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Medicines (732)

Medicines > mechanism: None

& routes

: intramuscular

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Acetaminophen (paracetamol, APAP) (1) · Aspirin (acetylsalicylic acid; ASA) (1) · Diazepam (1) · Docusate (sodium or calcium) (1) · Hydrocortisone (cortisol) (1) · Indomethacin (1) · Lorazepam (1) · Mesalamine (5-aminosalicylic acid, 5-ASA) (1) · Methocarbamol (1) · Methotrexate (1) · Morphine (sulfate) (1) · Nitroglycerin (glyceryl trinitrate, GTN) (1) · Progesterone (micronized) (1) · Promethazine (hydrochloride) (1) · Triamcinolone (acetonide and other esters) (1)

Asacol HD, Pentasa, Lialda, Apriso, Delzicol, Rowasa (rectal), Canasa (suppository) (1) · Ativan (oral, injectable), Loreev XR (1) · Bayer, Ecotrin, Bufferin, St. Joseph (low-dose 81 mg), Excedrin (with acetaminophen and caffeine) (1) · Colace (sodium), Surfak (calcium); many generics OTC (1) · Cortef (oral), Solu-Cortef (IV), many topical brands (Cortizone, OTC); Plenadren, Alkindi (modified-release for adrenal insufficiency) (1) · Indocin (oral, IV, suppository), Tivorbex (low-dose), Indo-Lemmon (1) · Kenalog (injectable), Nasacort (intranasal), Aristocort (topical), Trianex (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) · Nitrostat, Nitrolingual, NitroMist, Nitro-Bid, Nitro-Dur, Minitran, Rectiv (1) · Phenergan, Promethegan (suppositories) (1) · Prometrium (oral), Endometrin (vaginal), Crinone (vaginal gel), Prochieve (1) · Robaxin (oral, injectable) (1) · Trexall, Otrexup, Rasuvo, Xatmep, Rheumatrex (discontinued) (1) · Tylenol, Panadol (international), Ofirmev (IV); huge OTC presence (1) · Valium (oral, IV/IM, rectal), Diastat (rectal gel for breakthrough seizures), Valtoco (nasal spray for breakthrough seizures), Libervant (buccal film) (1)

100-200 mg PO once or twice daily; pediatric weight-based (1) · 325-1000 mg PO every 4-6 hours as needed; maximum 4 g/d in healthy adults, 3 g/d in regular users or hepatic risk; pediatric 10-15 mg/kg every 4-6 hours (1) · Active UC: Lialda 2.4-4.8 g PO once daily, Apriso 1.5 g PO once daily; maintenance 1.2-2.4 g/d; rectal Rowasa enema 4 g HS for distal disease; Canasa 1 g suppository HS for proctitis (1) · Acute gout: 50 mg PO TID until symptom relief, then taper; maximum 200 mg/day for 3-5 days. Rheumatoid arthritis / osteoarthritis: 25-50 mg PO BID-TID. Patent ductus arteriosus: 0.2 mg/kg IV, then 0.1-0.2 mg/kg every 12-24 hours for 2 doses (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) · Antiplatelet: 81 mg PO once daily. Acute MI/stroke: 162-325 mg chewed. Analgesic: 325-650 mg PO every 4-6 hours as needed (1) · Anxiety: 0.5-1 mg PO BID-TID. Insomnia: 1-2 mg PO at bedtime. Status epilepticus: 4 mg IV (adult), repeat after 5-10 minutes if needed. Acute agitation: 1-2 mg IM (1) · Anxiety: 2-10 mg PO 2-4 times daily. Alcohol withdrawal: 10-20 mg PO/IV every 4-6 hours, symptom-triggered. Status epilepticus: 5-10 mg IV. Breakthrough seizures: Diastat rectal 0.2-0.5 mg/kg or Valtoco intranasal 5-20 mg (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: 1500 mg PO QID for 2-3 days (load), then 750-1500 mg QID maintenance. IV/IM: 1000 mg every 8 hours for acute spasm (1) · Physiologic replacement 15-25 mg/d divided (e.g., 10 mg AM, 5 mg noon, 5 mg afternoon); stress dose 50-100 mg IV q6-8h; adrenal crisis 100 mg IV then 50-100 mg q6h; topical 0.5-2.5% applied 2-4×/d (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) · SL 0.3-0.6 mg every 5 minutes up to 3 doses for acute angina (call EMS if not resolved after the third); IV infusion 5-10 mcg/min titrated; transdermal patch 0.2-0.4 mg/hr for 12-14 hours daily (nitrate-free interval prevents tolerance) (1) · Topical 0.025-0.5% cream/ointment BID; intra-articular 5-40 mg per joint q3-6 months; intranasal Nasacort 110 mcg/spray, 2 sprays/nostril daily; oral paste 0.1% to lesion 2-3×/d (1)

