Drilldown: Medicines

None (2) · Bumetanide (1) · Duloxetine (1)

Belsomra (1) · Bumex (1) · Cymbalta, Drizalma Sprinkle, Irenka, Yentreve (1) · Wakix (1)

Antidepressant (1) · Anxiolytic (1) · Dual orexin receptor antagonist (DORA) (1) · Histamine H3 receptor inverse agonist / antagonist (1) · SNRI (1) · the first approved (1) · wake-promoting agent (1) · [[:Category:Loop_diuretics|Loop diuretic]] (1)

None (2) · Competitive antagonist at OX1R and OX2R. First-in-class DORA. Receptor dissociation slower than lemborexant or daridorexant. (1) · Serotonin–norepinephrine reuptake inhibition (balanced) (1)

Depression, anxiety, neuropathic pain, fibromyalgia, chronic musculoskeletal pain (1) · Excessive daytime sleepiness or cataplexy in adults with narcolepsy (FDA-approved August 2019) (1) · Insomnia (sleep onset and/or maintenance) in adults (FDA-approved August 2014). Also studied for insomnia in mild-moderate Alzheimer disease. (1) · '"`UNIQ--vote-00000DDF-QINU`"', '"`UNIQ--vote-00000DE0-QINU`"', '"`UNIQ--vote-00000DE1-QINU`"', '"`UNIQ--vote-00000DE2-QINU`"' (1)

None (1) · 0.5-1 mg PO/IV once or twice daily; titrate to clinical response. Approximate equipotency: bumetanide 1 mg ≈ furosemide 40 mg ≈ torsemide 20 mg (1) · 10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · Week 1: 8.9 mg PO once daily in the morning. Week 2: 17.8 mg. Week 3+: 35.6 mg (max). Titrate as needed. (1)

None (1) · 0.5, 1, 2 mg tablets; 0.25 mg/mL IV (1) · 4.45 mg, 17.8 mg tablets (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (1)

None (1) · 20 mg/d (1) · 35.6 mg/d (1) · ~10 mg/d typical (1)

IM (1) · IV (1) · Oral (4)

Mood: 2–4 weeks. Pain: often within 1–2 weeks. (1) · PO 30-60 minutes; IV minutes (1) · Wake-promoting effect over weeks of titration (1) · ~30 min (1)

4-6 hours (1) · Chronic daily dosing (1) · Daily morning dosing (1) · ~7-8 hours (1)

None · ~12 hours · ~27 days · ~5 h (caffeine) · '''Autoinduction''': 25-65 hours initially, falling to 12-17 hours after 2-3 weeks of dosing as carbamazepine induces its own CYP3A4 metabolism. Major clinical implication: doses require re-titration after the autoinduction period'"`UNIQ--ref-0000001D-QINU`"' · 0.5-1.5 hours (plasma); pharmacodynamic effect persists 24+ hours'"`UNIQ--ref-000000DE-QINU`"' · 1-1.3 hours'"`UNIQ--ref-000001A1-QINU`"' · 1-1.5 hours'"`UNIQ--ref-00000DE3-QINU`"' · 1-2 hours (parent compound)'"`UNIQ--ref-00000029-QINU`"' · 1-2 hours (parent); 18-30 hours for active metabolite oxypurinol'"`UNIQ--ref-0000030F-QINU`"' · 1-2 hours'"`UNIQ--ref-00000017-QINU`"' · 1-3 days acute, 4-6 days chronic; 4-16 days for norfluoxetine'"`UNIQ--ref-0000004C-QINU`"' · 1-3 hours (normal liver); markedly prolonged in overdose with glutathione depletion'"`UNIQ--ref-00000022-QINU`"' · 1-3 minutes (very short)'"`UNIQ--ref-00000C0F-QINU`"' · 1.4 hours (parent); 13-24 hours for active metabolite canrenone'"`UNIQ--ref-00000354-QINU`"' · 1.5-2 hours (longer in renal failure)'"`UNIQ--ref-00000222-QINU`"' · 1.5-2 hours'"`UNIQ--ref-00000020-QINU`"' · 10-11 hours (benazeprilat, the active metabolite)'"`UNIQ--ref-00000A22-QINU`"' · 11-13 h (immediate-release); 11-16 h (extended-release) · 11-15 hours'"`UNIQ--ref-00000842-QINU`"'

Other values:

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Not formally established; oral once-daily adequate (1) · ~50% (highly variable) (1) · ~80-95% (oral; more reliable than furosemide, comparable to torsemide)'"`UNIQ--ref-00000DE4-QINU`"' (1) · ~82% (1)

Avoid where possible; class concerns as for other loop diuretics.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Category C (1) · Limited data; avoid (1) · Limited data; pitolisant may reduce hormonal contraceptive efficacy (1)

Rx, '''not a controlled substance''' (unique among wake-promoting agents) (1) · Rx, Schedule IV (US) (1) · Rx-only (1) · [[USLegal:Prescription only|Rx-only]] in US (1)