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Medicines > routes : IM or Topical ophthalmic & legal: [[USLegal:Prescription only|Rx-only]] in US

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classes:
high-potency)]] (2) · [[:Category:5-HT3_antagonists|5-HT3 receptor antagonist]] (1) · [[:Category:Alpha-2_agonists|Alpha-2 adrenergic agonist]] (1) · [[:Category:Aminoglycosides|Aminoglycoside antibiotic]] (1) · [[:Category:Analgesics|Analgesic (opioid-sparing parenteral)]] (1) · [[:Category:Antibacterials|Antibacterial]] (1) · [[:Category:Antiemetics|Antiemetic]] (1) · [[:Category:Antihypertensives|Antihypertensive]] (1) · [[:Category:Beta-lactam_antibiotics|β-lactam antibiotic]] (1) · [[:Category:Carbonic_anhydrase_inhibitors|Carbonic anhydrase inhibitor (topical)]] (1) · [[:Category:Catecholamines|Catecholamine]] (1) · [[:Category:Cephalosporins|Cephalosporin (second-generation)]] (1) · [[:Category:Corticosteroids|Corticosteroid]] (4) · [[:Category:Direct_vasodilators|Direct arteriolar vasodilator]] (1) · [[:Category:Diuretics|Diuretic]] (1) · [[:Category:Glaucoma_medications|Glaucoma medication]] (4) · [[:Category:Glucocorticoids|Glucocorticoid (intermediate-acting)]] (2) · [[:Category:Glucocorticoids|Glucocorticoid (long-acting (2) · [[:Category:Immunosuppressants|Immunosuppressant]] (3) · [[:Category:Inotropes|Inotrope]] (1) · [[:Category:Loop_diuretics|Loop diuretic]] (2) · [[:Category:NSAIDs|Non-steroidal anti-inflammatory (NSAID)]] (1) · [[:Category:Ocular_hypotensive_agents|Ocular hypotensive agent]] (4) · [[:Category:Prostaglandin_analogs|Prostaglandin F2α analog]] (2) · [[:Category:Sympathomimetics|Sympathomimetic]] (1) · [[:Category:Topical_corticosteroids|Topical corticosteroid (high-to-super-high potency depending on ester)]] (1) · [[:Category:Vasopressors|Vasopressor]] (1)
uses:
'"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-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) · '"`UNIQ--vote-00000374-QINU`"', '"`UNIQ--vote-00000375-QINU`"', '"`UNIQ--vote-00000376-QINU`"', '"`UNIQ--vote-00000377-QINU`"' (1) · '"`UNIQ--vote-00000415-QINU`"', '"`UNIQ--vote-00000416-QINU`"' (1) · '"`UNIQ--vote-00000683-QINU`"', '"`UNIQ--vote-00000684-QINU`"', '"`UNIQ--vote-00000685-QINU`"', '"`UNIQ--vote-00000686-QINU`"' (1) · '"`UNIQ--vote-00000862-QINU`"', '"`UNIQ--vote-00000863-QINU`"', '"`UNIQ--vote-00000864-QINU`"', '"`UNIQ--vote-00000865-QINU`"', '"`UNIQ--vote-00000866-QINU`"' (1) · '"`UNIQ--vote-000008C0-QINU`"', '"`UNIQ--vote-000008C1-QINU`"', '"`UNIQ--vote-000008C2-QINU`"', '"`UNIQ--vote-000008C3-QINU`"' (1) · '"`UNIQ--vote-00000B08-QINU`"', '"`UNIQ--vote-00000B09-QINU`"' (1) · '"`UNIQ--vote-00000D9E-QINU`"', '"`UNIQ--vote-00000D9F-QINU`"', '"`UNIQ--vote-00000DA0-QINU`"' (1) · '"`UNIQ--vote-00000DDF-QINU`"', '"`UNIQ--vote-00000DE0-QINU`"', '"`UNIQ--vote-00000DE1-QINU`"', '"`UNIQ--vote-00000DE2-QINU`"' (1) · '"`UNIQ--vote-00000E23-QINU`"', '"`UNIQ--vote-00000E24-QINU`"', '"`UNIQ--vote-00000E25-QINU`"', '"`UNIQ--vote-00000E26-QINU`"', '"`UNIQ--vote-00000E27-QINU`"', '"`UNIQ--vote-00000E28-QINU`"', '"`UNIQ--vote-00000E29-QINU`"', '"`UNIQ--vote-00000E2A-QINU`"' (1) · '"`UNIQ--vote-00000E4C-QINU`"', '"`UNIQ--vote-00000E4D-QINU`"', '"`UNIQ--vote-00000E4E-QINU`"', '"`UNIQ--vote-00000E4F-QINU`"', '"`UNIQ--vote-00000E50-QINU`"', '"`UNIQ--vote-00000E51-QINU`"' (1) · '"`UNIQ--vote-00000FF3-QINU`"', '"`UNIQ--vote-00000FF4-QINU`"', '"`UNIQ--vote-00000FF5-QINU`"', '"`UNIQ--vote-00000FF6-QINU`"', '"`UNIQ--vote-00000FF7-QINU`"', '"`UNIQ--vote-00000FF8-QINU`"' (1) · '"`UNIQ--vote-00001016-QINU`"', '"`UNIQ--vote-00001017-QINU`"', '"`UNIQ--vote-00001018-QINU`"', '"`UNIQ--vote-00001019-QINU`"' (1) · '"`UNIQ--vote-000010AF-QINU`"', '"`UNIQ--vote-000010B0-QINU`"', '"`UNIQ--vote-000010B1-QINU`"', '"`UNIQ--vote-000010B2-QINU`"' (1) · '"`UNIQ--vote-000010CE-QINU`"', '"`UNIQ--vote-000010CF-QINU`"', '"`UNIQ--vote-000010D0-QINU`"' (1)
