Drilldown: Medicines
Medicines > routes 
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Subcutaneous or
ophthalmic
& legal:
[[USLegal:Prescription only|Rx-only]] in US
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Subcutaneous or
ophthalmic
& legal:
[[USLegal:Prescription only|Rx-only]] in US Use the filters below to narrow your results.
generic:
brand:
Imitrex (oral, injectable, nasal), Tosymra (nasal spray), Onzetra Xsail (nasal powder), Zembrace SymTouch (low-dose autoinjector), Sumavel DosePro (needle-free SC) (1) ·
Levemir, Levemir FlexTouch (US discontinuation announced 2024) (1) ·
NovoLog, Fiasp (ultra-rapid), Trurapi (1) ·
Prelone, Pediapred, Orapred ODT, Millipred, Veripred (1) ·
Repatha (1) ·
Timoptic (ophthalmic), Timoptic-XE (gel-forming once-daily), Istalol (once-daily 0.5%), Betimol; Blocadren (oral, discontinued in many markets); combination eye drops Combigan (with brimonidine), Cosopt (with dorzolamide) (1) ·
Tobrex (ophthalmic), Tobi, Tobi Podhaler, Bethkis (inhaled, cystic fibrosis), generic IV (1) ·
Toradol (IV/IM, US brand discontinued), Sprix (nasal spray), Acular and Acuvail (ophthalmic) (1) ·
Trexall, Otrexup, Rasuvo, Xatmep, Rheumatrex (discontinued) (1)
classes:
[[:Category:Aminoglycosides|Aminoglycoside antibiotic]] (1) ·
[[:Category:Analgesics|Analgesic (opioid-sparing parenteral)]] (1) ·
[[:Category:Analgesics|Analgesic]] (1) ·
[[:Category:Antibacterials|Antibacterial]] (1) ·
[[:Category:Antifolates|Antifolate]] (1) ·
[[:Category:Antiglaucoma medicines|Antiglaucoma medicine]] (1) ·
[[:Category:Antihypertensives|Antihypertensive]] (1) ·
[[:Category:Antimigraine medicines|Antimigraine medicine]] (1) ·
[[:Category:Antineoplastics|Antineoplastic]] (1) ·
[[:Category:Basal_insulins|Basal insulin]] (1) ·
[[:Category:Beta blockers|Beta blocker (non-selective)]] (1) ·
[[:Category:Biologics|Biologic]] (1) ·
[[:Category:Corticosteroids|Corticosteroid]] (1) ·
[[:Category:DMARDs|DMARD]] (1) ·
[[:Category:Glucocorticoids|Glucocorticoid (intermediate-acting)]] (1) ·
[[:Category:Immunosuppressants|Immunosuppressant]] (2) ·
[[:Category:Insulins|Insulin]] (2) ·
[[:Category:Lipid-lowering_agents|Lipid-lowering agent]] (1) ·
[[:Category:Long-acting_insulins|Long-acting insulin analog]] (1) ·
[[:Category:Mealtime_insulins|Mealtime (bolus) insulin]] (1) ·
[[:Category:Migraine prophylactics|Migraine prophylactic]] (1) ·
[[:Category:Monoclonal_antibodies|Monoclonal antibody (fully human IgG2)]] (1) ·
[[:Category:NSAIDs|Non-steroidal anti-inflammatory (NSAID)]] (1) ·
[[:Category:PCSK9_inhibitors|PCSK9 inhibitor]] (1) ·
[[:Category:Rapid-acting_insulins|Rapid-acting insulin analog]] (1) ·
[[:Category:Triptans|Triptan (5-HT1B/1D agonist)]] (1)
mechanism:
uses:
'"`UNIQ--vote-00000013-QINU`"', '"`UNIQ--vote-00000014-QINU`"' (1) ·
'"`UNIQ--vote-00000017-QINU`"', '"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"' (1) ·
'"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"' (1) ·
'"`UNIQ--vote-000005EF-QINU`"', '"`UNIQ--vote-000005F0-QINU`"', '"`UNIQ--vote-000005F1-QINU`"' (1) ·
'"`UNIQ--vote-000007C1-QINU`"', '"`UNIQ--vote-000007C2-QINU`"', '"`UNIQ--vote-000007C3-QINU`"', '"`UNIQ--vote-000007C4-QINU`"', '"`UNIQ--vote-000007C5-QINU`"', '"`UNIQ--vote-000007C6-QINU`"', '"`UNIQ--vote-000007C7-QINU`"' (1) ·
'"`UNIQ--vote-000008C0-QINU`"', '"`UNIQ--vote-000008C1-QINU`"', '"`UNIQ--vote-000008C2-QINU`"', '"`UNIQ--vote-000008C3-QINU`"' (1) ·
'"`UNIQ--vote-000010AF-QINU`"', '"`UNIQ--vote-000010B0-QINU`"', '"`UNIQ--vote-000010B1-QINU`"', '"`UNIQ--vote-000010B2-QINU`"' (1) ·
