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generic:
brand:
None (237)
classes:
Research material (132) · Classic Psychedelic (69) · Stimulant (43) · Sedative-Hypnotic (30) · Opioid (29) · Tryptamine (26) · Phenethylamine (25) · Botanical (23) · Benzodiazepine (22) · Anticonvulsant (19) · Dissociative (19) · Antidepressant (17) · Antiparkinsonian (16) · Antipsychotic (16) · Empathogen (16) · Analgesic (15) · Neuroleptic (15) · Cathinone (14) · Plant Medicine (14) · Nootropic (13)
uses:
None (394) · '"`UNIQ--vote-00000008-QINU`"', '"`UNIQ--vote-00000009-QINU`"' (5) · '"`UNIQ--vote-00000006-QINU`"' (4) · Preventive treatment of migraine in adults (episodic and chronic) (2)
starting dose:
None (408) · 0.5–1 oz (10–30 g) ground for psychoactive effect; far smaller for culinary use (1) · 1 tablet (dextromethorphan 45 mg / bupropion 105 mg) PO daily × 3 days, then increase to 1 tablet BID (1) · 1-2 capsules (50 mg butalbital / 325 mg acetaminophen / 40 mg caffeine each) PO every 4 hours as needed; maximum 6 capsules/d (1) · 10 mg (one spray) intranasally in one nostril (1) · 10 mg PO once daily (1) · 10 mg PO once daily (5 mg in older adults or if sedation occurs) (1) · 10 mg PO once daily × 7 days, then 20 mg × 7 days, then 40 mg as target dose (take with food) (1) · 10 mg PO once daily; may increase to 20 mg as tolerated, or decrease to 5 mg if needed (1) · 100 mg IV every 3 months; may increase to 300 mg IV every 3 months (1) · 100-200 mg PO once or twice daily; pediatric weight-based (1) · 12.5 mg PO once or twice daily. Titrate gradually: 25-50 mg/day increments every 1-2 days as tolerated. Target dose 300-450 mg/day in divided doses (BID or TID). Most patients stabilize between 200-600 mg/day. Therapeutic plasma level guide: target trough clozapine ≥350 ng/mL. (1) · 15-37.5 mg PO once daily before breakfast or 1-2 hours after; Lomaira 8 mg TID (1) · 200-400 mg PO q4h (IR); 600-1200 mg PO q12h (Mucinex 12-Hour ER) (1) · 225 mg SC monthly, or 675 mg SC every 3 months (quarterly) (1) · 300 mg PO at bedtime night 1, 300 mg BID day 2, 300 mg TID day 3; titrate to clinical effect, commonly 1800-3600 mg/day divided TID (1) · 325 mg PO daily to TID (=65 mg elemental iron/tablet); alternate-day dosing is now favored by hepcidin physiology for better absorption with less GI burden (1) · 4 mg PO initially, then 2 mg after each loose stool, '''not to exceed 16 mg/d''' (8 mg OTC); chronic-use lower (1) · 40 mg SC every other week (most adult indications); IBD induction 160 mg week 0, 80 mg week 2, then 40 mg every other week (1) · 42 mg PO once daily with food (no titration) (1) · 5 mg PO once daily in the evening (1) · 5-15 mg PO once at bedtime; 10 mg PR for faster effect; bowel prep regimens use higher single doses (1) · 500-750 mg PO BID; 400 mg IV q8-12h (1) · 60 mg PO BID or 180 mg PO once daily (1) · 70 mg SC monthly; may increase to 140 mg monthly (1) · Allergy: 25 mg PO BID-QID. Nausea/vomiting: 12.5-25 mg PO/IM/IV/PR every 4-6 hours. Motion sickness: 25 mg PO 30-60 minutes before travel. '''Pediatric <2 years: contraindicated''' (1) · General supplementation 75-90 mg/d (RDA); scurvy treatment 100-1000 mg/d for several weeks; megadose claims unsupported (1) · Migraine prophylaxis: 400 mg PO daily; deficiency replacement 5-30 mg/d (1) · Migraine: 240 mg SC loading dose, then 120 mg SC monthly. Cluster: 300 mg SC at onset of cluster period, then monthly during cluster. (1) · Modern clinical-trial standard: 25 mg synthesized psilocybin, single oral dose with psychological support (1) · No medical dose. Active recreational doses reported in the 0.5–1.5 mg range (similar potency to alprazolam). (1) · One cup (~40–60 mg caffeine; about half of brewed coffee) (1) · Ophthalmic 1 drop in each eye every 8-12 