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Butalbital / Acetaminophen / Caffeine (1) · Butalbital / Aspirin / Caffeine (1) · Celecoxib (1) · Cetirizine (1) · Codeine / Acetaminophen (1) · Cyproheptadine (hydrochloride) (1) · Fexofenadine (1) · Glimepiride (1) · Insulin detemir (1) · Insulin glargine (1) · Levocetirizine (1) · Loperamide (1) · Naproxen (sodium; free acid) (1) · Pseudoephedrine (hydrochloride; sulfate) (1) · Tizanidine (1) · Tramadol / Acetaminophen (1)

Aleve (OTC), Naprosyn (Rx), Anaprox (Rx), Naprelan (ER), EC-Naprosyn (enteric-coated), Vimovo (with esomeprazole) (1) · Allegra, Allegra Allergy 24 Hour, Mucinex Allergy (combo) — all now OTC in US (1) · Amaryl (1) · Celebrex (oral capsules), Elyxyb (oral solution, for acute migraine) (1) · Fioricet, Esgic; with codeine as Fioricet with Codeine (Schedule III) (1) · Fiorinal; with codeine as Fiorinal with Codeine (Schedule III) (1) · Imodium, Imodium A-D (1) · Lantus, Basaglar, Semglee, Toujeo (U-300) (1) · Levemir, Levemir FlexTouch (US discontinuation announced 2024) (1) · Periactin (US brand discontinued; generic widely available) (1) · Sudafed (IR, 12-hour, 24-hour); many combination products including Claritin-D, Allegra-D, Zyrtec-D, Mucinex-D (1) · Tylenol with Codeine #3 (30 mg codeine), Tylenol #4 (60 mg codeine), Capital with Codeine, Phenaphen with Codeine (1) · Ultracet, Tramacet (1) · Xyzal, Xyzal Allergy 24HR (OTC) (1) · Zanaflex (1) · Zyrtec, Zyrtec-D (1)

None (10) · '"`UNIQ--vote-00000017-QINU`"' Anticholinergic and sedating, with the standard first-generation antihistamine Beers-list concerns in elderly patients'"`UNIQ--ref-00000018-QINU`"'. (1) · '"`UNIQ--vote-00000237-QINU`"' Binds the same insulin receptor as endogenous insulin with comparable mitogenic-to-metabolic ratio; provides basal hepatic glucose suppression and peripheral glucose uptake without prandial peaks'"`UNIQ--ref-00000238-QINU`"'. (1) · '"`UNIQ--vote-00000391-QINU`"' Minimal CYP metabolism; mostly renally cleared unchanged. Cetirizine is the active racemate; levocetirizine is the active R-enantiomer marketed separately'"`UNIQ--ref-00000392-QINU`"'. (1) · '"`UNIQ--vote-00000950-QINU`"' Mostly renally cleared unchanged; dose-reduce in renal impairment. Like cetirizine, retains slightly more sedation than fexofenadine in some users'"`UNIQ--ref-00000951-QINU`"'. (1) · '"`UNIQ--vote-00000CC9-QINU`"' Mostly excreted unchanged in feces and urine; P-glycoprotein substrate (the basis of the fruit-juice interaction). (1) · '"`UNIQ--vote-00001513-QINU`"' The combination with acetaminophen provides additive non-opioid analgesia and lowers required codeine dose. CYP2D6 PGx is one of the most clinically actionable in current pharmacology; CPIC supports genotype-guided opioid selection'"`UNIQ--ref-00001514-QINU`"'. (1)

