Riluzole
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Systematic (IUPAC) name | |
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6-(trifluoromethoxy)benzothiazol-2-amine
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Clinical data | |
Trade names | Rilutek |
AHFS/Drugs.com | monograph |
MedlinePlus | a696013 |
Licence data | US FDA:link |
Pregnancy category |
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Legal status | |
Routes of administration |
Oral |
Pharmacokinetic data | |
Bioavailability | 60±18%[1] |
Protein binding | 97%[1] |
Metabolism | Hepatic (CYP1A2)[1] |
Biological half-life | 9-15 hours[1] |
Excretion | Urine (90%)[1] |
Identifiers | |
CAS Number | 1744-22-5 ![]() |
ATC code | N07XX02 (WHO) |
PubChem | CID: 5070 |
IUPHAR/BPS | 2326 |
DrugBank | DB00740 ![]() |
ChemSpider | 4892 ![]() |
UNII | 7LJ087RS6F ![]() |
KEGG | D00775 ![]() |
ChEMBL | CHEMBL744 ![]() |
Chemical data | |
Formula | C8H5F3N2OS |
Molecular mass | 234.199 g/mol |
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Riluzole (Rilutek) is a drug used to treat amyotrophic lateral sclerosis and is marketed by Sanofi Pharmaceuticals. It delays the onset of ventilator-dependence or tracheostomy in selected patients and may increase survival by approximately two to three months.[2]
Contents
Medical use
Amyotrophic lateral sclerosis
There has been some evidence to show that higher doses might produce more significant improvements in ALS patients but at almost £6 (US$10) per tablet it is at risk of being prohibitively expensive given the modest benefit to patients. One study in the Netherlands found that riluzole is metabolized differently by males and females, and its levels in plasma are decreased in patients who smoke cigarettes or take omeprazole.[3] A Cochrane Library review states a 9% gain in the probability of surviving one year.[2]
Psychiatric use
A number of recent case studies have indicated that riluzole may have clinical use in mood and anxiety disorders.[4] It has been shown to have antidepressant properties in the treatment of refractory depression[5] and act as an anxiolytic in obsessive-compulsive disorder[6] and in GAD.[7]
Alzheimer's disease
A clinical study on mice has shown Riluzole to compensate for harmful glutamate levels and promote dendritic spine clustering in hippocampal circuits implicated in memory and emotion. Therefore, the drug may act as an effective treatment for age-related memory loss and other forms of cognitive decline.[8] The effect of riluzole on glutamate dysfunction in humans with AD is unknown, however a clinical trial is taking place to investigate this.[9]
Research
A reformulation of riluzole that originated at Yale University and is known by the code name BHV-0223 is under development for the treatment of generalized anxiety disorder and mood disorders now by Biohaven Pharmaceuticals.[10][1]
Adverse effects
Very common (>10% frequency):[11]
- Nausea
- Weakness
- Decreased lung function
Common (1-10% frequency):[12]
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- Headache
- Dizziness
- Drowsiness
- Vomiting
- Abdominal pain
- Increased aminotransferases
Uncommon (0.1-1% frequency):[12]
Rare (<0.1% frequency):[12]
- Neutropenia
- Allergic reaction (including angiooedema, anaphylactoid reaction)
Contraindications
Contraindications for riluzole include: known prior hypersensitivity to riluzole or any of the excipients inside the preparations, liver disease, pregnancy or lactation.[1]
Interactions
CYP1A2 substrates, inhibitors and inducers would probably interact with riluzole, due its dependency on this cytochrome for metabolism.[1]
Overdose
Symptoms of overdose include: neurological and psychiatric symptoms, acute toxic encephalopathy with stupor, coma and methemoglobinemia.[1] Severe methemoglobinemia may be rapidly reversible after treatment with methylene blue.[1]
Mechanism
Riluzole preferentially blocks TTX-sensitive sodium channels, which are associated with damaged neurons.[13][14] Riluzole has also been reported to directly inhibit the kainate and NMDA receptors.[15] However, the action of riluzole on glutamate receptors has been controversial, as no binding of the drug to any known sites has been shown for them.[16][17] In addition, as its antiglutamatergic action is still detectable in the presence of sodium channel blockers, it is also uncertain whether or not it acts via this way. Rather, its ability to stimulate glutamate uptake seems to mediate many of its effects.[18][19] In addition to its role in accelerating glutamate clearance from the synapse, Riluzole may also prevent glutamate release from presynaptic terminals.[20] These effects combined could significantly reduce glutamate signaling and cause indirect antagonism without acting at glutamate receptors themselves.
Synthesis
It can be prepared by the reaction of 4-(trifluoromethoxy)aniline with potassium thiocyanate presumably to form the thiourea in situ; addition of bromine to the reaction mixture probably leads to bromination of the ortho position. Displacement of halogen by sulfun forms the thiazole ring to afford riluzole.
See also
References
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External links
- National Institute for Health and Clinical Excellence (NICE) guidelines for prescription of riluzole in the UK [2]
- Manufacturer's website [3]
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- ↑ Review of the Use of the Glutamate Antagonist Riluzole in Psychiatric Disorders and a Description of Recent Use in Childhood Obsessive-Compulsive Disorder. J Child Adolesc Psychopharmacol. 2010 August; 20(4): 309–315.
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- ↑ L. M. Yagupol'skii, L. Z. Gandel'sman, Zh. Obshch. Khim. 33, 2301 (1963), C.A. 60, 692a (1964).
- ↑ J. Mizoule, EP 50551; idem, U.S. Patent 4,370,338 (1982, 1983 both to Pharmindustrie).
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- Benzothiazoles
- Organofluorides
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