hours (1) · Replacement: 15-30 mg (22.5-45 IU) daily; NASH: 800 IU daily; AREDS-2: 400 IU daily (in combination formula) (1) · Schizophrenia / acute mania: 5-10 mg PO once daily, target 10-15 mg/day. Acute agitation IM: 10 mg, may repeat in 2 hours. Relprevv LAI: 150-300 mg every 4 weeks after oral overlap (1) · Schizophrenia/bipolar mania: 10-15 mg PO once daily, target 15-30 mg. MDD adjunct: 2-5 mg/day, target 5-15 mg. Pediatric autism irritability: 2 mg, titrate to 5-15 mg. Maintena LAI: 400 mg IM every 4 weeks after oral overlap (1) · Schizophrenia: 1 mg PO daily × 4 days, then 2 mg daily × 3 days, then 4 mg daily. MDD adjunct: 0.5-1 mg daily, increase to 2 mg max. AD agitation: 0.5 mg daily, titrate to 2-3 mg daily. (1) · Schizophrenia: 1.5 mg PO daily, increase to 1.5-6 mg as tolerated. Bipolar mania: 1.5 mg, may increase to 3-6 mg. Bipolar depression: 1.5 mg daily for 14 days, then 3 mg. MDD adjunct: 1.5 mg, may increase to 3 mg. (1) · Week 1: 1 tablet (8/90 mg) PO morning; week 2: 1 tablet AM + 1 PM; week 3: 2 AM + 1 PM; week 4 onward: 2 AM + 2 PM (32 mg naltrexone / 360 mg bupropion/d) (1)
preparations:
None (392)
fda max:
None (406) · 10 mg/d (adults) (2)
onset:
None (404) · 1-2 hours (1) · 1-2 weeks for neuropathic pain and anxiolytic effect; anticonvulsant effect at therapeutic plasma level (1) · 1-3 days (1) · 1-3 hours (slower onset than cetirizine; symptom relief somewhat less) (1) · 15–30 min (1) · 20 minutes (oral); 5 minutes (IV) (1) · 20-45 min subjective onset; psilocin formation from psilocybin requires intestinal and hepatic alkaline phosphatase (1) · 30 minutes (1) · 30-60 minutes (4) · 4-6 weeks for full antidepressant effect (claimed earlier onset for some patients due to 5HT1A partial agonism) (1) · Antipsychotic effect over weeks (1) · Appetite suppression within hours; weight loss over weeks-months (1) · Days for symptom improvement in scurvy (1) · Days to weeks for tissue saturation (1) · Effect demonstrated within 24 hours in some patients (1) · Hours (1) · Migraine effect after 1-3 months of daily use (1) · Modest appetite suppression within weeks; weight loss over months (1) · Neuroleptic effect emerges over days to weeks; activation symptoms (akathisia, insomnia) often within days (1) · Onset of preventive effect over weeks; some patients respond after first dose (1) · Oral analgesic effect 30-60 minutes; opioid-withdrawal suppression 30 minutes (oral); IV ~10 minutes (1) · Oral peak plasma 1 hour; therapeutic opioid blockade within hours of first dose. IM Vivitrol: peak plasma 2-3 days; therapeutic blockade through the dosing interval. (1) · Oral peak plasma 2.5 hours. Clinical antipsychotic response typically emerges over weeks with continued titration; full response assessment requires 3-6 months at adequate therapeutic levels. (1) · Over weeks (2) · Pain relief reported within 15 min in trials (1) · Peak plasma concentration in 2-4 hours after oral administration. Clinically perceptible wakefulness-promoting effects typically begin within 1-2 hours of dosing.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · PO 6-12 hours; PR 15-60 minutes (1) · Reticulocyte response at 7-10 days; hemoglobin rise of ~1 g/dL per 3 weeks (1) · Sedation from first dose; neuroleptic effect emerges over days to weeks (1) · Significant antidepressant response by week 1 in trials (faster than monoaminergic antidepressants which take 4-6 weeks) (1) · Slow, 2–6 h (1) · Sublingual analgesic effect 30-60 minutes; MOUD craving suppression within hours; Butrans patch steady-state in 3 days. (1) · Symptomatic effect within weeks; full response by 12-24 weeks (1) · Typical antidepressant 4-6 week onset (1) · Weeks for psychosis/depression; AD agitation benefit emerges over weeks (1) · Weeks for psychosis/mood efficacy (1) · Within minutes (1) · ~20–40 min PO; faster sublingual/intranasal. (1)
