Drilldown: Medicines

None (3) · Butalbital / Acetaminophen / Caffeine (1) · Butalbital / Aspirin / Caffeine (1) · Celecoxib (1) · Cetirizine (1) · Codeine / Acetaminophen (1) · Cyproheptadine (hydrochloride) (1) · Guaifenesin (1) · Levocetirizine (1) · Loperamide (1) · Naproxen (sodium; free acid) (1) · Pseudoephedrine (hydrochloride; sulfate) (1) · Tizanidine (1) · Tramadol / Acetaminophen (1) · Vardenafil (1)

Aleve (OTC), Naprosyn (Rx), Anaprox (Rx), Naprelan (ER), EC-Naprosyn (enteric-coated), Vimovo (with esomeprazole) (1) · Belsomra (1) · Celebrex (oral capsules), Elyxyb (oral solution, for acute migraine) (1) · Dayvigo (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) · Levitra, Staxyn (1) · Mucinex, Robitussin, Tussin (1) · Periactin (US brand discontinued; generic widely available) (1) · Quviviq (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 (1) · Dual orexin receptor antagonist (DORA) (3) · gut-restricted)]] (1) · PDE5 Inhibitor (1) · selective COX-2)]] (1) · the first approved (1) · weak)]] (1) · [[:Category:Alpha-2 adrenergic agonists|Alpha-2 adrenergic agonist]] (1) · [[:Category:Analgesics|Analgesic]] (2) · [[:Category:Antidiarrheals|Antidiarrheal]] (1) · [[:Category:Antihistamines|Antihistamine]] (2) · [[:Category:Antihistamines|First-generation antihistamine]] (1) · [[:Category:Antipyretics|Antipyretic]] (1) · [[:Category:Antispastics|Antispastic]] (1) · [[:Category:Barbiturates|Barbiturate (butalbital)]] (2) · [[:Category:Decongestants|Decongestant]] (1) · [[:Category:Expectorants|Expectorant]] (1) · [[:Category:Fixed-dose_combinations|Fixed-dose combination]] (3) · [[:Category:H1_receptor_antagonists|Histamine H1 receptor antagonist (second-generation)]] (2) · [[:Category:Methylxanthines|Methylxanthine (caffeine)]] (2) · [[:Category:Mucolytics|Mucolytic]] (1) · [[:Category:Non-opioid_analgesics|Non-opioid analgesic (acetaminophen)]] (2) · [[:Category:NSAIDs|Non-steroidal anti-inflammatory (NSAID (1) · [[:Category:NSAIDs|Non-steroidal anti-inflammatory (NSAID)]] (1) · [[:Category:NSAIDs|NSAID (aspirin)]] (1) · [[:Category:Opioid_analgesics|Opioid analgesic (codeine (1) · [[:Category:Opioid_receptor_agonists|Peripheral opioid receptor agonist (μ-selective (1) · [[:Category:Orexigenics|Appetite-promoting medicine (orexigenic)]] (1) · [[:Category:Schedule_III_controlled_substances|Schedule III controlled substance]] (2) · [[:Category:Serotonin antagonists|Serotonin 5-HT2 antagonist]] (1) · [[:Category:Skeletal muscle relaxants|Skeletal muscle relaxant (centrally-acting)]] (1) · [[:Category:Sympathomimetics|Sympathomimetic (indirect-acting)]] (1)

None (9) · Competitive antagonist at OX1R and OX2R. Faster receptor association/dissociation kinetics than suvorexant (~16 sec dissociation vs ~57 sec) hypothesized to support sleep onset, with sufficient duration for maintenance. (1) · Competitive antagonist at OX1R and OX2R. First-in-class DORA. Receptor dissociation slower than lemborexant or daridorexant. (1) · Selective inhibitor of PDE5. Slightly higher PDE5/PDE6 selectivity vs sildenafil (less visual side effect) but more PDE1 cross-activity (occasional QT effects at high doses). (1) · '"`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-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-0000104D-QINU`"' Adequate hydration is at least as important as the drug in producing the expectorant effect clinically. Used in combination with dextromethorphan, decongestants, or antihistamines in many proprietary OTC cold preparations. (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)

Insomnia (sleep onset and/or maintenance) in adults (FDA-approved August 2014). Also studied for insomnia in mild-moderate Alzheimer disease. (1) · Insomnia (sleep onset and/or maintenance) in adults (FDA-approved Dec 2019) (1) · Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022) (1) · '"`UNIQ--vote-00000017-QINU`"', '"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"' (1) · '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"', '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"' (1) · '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"', '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"' (1) · '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"', '"`UNIQ--vote-00000026-QINU`"', '"`UNIQ--vote-00000027-QINU`"', '"`UNIQ--vote-00000028-QINU`"' (2) · '"`UNIQ--vote-00000393-QINU`"', '"`UNIQ--vote-00000394-QINU`"', '"`UNIQ--vote-00000395-QINU`"' (1) · '"`UNIQ--vote-00000669-QINU`"' (1) · '"`UNIQ--vote-00000952-QINU`"', '"`UNIQ--vote-00000953-QINU`"' (1) · '"`UNIQ--vote-00000FCF-QINU`"', '"`UNIQ--vote-00000FD0-QINU`"', '"`UNIQ--vote-00000FD1-QINU`"' (1) · '"`UNIQ--vote-0000104E-QINU`"', '"`UNIQ--vote-0000104F-QINU`"' (1) · '"`UNIQ--vote-00001515-QINU`"', '"`UNIQ--vote-00001516-QINU`"' (1) · '"`UNIQ--vote-0000152F-QINU`"' (1) · '"`UNIQ--vote-0000159D-QINU`"', '"`UNIQ--vote-0000159E-QINU`"' (1) · '"`UNIQ--vote-000015B6-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 tablets (15-60 mg codeine, 300-600 mg acetaminophen) PO every 4-6 hours as needed (1) · 10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · 10 mg PO once daily (5 mg in older adults or if sedation occurs) (1) · 10 mg ~1 h before sexual activity (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) · 200-400 mg PO q4h (IR); 600-1200 mg PO q12h (Mucinex 12-Hour ER) (1) · 25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate (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 at bedtime; may increase to 10 mg if inadequate (1) · 5 mg PO once daily in the evening (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)

