Drilldown: Medicines

None (2) · Diclofenac (sodium, potassium, epolamine; multiple salt forms) (1) · Duloxetine (1)

Belsomra (1) · Cymbalta, Drizalma Sprinkle, Irenka, Yentreve (1) · Voltaren (IR oral, topical gel), Cataflam (potassium IR), Cambia (oral powder, migraine), Zorvolex (low-dose), Pennsaid (topical 2% solution), Flector (transdermal patch), Solaraze (3% gel for actinic keratosis) (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:Analgesics|Analgesic]] (1) · [[:Category:NSAIDs|Non-steroidal anti-inflammatory (NSAID)]] (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-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"', '"`UNIQ--vote-00000026-QINU`"', '"`UNIQ--vote-00000027-QINU`"', '"`UNIQ--vote-00000028-QINU`"' (1)

None (1) · 10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · IR oral 50 mg PO TID or 75 mg BID. Voltaren 1% gel: apply 2-4 g to affected area QID. Pennsaid 2%: 40 drops to knee BID. Flector patch: every 12 hours (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) · 4.45 mg, 17.8 mg tablets (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (1) · IR tablets 25, 50 mg; ER tablets 100 mg; Cataflam IR 50 mg; Zorvolex 18, 35 mg; Voltaren gel 1%; Pennsaid 2% topical solution; Flector transdermal patch; Solaraze 3% gel; Cambia oral powder 50 mg (1)

None (1) · 150 mg/day (oral); use lowest effective dose for shortest duration per FDA NSAID class guidance (1) · 20 mg/d (1) · 35.6 mg/d (1)

Oral (4) · oral powder (Cambia for migraine) (1) · topical (1) · transdermal (1)

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

6-8 hours (IR oral); 12-24 hours (ER) (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:

Search

Not formally established; oral once-daily adequate (1) · ~50% (highly variable) (1) · ~50-60% (oral; substantial first-pass metabolism)'"`UNIQ--ref-0000002A-QINU`"' (1) · ~82% (1)

Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)'"`UNIQ--ref-0000002B-QINU`"' (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]] for oral and most topical formulations in US; Voltaren Arthritis Pain 1% gel switched to [[USLegal:Over-the-counter|OTC]] in 2020 (1)