duration:
None (404) · 12 hours (BID dosing required) (1) · 12-24 hours (1) · 12–24 h or longer (1) · 2 weeks per dose (1) · 24 hours (3) · 24 hours (oral); 2-4 weeks (LAI) (1) · 24 hours (oral); 4-8 weeks (LAI) (1) · 3-month dosing interval (1) · 3–4 h (1) · 4 hours (IR); 12 hours (ER) (1) · 4-6 hours (3) · 6–10 h subjective; full pharmacologic effect considerably longer. (1) · 8-12 hours (3) · Analgesic effect 4-8 hours (much shorter than half-life would suggest, due to receptor kinetics); MOUD effect (opioid withdrawal suppression) 24-36 hours per single daily dose (1) · Daily dosing (4) · Daily dosing; active metabolites with very long half-lives (up to 1-3 weeks) (1) · Due to the half-life of 12 hours (wide range), dosing is BID or TID. Once-daily dosing produces higher peak/trough fluctuations and is generally not used except for a single end-of-day dose in stable patients. (1) · Effective duration approximately 12-15 hours at the 200 mg dose, consistent with the elimination half-life. A single morning dose generally sustains wakefulness throughout the day without substantially disrupting nighttime sleep onset when taken early.'"`UNIQ--ref-0000006D-QINU`"' (1) · Hours (3) · Monthly dosing (2) · Monthly or quarterly dosing (1) · MOUD: 24-72 hours per sublingual dose (long; permits every-other-day or three-times-weekly dosing in stable patients); Butrans patch: 7 days; Sublocade depot: 28+ days; Buprenex IV/IM: 6-8 hours. (1) · N/A (1) · N/A (replacement) (1) · Oral mu-blockade clinically meaningful for 24-72 hours; IM Vivitrol blockade through 4 weeks. (1) · Sustained with twice-daily dosing (1) · TID dosing for IR; once-daily for ER formulations (1) · Weeks (fat-soluble) (1) · ~12-14 hours (1) · ~48 h sustained pain freedom in responders (1)
halflife:
None (408) · 12-15 hours'"`UNIQ--ref-00000022-QINU`"' (1) · 21-54 hours'"`UNIQ--ref-00000026-QINU`"' (1) · 4 hours'"`UNIQ--ref-00000938-QINU`"' (1) · 5-7 hours'"`UNIQ--ref-00000029-QINU`"' (1) · 8-10 hours (longer in elderly and renal impairment)'"`UNIQ--ref-00000396-QINU`"' (1) · Buprenorphine sublingual: 24-42 hours (long, contributes to extended dosing intervals). Norbuprenorphine (active metabolite, weaker mu-agonist): 24-48 hours.'"`UNIQ--ref-0000004F-QINU`"' (1) · Butalbital ~35 hours (long; cumulative effects with frequent use); acetaminophen 1-3 hours; caffeine 3-7 hours'"`UNIQ--ref-0000159F-QINU`"' (1) · Cariprazine ~2-4 d; major active metabolites desmethyl-cariprazine (DCAR) ~1-3 weeks → 'oral depot' effect with delayed steady-state and reduced effect of missed doses (1) · Dextromethorphan ~22 h (when CYP2D6 inhibited); bupropion ~21 h (1) · Estimated ~12–17 h (some sources cite up to ~21 h); active metabolites prolong effect. (1) · N/A (incorporated into hemoglobin and tissue stores) (1) · Naltrexone parent ~4 hours (oral); 6-beta-naltrexol (active metabolite) ~13 hours. Vivitrol depot terminal half-life 5-10 days with sustained release from microspheres maintaining blockade for the 4-week dosing interval.'"`UNIQ--ref-0000004F-QINU`"' (1) · Naltrexone ~4 hours (6β-naltrexol metabolite ~13 hours); bupropion ~21 hours'"`UNIQ--ref-00001568-QINU`"' (1) · Not meaningfully described (1) · Not meaningfully described for ophthalmic use'"`UNIQ--ref-00001287-QINU`"' (1) · Psilocin: ~2-3 h; psilocybin itself is a prodrug, dephosphorylated within minutes of absorption (1) · Variable; effect dependent on local intestinal action rather than systemic kinetics'"`UNIQ--ref-0000106B-QINU`"' (1) · ~1 hour'"`UNIQ--ref-00001050-QINU`"' (1) · ~1-2 hours plasma (riboflavin itself); FAD/FMN tissue cofactors are continuous (1) · ~10-20 days (steady-state body pool); single