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Luo L, Yin J, Li Z, Zhang W, Yuan Y, Tang Y, Deng Y, Zhu L. Bilateral tonic seizures probably induced by eperisone hydrochloride: a case report. Front Neurol 2023; 14:1240526. [PMID: 37780713 PMCID: PMC10538527 DOI: 10.3389/fneur.2023.1240526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/16/2023] [Indexed: 10/03/2023] Open
Abstract
Eperisone hydrochloride is a central muscle relaxant used to treat osteoporosis. Seizures are rare side effects of eperisone hydrochloride and have been previously reported in the medical literature in overdose situations but not at regular doses. This case report describes a 42-year-old male painter who developed severe bilateral tonic seizures after the initiation of eperisone hydrochloride at regular doses for low back pain. Symptoms gradually eased in the days following the discontinuation of eperisone hydrochloride and antiepileptic treatment, with no recurrence. This rare adverse drug reaction warrants clinical awareness; however, the mechanisms underlying these adverse reactions remain to be clarified.
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Affiliation(s)
- Long Luo
- Department of Neurology, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Jun Yin
- Department of Neurology, Xiangya Hospital, Changsha, Hunan, China
| | - Zhigang Li
- Department of Neurology, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Wei Zhang
- Department of Neurology, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Ying Yuan
- Department of Neurology, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Ying Tang
- Department of Neurology, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Ye Deng
- Department of Neurology, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Ling Zhu
- Department of Neurology, Xiangtan Central Hospital, Xiangtan, Hunan, China
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2
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Byeon JY, Cho CK, Kang P, Kim SH, Jang CG, Lee SY, Lee YJ. Effects of CYP2D6 and CYP2C19 genetic polymorphisms and cigarette smoking on the pharmacokinetics of tolperisone. Arch Pharm Res 2023; 46:713-721. [PMID: 37728834 DOI: 10.1007/s12272-023-01462-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023]
Abstract
Tolperisone, a muscle relaxant used for post-stroke spasticity, is metabolized to its main metabolite by CYP2D6 and to a lesser extent by CYP2C19 and CYP1A2. We investigated the effects of CYP2D6 and CYP2C19 genetic polymorphisms and cigarette smoking on tolperisone pharmacokinetics. A 150 mg oral dose of tolperisone was given to 184 healthy Korean subjects and plasma concentrations of tolperisone were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). A 3.14-fold significant increase in AUC0-∞ was observed in the CYP2D6*10/*10 group compared with the CYP2D6*wt/*wt group, whereas a 3.59-fold increase in AUC0-∞ was observed in CYP2C19PMs compared to CYP2C19EMs. Smokers had a 38.5% decrease in AUC0-∞ when compared to non-smokers. When these effects were combined, CYP2D6*10/*10-CYP2C19PM-Non-smokers had a 25.9-fold increase in AUC0-∞ compared to CYP2D6*wt/*wt-CYP2C19EM-Smokers. Genetic polymorphisms of CYP2D6 and CYP2C19 and cigarette smoking independently and significantly affected tolperisone pharmacokinetics and these effects combined resulted in a much greater impact on tolperisone pharmacokinetics.
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Affiliation(s)
- Ji-Young Byeon
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Chang-Keun Cho
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Pureum Kang
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Se-Hyung Kim
- College of Pharmacy, Dankook University, Cheonan, 31116, Republic of Korea
| | - Choon-Gon Jang
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Seok-Yong Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea.
| | - Yun Jeong Lee
- College of Pharmacy, Dankook University, Cheonan, 31116, Republic of Korea.
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3
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Jiang W, Yang Z, Chen P, Zhao M, Wang Y, Wang J, Li X, Wang M, Hou P. Tolperisone induces UPR-mediated tumor inhibition and synergizes with proteasome inhibitor and immunotherapy by targeting LSD1. Expert Opin Ther Targets 2023; 27:879-895. [PMID: 37704953 DOI: 10.1080/14728222.2023.2259097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 09/11/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Drug repurposing is an attractive strategy for extending the arsenal of oncology therapies. Tolperisone is an old centrally acting muscle relaxant used for treatment of chronic pain conditions. In this study, we investigated the therapeutic effect and mechanism of tolperisone in human cancers and explored the combination strategy with proteasome inhibitor and immunotherapy. RESEARCH DESIGN AND METHODS The antitumor effect of tolperisone was evaluated by measuring half maximal inhibitory concentration, cell death, and cell growth. RNA sequencing, western blotting, molecular docking, enzyme activity assay, and ChIP-qPCR were performed to reveal the underlying mechanism. Xenograft models were used to evaluate the efficacy of tolperisone alone or in combination with proteasome inhibitor or immunotherapy. RESULTS Tolperisone inhibited cell growth and induced cell death in human cancer cell lines. Unfolded protein responses (UPR) pathway was hyperactivated in tolperisone-treated cells. We further identified histone lysine-specific demethylase 1 (LSD1) as a potential target of tolperisone, which directly demethylates UPR-related genes in H3K4me2. Tolperisone synergistically improved the efficacy of MG132 by enhancing UPR and sensitized tumors to immunotherapy by reprogramming M2 macrophages into M1 phenotype. CONCLUSIONS Tolperisone inhibits human cancer by targeting LSD1. Repurposing tolperisone in cancer therapy by a combination strategy implies clinical potential.
