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Drilldown: Medicines

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Medicines > routes : IM or Subcutaneous (abdomen or subcutaneous

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brand:
classes:
[[:Category:Corticosteroids|Corticosteroid]] (5) · [[:Category:Immunosuppressants|Immunosuppressant]] (5) · [[:Category:Antiemetics|Antiemetic]] (4) · [[:Category:Insulins|Insulin]] (3) · Anti-CGRP ligand monoclonal antibody (2) · high-potency)]] (2) · [[:Category:Analgesics|Analgesic]] (2) · [[:Category:Antibacterials|Antibacterial]] (2) · [[:Category:B-vitamins|B-vitamin]] (2) · [[:Category:Biologics|Biologic]] (2) · [[:Category:DMARDs|DMARD]] (2) · [[:Category:Glucocorticoids|Glucocorticoid (intermediate-acting)]] (2) · [[:Category:Glucocorticoids|Glucocorticoid (long-acting (2) · [[:Category:Hematinics|Hematinic]] (2) · [[:Category:Loop_diuretics|Loop diuretic]] (2) · [[:Category:Mealtime_insulins|Mealtime (bolus) insulin]] (2) · [[:Category:Rapid-acting_insulins|Rapid-acting insulin analog]] (2) · [[:Category:Vitamins|Vitamin]] (2) · [[GLP-1 receptor agonist]] · [[Antidiabetic medicines|Antidiabetic]] · [[Anti-obesity medicines|Anti-obesity]] · [[Cardiovascular risk reduction]] agent (2)
mechanism:
None (23) · Agonist of the [[GLP-1 receptor]]; exendin-4 derivative from Gila monster venom. (1) · Dual agonist of the [[GIP receptor]] and [[GLP-1 receptor]] ("twincretin"). (1) · Endogenous androgen binding to androgen receptors; mediates male secondary sex characteristics, anabolism, libido, erythropoiesis, and CNS effects on mood/energy/aggression. Aromatized peripherally to estradiol; reduced to DHT. (1) · High-affinity D2 receptor antagonist (1) · Humanized IgG2 monoclonal antibody binding both isoforms of CGRP peptide (1) · Humanized IgG2 monoclonal antibody binding the CGRP receptor (not the peptide); blocks CGRP-mediated vasodilation and nociceptive signaling (1) · Humanized IgG4 monoclonal antibody binding CGRP peptide; prevents CGRP from activating its receptor (1) · Long-acting agonist of the [[GLP-1 receptor]]. (1) · Long-acting agonist of the [[GLP-1 receptor]]; Fc-fusion construct. (1) · Once-daily agonist of the [[GLP-1 receptor]]. (1) · '"`UNIQ--vote-0000001D-QINU`"' Major Beers-list concern in elderly patients for cognitive and fall risks. CYP2D6 substrate. At massive overdose, also produces sodium channel blockade with cardiac toxicity'"`UNIQ--ref-0000001E-QINU`"'. '"`UNIQ--effect-0000001F-QINU`"' (1) · '"`UNIQ--vote-00000584-QINU`"' Binds the same insulin receptor as endogenous insulin with comparable mitogenic-to-metabolic ratio. Ultra-rapid formulations (Lyumjev) add treprostinil and citrate to accelerate absorption further'"`UNIQ--ref-00000585-QINU`"'. (1) · '"`UNIQ--vote-00000860-QINU`"' Activates the glucocorticoid receptor to broadly remodel inflammatory, immune, and metabolic transcription. Unlike prednisone, it does not require hepatic activation, making it the preferred oral choice in severe hepatic dysfunction'"`UNIQ--ref-00000861-QINU`"'. (1) · '"`UNIQ--vote-000008BE-QINU`"' Preferred over prednisone in advanced hepatic dysfunction where hepatic 11β-HSD1 activation is impaired. Liquid formulations are the workhorse pediatric oral corticosteroid for asthma and croup'"`UNIQ--ref-000008BF-QINU`"'. (1) · '"`UNIQ--vote-00000E4A-QINU`"' The