CPJE Drugs & Dosing

calcium carbonate

Tums

calcium carbonate + magnesium

Mylanta supreme

calcium carbonate + simethicone

Maalox Advanced Maximum strength

magnesium hydroxide

milk of magnesia

magnesium hydroxide + aluminum

Gaviscon, Mag- Al

magnesium hydroxide + aluminum + simethicone

Mylanta Classic

sodium bicarb + aspirin + citric acid

Alka seltzer

Famotidine

Pepcid, + ibuprofen (Duexis)

OTC: 10-20 mg 1-2 x daily prn

RX: 20 mg BID

decrease dose when CrCl< 60

Ranitidine

Zantac

Nizatidine

Solution/Suspension formulation

Cimetidine

Tagamet

Dexlansoprazole

Dexilant

RX: 30-60 mg daily

Esomeprazole

Nexium, + naproxen (Vimovo)

OTC: 20 mg daily

RX: 20-40 mg daily

Available IV

Lansoprazole

Prevacid

OTC: 15 mg daily

RX: 15-30 mg daily

Omeprazole

Prilosec, + sodium bicarbonate (Zegerid), + aspirin (Yosprala)

OTC: 20 mg daily

RX: 20-40 mg daily

Pantoprazole

Protonix

RX: 40 mg daily

Available IV

Rabeprazole

Aciphex

RX: 20 mg daily

Metoclopramide

Reglan

10-15 mg QID 30 min before meals and at bedtime

Renal impairment: CrCl <60 mL/min, decrease dose by 50%

Quadruple therapy

bismuth subsalicyclate 300 mg QID

metronidazole 250 - 500 mg QID

tetracycline 500 mg QID

PPI BID

x 10-14 days

Pylera

Bismuth subcitrate potassium, metronidazole, and tetracycline

Alternate quadruple therapy

Amoxicillin 1000 mg BID

Clarithromycin 500 mg BID

Metronidazole 250-500 mg QID

PPI BID

Clarithromycin triple therapy

Amoxicillin 1000 mg BID

Clarithromycin 500 mg BID

PPI BID

misoprostol

cytotec

200 mcg PO QID with food

sucralfate

Carafate

1 g PO QID before meals & bedtime

psyllium

Metamucil

bulk forming agent

calcium polycarbophil

FiberCon

bulk forming agent

Methylcellulose

Citrucel

bulk forming agent

Wheat dextrin

Benefiber

bulk forming agent

Polyethylene Glycol 3350

Miralax, Gavilax, Glycolax

Osmotic

Glycerin

Fleet

Osmotic

Sorbitol

Osmotic

Lactulose

Constulose, Enulose, Generlac, Kristalose

Osmotic

Senna

Ex-Lax, Senokot

Stimulant laxative

Bisacodyl

Dulcolax

Stimulant laxative

Docusate sodium

Colace

Emollient Laxative

Lubiprostone

Amitiza

chloride channel activator, use in women only

Linaclotide

Linzess

Guanylate cyclase-C agonist

Plecanatide

Trulance

Guanylate cyclase-C agonist

Alvimopan

Entereg

Max 15 doses

Peripherally acting mu opioid receptor antagonist (PAMORAs)

bismuth subsalicylate

Pepto Bismol

TD: 524-1050 mg QID with meals and at bedtime

Loperamide

Imodium

4 mg PO after first stool, then 2 mg after each subsequent loose stool

max 16 mg /day

max OTC 8 mg /day

Diphenoxylate/Atropine

Lomotil (C-V)

Max: 20 mg/day

Dicyclomine

Bentyl

20 mg QID

Antispasmotic

Eluxadoline

Viberzi

PAMORAs for IBS- D

Budesonide

Entocort EC, Uceris (rectal)

Steroid for IBD, rectal steroid for UC only

Mesalamine

Asacol, Lialda(ER tablet), Pentasa(ER capsule), Rowasa (Enema)

Aminosalicylate

Sulfasalazine

Azulfidine

Aminosalicylate

Balsalazide

Giazo (tablet), Colazal (capsule)

Aminosalicylate

Azathioprine

Azasan, Imuran

Thiopurine

Mercaptopurine

Purixan

Thiopurine

Scopalamine

Transderm Scop

1 patch behind ear 4 hrs before effect is needed. New patch every 3 days PRN

Dimenhydrinate

Dramamine

50-100 mg Q4-6H

Meclizine

Bonine

25-50 mg PO 1 hr before travel, can repeat Q24H PRN

Citalopram

Celexa

SSRI

20-40 mg/day, max 40 mg

Max dose elderly: 20 mg/day

Escitalopram

Lexapro

SSRI

Max 20 mg/day

Max dose elderly: 10 mg/day

Fluoxetine

Prozac, Sarafem(PMDD), + olanzapine(Symbyax)

