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None (1) · Avanafil (1) · Bisoprolol (1) · Dexmethylphenidate (1) · Memantine ER / Donepezil (1) · Methamphetamine (1) · Methylphenidate (1) · Metoprolol (1) · Mixed amphetamine salts (1) · Nebivolol (1) · Prazosin (1) · Propranolol (1) · Sertraline (1) · Sildenafil (1) · Tadalafil (1) · Vardenafil (1)

Adderall, Adderall XR, Mydayis (1) · Bystolic (1) · Cialis, Adcirca (1) · Desoxyn (1) · Focalin, Focalin XR (1) · Inderal (1) · Levitra, Staxyn (1) · Lopressor (tartrate), Toprol XL (succinate) (1) · Minipress (1) · Namzaric (1) · REL-1017 / esmethadone (investigational; not yet FDA-approved as of mid-2024) (1) · Ritalin, Ritalin LA, Concerta, Metadate CD, Daytrana, Quillivant XR (1) · Stendra (1) · Viagra, Revatio (1) · Zebeta (1) · Zoloft (1)

Alpha-1 Adrenergic Antagonist (1) · Amphetamine (2) · Antidepressant (1) · Anxiolytic (1) · Beta Blocker (4) · Cardioselective (β1) (2) · Cardioselective (β1) + vasodilator (1) · CNS stimulant (1) · Combined cholinesterase inhibitor + NMDA antagonist (1) · low-trapping) (1) · NDRI (2) · NMDA receptor antagonist (uncompetitive (1) · Non-selective (1) · PDE5 Inhibitor (4) · Psychostimulant (4) · SSRI (1)

None (1) · Cardioselective β1-adrenergic antagonist. Selectivity is dose-dependent and partially lost at higher doses. (1) · Donepezil: reversible AChE inhibitor, increases synaptic acetylcholine. Memantine: uncompetitive low-affinity NMDA receptor antagonist, dampens pathological glutamate overactivation while preserving normal synaptic signaling. Targets two distinct mechanisms in Alzheimer's. (1) · Highly β1-selective adrenergic antagonist. Greater selectivity than metoprolol or atenolol. (1) · Monoamine releasing agent, TAAR1 agonism, VMAT2 substrate, DAT/NET reverse transport (1) · Non-selective competitive antagonist at β1 and β2 adrenergic receptors. Lipophilic; significant blood–brain barrier penetration, accounting for its CNS effects. (1) · Norepinephrine–dopamine reuptake inhibition (DAT, NET) (1) · Norepinephrine–dopamine reuptake inhibition (DAT, NET), d-threo enantiomer of methylphenidate (1) · Selective alpha-1 adrenergic receptor antagonist. Lowers peripheral vascular resistance via vasodilation; in the CNS, blunts noradrenergic hyperarousal thought to drive trauma-related nightmares. (1) · Selective inhibitor of PDE5 with a substantially longer half-life than other PDE5 inhibitors, allowing once-daily continuous dosing. (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 inhibitor of phosphodiesterase type 5 (PDE5), preventing cGMP breakdown in vascular smooth muscle. In the corpus cavernosum, potentiates the NO/cGMP cascade triggered by sexual stimulation. (1) · Selective inhibitor of phosphodiesterase type 5 (PDE5); increases cGMP in cavernous smooth muscle, producing erection in response to sexual stimulation. (1) · TAAR1 agonism, VMAT2 substrate, DAT/NET reverse transport, net release of dopamine and norepinephrine (1) · The d-enantiomer is a highly β1-selective antagonist; the l-enantiomer triggers endothelial nitric-oxide–mediated vasodilation. Unique among beta blockers for this NO mechanism. (1) · TrkB/BDNF'"`UNIQ--ref-00000084-QINU`"' '"`UNIQ--vote-00000085-QINU`"' (1)

None (2) · 1 mg at bedtime (PTSD nightmares); 1 mg BID–TID (HTN) (1) · 10 mg PRN; 2.5–5 mg daily for continuous coverage / BPH (1) · 10 mg ~1 h before sexual activity (1) · 100 mg ~15 min before sexual activity (1) · 10–40 mg (situational anxiety); 40 mg BID (HTN) (1) · 2.5 mg IR, 5 mg XR, or 12.5mg Mydayis (1) · 2.5–5 mg daily (HTN); 1.25 mg daily (HFrEF, slow titration) (1) · 25 mg (1) · 25–50 mg BID (tartrate); 25–100 mg daily (succinate); 12.5 mg daily in HFrEF (1) · 5 mg daily (1) · 5 mg PO (1) · 50 mg ~1 h before sexual activity (ED); 20 mg TID (PAH) (1) · For patients already stable on memantine 28 mg/d + donepezil 10 mg/d, switch to one capsule daily of equivalent strength (1) · Trials use 25 mg or 50 mg PO daily (1)