narrow safe-bolus window for IV use (sharp risk of arrhythmia, hypertensive emergency, intracerebral hemorrhage) is why anaphylaxis dosing is '''IM, not IV''', outside critical care'"`UNIQ--ref-00000E4B-QINU`"'. (1) · '"`UNIQ--vote-00001014-QINU`"' Activates the glucocorticoid receptor to broadly remodel inflammatory, immune, and metabolic transcription. The dipropionate, valerate, and augmented dipropionate ester forms determine topical potency (high to super-high)'"`UNIQ--ref-00001015-QINU`"'. (1) · '"`UNIQ--vote-000010F8-QINU`"' Pre-treatment screening for latent TB (PPD or IGRA) and chronic hepatitis B is standard. Anti-drug antibody formation is a recognized cause of secondary loss of response'"`UNIQ--ref-000010F9-QINU`"'. (1)
uses:
None (1) · Preventive treatment of migraine in adults (episodic and chronic) (2) · Preventive treatment of migraine in adults; episodic cluster headache (1) · Schizophrenia, acute psychosis, agitation, delirium, Tourette syndrome, severe nausea (1) · [[Type 2 diabetes mellitus]] (adjunct, second-line) (1) · [[Type 2 diabetes mellitus]] (incl. pediatric ≥10 y) · [[Obesity]] (incl. pediatric ≥12 y) · [[Cardiovascular risk reduction]] in T2DM (1) · [[Type 2 diabetes mellitus]] · [[Cardiovascular risk reduction]] in T2DM (1) · [[Type 2 diabetes mellitus]] · [[Obesity]] · [[Cardiovascular risk reduction]] in obesity without diabetes · [[MASH]] with stage 2–3 fibrosis · [[Chronic kidney disease]] in T2DM (1) · [[Type 2 diabetes mellitus]] · [[Obesity]] · [[Obstructive sleep apnea]] in obesity (1) · '"`UNIQ--vote-00000013-QINU`"', '"`UNIQ--vote-00000014-QINU`"' (1) · '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"' (2) · '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"' (1) · '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"' (1) · '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"' (1) · '"`UNIQ--vote-00000063-QINU`"', '"`UNIQ--vote-00000064-QINU`"' (1) · '"`UNIQ--vote-0000021C-QINU`"', '"`UNIQ--vote-0000021D-QINU`"', '"`UNIQ--vote-0000021E-QINU`"', '"`UNIQ--vote-0000021F-QINU`"', '"`UNIQ--vote-00000220-QINU`"', '"`UNIQ--vote-00000221-QINU`"' (1) · '"`UNIQ--vote-00000374-QINU`"', '"`UNIQ--vote-00000375-QINU`"', '"`UNIQ--vote-00000376-QINU`"', '"`UNIQ--vote-00000377-QINU`"' (1) · '"`UNIQ--vote-00000586-QINU`"', '"`UNIQ--vote-00000587-QINU`"', '"`UNIQ--vote-00000588-QINU`"' (1) · '"`UNIQ--vote-000005B3-QINU`"', '"`UNIQ--vote-000005B4-QINU`"', '"`UNIQ--vote-000005B5-QINU`"', '"`UNIQ--vote-000005B6-QINU`"' (1) · '"`UNIQ--vote-000005EF-QINU`"', '"`UNIQ--vote-000005F0-QINU`"', '"`UNIQ--vote-000005F1-QINU`"' (1) · '"`UNIQ--vote-00000607-QINU`"', '"`UNIQ--vote-00000608-QINU`"', '"`UNIQ--vote-00000609-QINU`"', '"`UNIQ--vote-0000060A-QINU`"' (1) · '"`UNIQ--vote-00000683-QINU`"', '"`UNIQ--vote-00000684-QINU`"', '"`UNIQ--vote-00000685-QINU`"', '"`UNIQ--vote-00000686-QINU`"' (1) · '"`UNIQ--vote-00000758-QINU`"', '"`UNIQ--vote-00000759-QINU`"', '"`UNIQ--vote-0000075A-QINU`"' (1) · '"`UNIQ--vote-000007C1-QINU`"', '"`UNIQ--vote-000007C2-QINU`"', '"`UNIQ--vote-000007C3-QINU`"', '"`UNIQ--vote-000007C4-QINU`"', '"`UNIQ--vote-000007C5-QINU`"', '"`UNIQ--vote-000007C6-QINU`"', '"`UNIQ--vote-000007C7-QINU`"' (1) · '"`UNIQ--vote-00000862-QINU`"', '"`UNIQ--vote-00000863-QINU`"', '"`UNIQ--vote-00000864-QINU`"', '"`UNIQ--vote-