Drilldown: Medicines

Cyclobenzaprine (1) · Diazepam (1) · Insulin degludec (1) · Meclizine (1)

Antivert (Rx), Bonine (OTC), Dramamine Less Drowsy (OTC) (1) · Flexeril (IR; brand discontinued in US, generic widely available), Amrix (ER) (1) · Tresiba (1) · Valium (oral, IV/IM, rectal), Diastat (rectal gel for breakthrough seizures), Valtoco (nasal spray for breakthrough seizures), Libervant (buccal film) (1)

[[:Category:Anticonvulsants|Anticonvulsant]] (1) · [[:Category:Antiemetics|Antiemetic]] (1) · [[:Category:Antihistamines|First-generation antihistamine (piperazine)]] (1) · [[:Category:Antivertigo medicines|Antivertigo medicine]] (1) · [[:Category:Anxiolytics|Anxiolytic]] (1) · [[:Category:Basal_insulins|Basal insulin]] (1) · [[:Category:Benzodiazepines|Benzodiazepine (long-acting)]] (1) · [[:Category:Insulins|Insulin]] (1) · [[:Category:Schedule IV controlled substances|Schedule IV controlled substance]] (1) · [[:Category:Skeletal muscle relaxants|Skeletal muscle relaxant (centrally-acting)]] (1) · [[:Category:Skeletal muscle relaxants|Skeletal muscle relaxant]] (1) · [[:Category:Tricyclic-related compounds|Tricyclic-related compound]] (1) · [[:Category:Ultra-long-acting_insulins|Ultra-long-acting insulin analog]] (1)

None (2) · '"`UNIQ--vote-00000013-QINU`"' Anticholinergic burden (dry mouth, blurred vision, urinary retention, cognitive effects) is the principal adverse-event concern and the basis for Beers-list cautions in elderly patients'"`UNIQ--ref-00000014-QINU`"'. (1) · '"`UNIQ--vote-00001356-QINU`"' Binds the same insulin receptor as endogenous insulin with comparable mitogenic-to-metabolic ratio'"`UNIQ--ref-00001357-QINU`"'. (1)

'"`UNIQ--vote-00000015-QINU`"', '"`UNIQ--vote-00000016-QINU`"', '"`UNIQ--vote-00000017-QINU`"' (1) · '"`UNIQ--vote-00000017-QINU`"', '"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"' (1) · '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"', '"`UNIQ--vote-00000026-QINU`"', '"`UNIQ--vote-00000027-QINU`"', '"`UNIQ--vote-00000028-QINU`"', '"`UNIQ--vote-00000029-QINU`"' (1) · '"`UNIQ--vote-00001358-QINU`"', '"`UNIQ--vote-00001359-QINU`"' (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) · IR 5 mg PO TID; titrate to 10 mg TID if needed. Amrix ER 15 mg PO once daily. Off-label insomnia / fibromyalgia: 5-10 mg PO at bedtime (1) · Motion sickness: 25-50 mg PO 1 hour before travel, repeat every 24 hours as needed. Vertigo: 25-100 mg/day divided (1) · ~10 units SC at the same time daily, or 0.1-0.2 units/kg/d; titrate by fasting glucose (1)

100 U/mL (FlexTouch pen) and 200 U/mL (FlexTouch pen, higher-dose convenience) (1) · IR tablets 5, 7.5, 10 mg; Amrix ER capsules 15, 30 mg (1) · Tablets 12.5, 25 mg; chewable tablets 25 mg (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)

100 mg/day (vertigo) (1) · 30 mg/day (IR or ER) (1) · 40 mg/day (oral, anxiety) (1) · Titrated to glucose; no fixed ceiling (1)

buccal (1) · IM (1) · intranasal (1) · IV (1) · Oral (3) · rectal (1) · Subcutaneous (never IV; not for use in insulin pumps) (1)

None · Hours · 30-60 minutes · 1-2 hours · ~30 min · LDL lowering at 2 weeks, max by 4 weeks · ~1 hour · 15-30 minutes · 15–30 min · 1–2 h · 30–60 min · Antidepressant effect emerges over 1-2 weeks · BP and symptomatic LUTS improvement within 1-2 weeks · BP effect within 1-2 weeks · Clinical improvement within 24-72 hours · Days · Motor improvement over days at therapeutic dose · Over weeks · Postprandial glucose effect within days; HbA1c by 12 weeks · Sleep effect from first dose; antidepressant effect over 1-4 weeks

Other values:

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12-24 hours (IR); 24 hours (Amrix ER) (1) · 12-24 hours (long for an antihistamine) (1) · 6-24 hours (parent); much longer when accounting for the long-lived active metabolites (1) · >42 hours per dose (effectively flat once at steady state) (1)

18 hours (IR); 32-33 hours (ER)'"`UNIQ--ref-0000001A-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-0000002A-QINU`"' (1) · ~25 hours apparent (functional duration well over 42 hours from multi-hexamer depot)'"`UNIQ--ref-0000135A-QINU`"' (1) · ~6 hours'"`UNIQ--ref-00000018-QINU`"' (1)

~100% from subcutaneous depot (1) · ~25% (oral)'"`UNIQ--ref-00000019-QINU`"' (1) · ~33-55% (IR); reduced by food'"`UNIQ--ref-0000001B-QINU`"' (1) · ~93% (oral); ~90% (rectal)'"`UNIQ--ref-0000002B-QINU`"' (1)

Insulin is the preferred glucose-lowering therapy in pregnancy; degludec has reassuring observational data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited human data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Older agent with substantial use experience; observational signals reassuring for first-trimester exposure.<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)

[[USLegal:Over-the-counter|OTC]] as Bonine and Dramamine Less Drowsy; [[USLegal:Prescription only|Rx-only]] as Antivert (1) · [[USLegal:Prescription only|Rx-only]] in US (1) · [[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, distinguishing it from the carisoprodol alternative for muscle spasm'"`UNIQ--ref-0000001C-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-0000002C-QINU`"' (1)