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Research material (132) · Classic Psychedelic (69) · Stimulant (43) · Sedative-Hypnotic (30) · Opioid (29) · Tryptamine (26) · Phenethylamine (25) · Botanical (23) · Benzodiazepine (22) · Anticonvulsant (19) · Dissociative (19) · Antidepressant (17) · Antiparkinsonian (16) · Antipsychotic (16) · Empathogen (16) · Analgesic (15) · Neuroleptic (15) · Cathinone (14) · Plant Medicine (14) · Nootropic (13)

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None (28) · 5-HT2A agonist (27) · GABAA positive allosteric modulator (22) · Monoamine releasing agent (11) · CB1/CB2 agonist (7) · Potent mu-opioid receptor agonist (6) · Sodium channel blocker (6) · Dopamine/norepinephrine reuptake inhibitor (5) · GABAA potentiator; NMDA antagonist (5) · Phenothiazine D2 antagonist (5) · Potent 5-HT2A agonist (5) · 5-HT1B/1D agonist (4) · LSD analogue; 5-HT2A agonist (4) · Mu-opioid receptor agonist (4) · Muscarinic receptor antagonist (4) · Prodrug of LSD; 5-HT2A agonist (4) · Selective norepinephrine reuptake inhibitor (4)

None (394) · (investigational) '"`UNIQ--vote-000000EF-QINU`"', '"`UNIQ--vote-000000F0-QINU`"', '"`UNIQ--vote-000000F1-QINU`"', '"`UNIQ--vote-000000F2-QINU`"', '"`UNIQ--vote-000000F3-QINU`"' (1) · Acute treatment of migraine with or without aura in adults (1) · Major depressive disorder in adults (FDA-approved 2011) (1) · Major depressive disorder in adults (FDA-approved 2013). Notable for evidence of cognitive benefit (processing speed) that distinguishes it from other antidepressants. (1) · Major depressive disorder in adults (FDA-approved August 2022) (1) · No approved medical problem. Encountered as a designer/research benzodiazepine and, increasingly, as an adulterant in illicit opioid supplies. (1) · Pain, cough, disquiet (1) · Preventive treatment of migraine in adults (1) · Preventive treatment of migraine in adults (episodic and chronic) (2) · Preventive treatment of migraine in adults; episodic cluster headache (1) · Schizophrenia (FDA-approved 2015). Acute manic or mixed episodes of bipolar I disorder. Bipolar I depression (FDA-approved 2019). Adjunctive treatment of major depressive disorder (FDA-approved Dec 2022). (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) · Schizophrenia (FDA-approved Dec 2019). Bipolar depression as monotherapy or adjunct to lithium/valproate (FDA-approved Dec 2021). (1) · '"`UNIQ--vote-00000006-QINU`"' (4) · '"`UNIQ--vote-00000008-QINU`"', '"`UNIQ--vote-00000009-QINU`"' (5) · '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-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-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-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"', '"`UNIQ--vote-00000026-QINU`"', '"`UNIQ--vote-00000027-QINU`"', '"`UNIQ--vote-00000028-QINU`"' (1) · '"`UNIQ--vote-0000004B-QINU`"', '"`UNIQ--vote-0000004C-QINU`"', '"`UNIQ--vote-0000004D-QINU`"', '"`UNIQ--vote-0000004E-QINU`"' (1) · '"`UNIQ--vote-0000004C-QINU`"', '"`UNIQ--vote-0000004D-QINU`"', '"`UNIQ--vote-0000004E-QINU`"' (1) · '"`UNIQ--vote-00000065-QINU`"' (1) · '"`UNIQ--vote-000000AD-QINU`"', '"`UNIQ--vote-000000AE-QINU`"' (1) · '"`UNIQ--vote-000003A0-QINU`"', '"`UNIQ--vote-000003A1-QINU`"' (1) · '"`UNIQ--vote-0000069B-QINU`"', '"`UNIQ--vote-0000069C-QINU`"' (1) · '"`UNIQ--vote-00000747-QINU`"', '"`UNIQ--vote-00000748-QINU`"' (1) · '"`UNIQ--vote-0000081E-QINU`"' (1) · '"`UNIQ--vote-00000932-QINU`"', '"`UNIQ--vote-00000933-QINU`"', '"`UNIQ--vote-00000934-QINU`"', '"`UNIQ--vote-00000935-QINU`"', '"`UNIQ--vote-00000936-QINU`"', '"`UNIQ--vote-00000937-QINU`"' (1) · '"`UNIQ--vote-0000129E-QINU`"' (1) · '"`UNIQ--vote-00001567-QINU`"' (1) · '"`UNIQ--vote-0000159D-QINU`"', '"`UNIQ--vote-0000159E-QINU`"' (1)

