · 10 mg, 34 mg capsules/tablets (1) · 2.5, 5, 10, 20 mg tabs (Levitra); 10 mg ODT (Staxyn) (1) · 400 mg tablets; 400 mg/250 mL IV; 0.5% ophthalmic solution (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (1) · 5 mg, 10 mg, 20 mg tablets (1) · 5, 10 mg tabs (1) · 50, 100, 150 mg tablets (1) · Tartrate: 25, 50, 100 mg tabs; 1 mg/mL IV. Succinate ER: 25, 50, 100, 200 mg. (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:

Search

IV (2) · Oral (9) · topical ophthalmic (1)

1–2 h (1) · 1–2 h (PO); immediate (IV) (1) · AF conversion within hours of single PO dose (1) · Benefit over weeks of dosing (1) · BP and symptomatic LUTS improvement within 1-2 weeks (1) · Hours (1) · Typical antidepressant 4-6 week onset (1) · ~30 min (2)

12 hours (1) · 24 h (1) · 24 hours (2) · 4–5 h (1) · 6–12 h (tartrate); 24 h (succinate) (1) · Daily dosing (2) · ~7-8 hours (1)

3–7 h (1) · 4–5 h (1) · 9–12 h (1) · ~12 hours (1) · ~12 hours'"`UNIQ--ref-00000D82-QINU`"' (1) · ~12 hours'"`UNIQ--ref-0000111F-QINU`"' (1) · ~14 hours (adults); longer in elderly and renal impairment'"`UNIQ--ref-0000113F-QINU`"' (1) · ~57 hours (parent), ~200 h (active metabolite) (1) · ~66 hours (1)

>90% (oral; not significantly affected by food)'"`UNIQ--ref-00001120-QINU`"' (1) · Not characterized; oral dosing once daily (1) · ~15% (extensive hepatic first-pass) (1) · ~50% (1) · ~75% (1) · ~82% (1) · ~90% (low first-pass) (1) · ~90% (oral)'"`UNIQ--ref-00001140-QINU`"' (1) · ~90% (oral; not affected by food but reduced by divalent cations)'"`UNIQ--ref-00000D83-QINU`"' (1)

'''Avoid in pregnancy where alternatives exist''' (animal cartilage toxicity).<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Category B (1) · Category C (2) · 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 (2) · Limited data; weigh benefits/risks (1) · Use in fetal SVT (transplacental antiarrhythmic therapy) is established; otherwise weigh against alternatives.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

Rx (1) · Rx, Schedule IV (US) (1) · Rx-only in US (3) · Rx. FDA black-box warning for increased mortality in elderly patients with dementia-related psychosis (class warning shared with all antipsychotics) (1) · [[USLegal:Prescription only|Rx-only]] in US (1) · [[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)