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Drilldown: Medicines

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Medicines > routes: Oral & halflife : ~12 hours or ~8 hours (shorter than suvorexant and lemborexant)

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generic:
None (2) · Duloxetine (1)
brand:
Belsomra (1) · Cymbalta, Drizalma Sprinkle, Irenka, Yentreve (1) · Quviviq (1)
classes:
Antidepressant (1) · Anxiolytic (1) · Dual orexin receptor antagonist (DORA) (2) · SNRI (1) · the first approved (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)
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) · Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022) (1)
starting dose:
None (1) · 10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · 25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate (1)
preparations:
None (1) · 25 mg, 50 mg tablets (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (1)
fda max:
None (1) · 20 mg/d (1) · 50 mg/d (1)
routes: (Click arrow to add another value)
onset:
Mood: 2–4 weeks. Pain: often within 1–2 weeks. (1) · ~30 min (2)
duration:
Chronic daily dosing (1) · ~7-8 hours (2)
halflife: (Click arrow to add another value)
bioavailability:
~50% (highly variable) (1) · ~62% (1) · ~82% (1)
pregnancy:
Category C (1) · Limited data; avoid (2)
legal:
Rx, Schedule IV (US) (2) · Rx-only (1)

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