2.5 mg tablets; 10-50 mg/mL injection; pre-filled subcutaneous autoinjectors (Otrexup, Rasuvo); 2.5 mg/mL oral solution (Xatmep) (1) · 325, 500, 650 mg tablets; 80, 160 mg chewables; 160 mg/5 mL pediatric liquid; 325 mg suppository; 1000 mg/100 mL IV (Ofirmev); fixed-dose combinations with opioids, decongestants, antihistamines (1) · 5, 10, 20 mg oral tablets; 100, 250, 500, 1000 mg IV (Solu-Cortef); 0.5%, 1%, 2.5% topical creams/ointments; rectal foam and enemas (1) · 50, 100, 250 mg capsules; 50 mg/5 mL syrup; OTC (1) · Capsules 25, 50 mg; ER capsules 75 mg; oral suspension 25 mg/5 mL; suppositories 50 mg; injection 1 mg/vial (PDA closure) (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) · Multiple non-bioequivalent oral formulations (pH-, time-, and moisture-dependent release); rectal enema 4 g/60 mL; 1 g rectal suppository (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) · SL 0.3, 0.4, 0.6 mg tablets; lingual spray 0.4 mg/spray; ER 2.5-9 mg capsules; transdermal patch 0.1-0.8 mg/hr; 2% ointment; 0.4% rectal ointment; 5 mg/mL IV (1) · Tablets 0.5, 1, 2 mg; oral concentrate 2 mg/mL; injection 2 mg/mL and 4 mg/mL; Loreev XR capsules 1, 2, 3 mg (1) · Tablets 12.5, 25, 50 mg; oral syrup 6.25 mg/5 mL; suppositories 12.5, 25, 50 mg; injection 25 mg/mL and 50 mg/mL (1) · Tablets 2, 5, 10 mg; oral solution 1, 5 mg/mL; injection 5 mg/mL; Diastat rectal gel 2.5, 5, 10, 20 mg; Valtoco nasal spray 5, 7.5, 10 mg/dose; Libervant buccal film (1) · Tablets 500, 750 mg; injection 100 mg/mL (1) · Tablets 81 (low-dose), 325, 500, 650 mg; chewable 81 mg; enteric-coated tablets; effervescent tablets; suppositories (1) · Topical creams, ointments, lotions, dental paste (0.025-0.5%); Kenalog 10 mg/mL, 40 mg/mL injection; Nasacort 55 mcg/spray intranasal; oral inhaler discontinued in US (1)

10 mg/day (anxiety, oral) (1) · 100 mg/day (adult) (1) · 200 mg/day (typical adult oral) (1) · 4 g/d in healthy adults; 3 g/d conservative limit; 2 g/d in cirrhosis or chronic alcohol use (1) · 40 mg/day (oral, anxiety) (1) · 4000 mg/day (analgesic) (1) · 8 g/day (oral, short-term load); 6 g/day (chronic) (1) · Formulation-specific; ~4.8 g/d typical maximum oral (1) · Indication-dependent; 200-400 mg/d oral typical (1) · Indication-specific (2) · Indication-specific; titrated to effect (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) · ~500 mg/d typical (1)

1-3 days (1) · 15-60 minutes (oral); 1-5 minutes (IV); 4-10 minutes (rectal or intranasal) (1) · 20 minutes (oral); 5 minutes (IV) (1) · 30-60 minutes (oral); 5 minutes (IV); 15-30 minutes (IM) (1) · 30-60 minutes (oral); rapid relief in acute gout (1) · 5-10 minutes (IV); 30 minutes (oral IR); slower for ER and rectal (1) · Antiplatelet effect within 30-60 minutes; analgesic effect 30-60 minutes (1) · Hours (1) · PO: 30-60 minutes; IV: minutes (1) · Rheumatologic effect at 4-8 weeks; ectopic resolution over 2-3 weeks (1) · Sedation/dizziness within hours of oral dose; endometrial effects over days (1) · SL/spray: 1-3 minutes; IV: minutes; patch: 30-60 minutes (1) · Symptomatic improvement 2-4 weeks (1) · Topical hours; intra-articular days to weeks (1) · ~30 minutes (oral) (1)

