The Elizabeth Hospice Palliative Reference Cards

MEDICATION KINETICS

Generic Name

T Cmax

Elimination t ½

Generic Name

T Cmax

Elimination t ½

ANTIDEPRESSANTS Amitriptyline EM aka Elavil

ANTICONVULSANTS Carbamazepine aka Tegretol Fosphenytoin (prodrug of phenytoin, (not 1 st order kinetics) aka Cerebyx Gabapentin aka Neurontin

PO IR: 4 hrs PO chew tab: 6 hrs PO suspension: 1.5 hrs

15 hrs (10-50) Metabolite: Nortriptyline

PO: 4 hrs (2-12)

12 hrs (12–17)

Bupropion

21 hrs Metabolites: (20-50)

PO: 2 hrs (3-12)

SC/IM: 30 min IV: immediate

Conversion to

aka Wellbutrin

phenytoin: 15 min Phenytoin: 7–42 hrs

Citalopram aka Celexa

PO: 4 hrs

35 hrs

(at end of infusion)

Desipramine

14.3–24.7 hrs

PO: 2 hrs (1.5–4) PO IR: 1 hr PO Solution: 1 hr PO ER: 4 hrs IV/SC: 1 hr PO: 10 hrs (8-12) SC/IM: 2 hrs (1-3) IV: 30 min IR PO: 1–2 hrs IV: 25 min (20–25)

6 hrs (5–7)

PO: 3–6 hrs

aka Norpramin

(variable 1 st pass)

16.8 hrs (8–25) Metabolites: 51.3 hrs (33.2–80.7) 12.5 hrs (9.2-19.1)

Doxepin Potent H 1 antagonist aka Sinequan Duloxetine aka Cymbalta Escitalopram aka Lexapro

Levetiracetam aka Keppra

7 hrs (6-8)

PO: 1 hrs

PO: 6 hr PO: 5 hr

Phenobarbital

96 hrs (50-120)

30 hrs (27-32)

5 days (4–6) Metabolites: 16 days 12 hrs (8-12) Metabolite: Desipramine

PO: 7–42 hrs

Fluoxetine EM aka Prozac

PO: 7 hrs (6–8)

Phenytoin (not 1 st order kinetics) aka Dilantin

(Polymorphic saturable enzyme)

Imipramine aka Tofranil

PO: 1 hr

Pregabalin aka Lyrica

1.5 hrs (1–1.5)

6 hrs (5–6.5)

Nortriptyline aka Pamelor

PO: 1 hr

40 hrs (20-100)

PO: Valproic acid capsules Depakene  : 2 hrs (1–4) PO: Divalproex tab: 4–8 hrs PO: Divalproex sprinkle capsule: 3.3–4.8 hrs PO: Na valproate solution: 1.2 hrs PR: Diluted valproic acid syrup: 3.1 hrs IV: Depacon  : at end of 1 hr infusion

Paroxetine aka Paxil

PO: 6 hrs (3-10)

21 hrs

24 hrs, Metabolites: 35 hrs (62–104)

Sertraline aka Zoloft

PO: 4 hrs (4–8)

Valproic acid

Trazodone EM aka Desyrel

PO: 1.5 hrs (0.5–2) PO IR: 2 hrs (1–2) PO ER: 5.5 hrs

7 hrs

aka Depakene, Depakote

12 hrs (6–17)

5 hrs Metabolite: 11 hrs

Venlafaxine aka Effexor

aka = also known as IR = Immediate Release ER = Extended Release EM = Essential Medicine as defined by WHO and IAHPC

67 NB: These Reference Cards do not replace careful clinical judgment specific to each patient / family situation. PCIC: Palliative Care Interdisciplinary Curriculum is a collaborative effort of OhioHealth, The Ohio State University Wexner Medical Center, and Nationwide Children’s Hospital in Columbus, Ohio, USA, and other contributors. Permission to reproduce any or all of these PCIC Reference Cards is granted for non-commercial educational purposes only, provided that the attribution statement and copyright are displayed. To reproduce for all other purposes, contact Frank D. Ferris at info@pallmed.us. Copyright © Frank D Ferris 2013-2024. All rights reserved. V14.1, 2024

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