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Affiliation(s)
- Wei Jiang
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
| | - Zhiwei Yang
- MOE Key Laboratory for Nonequilibrium Synthesis and Modulation of Condensed Matter, Xi'an Jiaotong University, Xi'an, P.R. China
| | - Pu Chen
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
| | - Man Zhao
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
| | - Yubo Wang
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
| | - Jingyuan Wang
- Department of Clinical Lab Diagnosis, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
| | - Xinru Li
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
| | - Meichen Wang
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
| | - Peng Hou
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
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Cho CK, Byeon JY, Kang P, Park HJ, Ko E, Mu CY, Jang CG, Lee SY, Lee YJ. Effects of CYP2C19 genetic polymorphism on the pharmacokinetics of tolperisone in healthy subjects. Arch Pharm Res 2023; 46:111-116. [PMID: 36564599 DOI: 10.1007/s12272-022-01423-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
Tolperisone hydrochloride is a centrally-acting muscle relaxant used for relieving spasticities of neurological origin and muscle spasms associated with painful locomotor diseases. It is metabolized to the inactive metabolite mainly by CYP2D6 and, to a lesser extent, by CYP2C19 and CYP1A2. In our previous study, the pharmacokinetics of tolperisone was significantly affected by the genetic polymorphism of CYP2D6, but the wide interindividual variation of tolperisone pharmacokinetics was not explained by genetic polymorphism of CYP2D6 alone. Thus, we studied the effects of CYP2C19 genetic polymorphism on tolperisone pharmacokinetics. Eighty-one subjects with different CYP2C19 genotypes received a single oral dose of 150 mg tolperisone with 240 mL of water, and blood samples were collected up to 12 h after dosing. The plasma concentration of tolperisone was measured by a liquid chromatography-tandem mass spectrometry system. The CYP2C19PM group had significantly higher Cmax and lower CL/F values than the CYP2C19EM and CYP2C19IM groups. The AUCinf of the CYP2C19PM group was 2.86-fold and 3.00-fold higher than the CYP2C19EM and CYP2C19IM groups, respectively. In conclusion, the genetic polymorphism of CYP2C19 significantly affected tolperisone pharmacokinetics.
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Affiliation(s)
- Chang-Keun Cho
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Ji-Young Byeon
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Pureum Kang
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Hye-Jung Park
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Eunvin Ko
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Chou Yen Mu
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Choon-Gon Jang
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Seok-Yong Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea.
| | - Yun Jeong Lee
- College of Pharmacy, Dankook University, Cheonan, 31116, Republic of Korea
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5
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Cho CK, Byeon JY, Kang P, Park JI, Jang CG, Lee SY, Choi CI, Bae JW, Lee YJ. Effects of CYP2D6*10 allele on the pharmacokinetics of tolperisone. Arch Pharm Res 2023; 46:59-64. [PMID: 36542291 DOI: 10.1007/s12272-022-01422-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Tolperisone, a muscle relaxant used for post-stroke spasticity, has been reported to have a very wide interindividual pharmacokinetic variability. It is metabolized mainly by CYP2D6 and, to a lesser extent, by CYP2C19 and CYP1A2. CYP2D6 is a highly polymorphic enzyme, and CYP2D6*wt/*wt, CYP2D6*wt/*10 and CYP2D6*10/*10 genotypes constitute more than 90% of the CYP2D6 genotypes in the Korean population. Thus, effects of the CYP2D6*10 on tolperisone pharmacokinetics were investigated in this study to elucidate the reasons for the wide interindividual variability. Oral tolperisone 150 mg was given to sixty-four healthy Koreans, and plasma concentrations of tolperisone were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The CYP2D6*10/*10 and CYP2D6*wt/*10 groups had significantly higher Cmax and lower CL/F values than the CYP2D6*wt/*wt group. The AUCinf of CYP2D6*10/*10 and CYP2D6*wt/*10 groups were 5.18-fold and 2.25-fold higher than the CYP2D6*wt/*wt group, respectively. There were considerable variations in the Cmax and AUC values within each genotype group, and the variations were greater as the activity of CYP2D6 decreased. These results suggest that the genetic polymorphism of CYP2D6 significantly affected tolperisone pharmacokinetics and factor(s) other than CYP2D6 may also have significant effects on the pharmacokinetics of tolperisone.
