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Medicines (732)

Medicines > mechanism: None

& routes

: Subcutaneous

or vaginal

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Clindamycin (1) · Clotrimazole (1) · Estradiol (17β-estradiol) (1) · Evolocumab (1) · Insulin aspart (1) · Insulin detemir (1) · Methotrexate (1) · Metronidazole (1) · Morphine (sulfate) (1) · Progesterone (micronized) (1) · Sumatriptan (succinate) (1)

Cleocin (oral, IV); Clindesse, Cleocin (vaginal); Clindets, Cleocin T (topical) (1) · Estrace, Vivelle-Dot, Climara, Divigel, Evamist, Estring, Estraderm, Premarin (CEE, not strictly estradiol) (1) · Flagyl, Metrocream, Metrogel, Metrogel-Vaginal, Noritate (1) · 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) · Lotrimin, Mycelex, Gyne-Lotrimin; OTC widely (1) · MS Contin (ER), Kadian (ER), Avinza (ER), Roxanol (IR oral solution), Duramorph (epidural / IT), Astramorph (IV), Infumorph (intrathecal pump), MorphaBond (IR abuse-deterrent) (1) · NovoLog, Fiasp (ultra-rapid), Trurapi (1) · Prometrium (oral), Endometrin (vaginal), Crinone (vaginal gel), Prochieve (1) · Repatha (1) · Trexall, Otrexup, Rasuvo, Xatmep, Rheumatrex (discontinued) (1)

140 mg SC every 2 weeks OR 420 mg SC monthly (3 consecutive injections 5 minutes apart due to volume) (1) · 500 mg PO TID × 7-10 days (most indications); 2 g single dose for trichomoniasis; 500 mg IV q8h for severe anaerobic infection; rectal 1 g BID (1) · HRT cyclic: 200 mg PO HS days 1-12 of each month; continuous: 100 mg PO daily; ART luteal support 100 mg vaginal TID or 90 mg gel daily (1) · IR oral: 15-30 mg every 4 hours as needed. ER opioid-naive: 15-30 mg every 12 hours. IV/IM/SC: 2-10 mg every 3-4 hours. Epidural / intrathecal: see surgical or palliative-care protocols (1) · Oral 1-2 mg daily; transdermal patch 0.025-0.05 mg/d twice weekly; transdermal gel 0.5-1 g/d; vaginal 10 mcg tablet twice weekly for GSM. Always combine with a progestogen in patients with an intact uterus. (1) · Oral 300-450 mg PO QID; IV 600-900 mg q8h; topical 1% solution/gel BID; vaginal 100 mg ovule × 3 days or 2% cream × 7 days (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) · 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) · Topical: 1% cream BID × 2-4 weeks; vaginal: 1% or 2% cream nightly × 7 days, or 100/200/500 mg vaginal tablet single or 3-day regimens; troche: 10 mg PO five times daily × 2 weeks for thrush (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)

1% topical cream, lotion, solution; 1%, 2% vaginal cream; 100, 200, 500 mg vaginal tablets; 10 mg oral troches; combination with betamethasone (Lotrisone, Rx) (1) · 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) · 250, 500 mg tablets; 750 mg ER; 500 mg/100 mL IV; 0.75-1% topical gel/cream; 0.75% vaginal gel; suppository (1) · 75, 150, 300 mg capsules; 75 mg/5 mL solution; 150 mg/mL IV; 1% topical; 2% vaginal cream (1) · IR tablets 15, 30 mg; oral solution 10 mg/5 mL, 20 mg/mL, 100 mg/5 mL (concentrated); suppositories; ER tablets and capsules in multiple strengths; injectable 0.5-50 mg/mL (1) · Oral 0.5, 1, 2 mg tablets; transdermal patches (twice-weekly and once-weekly); 0.06% gel; 1.53 mg/spray topical; vaginal ring (Estring); vaginal tablet (Vagifem/Yuvafem); vaginal cream (1) · Oral 100, 200 mg capsules (peanut oil; check allergy); 100 mg vaginal insert (Endometrin); 4%, 8% vaginal gel (Crinone); IM 50 mg/mL (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)

