Comparative Pharmacology
Head-to-head clinical analysis: AUVELITY versus TIAMATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AUVELITY versus TIAMATE.
AUVELITY vs TIAMATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
AUVELITY (dextromethorphan HBr and bupropion HCl) is an NMDA receptor antagonist (via dextromethorphan) and a norepinephrine-dopamine reuptake inhibitor (via bupropion). Dextromethorphan also modulates sigma-1 receptor activity.
Tiamate is a combination of tiamulin (a pleuromutilin antibiotic) and valnemulin (a pleuromutilin antibiotic). Tiamulin inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, specifically at the peptidyl transferase center, preventing peptide bond formation. Valnemulin similarly binds to the 50S subunit and inhibits protein synthesis.
45 mg orally once daily, given as dextromethorphan hydrobromide 45 mg and bupropion hydrochloride 105 mg combination tablet.
250 mg orally twice daily
None Documented
None Documented
Dextromethorphan: 13.5 hours (terminal half-life; prolonged due to CYP2D6 inhibition by bupropion, allowing sustained NMDA antagonism; bupropion: 13.7 hours)
Terminal half-life 2–4 hours; dose adjustment needed in renal impairment (CrCl <30 mL/min)
Renal 81% (dextromethorphan and metabolites: 78% as unchanged drug and 3% as dextrorphan conjugates), fecal 9% (dextromethorphan and metabolites), biliary <1%
Primarily renal (70–80% as unchanged drug); biliary/fecal (20–30%)
Category C
Category C
Antidepressant
Antidepressant