None (408) · 0.5–1 oz (10–30 g) ground for psychoactive effect; far smaller for culinary use (1) · 1 tablet (dextromethorphan 45 mg / bupropion 105 mg) PO daily × 3 days, then increase to 1 tablet BID (1) · 1-2 capsules (50 mg butalbital / 325 mg acetaminophen / 40 mg caffeine each) PO every 4 hours as needed; maximum 6 capsules/d (1) · 10 mg (one spray) intranasally in one nostril (1) · 10 mg PO once daily × 7 days, then 20 mg × 7 days, then 40 mg as target dose (take with food) (1) · 10 mg PO once daily; may increase to 20 mg as tolerated, or decrease to 5 mg if needed (1) · 100 mg IV every 3 months; may increase to 300 mg IV every 3 months (1) · 12.5 mg PO once or twice daily. Titrate gradually: 25-50 mg/day increments every 1-2 days as tolerated. Target dose 300-450 mg/day in divided doses (BID or TID). Most patients stabilize between 200-600 mg/day. Therapeutic plasma level guide: target trough clozapine ≥350 ng/mL. (1) · 15-37.5 mg PO once daily before breakfast or 1-2 hours after; Lomaira 8 mg TID (1) · 225 mg SC monthly, or 675 mg SC every 3 months (quarterly) (1) · 300 mg PO at bedtime night 1, 300 mg BID day 2, 300 mg TID day 3; titrate to clinical effect, commonly 1800-3600 mg/day divided TID (1) · 40 mg SC every other week (most adult indications); IBD induction 160 mg week 0, 80 mg week 2, then 40 mg every other week (1) · 42 mg PO once daily with food (no titration) (1) · 500-750 mg PO BID; 400 mg IV q8-12h (1) · 70 mg SC monthly; may increase to 140 mg monthly (1) · Allergy: 25 mg PO BID-QID. Nausea/vomiting: 12.5-25 mg PO/IM/IV/PR every 4-6 hours. Motion sickness: 25 mg PO 30-60 minutes before travel. '''Pediatric <2 years: contraindicated''' (1) · Migraine: 240 mg SC loading dose, then 120 mg SC monthly. Cluster: 300 mg SC at onset of cluster period, then monthly during cluster. (1) · Modern clinical-trial standard: 25 mg synthesized psilocybin, single oral dose with psychological support (1) · No medical dose. Active recreational doses reported in the 0.5–1.5 mg range (similar potency to alprazolam). (1) · One cup (~40–60 mg caffeine; about half of brewed coffee) (1) · Schizophrenia / acute mania: 5-10 mg PO once daily, target 10-15 mg/day. Acute agitation IM: 10 mg, may repeat in 2 hours. Relprevv LAI: 150-300 mg every 4 weeks after oral overlap (1) · Schizophrenia/bipolar mania: 10-15 mg PO once daily, target 15-30 mg. MDD adjunct: 2-5 mg/day, target 5-15 mg. Pediatric autism irritability: 2 mg, titrate to 5-15 mg. Maintena LAI: 400 mg IM every 4 weeks after oral overlap (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) · Schizophrenia: 1.5 mg PO daily, increase to 1.5-6 mg as tolerated. Bipolar mania: 1.5 mg, may increase to 3-6 mg. Bipolar depression: 1.5 mg daily for 14 days, then 3 mg. MDD adjunct: 1.5 mg, may increase to 3 mg. (1) · Week 1: 1 tablet (8/90 mg) PO morning; week 2: 1 tablet AM + 1 PM; week 3: 2 AM + 1 PM; week 4 onward: 2 AM + 2 PM (32 mg naltrexone / 360 mg bupropion/d) (1)

Other values:

None (406) · 10 mg per 24 h (1) · 100 mg/day (adult) (1) · 140 mg/month (1) · 2 tablets/day (dextromethorphan 90 mg / bupropion 210 mg) (1) · 20 mg/d (1) · 20 mg/day (oral) (1) · 240 mg loading + 120 mg/month for migraine; 300 mg/month for cluster (1) · 30 mg/day (adult schizophrenia); 15 mg/day (MDD adjunct) (1) · 300 mg/quarter (1) · 32 mg naltrexone / 360 mg bupropion per day (1) · 3600 mg/day; off-label doses higher are common but bioavailability saturates well below this (1) · 37.5 mg/d (1) · 4 mg/d (schizophrenia); 3 mg/d (AD agitation); 3 mg/d (MDD adjunct) (1) · 40 mg every week (selected indications); otherwise 40 mg every other week (1) · 40 mg/d (1) · 400 mg/day.'"`UNIQ--ref-0000006C-QINU`"' (1) · 42 mg/d (1) · 50 mg/day oral; 380 mg/4 weeks IM (Vivitrol); 32 mg + 360 mg naltrexone/bupropion daily (Contrave maximum after titration) (1) · 6 capsules/d (300 mg butalbital, 1950 mg acetaminophen, 240 mg caffeine) (1) · 6 mg/d (psychosis/mania); 3 mg/d (depression adjunct) (1) · 675 mg/quarter (1) · 900 mg/day (split into BID or TID dosing). Clinical practice rarely exceeds 600 mg/day; seizure risk increases substantially above 600 mg/day and requires consideration of prophylactic anticonvulsant.'"`UNIQ--ref-0000004A-QINU`"' (1) · MOUD: typical effective max 24 mg/day sublingual (doses above offer limited additional mu-occupancy due to ceiling). Pain (Belbuca): 900 mcg every 12 hours. (1) · N/A (never approved) (1) · No formal hard ceiling; in MOUD maintenance, doses typically remain at or below 120 mg/day with higher doses reserved for documented under-treatment after careful clinical assessment (1) · Not FDA-approved; clinical-trial protocols use up to 30 mg in adult investigational dosing (1) · ~1500 mg/d (oral); 1200 mg/d (IV) (1)

None (391) · buccal (Belbuca for pain) (1) · IM (2) · inhalation (2) · intramuscular (acute and long-acting) (2) · intramuscular (depot) (1) · Intranasal (1) · intranasal; rectal and IV reported. (1) · Intravenous infusion (1) · IV (2) · IV (with caution) (1) · IV/IM (Buprenex). Oral swallowed: very low bioavailability due to first-pass; not therapeutic. (1) · Oral (30) · Oral (buccal) (1) · Oral (primary) (1) · Oral (with MAOI) (2) · Oral only. No parenteral formulation (a major limitation in acute agitation requiring rapid tranquilization). (1) · otic (1) · rectal (1) · SC (1) · SC depot (Sublocade) (1) · smoked (extracted DMT) (1) · Subcutaneous (4) · sublingual (1) · Sublingual (primary for MOUD) (1) · sublingual; rectal off-label (1) · topical ophthalmic (1) · transdermal (Butrans) (1)

None (404) · 1-2 weeks for neuropathic pain and anxiolytic effect; anticonvulsant effect at therapeutic plasma level (1) · 15–30 min (1) · 20 minutes (oral); 5 minutes (IV) (1) · 20-45 min subjective onset; psilocin formation from psilocybin requires intestinal and hepatic alkaline phosphatase (1) · 30-60 minutes (1) · 4-6 weeks for full antidepressant effect (claimed earlier onset for some patients due to 5HT1A partial agonism) (1) · Antipsychotic effect over weeks (1) · Appetite suppression within hours; weight loss over weeks-months (1) · Effect demonstrated within 24 hours in some patients (1) · Hours (1) · Modest appetite suppression within weeks; weight loss over months (1) · Neuroleptic effect emerges over days to weeks; activation symptoms (akathisia, insomnia) often within days (1) · Onset of preventive effect over weeks; some patients respond after first dose (1) · Oral analgesic effect 30-60 minutes; opioid-withdrawal suppression 30 minutes (oral); IV ~10 minutes (1) · Oral peak plasma 1 hour; therapeutic opioid blockade within hours of first dose. IM Vivitrol: peak plasma 2-3 days; therapeutic blockade through the dosing interval. (1) · Oral peak plasma 2.5 hours. Clinical antipsychotic response typically emerges over weeks with continued titration; full response assessment requires 3-6 months at adequate therapeutic levels. (1) · Over weeks (2) · Pain relief reported within 15 min in trials (1) · Peak plasma concentration in 2-4 hours after oral administration. Clinically perceptible wakefulness-promoting effects typically begin within 1-2 hours of dosing.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) · Sedation from first dose; neuroleptic effect emerges over days to weeks (1) · Significant antidepressant response by week 1 in trials (faster than monoaminergic antidepressants which take 4-6 weeks) (1) · Slow, 2–6 h (1) · Sublingual analgesic effect 30-60 minutes; MOUD craving suppression within hours; Butrans patch steady-state in 3 days. (1) · Symptomatic effect within weeks; full response by 12-24 weeks (1) · Typical antidepressant 4-6 week onset (1) · Weeks for psychosis/depression; AD agitation benefit emerges over weeks (1) · Weeks for psychosis/mood efficacy (1) · ~20–40 min PO; faster sublingual/intranasal. (1)