00000865-QINU`"', '"`UNIQ--vote-00000866-QINU`"' (1) · '"`UNIQ--vote-000008C0-QINU`"', '"`UNIQ--vote-000008C1-QINU`"', '"`UNIQ--vote-000008C2-QINU`"', '"`UNIQ--vote-000008C3-QINU`"' (1) · '"`UNIQ--vote-00000ACD-QINU`"', '"`UNIQ--vote-00000ACE-QINU`"', '"`UNIQ--vote-00000ACF-QINU`"', '"`UNIQ--vote-00000AD0-QINU`"' (1) · '"`UNIQ--vote-00000DDF-QINU`"', '"`UNIQ--vote-00000DE0-QINU`"', '"`UNIQ--vote-00000DE1-QINU`"', '"`UNIQ--vote-00000DE2-QINU`"' (1) · '"`UNIQ--vote-00000E23-QINU`"', '"`UNIQ--vote-00000E24-QINU`"', '"`UNIQ--vote-00000E25-QINU`"', '"`UNIQ--vote-00000E26-QINU`"', '"`UNIQ--vote-00000E27-QINU`"', '"`UNIQ--vote-00000E28-QINU`"', '"`UNIQ--vote-00000E29-QINU`"', '"`UNIQ--vote-00000E2A-QINU`"' (1) · '"`UNIQ--vote-00000E4C-QINU`"', '"`UNIQ--vote-00000E4D-QINU`"', '"`UNIQ--vote-00000E4E-QINU`"', '"`UNIQ--vote-00000E4F-QINU`"', '"`UNIQ--vote-00000E50-QINU`"', '"`UNIQ--vote-00000E51-QINU`"' (1) · '"`UNIQ--vote-00000EF4-QINU`"', '"`UNIQ--vote-00000EF5-QINU`"', '"`UNIQ--vote-00000EF6-QINU`"', '"`UNIQ--vote-00000EF7-QINU`"', '"`UNIQ--vote-00000EF8-QINU`"' (1) · '"`UNIQ--vote-00000F1B-QINU`"', '"`UNIQ--vote-00000F1C-QINU`"', '"`UNIQ--vote-00000F1D-QINU`"', '"`UNIQ--vote-00000F1E-QINU`"', '"`UNIQ--vote-00000F1F-QINU`"' (1) · '"`UNIQ--vote-00000FF3-QINU`"', '"`UNIQ--vote-00000FF4-QINU`"', '"`UNIQ--vote-00000FF5-QINU`"', '"`UNIQ--vote-00000FF6-QINU`"', '"`UNIQ--vote-00000FF7-QINU`"', '"`UNIQ--vote-00000FF8-QINU`"' (1) · '"`UNIQ--vote-00001016-QINU`"', '"`UNIQ--vote-00001017-QINU`"', '"`UNIQ--vote-00001018-QINU`"', '"`UNIQ--vote-00001019-QINU`"' (1) · '"`UNIQ--vote-000010AF-QINU`"', '"`UNIQ--vote-000010B0-QINU`"', '"`UNIQ--vote-000010B1-QINU`"', '"`UNIQ--vote-000010B2-QINU`"' (1) · '"`UNIQ--vote-00001372-QINU`"', '"`UNIQ--vote-00001373-QINU`"' (1) · '"`UNIQ--vote-0000143C-QINU`"', '"`UNIQ--vote-0000143D-QINU`"', '"`UNIQ--vote-0000143E-QINU`"', '"`UNIQ--vote-0000143F-QINU`"', '"`UNIQ--vote-00001440-QINU`"', '"`UNIQ--vote-00001441-QINU`"' (1) · '"`UNIQ--vote-0000147C-QINU`"', '"`UNIQ--vote-0000147D-QINU`"', '"`UNIQ--vote-0000147E-QINU`"' (1)
starting dose:
preparations:
fda max:
None (1) · 1 g/d (oral); 6 g/d (IV) (1) · 1 mg/d typical Rx; higher in specific indications (1) · 1.8 mg/day SC (Victoza, T2DM)'"`UNIQ--ref-00000185-QINU`"' · 3.0 mg/day SC (Saxenda, obesity)'"`UNIQ--ref-00000186-QINU`"' (1) · 10 µg twice daily (Byetta)'"`UNIQ--ref-000000E7-QINU`"' · 2 mg once weekly (Bydureon BCise)'"`UNIQ--ref-000000E8-QINU`"' (1) · 100 mg/day (adult) (1) · 120 mg/day (IV/IM); 40 mg/day (oral); '''5-day maximum total combined therapy''' to mitigate the GI bleeding, AKI, and platelet dysfunction risks (1) · 140 mg/month (1) · 15 mg/wk SC'"`UNIQ--ref-000002FE-QINU`"''"`UNIQ--ref-000002FF-QINU`"' (1) · 2 mg/wk SC (Ozempic)'"`UNIQ--ref-0000024B-QINU`"' · 2.4 mg/wk SC (Wegovy)'"`UNIQ--ref-0000024C-QINU`"' · 14 mg PO daily (Rybelsus)'"`UNIQ--ref-0000024D-QINU`"' (1) · 200 mg/day (oral); 12 mg/day (SC); 40 mg/day (nasal spray); 44 mg/day (Onzetra) (1) · 240 mg loading + 120 mg/month for migraine; 300 mg/month for cluster (1) · 300 mg/d typical practical limit (toxicity rises sharply above) (1) · 300 mg/day (oral) (1) · 4.5 mg/wk SC'"`UNIQ--ref-00000055-QINU`"' (1) · 4.8 g/d (IV severe infection) (1) · 40 mg every week (selected indications); otherwise 40 mg every other week (1) · 40 mg/d (1) · 40 mg/day (oral, anxiety) (1) · 420 mg/month (1) · 600 mg/d typical practical ceiling in heart failure (1) · 675 mg/quarter (1) · Formulation-dependent (1) · Indication-specific (6) · Indication-specific; ACLS no fixed cumulative ceiling (1) · IV: monitored by levels (trough <1 mg/L for extended-interval; <2 mg/L for traditional) (1) · N/A (no current medical indication) (1) · No fixed ceiling; titrate to clinical effect and tolerability with CDC opioid prescribing guidance constraints on morphine-milligram-equivalent (MME) totals (1) · No strict ceiling; water-soluble vitamin, low toxicity (1) · Rheumatologic ~25 mg/week; oncology indication-specific (1) · Single doses ≤16 mg (FDA 2012 advisory withdrew the 32 mg single IV dose for QT-prolongation risk); 24-32 mg/d divided (1) · Titrated to glucose (1) · Titrated to glucose; no fixed maximum (2) · ~10 mg/d typical (1)
routes: (Click arrow to add another value)
onset:
1-2 hours (1) · 10 minutes (SC); 15-30 minutes (nasal); 30-60 minutes (oral) (1) · 15-30 minutes (oral); 1-2 minutes (IV) (1) · 15-60 minutes (oral); 1-5 minutes (IV); 4-10 minutes (rectal or intranasal) (1) · 20 minutes (oral); 5 minutes (IV) (1) · 30 minutes (IM); 30-60 minutes (oral) (1) · 30 minutes PO; minutes IV (1) · 5-10 minutes (IV); 30 minutes (oral IR); slower for ER and rectal (1) · Contraceptive within 24 hours if given in first 5 days of cycle; otherwise backup for 7 days (1) · Glycemic effect within days; full weight effect over months'"`UNIQ--ref-00000301-QINU`"' (1) · Glycemic effect within days; near-maximal HbA1c effect by 4 weeks at any given dose'"`UNIQ--ref-00000057-QINU`"' (1) · Glycemic effect within days; weight effect over weeks to months'"`UNIQ--ref-00000188-QINU`"' (1) · Glycemic effect within days;<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> full weight effect over months'"`UNIQ--ref-00000250-QINU`"' (1) · Glycemic effect within hours (Byetta); weeks (Bydureon, extended-release microsphere)'"`UNIQ--ref-000000EA-QINU`"' (1) · Hematologic response within days (1) · Hours (6) · Hours (systemic); minutes (ophthalmic) (1) · Hours (transdermal); days (IM esters) (1) · IM: 5-10 minutes; IV: seconds; nebulized: 5-10 minutes (1) · IV pulse: hours; PO: hours; intra-articular: days (1) · IV/IM 1-3 minutes; PO 30-60 minutes (1) · IV: 5 minutes; PO: 30-60 minutes (1) · IV: 5-20 minutes; PO: 30-60 minutes (1) · LDL reduction ~50-60% from baseline at 1-2 weeks (1) · Onset of preventive effect over weeks; some patients respond after first dose (1) · Over weeks (2) · PO 1–2 h; IM 30–60 min; IV 5–20 min (1) · PO 30-60 minutes; IV minutes (1) · Reticulocyte response at 3-5 days; neurologic recovery weeks to months (and may be incomplete if longstanding) (1) · Rheumatologic effect at 4-8 weeks; ectopic resolution over 2-3 weeks (1) · SC: 5-15 minutes (Fiasp 2.5 minutes earlier on average) (1) · SC: 5-15 minutes; ultra-rapid Lyumjev faster (1) · Smoked 2-5 min; insufflated 5-15 min; oral 30-60 min; IV / IM ~5-15 min (1) · Symptomatic effect within weeks; full response by 12-24 weeks (1)
duration:
12–24 h (oral); decanoate IM 3–4 weeks (1) · 2 weeks per dose (1) · 2-4 hours; headache recurrence rate ~20-30% within 24 hours (1) · 2-4 weeks per dose (1) · 3-5 hours (2) · 3-5 hours (IR); 8-24 hours (ER); 12-24 hours (epidural / intrathecal) (1) · 4-12 hours (1) · 4-6 hours (5) · 4-8 hours typical; longer at high doses; residual cognitive and perceptual effects up to 48 hours (1) · 5-15 minutes (1) · 6-12 hours systemic (1) · 6-24 hours (parent); much longer when accounting for the long-lived active metabolites (1) · 6-8 hours (1) · 8-12 hours (1) · Biologic 12-36 hours (intermediate-acting) (1) · Biologic 12-36 hours (intermediate-acting); Depo-Medrol depot weeks (1) · Biologic 36-54 hours (long-acting) (1) · Biologic 36-72 hours (long-acting) (1) · Biologic ~8-12 hours (short-acting) (1) · Depot IM 13 weeks (designed); often persists longer (1) · Hours (nasal); ~24 h (gel/patch); 1–2 weeks (cypionate/enanthate IM); ~10 weeks (undecanoate IM) (1) · IV: 1-4 hours; PO: 3-8 hours (1) · IV: ~2 hours; PO: 6-8 hours (1) · Monthly dosing (2) · Monthly or quarterly dosing (1) · N/A (replacement) (2) · Once-weekly dosing in rheumatology (1) · ~10 hours (Byetta)'"`UNIQ--ref-000000EB-QINU`"' · ~7 days steady-state (Bydureon, after ~6–7 weeks of weekly dosing to reach steady state)'"`UNIQ--ref-000000EC-QINU`"' (1) · ~12-24 hours (dose-dependent; BID dosing often needed at higher doses) (1) · ~24 h (daily dosing)'"`UNIQ--ref-00000189-QINU`"' (1) · ~7 days (weekly dosing)'"`UNIQ--ref-00000058-QINU`"' (1) · ~7 days (weekly dosing)'"`UNIQ--ref-00000302-QINU`"' (1) · ~7 days (weekly SC dosing)'"`UNIQ--ref-00000251-QINU`"' · ~24 h (oral)'"`UNIQ--ref-00000252-QINU`"' (1)
halflife:
bioavailability:
60-70% PO at low doses; saturable at high doses (parenteral routes preferred above 15-25 mg/week)'"`UNIQ--ref-000007C9-QINU`"' (1) · High (oral) (1) · IM/SC ~100%; oral negligible (extensive first-pass and gut metabolism — hence the no-oral route)'"`UNIQ--ref-00000E53-QINU`"' (1) · IV/IM ~100%; inhaled: minimal systemic; oral: negligible (not used orally for systemic infection)'"`UNIQ--ref-000010B4-QINU`"' (1) · Not formally established (1) · Not formally established (high SC) (1) · Oral non-undecanoate has essentially zero bioavailability (hepatic first-pass) (1) · Oral ~1-3% via passive diffusion at high doses (independent of intrinsic factor); IM/SC ~100% (1) · Oral ~70%; depot IM provides sustained release over weeks'"`UNIQ--ref-0000101B-QINU`"' (1) · Oral ~90%; depot IM essentially 100% over the dosing interval'"`UNIQ--ref-00000F21-QINU`"' (1) · SC ~47%–65%'"`UNIQ--ref-0000005A-QINU`"' (1) · SC ~55%'"`UNIQ--ref-0000018B-QINU`"' (1) · SC ~65%–75%<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · SC ~80%<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · SC ~89%<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> · Oral ~0.4–1% (SNAC-enhanced)'"`UNIQ--ref-00000254-QINU`"' (1) · ~100% (oral, but oral use is limited to continuation from parenteral)'"`UNIQ--ref-00000021-QINU`"' (1) · ~100% from subcutaneous depot (2) · ~14% (oral; substantial first-pass); ~97% (subcutaneous); ~17% (nasal)'"`UNIQ--ref-00000016-QINU`"' (1) · ~25% (oral, with extensive first-pass)'"`UNIQ--ref-00000023-QINU`"' (1) · ~25-40% (oral; extensive first-pass)'"`UNIQ--ref-00000021-QINU`"' (1) · ~25-50% (oral; substantial first-pass via NAT2 acetylation, phenotype-dependent)'"`UNIQ--ref-00000688-QINU`"' (1) · ~37% (oral, as axetil prodrug; food modestly improves absorption)'"`UNIQ--ref-00000FFA-QINU`"' (1) · ~40-60% (oral, with significant first-pass)'"`UNIQ--ref-00000027-QINU`"' (1) · ~50% (oral; highly