Drilldown: Medicines

Dexamethasone (1) · Methotrexate (1) · Methylprednisolone (1) · Morphine (sulfate) (1) · Triamcinolone (acetonide and other esters) (1)

Decadron (historical), Dexpak (taper pack), Hemady, Ozurdex (intravitreal) (1) · Kenalog (injectable), Nasacort (intranasal), Aristocort (topical), Trianex (1) · Medrol (oral), Solu-Medrol (IV/IM), Depo-Medrol (depot injection) (1) · MS Contin (ER), Kadian (ER), Avinza (ER), Roxanol (IR oral solution), Duramorph (epidural / IT), Astramorph (IV), Infumorph (intrathecal pump), MorphaBond (IR abuse-deterrent) (1) · Trexall, Otrexup, Rasuvo, Xatmep, Rheumatrex (discontinued) (1)

high-potency)]] (1) · [[:Category:Analgesics|Analgesic]] (1) · [[:Category:Antifolates|Antifolate]] (1) · [[:Category:Antineoplastics|Antineoplastic]] (1) · [[:Category:Corticosteroids|Corticosteroid]] (3) · [[:Category:DMARDs|DMARD]] (1) · [[:Category:Glucocorticoids|Glucocorticoid (intermediate-acting)]] (2) · [[:Category:Glucocorticoids|Glucocorticoid (long-acting (1) · [[:Category:Immunosuppressants|Immunosuppressant]] (3) · [[:Category:Opioid analgesics|Opioid analgesic (natural phenanthrene from opium poppy)]] (1) · [[:Category:Schedule II controlled substances|Schedule II controlled substance]] (1)

None (4) · '"`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-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"' (1) · '"`UNIQ--vote-00000661-QINU`"', '"`UNIQ--vote-00000662-QINU`"', '"`UNIQ--vote-00000663-QINU`"', '"`UNIQ--vote-00000664-QINU`"', '"`UNIQ--vote-00000665-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-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)

Indication-specific: 0.5-9 mg PO/IV daily for inflammation; 4 mg IV q6h for cerebral edema; 40 mg PO once weekly in MM; 6 mg PO/IV daily ×10 days for severe COVID-19; 0.6 mg/kg PO single dose for croup (max 16 mg) (1) · IR oral: 15-30 mg every 4 hours as needed. ER opioid-naive: 15-30 mg every 12 hours. IV/IM/SC: 2-10 mg every 3-4 hours. Epidural / intrathecal: see surgical or palliative-care protocols (1) · PO Medrol Dosepak (5-day taper from 24 mg to 4 mg) is the prototypic short-course outpatient regimen; IV pulse 1 g daily for 3-5 days for MS relapse; intra-articular 4-80 mg per joint q1-5 weeks (1) · Rheumatologic: 7.5-15 mg PO or SC '''once weekly''' (not daily — daily dosing is a recognized fatal error); folic acid 1 mg PO daily on non-MTX days; oncology dosing is far higher and indication-specific (1) · Topical 0.025-0.5% cream/ointment BID; intra-articular 5-40 mg per joint q3-6 months; intranasal Nasacort 110 mcg/spray, 2 sprays/nostril daily; oral paste 0.1% to lesion 2-3×/d (1)

0.5, 0.75, 1, 1.5, 2, 4, 6 mg tablets; oral solution; 4, 10, 20, 100 mg/mL IV; intravitreal implant (Ozurdex) (1) · 2, 4, 8, 16, 32 mg oral tablets; 40, 125, 500, 1000 mg IV vials; Depo-Medrol 20, 40, 80 mg/mL IM depot (1) · 2.5 mg tablets; 10-50 mg/mL injection; pre-filled subcutaneous autoinjectors (Otrexup, Rasuvo); 2.5 mg/mL oral solution (Xatmep) (1) · IR tablets 15, 30 mg; oral solution 10 mg/5 mL, 20 mg/mL, 100 mg/5 mL (concentrated); suppositories; ER tablets and capsules in multiple strengths; injectable 0.5-50 mg/mL (1) · Topical creams, ointments, lotions, dental paste (0.025-0.5%); Kenalog 10 mg/mL, 40 mg/mL injection; Nasacort 55 mcg/spray intranasal; oral inhaler discontinued in US (1)

Indication-specific (3) · No fixed ceiling; titrate to clinical effect and tolerability with CDC opioid prescribing guidance constraints on morphine-milligram-equivalent (MME) totals (1) · Rheumatologic ~25 mg/week; oncology indication-specific (1)

None · Oral · IV · Topical · IM · intranasal · rectal · Subcutaneous · Topical ophthalmic · ophthalmic · intramuscular · intravenous · transdermal · vaginal · Subcutaneous (abdomen · sublingual · thigh · inhaled · SC · intra-articular

Other values:

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5-10 minutes (IV); 30 minutes (oral IR); slower for ER and rectal (1) · Hours (1) · IV pulse: hours; PO: hours; intra-articular: days (1) · Rheumatologic effect at 4-8 weeks; ectopic resolution over 2-3 weeks (1) · Topical hours; intra-articular days to weeks (1)

3-5 hours (IR); 8-24 hours (ER); 12-24 hours (epidural / intrathecal) (1) · Biologic 12-36 hours (intermediate-acting); Depo-Medrol depot weeks (1) · Biologic 36-72 hours (long-acting) (1) · Intra-articular 3-6 months (depot effect of acetonide microcrystals) (1) · Once-weekly dosing in rheumatology (1)

3-10 hours (low dose); 8-15 hours (high dose); much longer in third-space accumulation (pleural effusion, ascites)'"`UNIQ--ref-000007C8-QINU`"' (1) · Morphine 2-4 hours; morphine-6-glucuronide active metabolite 2-4 hours (longer with renal impairment)'"`UNIQ--ref-00000020-QINU`"' (1) · Plasma 2-3 hours; biologic ~18-36 hours'"`UNIQ--ref-00000867-QINU`"' (1) · Plasma ~3-4.5 hours; biologic ~36-72 hours'"`UNIQ--ref-00000E2B-QINU`"' (1) · Plasma ~3-5 hours; biologic effect substantially longer (~12-36 hours for intermediate-acting glucocorticoids)'"`UNIQ--ref-00000666-QINU`"' (1)

60-70% PO at low doses; saturable at high doses (parenteral routes preferred above 15-25 mg/week)'"`UNIQ--ref-000007C9-QINU`"' (1) · Topical/intranasal: high local, low systemic; intra-articular: local depot then systemic absorption'"`UNIQ--ref-00000667-QINU`"' (1) · ~25-40% (oral; extensive first-pass)'"`UNIQ--ref-00000021-QINU`"' (1) · ~80% (oral)'"`UNIQ--ref-00000E2C-QINU`"' (1) · ~80-99% (oral)'"`UNIQ--ref-00000868-QINU`"' (1)

'''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) · 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) · Topical/intranasal generally low-risk; intra-articular and high-dose injection: weigh risk individually.<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) · 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)

OTC (lowest-strength topicals) and [[USLegal:Prescription only|Rx-only]] (higher strengths, injectable) in US (1) · [[USLegal:Prescription only|Rx-only]] in US (3) · [[USLegal:Schedule II|Schedule II controlled substance]] in US; WHO essential medicine'"`UNIQ--ref-00000022-QINU`"' (1)