'''Antiplatelet effect lasts the platelet's lifetime (~7-10 days)''' due to irreversible COX-1 acetylation; analgesic 4-6 hours (1) · 24 hours (most ER formulations) (1) · 3-5 hours (IR); 8-24 hours (ER); 12-24 hours (epidural / intrathecal) (1) · 4-6 hours (3) · 4-6 hours (IR); 24 hours (ER) (1) · 6-24 hours (parent); much longer when accounting for the long-lived active metabolites (1) · 6-8 hours (1) · Biologic ~8-12 hours (short-acting) (1) · Hours (1) · Intra-articular 3-6 months (depot effect of acetonide microcrystals) (1) · Once-weekly dosing in rheumatology (1) · Oral: 8-12 hours; vaginal: 24+ hours; IM: days (1) · SL: 30 minutes; patch: 12-14 hours; IV continuous (1)

1-2 hours'"`UNIQ--ref-00000017-QINU`"' (1) · 1-3 hours (normal liver); markedly prolonged in overdose with glutathione depletion'"`UNIQ--ref-000006A5-QINU`"' (1) · 1-3 minutes (very short)'"`UNIQ--ref-00000C0F-QINU`"' (1) · 12-15 hours (intermediate); '''no active metabolites''' (key clinical feature)'"`UNIQ--ref-00000023-QINU`"' (1) · 12-15 hours'"`UNIQ--ref-00000022-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) · 4-5 hours'"`UNIQ--ref-00000026-QINU`"' (1) · Aspirin 15-30 minutes; salicylate metabolite 2-3 hours (concentration-dependent, saturable at high doses)'"`UNIQ--ref-00000027-QINU`"' (1) · Diazepam 20-50 hours; '''N-desmethyldiazepam (nordazepam) 30-200 hours''' is the major active metabolite and accumulates substantially with chronic dosing'"`UNIQ--ref-00000026-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 (1) · Plasma ~1-2 hours; biologic ~8-12 hours'"`UNIQ--ref-00000AD1-QINU`"' (1) · Plasma ~3-5 hours; biologic effect substantially longer (~12-36 hours for intermediate-acting glucocorticoids)'"`UNIQ--ref-00000666-QINU`"' (1) · ~5-10 hours (5-ASA)'"`UNIQ--ref-00000BBE-QINU`"' (1) · ~5-20 hours (oral micronized; highly variable)'"`UNIQ--ref-00000726-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) · Highly formulation-dependent; the goal is colonic delivery with minimal systemic exposure'"`UNIQ--ref-00000BBF-QINU`"' (1) · Highly route-dependent: SL bypasses first-pass; oral has extensive first-pass (used only for chronic ER preparations); transdermal predictable'"`UNIQ--ref-00000C10-QINU`"' (1) · Local action; minimal systemic effect (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/intranasal: high local, low systemic; intra-articular: local depot then systemic absorption'"`UNIQ--ref-00000667-QINU`"' (1) · ~100% (oral)'"`UNIQ--ref-00000027-QINU`"' (1) · ~100% (oral; near-complete absorption)'"`UNIQ--ref-00000018-QINU`"' (1) · ~25% (oral, with extensive first-pass)'"`UNIQ--ref-00000023-QINU`"' (1) · ~25-40% (oral; extensive first-pass)'"`UNIQ--ref-00000021-QINU`"' (1) · ~50% (oral; reduced by buffering and enteric coating but onset clinically similar)'"`UNIQ--ref-00000028-QINU`"' (1) · ~85-98% (oral)'"`UNIQ--ref-000006A6-QINU`"' (1) · ~90% (oral)'"`UNIQ--ref-00000024-QINU`"' (1) · ~93% (oral); ~90% (rectal)'"`UNIQ--ref-00000027-QINU`"' (1) · ~96% (oral)'"`UNIQ--ref-00000AD2-QINU`"' (1)

None (1) · OTC (low-dose topicals) and [[USLegal:Prescription only|Rx-only]] (other forms) in US (1) · OTC (lowest-strength topicals) and [[USLegal:Prescription only|Rx-only]] (higher strengths, injectable) in US (1) · OTC and [[USLegal:Prescription only|Rx-only]] (IV, combination products) in US (1) · OTC in US (1) · [[USLegal:Over-the-counter|OTC]] in US at all standard strengths (1) · [[USLegal:Prescription only|Rx-only]] in US (5) · [[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, distinguishing it from carisoprodol which is Schedule IV'"`UNIQ--ref-00000019-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-00000025-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)