Drilldown: Medicines

None (1) · Cyclobenzaprine (1) · Insulin degludec (1) · Meclizine (1) · Pramipexole (1) · Ropinirole (1)

Antivert (Rx), Bonine (OTC), Dramamine Less Drowsy (OTC) (1) · Flexeril (IR; brand discontinued in US, generic widely available), Amrix (ER) (1) · Mirapex (IR), Mirapex ER (1) · Requip (IR), Requip XL (extended-release) (1) · Rexulti (1) · Tresiba (1)

5HT1A activity than aripiprazole (1) · 5HT2A (1) · Atypical antipsychotic (1) · D2/5HT1A partial agonist with stronger α1A (1) · [[:Category:Antiemetics|Antiemetic]] (1) · [[:Category:Antihistamines|First-generation antihistamine (piperazine)]] (1) · [[:Category:Antiparkinsonians|Antiparkinsonian]] (2) · [[:Category:Antivertigo medicines|Antivertigo medicine]] (1) · [[:Category:Basal_insulins|Basal insulin]] (1) · [[:Category:Dopamine agonists|Dopamine D2/D3 receptor agonist (non-ergot)]] (2) · [[:Category:Insulins|Insulin]] (1) · [[:Category:Skeletal muscle relaxants|Skeletal muscle relaxant (centrally-acting)]] (1) · [[:Category:Tricyclic-related compounds|Tricyclic-related compound]] (1) · [[:Category:Ultra-long-acting_insulins|Ultra-long-acting insulin analog]] (1)

None (3) · Partial agonist at D2 and 5HT1A. Antagonist at 5HT2A, α1A, α1B, α2C. More potent 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism (relative to D2 partial agonism) than aripiprazole, proposed to reduce akathisia and enhance affective/cognitive effects. (1) · '"`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)

Schizophrenia (FDA-approved 2015). Adjunctive treatment of major depressive disorder (2015). '''Agitation associated with dementia due to Alzheimer disease''' (FDA-approved May 2023, first agent specifically approved for this problem). Investigational for PTSD (combined with sertraline). (1) · '"`UNIQ--vote-00000013-QINU`"', '"`UNIQ--vote-00000014-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-00000017-QINU`"', '"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"' (1) · '"`UNIQ--vote-00001358-QINU`"', '"`UNIQ--vote-00001359-QINU`"' (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) · Parkinson disease: 0.125 mg PO TID, titrate weekly to maintenance ~1.5 mg TID. Restless legs syndrome: 0.125 mg PO 2-3 hours before bedtime, titrate to 0.5 mg/day if needed (1) · Parkinson disease: 0.25 mg PO TID, titrate weekly. Restless legs syndrome: 0.25 mg PO 1-3 hours before bedtime, titrate to 4 mg/day if needed (1) · Schizophrenia: 1 mg PO daily × 4 days, then 2 mg daily × 3 days, then 4 mg daily. MDD adjunct: 0.5-1 mg daily, increase to 2 mg max. AD agitation: 0.5 mg daily, titrate to 2-3 mg daily. (1) · ~10 units SC at the same time daily, or 0.1-0.2 units/kg/d; titrate by fasting glucose (1)

0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg tablets (1) · 100 U/mL (FlexTouch pen) and 200 U/mL (FlexTouch pen, higher-dose convenience) (1) · IR tablets 0.125, 0.25, 0.5, 0.75, 1, 1.5 mg; ER tablets 0.375, 0.75, 1.5, 2.25, 3, 3.75, 4.5 mg (1) · IR tablets 0.25, 0.5, 1, 2, 3, 4, 5 mg; XL tablets 2, 4, 6, 8, 12 mg (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)

100 mg/day (vertigo) (1) · 24 mg/day (Parkinson disease); 4 mg/day (restless legs syndrome) (1) · 30 mg/day (IR or ER) (1) · 4 mg/d (schizophrenia); 3 mg/d (AD agitation); 3 mg/d (MDD adjunct) (1) · 4.5 mg/day (Parkinson disease); 0.5 mg/day (restless legs syndrome) (1) · Titrated to glucose; no fixed ceiling (1)

Oral (5) · 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) · >42 hours per dose (effectively flat once at steady state) (1) · Daily dosing (1) · TID dosing (IR); once-daily (ER) (1) · TID dosing (IR); once-daily (XL) (1)

18 hours (IR); 32-33 hours (ER)'"`UNIQ--ref-0000001A-QINU`"' (1) · 8-12 hours (longer in elderly and renal impairment)'"`UNIQ--ref-0000001B-QINU`"' (1) · ~25 hours apparent (functional duration well over 42 hours from multi-hexamer depot)'"`UNIQ--ref-0000135A-QINU`"' (1) · ~6 hours'"`UNIQ--ref-00000015-QINU`"' (1) · ~6 hours'"`UNIQ--ref-00000018-QINU`"' (1) · ~91 hours (1)

>90% (oral)'"`UNIQ--ref-0000001C-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) · ~55% (oral)'"`UNIQ--ref-00000016-QINU`"' (1) · ~95% (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 data; National Pregnancy Registry available (1) · Limited human data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (2) · Limited human data; rarely indicated in pregnancy given the typical patient population.<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)

Rx (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 (3) · [[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)