'"`UNIQ--vote-00001372-QINU`"', '"`UNIQ--vote-00001373-QINU`"' (1) ·
'"`UNIQ--vote-0000147C-QINU`"', '"`UNIQ--vote-0000147D-QINU`"', '"`UNIQ--vote-0000147E-QINU`"' (1)
starting dose:
140 mg SC every 2 weeks OR 420 mg SC monthly (3 consecutive injections 5 minutes apart due to volume) (1) ·
IM: 60 mg single dose or 30 mg every 6 hours. IV: 30 mg every 6 hours. Oral (continuation only): 10-20 mg every 4-6 hours. Sprix nasal: 31.5 mg every 6-8 hours. '''Maximum 5 days total combined use''' (1) ·
IV: traditional 1-1.7 mg/kg q8h or extended-interval 5-7 mg/kg q24h with target-trough monitoring; inhaled CF 300 mg BID × 28 days on / 28 days off; ophthalmic 1-2 drops in affected eye(s) q4h (1) ·
Ophthalmic: 1 drop 0.5% in affected eye(s) BID (or once daily for XE / Istalol). Oral hypertension: 10 mg PO BID, titrate to 60 mg/day. Migraine prophylaxis: 10 mg BID, titrate to 30 mg/day (1) ·
Oral: 50-100 mg at migraine onset, may repeat in 2 hours if needed. SC: 6 mg, may repeat in 1 hour. Nasal: 5-20 mg per nostril, may repeat in 2 hours (1) ·
Pediatric 1-2 mg/kg/d (max 60 mg) PO for asthma exacerbation; adult dosing similar to prednisone milligram-for-milligram (~1:1 potency) (1) ·
Rheumatologic: 7.5-15 mg PO or SC '''once weekly''' (not daily — daily dosing is a recognized fatal error); folic acid 1 mg PO daily on non-MTX days; oncology dosing is far higher and indication-specific (1) ·
SC 4-6 units (or 1 unit per 10-15 g carbs) at meals; titrate to postprandial glucose (1) ·
~10 units SC at the same time daily, or 0.1-0.2 units/kg/d; titrate by fasting glucose. Frequently dosed BID at moderate-to-high doses (1)
preparations:
100 U/mL (NovoLog, Fiasp) vials, pens, cartridges (1) ·
100 U/mL FlexTouch pen, vial (1) ·
140 mg/mL single-use prefilled syringe and SureClick autoinjector; Pushtronex 420 mg/3.5 mL on-body infusor (1) ·
2.5 mg tablets; 10-50 mg/mL injection; pre-filled subcutaneous autoinjectors (Otrexup, Rasuvo); 2.5 mg/mL oral solution (Xatmep) (1) ·
5 mg tablets; 5 mg/5 mL, 10 mg/5 mL, 15 mg/5 mL oral solutions (sweetened pediatric); 5 mg/5 mL syrup; ophthalmic 0.12%, 1% suspensions and 1% solution (1) ·
IV 10 mg/mL, 40 mg/mL; inhaled 300 mg/5 mL solution (Tobi, Bethkis); Podhaler dry powder; 0.3% ophthalmic solution and ointment (1) ·
Oral tablets 25, 50, 100 mg; SC injection 4, 6 mg autoinjector; needle-free SC 6 mg (Sumavel); nasal spray 5, 20 mg; nasal powder 22 mg (Onzetra Xsail); low-dose autoinjector 3 mg (Zembrace SymTouch) (1) ·
Tablets 10 mg; injection 15 mg/mL and 30 mg/mL; nasal spray 15.75 mg/spray (Sprix); ophthalmic solution 0.4%, 0.45%, 0.5% (1) ·
Tablets 5, 10, 20 mg; ophthalmic solution 0.25%, 0.5%; ophthalmic gel-forming solution 0.25%, 0.5% (Timoptic-XE) (1)
fda max:
120 mg/day (IV/IM); 40 mg/day (oral); '''5-day maximum total combined therapy''' to mitigate the GI bleeding, AKI, and platelet dysfunction risks (1) ·
200 mg/day (oral); 12 mg/day (SC); 40 mg/day (nasal spray); 44 mg/day (Onzetra) (1) ·
420 mg/month (1) ·
60 mg/day (oral, hypertension); 0.5% BID (ophthalmic) (1) ·
Indication-specific (1) ·
IV: monitored by levels (trough <1 mg/L for extended-interval; <2 mg/L for traditional) (1) ·
Rheumatologic ~25 mg/week; oncology indication-specific (1) ·
Titrated to glucose (1) ·
Titrated to glucose; no fixed maximum (1)
routes: (Click arrow to add another value)
onset:
1-2 hours (1) ·
10 minutes (SC); 15-30 minutes (nasal); 30-60 minutes (oral) (1) ·
30 minutes (IM); 30-60 minutes (oral) (1) ·
BP effect within hours (oral); IOP reduction within 30 minutes, full effect 1-2 weeks (ophthalmic) (1) ·