None (404) · 12 hours (BID dosing required) (1) · 12–24 h or longer (1) · 2 weeks per dose (1) · 24 hours (oral); 2-4 weeks (LAI) (1) · 24 hours (oral); 4-8 weeks (LAI) (1) · 3-month dosing interval (1) · 3–4 h (1) · 4-6 hours (3) · 6–10 h subjective; full pharmacologic effect considerably longer. (1) · 8-12 hours (1) · Analgesic effect 4-8 hours (much shorter than half-life would suggest, due to receptor kinetics); MOUD effect (opioid withdrawal suppression) 24-36 hours per single daily dose (1) · Daily dosing (4) · Daily dosing; active metabolites with very long half-lives (up to 1-3 weeks) (1) · Due to the half-life of 12 hours (wide range), dosing is BID or TID. Once-daily dosing produces higher peak/trough fluctuations and is generally not used except for a single end-of-day dose in stable patients. (1) · Effective duration approximately 12-15 hours at the 200 mg dose, consistent with the elimination half-life. A single morning dose generally sustains wakefulness throughout the day without substantially disrupting nighttime sleep onset when taken early.'"`UNIQ--ref-0000006D-QINU`"' (1) · Monthly dosing (2) · Monthly or quarterly dosing (1) · MOUD: 24-72 hours per sublingual dose (long; permits every-other-day or three-times-weekly dosing in stable patients); Butrans patch: 7 days; Sublocade depot: 28+ days; Buprenex IV/IM: 6-8 hours. (1) · Oral mu-blockade clinically meaningful for 24-72 hours; IM Vivitrol blockade through 4 weeks. (1) · Sustained with twice-daily dosing (1) · TID dosing for IR; once-daily for ER formulations (1) · ~12-14 hours (1) · ~48 h sustained pain freedom in responders (1)

None (408) · 12-15 hours'"`UNIQ--ref-00000022-QINU`"' (1) · 21-54 hours'"`UNIQ--ref-00000026-QINU`"' (1) · 4 hours'"`UNIQ--ref-00000938-QINU`"' (1) · 5-7 hours'"`UNIQ--ref-00000029-QINU`"' (1) · Buprenorphine sublingual: 24-42 hours (long, contributes to extended dosing intervals). Norbuprenorphine (active metabolite, weaker mu-agonist): 24-48 hours.'"`UNIQ--ref-0000004F-QINU`"' (1) · Butalbital ~35 hours (long; cumulative effects with frequent use); acetaminophen 1-3 hours; caffeine 3-7 hours'"`UNIQ--ref-0000159F-QINU`"' (1) · Cariprazine ~2-4 d; major active metabolites desmethyl-cariprazine (DCAR) ~1-3 weeks → 'oral depot' effect with delayed steady-state and reduced effect of missed doses (1) · Dextromethorphan ~22 h (when CYP2D6 inhibited); bupropion ~21 h (1) · Estimated ~12–17 h (some sources cite up to ~21 h); active metabolites prolong effect. (1) · Naltrexone parent ~4 hours (oral); 6-beta-naltrexol (active metabolite) ~13 hours. Vivitrol depot terminal half-life 5-10 days with sustained release from microspheres maintaining blockade for the 4-week dosing interval.'"`UNIQ--ref-0000004F-QINU`"' (1) · Naltrexone ~4 hours (6β-naltrexol metabolite ~13 hours); bupropion ~21 hours'"`UNIQ--ref-00001568-QINU`"' (1) · Psilocin: ~2-3 h; psilocybin itself is a prodrug, dephosphorylated within minutes of absorption (1) · ~14 days'"`UNIQ--ref-00001103-QINU`"' (1) · ~18 hours (terminal) (1) · ~25 hours (1) · ~25 hours'"`UNIQ--ref-0000129F-QINU`"' (1) · ~27 days (2) · ~28 days (1) · ~31 days (1) · ~5 h (caffeine) (1) · ~6.6 h (1) · ~66 hours (1) · ~75 hours (long, accumulates over weeks)'"`UNIQ--ref-00000023-QINU`"' (1) · ~91 hours (1)