starting dose:
0.5-1 mg PO/IV once or twice daily; titrate to clinical response. Approximate equipotency: bumetanide 1 mg ≈ furosemide 40 mg ≈ torsemide 20 mg (1) · 1 drop in affected eye(s) TID (monotherapy); BID with timolol (Cosopt) (1) · 1 drop in the affected eye(s) once daily in the evening (1) · 1 drop in the affected eye(s) once daily in the evening (Lumigan); Latisse applied to upper lash line at bedtime (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) · 250-500 mg PO BID × 7-14 days; IV 1.5 g q8h for serious infections (1) · 4-8 mg PO or IV every 8 hours as needed; 16 mg single dose preoperatively for PONV prevention (1) · Anaphylaxis IM 0.3-0.5 mg (adult) into lateral thigh, repeat q5-15 minutes prn; pediatric 0.01 mg/kg IM (max 0.3 mg, max 0.5 mg in adolescents); cardiac arrest 1 mg IV/IO q3-5 minutes; severe asthma neb 0.1 mg/kg up to 5 mg; never IV bolus for anaphylaxis outside critical care (1) · Antenatal: Celestone Soluspan 12 mg IM q24h × 2 doses; topical: pea-sized amount BID; intra-articular varies by joint (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) · Indication-specific: 0.5-9 mg PO/IV daily for inflammation; 4 mg IV q6h for cerebral edema; 40 mg PO once weekly in MM; 6 mg PO/IV daily ×10 days for severe COVID-19; 0.6 mg/kg PO single dose for croup (max 16 mg) (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 in affected eye(s) TID; topical Mirvaso 0.33% gel applied to face daily (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) · PO 10 mg QID; IV 5-10 mg every 20-30 minutes for hypertensive emergency (1) · PO Medrol Dosepak (5-day taper from 24 mg to 4 mg) is the prototypic short-course outpatient regimen; IV pulse 1 g daily for 3-5 days for MS relapse; intra-articular 4-80 mg per joint q1-5 weeks (1)
preparations:
0.005% ophthalmic solution (50 mcg/mL); typical 2.5 mL bottle (1) · 0.01%, 0.03% ophthalmic solution (1) · 0.1%, 0.15%, 0.2% ophthalmic solutions; 0.33% topical gel; combinations with timolol (Combigan) and brinzolamide (Simbrinza) (1) · 0.5, 0.75, 1, 1.5, 2, 4, 6 mg tablets; oral solution; 4, 10, 20, 100 mg/mL IV; intravitreal implant (Ozurdex) (1) · 0.5, 1, 2 mg tablets; 0.25 mg/mL IV (1) · 0.6 mg/5 mL oral solution; Celestone Soluspan 6 mg/mL IM/IA (mix of sodium phosphate + acetate); 0.05% and 0.1% topical cream/ointment/lotion/foam (various salts); augmented betamethasone 0.05% (super-high potency) (1) · 10, 25, 50, 100 mg tablets; 20 mg/mL IV (1) · 125, 250, 500 mg tablets; 125 mg/5 mL, 250 mg/5 mL suspension; 750 mg, 1.5 g IV vials (1) · 2% ophthalmic solution (Trusopt); 2%/0.5% fixed combination with timolol (Cosopt, Cosopt PF) (1) · 2, 4, 8, 16, 32 mg oral tablets; 40, 125, 500, 1000 mg IV vials; Depo-Medrol 20, 40, 80 mg/mL IM depot (1) · 20, 40, 80 mg tablets; 10 mg/mL oral solution; 10 mg/mL IV (1) · 4 mg, 8 mg, 24 mg tablets; 4 mg, 8 mg orally disintegrating tablets; 4 mg/5 mL oral solution; IV (2 mg/mL) (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) · Auto-injectors 0.15 mg (Jr/pediatric), 0.3 mg (adult); 1 mg/mL (1:1,000) ampules for IM/SC use; 0.1 mg/mL (1:10,000) for IV use; 2.25% racemic nebulizer (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) · 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)