SSRI

10-60 mg/day, max 80 mg

Paroxetine

Paxil, Brisdelle

SSRI

IR: 10-60 mg/day

CR: 12.5- 62.5 mg/day

Sertraline

Zoloft (depression & PMDD)

SSRI

50-200 mg/day

preferred in pts with cardiac risk

Vilazodone

Viibryd

Vortioxetine

Trintellix

Venlafaxine

Effexor

SNRI

37.5-375 mg/day, max 375 mg

Duloxetine

Cymbalta

SNRI

40-60 mg/day, max 120 mg

Desvenlafaxine

Pristiq

SNRI

50 mg/day

Amitriptyline

Elavil

TCA (tertiary amine)

depression: 100-300 mg/day QHS

neuropathic pain/ migraine prophylaxis: 10-50 QHS

Doxepin

generic for depression, Silenor for insomnia

TCA (tertiary amine)

Depression: 100-300 mg/day

Insomnia: 6 mg PO QHS

Clomipramine

Anafranil

TCA (tertiary amine)

25 mg QD PO (Max 250 mg/d)

Imipramine

Tofranil

D: 25-50mg/d (up to 100-300mg/d)

TCA (tertiary amine)

Nortriptyline

Pamelor

TCA (secondary amine)

25 mg TID-QID

Desipramine

Norpramin

TCA (secondary amine)

Protriptyline

Vivactil

TCA (secondary amine)

Bupropion

Wellbutrin, Aplenzin, Forfivo, + naltrexone (contrave), Zyban(smoking cessation)

DA/NE reuptake inhibitor

Depression: Max 450 mg/day

smoking: Max 300 mg/day

Isocarboxazid

Marplan

MAOI

Phenelzine

Nardil

MAOI

Tranylcypromine

Parnate

MAOI

Selegiline transdermal patch

Emsam(depression), Zelapar(ODT for PD)

MAOI

Depression: 6 mg patch/day, max 12 mg patch/day

PD:

- capsule, tablet: 5 mg PO BID, w/ bfast and lunch b/c activating

- ODT: 1.25 - 2.5 mg daily

Mirtazapine

Remeron

15-45 mg QHS

Trazodone

Desyrel

Antidepressant

off label for sleep: 50-100 mg QHS

Nefazodone

Serzone

Antidepressant

200-600 mg/day divided BID

Aripiprazole

Abilify

SGA

10-30 mg PO QAM

Clozapine

Clozaril

SGA

300-900 mg/day, 3rd line agent

ANC >1500 to start, stop if ANC < 1000

Lurasidone

Latuda

SGA

40-160 mg/day, take with food >350 kcal

Olanzapine

Zyprexa, + fluoxetine (Symbyax)

SGA

10-20 mg QHS

Paliperidone

Invega

SGA

3-12 mg daily

Quetiapine

Seroquel, Seroquel XR

SGA

400-800 mg/day (25 mg BID)

XR take at night, without food

Risperidone

Risperdal

SGA

2-16 mg/day

Ziprasidone

Geodon

SGA

40-160 mg/day w/ food

Pimavanserin

Atypical antipsychotic used in Parkinson's Disease

High affinity for serotonin 2A receptors/ no dopamine

Asenapine

Saphris

SGA

10-20 mg/day, no food or drink for 10 min after dose

Valbenazine

Ingrezza

Deutetrabenazine

Austedo

Lithium

Lithobid

150-900 mg/day, max 900-1800 mg/day

take with meals

Therapeutic range 0.6-1.2 mEq/L

Methylphenidate IR

Ritalin, Methylin

5 mg BID 30 min before breakfast and lunch, max 60 mg/day

Methylphenidate ER

Aptensio XR, Ritalin LA (capsule, deliver med as %IR and %ER)

Concerta (OROS)

Metadate CD, Relexxii, Ritalin SR (Tablet)

Adhansia XR , Jornay PM (capsule)

Concerta: 18-36 mg QAM

Methylphenidate XR

Cotempla XR (ODT)

QuilliChew ER (chewable tabs)

Quillivant XR (oral suspension)

Methylphenidate transdermal patch

Daytrana

apply 2 hours before desired effect, remove after 9 hours, alternate hip daily

Dexmethylphenidate

Focalin

dextroamphetamine/amphetamine IR, ER

Adderall, Adderall XR, Mydayis

IR : Start 5 mg QAM or BID, max 40 mg/day

ER: start 20 mg QAM

Lisdexamfetamine

Vyvanse

Atomoxetine

Strattera

Non- stimulant (selective norepinephrine reuptake inhibitor)

>70 kg start 40 mg daily, Max 100 mg

<= 70 kg 0.5 mg/kg/d

approved for use in adults and children >= 6 yo

Guanfacine ER

Intuniv (ADHD), Tenex (hypertension)