Drilldown: Medicines

Atorvastatin (1) · Pravastatin (1) · Primidone (1)

Lipitor (1) · Mysoline (1) · Pravachol (1)

[[:Category:Anticonvulsants|Anticonvulsant]] (1) · [[:Category:Barbiturates|Barbiturate (parent compound)]] (1) · [[:Category:Lipid-lowering_agents|Lipid-lowering agent]] (2) · [[:Category:Statins|Statin]] (2) · [[:Category:Tremor medicines|Tremor medicine]] (1)

None (1) · '"`UNIQ--vote-00000013-QINU`"' Strong CYP3A4 induction via the phenobarbital metabolite produces many interactions (reduces oral contraceptives, warfarin, many psychotropics). Essential-tremor efficacy is the unique pharmacological selling point'"`UNIQ--ref-00000014-QINU`"'. (1) · '"`UNIQ--vote-000003D1-QINU`"' SLCO1B1 polymorphism affects exposure but is most clinically actionable for simvastatin'"`UNIQ--ref-000003D2-QINU`"'. (1)

'"`UNIQ--vote-00000015-QINU`"', '"`UNIQ--vote-00000016-QINU`"' (1) · '"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"' (1) · '"`UNIQ--vote-000003D3-QINU`"', '"`UNIQ--vote-000003D4-QINU`"' (1)

10-20 mg PO once daily (1) · 40 mg PO once daily (10-20 mg in elderly, hepatic impairment, or strong drug interactions) (1) · Seizures: 100-125 mg PO at bedtime x 3 days, then BID, then TID, escalating to 750-1500 mg/day. Essential tremor: 25-50 mg PO at bedtime, titrate slowly to 250-750 mg/day (1)

None · 10 mg, 20 mg, 40 mg, 80 mg tablets · 2.5, 5, 10, 20 mg tabs · 5 mg, 10 mg tablets · 5, 10 mg tablets · 5, 10, 20, 40 mg tablets · 0.005% ophthalmic solution (50 mcg/mL); typical 2.5 mL bottle · 0.01%, 0.03% ophthalmic solution · 0.025%, 0.035% ophthalmic solutions · 0.1% (Patanol), 0.2% (Pataday once-daily original), 0.7% (Pataday 24-hour) ophthalmic solutions; 0.6% nasal spray · 0.1%, 0.15% intranasal spray; 0.05% ophthalmic solution; combination Dymista (azelastine 0.137 mg + fluticasone 50 mcg/spray) · 0.1%, 0.15%, 0.2% ophthalmic solutions; 0.33% topical gel; combinations with timolol (Combigan) and brinzolamide (Simbrinza) · 0.225%, 0.45%, 0.9%, 3%, 5% IV solutions; 0.9% nasal spray; 3% and 7% nebulizer solutions; oral tablets (1 g) · 0.25 mg, 0.5 mg, 1 mg, 2 mg tablets (immediate-release and orally disintegrating); 0.5 mg, 1 mg, 2 mg, 3 mg extended-release tablets; 1 mg/mL oral concentrate · 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg tablets · 0.25, 0.5 mcg oral capsules; 1 mcg/mL oral solution; 1 mcg/mL IV; 3 mcg/g topical ointment · 0.35 mg POP tablets; 5 mg tablets (Aygestin); component of COCs and combination HRT · 0.4 mg capsules · 0.4, 0.8, 1 mg OTC; 1 mg Rx; 5 mg/mL injection · 0.5 g, 1 g capsules

Other values:

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2 g/day (seizures); typically much lower for essential tremor (1) · 80 mg/d (2)

Oral (3)

Anticonvulsant effect emerges with slow titration over weeks; tremor effect over weeks (1) · LDL lowering at 2 weeks, max by 4 weeks (1) · LDL lowering at 2 weeks, max by 4 weeks; cardiovascular benefit months to years (1)

24 hours (1) · 24-48 hours per dose (1) · BID-TID dosing (1)

14 hours (parent); 20-30 hours including active ortho- and para-hydroxylated metabolites'"`UNIQ--ref-0000001B-QINU`"' (1) · Primidone 5-15 hours; '''phenobarbital active metabolite 50-150 hours'''; PEMA (phenylethylmalonamide) active metabolite 16 hours'"`UNIQ--ref-00000017-QINU`"' (1) · ~2-3 hours (parent); pharmacodynamic effect 24 hours via target turnover'"`UNIQ--ref-000003D5-QINU`"' (1)

~14% (extensive hepatic first-pass)'"`UNIQ--ref-0000001C-QINU`"' (1) · ~17% (oral; food slightly reduces absorption)'"`UNIQ--ref-000003D6-QINU`"' (1) · ~90% (oral)'"`UNIQ--ref-00000018-QINU`"' (1)

Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021. Use individualized; lactation generally avoided.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Substantial teratogenic signal (barbiturate class effects including neonatal withdrawal and hemorrhagic disease of newborn).<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

[[USLegal:Prescription only|Rx-only]] in US (2) · [[USLegal:Prescription only|Rx-only]] in US. '''Federally non-controlled despite being a barbiturate''', a paradoxical situation given that its primary active metabolite phenobarbital is Schedule IV'"`UNIQ--ref-00000019-QINU`"' (1)