None (406) · '''Saturable''' via the LAT-1 amino-acid transporter, producing nonlinear pharmacokinetics: ~60% at 300 mg single dose, falling to ~35% at 1200 mg single dose'"`UNIQ--ref-0000002A-QINU`"' (1) · 100% (IV) (1) · Adequate oral bioavailability (1) · Approximately 50-60% (oral; subject to first-pass metabolism); food does not significantly affect absorption.'"`UNIQ--ref-0000004C-QINU`"' (1) · Butalbital well-absorbed; caffeine ~100%; acetaminophen 85-98%'"`UNIQ--ref-000015A0-QINU`"' (1) · High (oral)'"`UNIQ--ref-000012A0-QINU`"' (1) · Limited but adequate; take with food (1) · Naltrexone ~5% (oral, extensive first-pass to 6β-naltrexol); bupropion ER ~87%'"`UNIQ--ref-00001569-QINU`"' (1) · Not formally characterized for the combination (1) · Not formally characterized in humans. (1) · Not formally established (1) · Not formally established (high SC) (1) · Oral bioavailability is not precisely established in the label but absorption is rapid and essentially complete. Food delays peak plasma concentration by approximately one hour but does not reduce the extent of absorption.'"`UNIQ--ref-0000006F-QINU`"' (1) · Oral bioavailability of psilocin from administered psilocybin approximately 50% (1) · ~25% (oral, with extensive first-pass)'"`UNIQ--ref-00000023-QINU`"' (1) · ~30% (sublingual; the primary therapeutic route); ~10-20% (oral swallowed, low due to first-pass); ~50% (buccal Belbuca); transdermal Butrans bypasses first-pass.'"`UNIQ--ref-00000050-QINU`"' (1) · ~5% intranasal (1) · ~5-40% (oral, highly variable due to extensive first-pass metabolism; mean ~5-10% for parent naltrexone with the majority of pharmacologic effect coming from 6-beta-naltrexol). IM Vivitrol bypasses first-pass entirely.'"`UNIQ--ref-00000050-QINU`"' (1) · ~60% (oral); ~100% (IM)'"`UNIQ--ref-00000027-QINU`"' (1) · ~64% from SC depot'"`UNIQ--ref-00001104-QINU`"' (1) · ~70% (oral; reduced by divalent cations — antacids, iron, calcium, dairy)'"`UNIQ--ref-00000939-QINU`"' (1) · ~70-85% (oral, high relative to other opioids) (1) · ~72% (with food); much lower fasting (~36%) (1) · ~75% (1) · ~82% SC (1) · ~87% (oral)'"`UNIQ--ref-00000024-QINU`"' (1) · ~95% (1)

None (412) · '''Avoid in pregnancy where alternatives exist''' (animal cartilage toxicity; class-wide concern); use only when benefit clearly outweighs.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) · Avoid. Benzodiazepines are associated with neonatal sedation, floppy-infant syndrome, and withdrawal; teratogenic signal weak but non-zero. Designer benzo with no safety data, assume worst-case. (1) · Contraindicated in pregnancy (FDA label).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) · Contraindicated in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) · Generally avoided; barbiturate exposure in late pregnancy can produce neonatal withdrawal and respiratory depression.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) · Limited data (1) · Limited data; avoid (6) · Limited data; National Pregnancy Registry available (1) · Limited data; National Pregnancy Registry for Atypical Antipsychotics (1) · Limited data; weigh benefits/risks (2) · Limited human data; signal for neonatal extrapyramidal symptoms and withdrawal with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) · Limited human data; some signal for cardiac malformations and developmental delay but confounded by maternal disease and polytherapy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) · Not studied in human pregnancy; no approved clinical use in any population (1) · Older agent with substantial use experience, including in hyperemesis gravidarum; broadly reassuring observational data'"`UNIQ--ref-00000024-QINU`"' (1) · Signal for gestational diabetes and metabolic syndrome with maternal exposure; the metabolic load can be substantial during pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1)

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7-Hydroxymitragynine

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