None (2) · 1, 2, 5 mg caps (1) · 10, 20, 40, 60, 80 mg tabs; 60/80/120/160 mg ER caps; 1 mg/mL IV (1) · 2.5, 5, 10, 20 mg tabs (2) · 2.5, 5, 10, 20 mg tabs (Levitra); 10 mg ODT (Staxyn) (1) · 25 mg, 50 mg, 100 mg tablets; oral concentrate 20 mg/mL (1) · 25, 50, 100 mg tabs (Viagra); 20 mg tabs and 10 mg/mL oral suspension (Revatio) (1) · 5, 10 mg tabs (1) · 50, 100, 200 mg tabs (1) · 7/10, 14/10, 21/10, 28/10 mg ER capsules (memantine ER / donepezil) (1) · Desoxyn 5 mg tabs (1) · Investigational oral capsule (1) · IR tabs 5, 7.5, 10, 12.5, 15, 20, 30 mg; XR caps 5, 10, 15, 20, 25, 30 mg; Mydayis caps 12.5, 25, 37.5, 50 mg (1) · Tartrate: 25, 50, 100 mg tabs; 1 mg/mL IV. Succinate ER: 25, 50, 100, 200 mg. (1)

None (2) · 100 mg/d (ED); 20 mg TID (PAH) (1) · 20 mg/d (2) · 20 mg/d (ED, PRN); 5 mg/d (daily / BPH); 40 mg/d (PAH) (1) · 200 mg/d (1) · 200 mg/d (100 mg/d if on CYP3A4 inhibitors) (1) · 25 mg/day (ADHD per Desoxyn label); 15 mg/day (obesity, short-term, per Desoxyn label) (1) · 28/10 mg/d (1) · 40 mg/d (2) · 400 mg/d (1) · 640 mg/d (HTN); 240 mg/d (migraine) (1) · Not yet approved (1) · XR = 40 or 60 mg/d; IR = 40 or 60 mg/d'"`UNIQ--ref-00000567-QINU`"' (1)

IV (2) · IV (Revatio) (1) · Oral (14) · Oral (capsule whole or opened/sprinkled on applesauce) (1) · Oral (prescribed) (1) · transdermal (1)

None (1) · 1–2 h (2) · 1–2 h (PO), immediate (IV) (1) · 1–2 h (PO); immediate (IV) (1) · 20–60 min (oral) (1) · 30 min (1) · 30–60 min (2) · 30–90 min (1) · Anxiolysis classically 3-4 weeks, continuing improvement to 8-12 weeks (1) · Component effects accumulate over weeks (1) · IR: 30–60 min; XR: 1–2 h to peak effect (1) · Rapid (within 1 week in trials) (1) · ~15 min (fastest of the PDE5 inhibitors) (1) · ~30 min (1)

None (1) · 24 h (3) · 4–5 h (1) · 4–6 h (1) · 6–12 h (IR); 24 h (ER) (1) · 6–12 h (tartrate); 24 h (succinate) (1) · 6–8 h (1) · Daily dosing (1) · IR 3–5 h; LA/SR 6–8 h; Concerta 10–12 h; Daytrana ~9 h wear time (1) · IR 4–6 h; XR 10–12 h; Mydayis 14–16 h (1) · IR 4–6 h; XR 8–12 h (1) · Long (1) · Up to 36 h ("the weekend pill") (1) · ~4 h (1)

None (1) · 2.2 h (IR parent); ~3 h (XR parent) (1) · 2–3 h (1) · 2–3 h (parent compound) (1) · 3–6 h (1) · 3–7 h (1) · 4–5 h (1) · 9–12 h (1) · D-amphetamine ~10 h; L-amphetamine ~13 h (adults) (1) · Not formally established (1) · ~10 h (CYP2D6 extensive metabolizers); up to 31 h (poor metabolizers) (1) · ~17.5 h (1) · ~26 h (sertraline; range 13-45 h, longer in females); ~62-104 h (N-desmethylsertraline, weakly active) (1) · ~4 h (1) · ~5 h (1) · ~60–80 h (memantine); ~70 h (donepezil) (1)

None (1) · Absolute bioavailability not precisely characterized; food modestly increases exposure (1) · Oral bioavailability suitable for daily dosing (1) · Rapid absorption; absolute bioavailability not formally established (1) · Reasonable (not formally established as a percentage) (1) · ~100% both components (1) · ~12% (extensive metabolizers); ~96% (poor metabolizers) (1) · ~15% (extensive hepatic first-pass) (1) · ~22–25% (1) · ~25% (extensive hepatic first-pass) (1) · ~30% (high first-pass) (1) · ~40% (1) · ~50% (1) · ~60% (1) · ~75–90% (oral) (1) · ~90% (low first-pass) (1)

Category B (3) · Category C (7) · Category C (not relevant; not used in women) (1) · Category C (per Desoxyn label) (1) · Category C'"`UNIQ--ref-0000008F-QINU`"' (1) · Investigational (1) · Not relevant (geriatric problem) (1) · Pregnancy categories were retired by FDA in 2015. Limited reproductive data with small observational signal for cardiac malformations; risk-benefit decision, with many patients deferring ADHD treatment during pregnancy. See pregnancy_details for the full discussion. (1)