Drilldown: Medicines

Doxepin (hydrochloride) (1) · Linagliptin (1) · Magnesium (oxide, citrate, sulfate, hydroxide, gluconate, chloride salts) (1) · Mirtazapine (1) · Sitagliptin (1)

Januvia; with metformin Janumet/Janumet XR (1) · Mag-Ox, Slow-Mag, MagCitrate, Milk of Magnesia (hydroxide); IV sulfate generic (1) · Remeron (US brand discontinued; generic widely available), Remeron SolTab (ODT) (1) · Sinequan (oral antidepressant, US brand discontinued), Silenor (low-dose for insomnia), Prudoxin / Zonalon (topical cream) (1) · Tradjenta; with metformin Jentadueto (1)

hydroxide)]] (1) · torsades)]] (1) · [[:Category:Antacids|Antacid (hydroxide)]] (1) · [[:Category:Antiarrhythmics|Antiarrhythmic (IV sulfate (1) · [[:Category:Antidepressants|Antidepressant]] (2) · [[:Category:Antihistamines|Antihistamine (potent H1)]] (1) · [[:Category:Antihyperglycemic_agents|Antihyperglycemic agent]] (2) · [[:Category:DPP-4_inhibitors|DPP-4 inhibitor]] (2) · [[:Category:Electrolyte_replacements|Electrolyte replacement]] (1) · [[:Category:Incretin_modulators|Incretin pathway modulator]] (2) · [[:Category:Osmotic_laxatives|Osmotic laxative (citrate (1) · [[:Category:Sleep aids|Sleep aid (off-label)]] (1) · [[:Category:Sleep aids|Sleep aid (Silenor low-dose)]] (1) · [[:Category:Tetracyclic antidepressants|Tetracyclic antidepressant]] (1) · [[:Category:Tricyclic antidepressants|Tricyclic antidepressant (TCA)]] (1)

None (3) · '"`UNIQ--vote-00000762-QINU`"' Largely renally cleared, hence the eGFR-tiered dosing. Rare but well-documented signals: acute pancreatitis (uncertain causal contribution), severe joint pain, and bullous pemphigoid (class effect, especially in older Asian patients)'"`UNIQ--ref-00000763-QINU`"'. (1) · '"`UNIQ--vote-00001302-QINU`"' Renally cleared; accumulation in advanced CKD can produce neuromuscular and cardiac depression. Hypomagnesemia frequently co-exists with hypokalemia and is often the reason refractory potassium loss does not correct until magnesium is repleted. (1)

'"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"' (1) · '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"' (1) · '"`UNIQ--vote-00000764-QINU`"' (1) · '"`UNIQ--vote-0000117B-QINU`"' (1) · '"`UNIQ--vote-00001303-QINU`"', '"`UNIQ--vote-00001304-QINU`"', '"`UNIQ--vote-00001305-QINU`"', '"`UNIQ--vote-00001306-QINU`"', '"`UNIQ--vote-00001307-QINU`"', '"`UNIQ--vote-00001308-QINU`"', '"`UNIQ--vote-00001309-QINU`"' (1)

100 mg PO once daily (50 mg if CrCl 30-44; 25 mg if <30 or dialysis) (1) · 15 mg PO at bedtime, titrate to 30-45 mg/day after 1-2 weeks. '''Counterintuitive dose paradox''': lower doses (7.5-15 mg) are more sedating than higher doses because H1 antihistamine effect dominates at low dose (1) · 5 mg PO once daily (no renal dose adjustment, unlike sitagliptin) (1) · Depression: 25-75 mg/day to start, titrate to 75-150 mg/day at bedtime. Insomnia (Silenor): 3 mg PO 30 minutes before bedtime, max 6 mg. Topical (Prudoxin): apply to affected area every 3-4 hours (1) · Replacement oxide 400-800 mg/d in divided doses (high diarrhea rate); citrate 200-400 mg/d (better tolerated, better absorbed); IV sulfate 1-2 g over 5-60 minutes for hypomagnesemia or torsades; eclampsia 4-6 g IV loading then 1-2 g/h (1)

25, 50, 100 mg tablets; combination tablets with metformin (1) · 5 mg tablets; combination with metformin (1) · Capsules 10, 25, 50, 75, 100, 150 mg; oral concentrate 10 mg/mL; Silenor tablets 3, 6 mg; topical cream 5% (Prudoxin, Zonalon) (1) · Oxide 400, 500 mg tablets (240, 300 mg elemental); citrate 100, 150, 200 mg tablets; hydroxide oral suspension 400 mg/5 mL; sulfate IV 500 mg/mL ampules (1) · Tablets 7.5, 15, 30, 45 mg; orally disintegrating tablets (SolTab) 15, 30, 45 mg (1)

100 mg/d (1) · 300 mg/day (depression, hospitalized); 150 mg/day outpatient; 6 mg/day for insomnia (1) · 45 mg/day (1) · 5 mg/d (1) · Indication-specific; renal clearance limits tolerable cumulative dosing (1)

IV (1) · Oral (5) · topical (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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24 hours (2) · 24 hours (HS dosing) (2) · Variable (1)

20-40 hours'"`UNIQ--ref-00000023-QINU`"' (1) · Not meaningfully described (electrolyte; renally cleared) (1) · ~12 hours (effective); terminal much longer'"`UNIQ--ref-0000117C-QINU`"' (1) · ~12.4 hours'"`UNIQ--ref-00000765-QINU`"' (1) · ~15 hours (parent); nordoxepin active metabolite ~30 hours'"`UNIQ--ref-00000020-QINU`"' (1)

Highly salt-dependent: citrate ~25-30%; oxide ~4% (limited and causes osmotic diarrhea); chloride ~12% (1) · ~30% (oral)'"`UNIQ--ref-00000021-QINU`"' (1) · ~30% (oral)'"`UNIQ--ref-0000117D-QINU`"' (1) · ~50% (oral; substantial first-pass)'"`UNIQ--ref-00000024-QINU`"' (1) · ~87% (oral)'"`UNIQ--ref-00000766-QINU`"' (1)

IV sulfate is the cornerstone of eclampsia/preeclampsia management; oral replacement also safe.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data; switch to insulin where feasible.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (2) · Limited human data; some observational signals reassuring relative to other antidepressants.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · TCA class signal; limited human data specific to doxepin.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

OTC (oral salts) and [[USLegal:Prescription only|Rx-only]] (IV) in US (1) · [[USLegal:Prescription only|Rx-only]] in US (2) · [[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000022-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000025-QINU`"' (1)