1-2 capsules (50 mg butalbital / 325 mg acetaminophen / 40 mg caffeine each) PO every 4 hours as needed; maximum 6 capsules/d (1) · 1-2 capsules (50 mg butalbital / 325 mg aspirin / 40 mg caffeine each) PO every 4 hours as needed; maximum 6 capsules/d (1) · 1-2 mg PO once daily with breakfast; titrate by glycemic response (1) · 1-2 tablets (15-60 mg codeine, 300-600 mg acetaminophen) PO every 4-6 hours as needed (1) · 10 mg PO once daily (5 mg in older adults or if sedation occurs) (1) · 2 mg PO every 6-8 hours; titrate by 2-4 mg per dose every 1-4 days; maximum single dose 16 mg, maximum daily dose 36 mg (1) · 2 tablets (75 mg tramadol / 650 mg acetaminophen) PO every 4-6 hours as needed; maximum 8 tablets/day for ≤5 days (1) · 4 mg PO initially, then 2 mg after each loose stool, '''not to exceed 16 mg/d''' (8 mg OTC); chronic-use lower (1) · 5 mg PO once daily in the evening (1) · 60 mg PO BID or 180 mg PO once daily (1) · Allergy: 4 mg PO TID. Serotonin syndrome: 12 mg loading dose PO or by nasogastric tube, then 2 mg every 2 hours until clinical improvement. Appetite stimulation: 2-4 mg PO TID-QID (1) · IR: 60 mg PO every 4-6 hours. 12-hour ER: 120 mg PO every 12 hours. 24-hour ER: 240 mg PO once daily. Pediatric: weight-based (1) · Osteoarthritis: 200 mg PO once daily or 100 mg BID. Rheumatoid arthritis: 100-200 mg PO BID. Acute pain: 400 mg loading, then 200 mg every 12 hours (1) · OTC: 220 mg PO every 8-12 hours, max 660 mg/24h. Rx: 250-500 mg PO BID. Acute gout: 750 mg loading then 250 mg every 8 hours (1) · ~10 units SC at the same time daily, or 0.1-0.2 units/kg/d; titrate by fasting 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)

1 mg, 2 mg, 4 mg tablets (1) · 100 U/mL (Lantus, Basaglar, Semglee) vials and pens; 300 U/mL (Toujeo) pens (1) · 100 U/mL FlexTouch pen, vial (1) · 2 mg capsules and tablets; 1 mg/5 mL oral solution; combined with simethicone (Imodium Multi-Symptom) (1) · 30, 60, 180 mg tablets; 30 mg ODT; 6 mg/mL oral suspension; all OTC (1) · 5 mg tablets; 2.5 mg/5 mL oral solution; OTC (1) · 5 mg, 10 mg tablets; 5 mg, 10 mg chewables; 1 mg/mL oral syrup; OTC (1) · 50/325/40 mg capsules (1) · 50/325/40 mg capsules and tablets; oral solution (1) · Capsules 50, 100, 200, 400 mg; Elyxyb oral solution 25 mg/mL (1) · Codeine/acetaminophen 15/300 (#2 historical), 30/300 (#3), 60/300 (#4) mg tablets; 12/120 mg/5 mL elixir (1) · IR tablets 30, 60 mg; 12-hour ER tablets 120 mg; 24-hour ER tablets 240 mg; oral liquid; multiple combination products with antihistamines, NSAIDs, or expectorants (1) · OTC tablets 220 mg; Rx tablets 250, 375, 500 mg; ER tablets 375, 500, 750 mg (Naprelan); oral suspension 125 mg/5 mL; enteric-coated tablets (EC-Naprosyn) (1) · Tablets 2, 4 mg; capsules 2, 4, 6 mg ('''capsules and tablets are not bioequivalent''': capsules slower with food; tablets faster on empty stomach) (1) · Tablets 4 mg; oral syrup 2 mg/5 mL (1) · Tramadol/acetaminophen 37.5/325 mg tablets (1)

10 mg/d (adults) (1) · 1500 mg/day (Rx); 660 mg/24h (OTC, without provider direction) (1) · 16 mg/d (8 mg/d OTC) (1) · 180 mg/d (adults) (1) · 240 mg/day (1) · 32 mg/day adult; weight-based pediatric ceiling (1) · 36 mg/day in three divided doses; single dose maximum 16 mg (1) · 400 mg/day for chronic indications; higher for short-term acute pain (1) · 5 mg/d (adults) (1) · 6 capsules/d (300 mg butalbital, 1950 mg acetaminophen, 240 mg caffeine) (1) · 6 capsules/d (300 mg butalbital, 1950 mg aspirin, 240 mg caffeine) (1) · 8 mg/d (1) · 8 tablets/d (300 mg tramadol / 2600 mg acetaminophen); 5-day duration limit per label (1) · Acetaminophen 4 g/d absolute; codeine 240-360 mg/d typical practical limit (1) · Titrated to glucose (1) · Titrated to glucose; no fixed ceiling (1)