dose plasma ~2 hours (1) · ~14 days'"`UNIQ--ref-00001103-QINU`"' (1) · ~14 hours'"`UNIQ--ref-00000CCC-QINU`"' (1) · ~18 hours (terminal) (1) · ~25 hours (1) · ~25 hours'"`UNIQ--ref-0000129F-QINU`"' (1) · ~27 days (2) · ~28 days (1) · ~3-4 days plasma; adipose tissue stores last months (1) · ~31 days (1) · ~5 h (caffeine) (1) · ~6.6 h (1) · ~66 hours (1) · ~75 hours (long, accumulates over weeks)'"`UNIQ--ref-00000025-QINU`"' (1) · ~8 hours (longer in elderly and renal impairment)'"`UNIQ--ref-00000954-QINU`"' (1) · ~8 hours (parent); ~28 hours (desloratadine, the active metabolite, marketed separately as Clarinex)'"`UNIQ--ref-00000621-QINU`"' (1) · ~9-14 hours'"`UNIQ--ref-00000FD2-QINU`"' (1) · ~91 hours (1)
bioavailability:
None (406)
pregnancy:
None (412) · '''Avoid in pregnancy where alternatives exist''' (animal cartilage toxicity; class-wide concern); use only when benefit clearly outweighs.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Avoid. Benzodiazepines are associated with neonatal sedation, floppy-infant syndrome, and withdrawal; teratogenic signal weak but non-zero. Designer benzo with no safety data, assume worst-case. (1) · Contraindicated in pregnancy (FDA label).<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Contraindicated in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally avoided; barbiturate exposure in late pregnancy can produce neonatal withdrawal and respiratory depression.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered acceptable for short-term use.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered acceptable when needed.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered acceptable.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe (minimal systemic exposure).<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe; loratadine and cetirizine have more pregnancy data and are typically preferred.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe; widely used. Cetirizine and loratadine remain the more-studied alternatives.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe; widely used. Levocetirizine (the R-enantiomer) is an alternative with similar safety.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe; widely used. Loratadine and cetirizine are the most-recommended 2nd-gen H1s in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data (1) · Limited data; avoid (6) · Limited data; National Pregnancy Registry available (1) · Limited data; National Pregnancy Registry for Atypical Antipsychotics (1) · Limited data; weigh benefits/risks (2) · Limited human data; signal for neonatal extrapyramidal symptoms and withdrawal with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited human data; some signal for cardiac malformations and developmental delay but confounded by maternal disease and polytherapy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Not studied in human pregnancy; no approved clinical use in any population (1) · Older agent with substantial use experience, including in hyperemesis gravidarum; broadly reassuring observational data'"`UNIQ--ref-00000024-QINU`"' (1) · Routinely used; iron requirements rise substantially in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Safe at replacement and supplement doses.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Safe at replacement doses; high-dose use generally avoided.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Safe at routine doses; routinely supplemented in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Signal for gestational diabetes and metabolic syndrome with maternal exposure; the metabolic load can be substantial during pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
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