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Medicines > halflife : 1.5-2 hours (longer in renal failure)'"`UNIQ--ref-00000222-QINU`"' or Not applicable (electrolyte solution) or ~12 hours

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generic:
None (1) · Duloxetine (1) · Furosemide (1) · Lactated Ringer's solution (1)
brand:
Belsomra (1) · Cymbalta, Drizalma Sprinkle, Irenka, Yentreve (1) · Lactated Ringer's Injection (Baxter, B. Braun, ICU Medical); Hartmann's solution (intl.) (1) · Lasix (1)
classes:
Antidepressant (1) · Anxiolytic (1) · Dual orexin receptor antagonist (DORA) (1) · SNRI (1) · the first approved (1) · [[:Category:Crystalloid_IV_fluids|Crystalloid IV fluid]] (1) · [[:Category:Diuretics|Diuretic]] (1) · [[:Category:Electrolyte_replacements|Electrolyte replacement]] (1) · [[:Category:Loop_diuretics|Loop diuretic]] (1)
mechanism:
None (1) · Competitive antagonist at OX1R and OX2R. First-in-class DORA. Receptor dissociation slower than lemborexant or daridorexant. (1) · Serotonin–norepinephrine reuptake inhibition (balanced) (1) · '"`UNIQ--vote-00000086-QINU`"' Calcium content is a relative contraindication for co-administration with citrated blood products through the same line'"`UNIQ--ref-00000087-QINU`"'. (1)
uses:
Depression, anxiety, neuropathic pain, fibromyalgia, chronic musculoskeletal pain (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-00000088-QINU`"', '"`UNIQ--vote-00000089-QINU`"', '"`UNIQ--vote-0000008A-QINU`"', '"`UNIQ--vote-0000008B-QINU`"' (1) · '"`UNIQ--vote-0000021C-QINU`"', '"`UNIQ--vote-0000021D-QINU`"', '"`UNIQ--vote-0000021E-QINU`"', '"`UNIQ--vote-0000021F-QINU`"', '"`UNIQ--vote-00000220-QINU`"', '"`UNIQ--vote-00000221-QINU`"' (1)
starting dose:
None (1) · 10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · 20-40 mg PO/IV; titrate by clinical response. In diuretic-resistant heart failure or CKD, doses to 200 mg or higher may be needed (1) · Volume titrated to clinical status; typical adult bolus 500-1000 mL, then reassess (1)
preparations:
None (1) · 20, 40, 80 mg tablets; 10 mg/mL oral solution; 10 mg/mL IV (1) · 250, 500, 1000 mL IV bags. Composition per liter: Na+ 130 mEq, K+ 4 mEq, Ca2+ 3 mEq, Cl- 109 mEq, lactate 28 mEq (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (1)
fda max:
None (1) · 20 mg/d (1) · 600 mg/d typical practical ceiling in heart failure (1) · No fixed maximum; titrated to clinical endpoints (1)
routes:
IM (1) · IV (2) · Oral (3)
onset:
Immediate intravascular expansion (1) · IV: 5 minutes; PO: 30-60 minutes (1) · Mood: 2–4 weeks. Pain: often within 1–2 weeks. (1) · ~30 min (1)
duration:
Chronic daily dosing (1) · IV: ~2 hours; PO: 6-8 hours (1) · Roughly 20-30% remains intravascular at 1 hour (1) · ~7-8 hours (1)
halflife: (Click arrow to add another value)
bioavailability:
100% (IV) (1) · ~50% (highly variable) (1) · ~50% (oral; highly variable, 10-100%, hence the standard 1:2 IV-to-PO conversion)'"`UNIQ--ref-00000223-QINU`"' (1) · ~82% (1)
pregnancy:
Avoid where possible; can reduce uteroplacental perfusion and produce neonatal electrolyte disturbance. Reserved for compelling indications.<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) · Standard resuscitation fluid in pregnancy (1)
legal:
Rx, Schedule IV (US) (1) · Rx-only (1) · [[USLegal:Prescription only|Rx-only]] in US (2)
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