routes: (Click arrow to add another value)
bioavailability:
IM/SC ~100%; oral negligible (extensive first-pass and gut metabolism — hence the no-oral route)'"`UNIQ--ref-00000E53-QINU`"' (1) · IV/IM ~100%; inhaled: minimal systemic; oral: negligible (not used orally for systemic infection)'"`UNIQ--ref-000010B4-QINU`"' (1) · Oral ~70%; depot IM provides sustained release over weeks'"`UNIQ--ref-0000101B-QINU`"' (1) · Topical with measurable systemic absorption (small CA inhibition observed clinically with chronic use)'"`UNIQ--ref-00000B0B-QINU`"' (1) · Topical; clinically meaningful systemic absorption can produce systemic α2 effects (somnolence, hypotension), especially in children'"`UNIQ--ref-000010D2-QINU`"' (1) · Topical; minimal systemic absorption'"`UNIQ--ref-00000418-QINU`"' (1) · Topical; minimal systemic absorption'"`UNIQ--ref-00000DA2-QINU`"' (1) · ~100% (oral, but oral use is limited to continuation from parenteral)'"`UNIQ--ref-00000021-QINU`"' (1) · ~25-50% (oral; substantial first-pass via NAT2 acetylation, phenotype-dependent)'"`UNIQ--ref-00000688-QINU`"' (1) · ~37% (oral, as axetil prodrug; food modestly improves absorption)'"`UNIQ--ref-00000FFA-QINU`"' (1) · ~50% (oral; highly variable, 10-100%, hence the standard 1:2 IV-to-PO conversion)'"`UNIQ--ref-00000223-QINU`"' (1) · ~60% (oral)'"`UNIQ--ref-00000379-QINU`"' (1) · ~70% (oral)'"`UNIQ--ref-000008C5-QINU`"' (1) · ~80% (oral)'"`UNIQ--ref-00000E2C-QINU`"' (1) · ~80-95% (oral; more reliable than furosemide, comparable to torsemide)'"`UNIQ--ref-00000DE4-QINU`"' (1) · ~80-99% (oral)'"`UNIQ--ref-00000868-QINU`"' (1)
pregnancy:
None (2) · Aminoglycoside-class ototoxicity in fetal cochlea is documented; use only when alternatives have failed.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</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) · 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) · Avoid where possible; class concerns as for other loop diuretics.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data; weigh against alternatives, though systemic exposure is low.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data; weigh against alternatives.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (2) · One of the historically preferred IV agents for severe hypertension in pregnancy alongside labetalol and nifedipine.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Use when benefits outweigh; small association with oral clefts debated.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Use when benefits outweigh; small association with oral clefts in first trimester debated.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Used in antenatal lung maturation (24-34 weeks gestation; 6 mg IM q12h × 4 doses); broader use weighs benefits against fetal HPA suppression.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Used in life-threatening obstetric anaphylaxis without hesitation; benefits clearly outweigh.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal: (Click arrow to add another value)

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