200 mg/day (oral); 12 mg/day (SC); 40 mg/day (nasal spray); 44 mg/day (Onzetra) (1) · 4.8 g/d (IV severe infection) (1) · 420 mg/month (1) · Indication-dependent; 200-400 mg/d oral typical (1) · Indication-specific; lowest effective dose for shortest duration is the WHI-era standard (1) · No fixed ceiling; titrate to clinical effect and tolerability with CDC opioid prescribing guidance constraints on morphine-milligram-equivalent (MME) totals (1) · Rheumatologic ~25 mg/week; oncology indication-specific (1) · Titrated to glucose (1) · Titrated to glucose; no fixed maximum (1) · Topical: BID; troche: 5×/day (1) · ~4 g/d (severe systemic infection) (1)

1-2 hours (1) · 10 minutes (SC); 15-30 minutes (nasal); 30-60 minutes (oral) (1) · 5-10 minutes (IV); 30 minutes (oral IR); slower for ER and rectal (1) · Days (1) · Hours (2) · 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) · Sedation/dizziness within hours of oral dose; endometrial effects over days (1) · Vasomotor relief 2-4 weeks; bone density gains over months (1)

2-4 hours; headache recurrence rate ~20-30% within 24 hours (1) · 2-4 weeks per dose (1) · 3-5 hours (1) · 3-5 hours (IR); 8-24 hours (ER); 12-24 hours (epidural / intrathecal) (1) · 6-8 hours (1) · 8-12 hours (1) · Hours per application (1) · Once-weekly dosing in rheumatology (1) · Oral: 8-12 hours; vaginal: 24+ hours; IM: days (1) · Route- and formulation-dependent (1) · ~12-24 hours (dose-dependent; BID dosing often needed at higher doses) (1)

2 hours'"`UNIQ--ref-00000015-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) · 6-8 hours'"`UNIQ--ref-00000BEB-QINU`"' (1) · Morphine 2-4 hours; morphine-6-glucuronide active metabolite 2-4 hours (longer with renal impairment)'"`UNIQ--ref-00000020-QINU`"' (1) · Not meaningfully described (minimal systemic absorption from topical use)'"`UNIQ--ref-00000F45-QINU`"' (1) · ~11-17 days'"`UNIQ--ref-0000147F-QINU`"' (1) · ~13-20 hours (oral); transdermal pharmacokinetics buffer the peaks/troughs of oral dosing'"`UNIQ--ref-000003BA-QINU`"' (1) · ~2.5-3 hours'"`UNIQ--ref-00001442-QINU`"' (1) · ~5-20 hours (oral micronized; highly variable)'"`UNIQ--ref-00000726-QINU`"' (1) · ~7 hours apparent'"`UNIQ--ref-00001374-QINU`"' (1) · ~80 minutes SC'"`UNIQ--ref-000005F2-QINU`"' (1)

60-70% PO at low doses; saturable at high doses (parenteral routes preferred above 15-25 mg/week)'"`UNIQ--ref-000007C9-QINU`"' (1) · Oral ~5% (extensive first-pass to estrone and conjugates); transdermal bypasses first-pass, giving more physiologic estradiol:estrone ratio'"`UNIQ--ref-000003BB-QINU`"' (1) · Oral: very low (extensive first-pass); micronization improves uptake somewhat. Vaginal: high local effect with lower systemic levels (first-uterine-pass concentration)'"`UNIQ--ref-00000727-QINU`"' (1) · Topical: minimal systemic; troche: ~3% systemic'"`UNIQ--ref-00000F46-QINU`"' (1) · ~100% from subcutaneous depot (1) · ~14% (oral; substantial first-pass); ~97% (subcutaneous); ~17% (nasal)'"`UNIQ--ref-00000016-QINU`"' (1) · ~25-40% (oral; extensive first-pass)'"`UNIQ--ref-00000021-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) · ~72% from SC depot'"`UNIQ--ref-00001480-QINU`"' (1) · ~80% (oral)'"`UNIQ--ref-00000BEC-QINU`"' (1) · ~90% (oral)'"`UNIQ--ref-00001443-QINU`"' (1)

OTC (lower strengths) and [[USLegal:Prescription only|Rx-only]] (combination with betamethasone) in US (1) · [[USLegal:Prescription only|Rx-only]] in US (8) · [[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:Schedule II|Schedule II controlled substance]] in US; WHO essential medicine'"`UNIQ--ref-00000022-QINU`"' (1)