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Medicines > mechanism: None & routes : IV or Subcutaneous

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generic:
brand:
classes:
[[:Category:Antibacterials|Antibacterial]] (5) · [[:Category:Antihypertensives|Antihypertensive]] (3) · [[:Category:Immunosuppressants|Immunosuppressant]] (3) · [[:Category:Vitamins|Vitamin]] (3) · [[:Category:Analgesics|Analgesic]] (2) · [[:Category:Antianginals|Antianginal]] (2) · [[:Category:Antiemetics|Antiemetic]] (2) · [[:Category:Antineoplastics|Antineoplastic]] (2) · [[:Category:B-vitamins|B-vitamin]] (2) · [[:Category:Corticosteroids|Corticosteroid]] (2) · [[:Category:Fluoroquinolones|Fluoroquinolone antibiotic]] (2) · [[:Category:Hematinics|Hematinic]] (2) · [[:Category:Insulins|Insulin]] (2) · [[:Category:Loop_diuretics|Loop diuretic]] (2) · [[:Category:Macrolide_antibiotics|Macrolide antibiotic]] (2) · [[:Category:Schedule II controlled substances|Schedule II controlled substance]] (2)
mechanism: (Click arrow to add another value)
uses:
'"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"' (2)
starting dose:
preparations:
fda max:
40 mg/d (2) · Indication-specific (2)
routes: (Click arrow to add another value)
onset:
1-2 hours (1) · 10 minutes (SC); 15-30 minutes (nasal); 30-60 minutes (oral) (1) · 15-60 minutes (oral); 1-5 minutes (IV); 4-10 minutes (rectal or intranasal) (1) · 30 minutes (IM); 30-60 minutes (oral) (1) · 30 minutes PO; minutes IV (1) · 5-10 minutes (IV); 30 minutes (oral IR); slower for ER and rectal (1) · BP effect 1 hour; max at 4-6 hours (1) · Clinical improvement within 24-72 hours (2) · Days for calcium effect; weeks for PTH suppression (1) · Days for immunosuppressive effect (1) · Days for symptom improvement in scurvy (1) · Hematologic response within days (1) · Hours (9) · Hours (faster than T4); peak biologic activity 24-48 hours (1) · Hours (PO); IV faster but rate-limited (1) · Hours (systemic); minutes (ophthalmic) (1) · IV/IM 1-3 minutes; PO 30-60 minutes (1) · IV: 1-3 minutes (SVT termination); PO IR: 30-60 minutes; ER: hours (1) · IV: 5 minutes; PO: 30-60 minutes (1) · IV: 5-20 minutes; PO: 30-60 minutes (1) · IV: minutes; oral: weeks to load (1) · LDL reduction ~50-60% from baseline at 1-2 weeks (1) · Oral analgesic effect 30-60 minutes; opioid-withdrawal suppression 30 minutes (oral); IV ~10 minutes (1) · PO 30-60 minutes; IV minutes (1) · PO: 30-60 minutes; IV: minutes (1) · Reticulocyte response at 3-5 days; neurologic recovery weeks to months (and may be incomplete if longstanding) (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) · Serum urate falls gradually over days to weeks; acute flare prevention requires colchicine cover during initiation (1) · SL/spray: 1-3 minutes; IV: minutes; patch: 30-60 minutes (1) · Smoked 2-5 min; insufflated 5-15 min; oral 30-60 min; IV / IM ~5-15 min (1) · Symptom relief within 24-48 hours of starting episodic treatment (1) · Topical: inflammation, erythema, crusting at 2 weeks; complete response weeks to months after course (1)
duration:
12 hours (1) · 12-24 hours (1) · 2-4 hours; headache recurrence rate ~20-30% within 24 hours (1) · 2-4 weeks per dose (1) · 24 hours (3) · 24-72 hours (1) · 3-5 hours (1) · 3-5 hours (IR); 8-24 hours (ER); 12-24 hours (epidural / intrathecal) (1) · 4-12 hours (1) · 4-6 hours (4) · 4-8 hours typical; longer at high doses; residual cognitive and perceptual effects up to 48 hours (1) · 6-12 hours systemic (1) · 6-24 hours (parent); much longer when accounting for the long-lived active metabolites (1) · 6-8 hours (2) · 8 hours per oral dose (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) · Biologic 36-72 hours (long-acting) (1) · Biologic ~8-12 hours (short-acting) (1) · Dosing-frequency dependent (1) · Hours (1) · Hours per dose (much shorter biologic effect than ergocalciferol/cholecalciferol because it is the already-active form, not the storage form) (1) · IR: 6-8 hours; ER: 24 hours (1) · IV: 1-4 hours; PO: 3-8 hours (1) · IV: ~2 hours; PO: 6-8 hours (1) · N/A (1) · N/A (replacement) (2) · Once-weekly dosing in rheumatology (1) · SL: 30 minutes; patch: 12-14 hours; IV continuous (1) · Tissue half-life supports once-daily and post-treatment effect (1) · Variable; depends on ongoing losses (1) · Weeks after discontinuation (extremely long half-life) (1) · ~12-24 hours (dose-dependent; BID dosing often needed at higher doses) (1)
halflife:
bioavailability:
pregnancy:
None (5) · '''Avoid in pregnancy where alternatives exist''' (animal cartilage toxicity; class-wide concern).<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · '''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) · '''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, skull hypoplasia, hypotension. Stop on detection'"`UNIQ--ref-00000B86-QINU`"' (1) · '''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.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</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.">&#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) · Chronic third-trimester exposure produces neonatal opioid withdrawal syndrome and respiratory depression at delivery.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally avoided; fetal goiter/hypothyroidism risk (iodine load). Used only for life-threatening arrhythmia.