Hours (1) ·
Hours (systemic); minutes (ophthalmic) (1) ·
LDL reduction ~50-60% from baseline at 1-2 weeks (1) ·
Rheumatologic effect at 4-8 weeks; ectopic resolution over 2-3 weeks (1) ·
SC: 5-15 minutes (Fiasp 2.5 minutes earlier on average) (1)
duration:
12 hours (oral BID); 24 hours (Timoptic-XE) (1) ·
2-4 hours; headache recurrence rate ~20-30% within 24 hours (1) ·
2-4 weeks per dose (1) ·
3-5 hours (1) ·
4-6 hours (1) ·
6-12 hours systemic (1) ·
Biologic 12-36 hours (intermediate-acting) (1) ·
Once-weekly dosing in rheumatology (1) ·
~12-24 hours (dose-dependent; BID dosing often needed at higher doses) (1)
halflife:
2 hours'"`UNIQ--ref-00000015-QINU`"' (1) ·
2-3 hours (normal renal function); markedly prolonged in renal impairment'"`UNIQ--ref-000010B3-QINU`"' (1) ·
3-10 hours (low dose); 8-15 hours (high dose); much longer in third-space accumulation (pleural effusion, ascites)'"`UNIQ--ref-000007C8-QINU`"' (1) ·
5-6 hours'"`UNIQ--ref-00000020-QINU`"' (1) ·
Plasma 2-3 hours; biologic ~18-36 hours'"`UNIQ--ref-000008C4-QINU`"' (1) ·
~11-17 days'"`UNIQ--ref-0000147F-QINU`"' (1) ·
~4 hours (oral)'"`UNIQ--ref-0000001B-QINU`"' (1) ·
~7 hours apparent'"`UNIQ--ref-00001374-QINU`"' (1) ·
~80 minutes SC'"`UNIQ--ref-000005F2-QINU`"' (1)
bioavailability:
60-70% PO at low doses; saturable at high doses (parenteral routes preferred above 15-25 mg/week)'"`UNIQ--ref-000007C9-QINU`"' (1) ·
IV/IM ~100%; inhaled: minimal systemic; oral: negligible (not used orally for systemic infection)'"`UNIQ--ref-000010B4-QINU`"' (1) ·
~100% (oral, but oral use is limited to continuation from parenteral)'"`UNIQ--ref-00000021-QINU`"' (1) ·
~100% from subcutaneous depot (1) ·
~14% (oral; substantial first-pass); ~97% (subcutaneous); ~17% (nasal)'"`UNIQ--ref-00000016-QINU`"' (1) ·
~50% (oral); systemic absorption from ophthalmic application is clinically meaningful via nasolacrimal drainage'"`UNIQ--ref-0000001C-QINU`"' (1) ·
~60% from subcutaneous depot (reduced by reversible albumin binding via the myristic acid side chain that also extends duration)'"`UNIQ--ref-00001375-QINU`"' (1) ·
~70% (oral)'"`UNIQ--ref-000008C5-QINU`"' (1) ·
~72% from SC depot'"`UNIQ--ref-00001480-QINU`"' (1)
pregnancy:
'''Contraindicated in pregnancy''' (Category X); abortifacient and teratogenic. Discontinuation 3-6 months before conception is standard.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Aminoglycoside-class ototoxicity in fetal cochlea is documented; use only when alternatives have failed.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning; contraindicated from 30 weeks. Specifically contraindicated in labor and delivery due to inhibition of uterine contractions'"`UNIQ--ref-00000022-QINU`"' (1) ·
Insulin is the preferred glucose-lowering therapy in pregnancy; aspart is widely used.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited human data; pregnancy registry data have been broadly reassuring relative to baseline malformation rates.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited human data; β-blocker class effects include fetal growth restriction and neonatal bradycardia/hypoglycemia.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
One of the better-studied basal insulin analogs in pregnancy; reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Use when benefits outweigh; small association with oral clefts debated.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1)
legal: (Click arrow to add another value)
Showing below up to 9 results in range #1 to #9.