100, 200, 400 mg IR tablets; 600 mg, 1200 mg Mucinex ER tablets; many liquid formulations and combination products with dextromethorphan, pseudoephedrine, antihistamines (1) · 2 mg capsules and tablets; 1 mg/5 mL oral solution; combined with simethicone (Imodium Multi-Symptom) (1) · 2.5, 5, 10, 20 mg tabs (Levitra); 10 mg ODT (Staxyn) (1) · 25 mg, 50 mg tablets (1) · 5 mg tablets; 2.5 mg/5 mL oral solution; OTC (1) · 5 mg, 10 mg tablets (1) · 5 mg, 10 mg tablets; 5 mg, 10 mg chewables; 1 mg/mL oral syrup; OTC (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (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 (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) · 2.4 g/d (1) · 20 mg/d (2) · 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) · 50 mg/d (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 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)

Oral (17)

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:

Search

12-24 hours (1) · 24 hours (2) · 3-6 hours per dose (1) · 4 hours (IR); 12 hours (ER) (1) · 4-6 hours (4) · 4-6 hours (IR); 12-24 hours (ER) (1) · 4–5 h (1) · 6-8 hours (1) · 8-12 hours (1) · 8-12 hours (the long-duration feature relative to ibuprofen) (1) · ~7-8 hours (3)

12-17 hours'"`UNIQ--ref-00000029-QINU`"' (1) · 2.5 hours (short, requires TID-QID dosing)'"`UNIQ--ref-0000001D-QINU`"' (1) · 4–5 h (1) · 8-10 hours (longer in elderly and renal impairment)'"`UNIQ--ref-00000396-QINU`"' (1) · 8-16 hours'"`UNIQ--ref-0000001E-QINU`"' (1) · 9-16 hours (pH-dependent: acidic urine shortens, alkaline urine substantially extends)'"`UNIQ--ref-0000001B-QINU`"' (1) · Butalbital ~35 hours (long; cumulative effects with frequent use); acetaminophen 1-3 hours; caffeine 3-7 hours'"`UNIQ--ref-0000159F-QINU`"' (1) · Butalbital ~35 hours; aspirin (acetyl group) ~15 minutes, salicylate 2-3 hours; caffeine 3-7 hours'"`UNIQ--ref-000015B7-QINU`"' (1) · Codeine 2.5-3.5 hours; acetaminophen 1-3 hours'"`UNIQ--ref-00001517-QINU`"' (1) · Tramadol ~5-7 hours (M1 metabolite ~9 hours); acetaminophen 1-3 hours'"`UNIQ--ref-00001530-QINU`"' (1) · ~1 hour'"`UNIQ--ref-00001050-QINU`"' (1) · ~11 hours'"`UNIQ--ref-00000029-QINU`"' (1) · ~12 hours (1) · ~17-19 hours (longer than daridorexant) (1) · ~8 hours (longer in elderly and renal impairment)'"`UNIQ--ref-00000954-QINU`"' (1) · ~8 hours (shorter than suvorexant and lemborexant) (1) · ~9-14 hours'"`UNIQ--ref-00000FD2-QINU`"' (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) · High (oral)'"`UNIQ--ref-00001051-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) · ~15% (extensive hepatic first-pass) (1) · ~40% (oral); food and formulation substantially alter the absorption profile'"`UNIQ--ref-0000001E-QINU`"' (1) · ~44% (1) · ~62% (1) · ~82% (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) · Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)'"`UNIQ--ref-0000002B-QINU`"' (2) · Avoid; neonatal opioid withdrawal documented.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Avoided; barbiturate + aspirin teratogenicity and bleeding concerns.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Category B (1) · Generally avoided; barbiturate exposure in late pregnancy can produce neonatal withdrawal and respiratory depression.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered acceptable when needed.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered acceptable.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe; widely used. Cetirizine and loratadine remain the more-studied alternatives.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe; widely used. Levocetirizine (the R-enantiomer) is an alternative with similar safety.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data; avoid (3) · Limited human data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited human data; older agent with substantial use experience.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Some controversial signal for first-trimester gastroschisis association in observational studies; limited use is generally considered acceptable after the first trimester.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (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) · Rx, Schedule IV (US) (3) · Rx-only in US (1) · [[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 (2) · [[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)