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe after the first trimester; first-trimester use weighed against indication.<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) · 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; commonly used in pregnancy when macrolide indicated.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe; commonly used in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally safe at replacement doses; treat the underlying cause of hypokalemia.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Insulin is the preferred glucose-lowering therapy in pregnancy; aspart is widely used.<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; alternative antihypertensives generally preferred. Crosses placenta.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</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.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited safety data; weigh benefit individually.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Long the preferred analgesic-antipyretic in pregnancy; recent observational studies have raised speculative neurodevelopmental signals that remain under investigation.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · One of the better-studied basal insulin analogs in pregnancy; reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · 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) · Routinely supplemented in pregnancy and preconception to prevent neural tube defects.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Routinely supplemented in vegan pregnancies and pernicious anemia.<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) · Some signal for cleft palate with first-trimester exposure (debated); neonatal sedation 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) · T4 (levothyroxine) is the first-line in pregnancy; T3 is rarely needed.'"`UNIQ--ref-0000001C-QINU`"' (1) · Topical: avoid; systemic: contraindicated in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Use when benefits outweigh; widely used at physiologic doses for adrenal insufficiency.<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 obstetric emergencies (uterine relaxation, severe hypertension) when needed; otherwise limited routine use.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Used in transplant pregnancy when continued immunosuppression is required; reassuring data overall but careful monitoring needed.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Used when needed for hypoparathyroidism or renal osteodystrophy in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Widely used for hyperemesis gravidarum; reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Widely used in pregnancy for HSV/VZV indications; reassuring registry data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (2) · OTC (low-dose topicals) and [[USLegal:Prescription only|Rx-only]] (other forms) in US (1) · OTC (low-dose) and [[USLegal:Prescription only|Rx-only]] (1 mg, injectable) in US (1) · OTC (low/mid-dose oral) and [[USLegal:Prescription only|Rx-only]] (injection, intranasal) in US (1) · OTC (ophthalmic ointment) and [[USLegal:Prescription only|Rx-only]] (other forms) in US (1) · OTC and [[USLegal:Prescription only|Rx-only]] (IV, combination products) in US (1) · OTC in US (1) · [[USLegal:DEA Schedule II|Schedule II]] controlled substance in US (rescheduled from Schedule III in 1978). No accepted medical use. UN Convention on Psychotropic Substances Schedule II internationally.'"`UNIQ--ref-00000067-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] (higher concentrations and IV) and OTC (low-dose supplements) in US (1) · [[USLegal:Prescription only|Rx-only]] in US (25) · [[USLegal:Prescription only|Rx-only]] in US. Carries '''Boxed Warning''' for risk of malignancy and serious infection; nephrotoxicity, hypertension, and immunosuppression-associated complications'"`UNIQ--ref-00000A93-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries '''Boxed Warnings''' for pulmonary toxicity (interstitial pneumonitis, fibrosis), hepatotoxicity, and proarrhythmia'"`UNIQ--ref-00000CB5-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' for '''tardive dyskinesia''' (irreversible movement disorder), driving the 12-week chronic-use limit'"`UNIQ--ref-00000EFB-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' for Clostridioides difficile colitis (one of the most C. difficile-inducing antibiotic classes)'"`UNIQ--ref-00001444-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the same fluoroquinolone-class '''Boxed Warnings''' as ciprofloxacin: tendinitis/tendon rupture (especially elderly, corticosteroid co-use), peripheral neuropathy, CNS effects, worsening of myasthenia gravis'"`UNIQ--ref-00000CF7-QINU`"' (1) · [[USLegal:Schedule II|Schedule II controlled substance]] in US; WHO essential medicine'"`UNIQ--ref-00000022-QINU`"' (1) · [[USLegal:Schedule IV|Schedule IV controlled substance]] in US. Carries the benzodiazepine class '''Boxed Warning''' for risk of fatal respiratory depression, coma, and death when combined with opioids'"`UNIQ--ref-00000028-QINU`"' (1)

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