Oral (14) · Subcutaneous (1) · Subcutaneous (never IV; not for use in insulin pumps) (1)

12-24 hours (2) · 24 hours (3) · 3-6 hours per dose (1) · 4-6 hours (4) · 4-6 hours (IR); 12-24 hours (ER) (1) · 6-8 hours (1) · 8-12 hours (1) · 8-12 hours (the long-duration feature relative to ibuprofen) (1) · ~12-24 hours (dose-dependent; BID dosing often needed at higher doses) (1) · ~24 hours per dose (peakless profile by design) (1)

Butalbital well-absorbed; aspirin 50-75%; caffeine ~100%'"`UNIQ--ref-000015B8-QINU`"' (1) · Butalbital well-absorbed; caffeine ~100%; acetaminophen 85-98%'"`UNIQ--ref-000015A0-QINU`"' (1) · Codeine ~60% (oral); acetaminophen 85-98%'"`UNIQ--ref-00001518-QINU`"' (1) · High (oral); not significantly affected by food'"`UNIQ--ref-00000397-QINU`"' (1) · Tramadol ~75% (oral); acetaminophen 85-98%'"`UNIQ--ref-00001531-QINU`"' (1) · ~0.3% (oral; extensive first-pass via CYP3A4 and P-glycoprotein-mediated efflux at the intestinal and blood-brain barriers limit systemic and CNS exposure at therapeutic doses)'"`UNIQ--ref-00000FD3-QINU`"' (1) · ~100% (oral; not significantly affected by food)'"`UNIQ--ref-00000493-QINU`"' (1) · ~100% from subcutaneous depot (by definition of the route) (1) · ~33% (oral; fruit juices including grapefruit, orange, and apple reduce absorption substantially via OATP1A2 inhibition — distinctive interaction not seen with most other H1s)'"`UNIQ--ref-00000CCD-QINU`"' (1) · ~40% (oral); food and formulation substantially alter the absorption profile'"`UNIQ--ref-0000001E-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) · ~85-90% (oral; not significantly affected by food)'"`UNIQ--ref-00000955-QINU`"' (1) · ~90% (oral, low first-pass)'"`UNIQ--ref-0000001C-QINU`"' (1) · ~95% (oral)'"`UNIQ--ref-0000001F-QINU`"' (1) · ~95% (oral)'"`UNIQ--ref-0000002A-QINU`"' (1) · ~99% (oral)'"`UNIQ--ref-0000002A-QINU`"' (1)

None (1) · '''[[USLegal:Behind-the-counter|Behind-the-counter]] in US''' under the Combat Methamphetamine Epidemic Act 2005: purchase restricted to ≤3.6 g/day and ≤9 g/30 days, with photo ID, logbook signature, and quantity logging required. Several states schedule higher than federal (1) · OTC in US (4) · [[USLegal:Over-the-counter|OTC]] in US at ≤220 mg/tablet and ≤660 mg/day; [[USLegal:Prescription only|Rx-only]] at higher 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 among muscle-spasm options'"`UNIQ--ref-0000001F-QINU`"' (1) · [[USLegal:Schedule III|Schedule III controlled substance]] in US (Fiorinal is scheduled federally; Fioricet with acetaminophen is unscheduled federally despite identical butalbital content, a regulatory quirk) (1) · [[USLegal:Schedule III|Schedule III controlled substance]] in US. '''Contraindicated in children <12''' for any indication and in any age post-tonsillectomy/adenoidectomy (FDA 2017 black-box advisory)'"`UNIQ--ref-00001519-QINU`"' (1) · [[USLegal:Schedule IV|Schedule IV controlled substance]] in US (tramadol was reclassified from non-controlled to Schedule IV in 2014 after recognition of dependence risk) (1)