variable, 10-100%, hence the standard 1:2 IV-to-PO conversion)'"`UNIQ--ref-00000223-QINU`"' (1) · ~60% (oral)'"`UNIQ--ref-00000379-QINU`"' (1) · ~60% from subcutaneous depot (reduced by reversible albumin binding via the myristic acid side chain that also extends duration)'"`UNIQ--ref-00001375-QINU`"' (1) · ~60–70% (oral) (1) · ~64% from SC depot'"`UNIQ--ref-00001104-QINU`"' (1) · ~70% (oral)'"`UNIQ--ref-000008C5-QINU`"' (1) · ~72% from SC depot'"`UNIQ--ref-00001480-QINU`"' (1) · ~72% oral; ~85% smoked'"`UNIQ--ref-00000066-QINU`"' (1) · ~80% (oral)'"`UNIQ--ref-00000E2C-QINU`"' (1) · ~80% (oral; reduced by significant first-pass)'"`UNIQ--ref-00000EFA-QINU`"' (1) · ~80-95% (oral; more reliable than furosemide, comparable to torsemide)'"`UNIQ--ref-00000DE4-QINU`"' (1) · ~80-99% (oral)'"`UNIQ--ref-00000868-QINU`"' (1) · ~82% SC (1) · ~90% (oral)'"`UNIQ--ref-00001443-QINU`"' (1) · ~93% (oral); ~90% (rectal)'"`UNIQ--ref-00000027-QINU`"' (1) · ~96% (oral)'"`UNIQ--ref-00000AD2-QINU`"' (1)
pregnancy:
None (5) · '''Contraindicated in pregnancy''' (Category X); abortifacient and teratogenic. Discontinuation 3-6 months before conception is standard.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Aminoglycoside-class ototoxicity in fetal cochlea is documented; use only when alternatives have failed.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning; contraindicated from 30 weeks. Specifically contraindicated in labor and delivery due to inhibition of uterine contractions'"`UNIQ--ref-00000022-QINU`"' (1) · Avoid where possible; can reduce uteroplacental perfusion and produce neonatal electrolyte disturbance. Reserved for compelling indications.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Avoid where possible; class concerns as for other loop diuretics.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Avoid. Discontinue at least 1 month before planned pregnancy. Animal data show embryofetal harm.'"`UNIQ--ref-0000005B-QINU`"' (1) · Avoid. Discontinue before planned pregnancy.'"`UNIQ--ref-000000EF-QINU`"' (1) · Avoid. Discontinue before planned pregnancy.'"`UNIQ--ref-0000018C-QINU`"' (1) · Avoid. Discontinue ≥1 month pre-conception. May reduce oral contraceptive efficacy during titration.'"`UNIQ--ref-00000304-QINU`"' (1) · Category C (1) · Category X, contraindicated; teratogenic (virilization of female fetus) (1) · Chronic third-trimester exposure produces neonatal opioid withdrawal syndrome and respiratory depression at delivery.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Contraindicated in known pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Insulin is the preferred glucose-lowering therapy in pregnancy; aspart is widely used.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Insulin is the preferred glucose-lowering therapy in pregnancy; lispro is widely used.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data.<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; pregnancy registry data have been broadly reassuring relative to baseline malformation rates.<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, including in hyperemesis gravidarum; broadly reassuring observational data'"`UNIQ--ref-00000024-QINU`"' (1) · Older agent with substantial use experience; broadly considered safe in pregnancy'"`UNIQ--ref-00000028-QINU`"' (1) · One of the better-studied basal insulin analogs in pregnancy; reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · One of the historically preferred IV agents for severe hypertension in pregnancy alongside labetalol and nifedipine.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Routinely supplemented in pregnancy and preconception to prevent neural tube defects.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Routinely supplemented in vegan pregnancies and pernicious anemia.<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) · Use when benefits outweigh; small association with oral clefts debated.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Use when benefits outweigh; small association with oral clefts in first trimester debated.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Use when benefits outweigh; widely used at physiologic doses for adrenal insufficiency.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Used in antenatal lung maturation (24-34 weeks gestation; 6 mg IM q12h × 4 doses); broader use weighs benefits against fetal HPA suppression.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Used in life-threatening obstetric anaphylaxis without hesitation; benefits clearly outweigh.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Widely used for hyperemesis gravidarum; reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (2) · OTC (low-dose topicals) and [[USLegal:Prescription only|Rx-only]] (other forms) in US (1) · OTC (low-dose) and [[USLegal:Prescription only|Rx-only]] (1 mg, injectable) in US (1) · OTC (low/mid-dose oral) and [[USLegal:Prescription only|Rx-only]] (injection, intranasal) in US (1) · Rx (3) · Rx-only (1) · Rx-only;'"`UNIQ--ref-0000005C-QINU`"' not a controlled substance (1) · Rx-only;'"`UNIQ--ref-000000F0-QINU`"' not a controlled substance (1) · Rx-only;'"`UNIQ--ref-0000018D-QINU`"' not a controlled substance (1) · Rx-only;'"`UNIQ--ref-00000256-QINU`"' not a controlled substance (1) · Rx-only;'"`UNIQ--ref-00000305-QINU`"' not a controlled substance (1) · Schedule III (DEA, US) (1) · [[USLegal:DEA Schedule II|Schedule II]] controlled substance in US (rescheduled from Schedule III in 1978). No accepted medical use. UN Convention on Psychotropic Substances Schedule II internationally.'"`UNIQ--ref-00000067-QINU`"' (1) · [[USLegal:Over-the-counter|OTC]] for most oral and topical formulations; [[USLegal:Prescription only|Rx-only]] for injectable (1) · [[USLegal:Prescription only|Rx-only]] in US (17) · [[USLegal:Prescription only|Rx-only]] in US (some OTC formulations exist) (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' for '''tardive dyskinesia''' (irreversible movement disorder), driving the 12-week chronic-use limit'"`UNIQ--ref-00000EFB-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' for bone mineral density loss with prolonged use (≥2 years; partially reversible after discontinuation)'"`UNIQ--ref-00000F22-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' for Clostridioides difficile colitis (one of the most C. difficile-inducing antibiotic classes)'"`UNIQ--ref-00001444-QINU`"' (1) · [[USLegal:Schedule II|Schedule II controlled substance]] in US; WHO essential medicine'"`UNIQ--ref-00000022-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-00000028-QINU`"' (1)

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