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Affiliation(s)
- Chang-Keun Cho
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Ji-Young Byeon
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Pureum Kang
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Jung-In Park
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Choon-Gon Jang
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Seok-Yong Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea.
| | - Chang-Ik Choi
- College of Pharmacy, Dongguk University-Seoul, Goyang, 10326, Republic of Korea
| | - Jung-Woo Bae
- College of Pharmacy, Keimyung University, Daegu, 42601, Republic of Korea
| | - Yun Jeong Lee
- College of Pharmacy, Dankook University, Cheonan, 31116, Republic of Korea.
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Jain M, Garg SJ, Khan M, Chaudhary V, Zeraatkar D, Kurian D, Lal S. The associations between central serous chorioretinopathy and muscle relaxants: A case-control study. Taiwan J Ophthalmol 2022; 12:415-422. [PMID: 36660119 PMCID: PMC9843563 DOI: 10.4103/2211-5056.361975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/09/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To evaluate the role of muscle-relaxants as risk factors for the development of central serous chorioretinopathy (CSC) - the second most common retinopathy in our settings; despite multiple risk factors seen in our patients, 21% were initially labelled as idiopathic. MATERIALS AND METHODS Retrospective case-control study at a tertiary hospital in the United Arab Emirates, where we reviewed the medical records of 273 patients with CSC examined between 2010 and 2019 for use of muscle-relaxants including tolperisone/eperisone, carisoprodol and gabapentin/pregabalin within a year of onset/recurrence of the disease. Intake of drugs with known association with CSC (including corticosteroids/sympathomimetics) was also recorded. Two hundred eighty-six subjects with adverse events seen at the same institute during the same study period served as controls. Odds ratios, Chi-Square tests and multivariate logistic regression were carried out to determine any associations with the muscle-relaxants and other pharmacological confounders - corticosteroids/sympathomimetics. RESULTS Muscle relaxants may increase the risk of CSC as evident on multivariate regression analysis (OR: 2.55; confidence interval [CI]: 1.208-5.413); the significance was retained on removing the 6 subjects who had corticosteroids/sympathomimetics (OR: 2.30; CI: 1.073-4.939). Univariate analysis yielded an OR of 2.52 for muscle relaxants (CI: 1.2149-5.2276), 2.96 for eperisone/tolperisone (CI: 1.3531-6.5038), and 6.26 for eperisone as an individual agent (CI: 1.8146-21.6252). CONCLUSION We found muscle relaxants to be associated factors of CSC regardless of inclusion of corticosteroids/sympathomimetics (P < 0.05). Among individual classes of muscle relaxants in this study, only eperisone/tolperisone posed a significant risk (P < 0.05). The vascular smooth muscle relaxation could be the possible mechanism that affects the choroidal blood flow and indirectly predisposes to CSC.
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Affiliation(s)
- Manish Jain
- Department of Ophthalmology, Veer Chandra Singh Garhwali, Government Institute of Medical Sciences and Research, Srinagar, Uttarakhand, India,Department of Ophthalmology, NMC Hospital, Al Ain, United Arab Emirates,Address for correspondence: Dr. Manish Jain, Department of Ophthalmology, Veer Chandra Singh Garhwali, Government Institute of Medical Sciences and Research, Srinagar - 246 174, Uttarakhand, India. E-mail:
| | - Sunir J. Garg
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mohammad Khan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada
| | - Varun Chaudhary
- Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, Ontario, Canada
| | - Dena Zeraatkar
- Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Dhanya Kurian
- Department of Ophthalmology, NMC Hospital, Al Ain, United Arab Emirates
| | - Sarath Lal
- Department of Ophthalmology, NMC Hospital, Al Ain, United Arab Emirates
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Vaughan SA, Torres K, Kaye R. RESUME-1: a Phase III study of tolperisone in the treatment of painful, acute muscle spasms of the back. Pain Manag 2021; 12:25-33. [PMID: 34192885 DOI: 10.2217/pmt-2021-0041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Tolperisone is a nonopioid, centrally acting muscle relaxant in clinical development in the USA for the treatment of symptoms associated with acute, painful muscles spasms of the back. CLN-301, RESUME-1, is a 14-day double-blind, randomized, placebo-controlled, parallel-group Phase III study of the efficacy and safety of tolperisone administered orally three-times daily in 1000 male and female subjects at approximately 70 clinical sites in the USA experiencing back pain due to or associated with muscle spasm of acute onset. Tolperisone is a promising therapeutic for managing acute, painful muscle spasms of the back as it appears to lack the off-target CNS effects often seen with conventional skeletal muscle relaxants. Clinical Trials Registration: NCT04671082.
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Affiliation(s)
| | - Kayla Torres
- Neurana Pharmaceuticals, Inc., San Diego, CA 92122, USA
| | - Randall Kaye
- Neurana Pharmaceuticals, Inc., San Diego, CA 92122, USA
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Debieu S, Solier S, Colombeau L, Versini A, Sindikubwabo F, Forrester A, Müller S, Cañeque T, Rodriguez R. Small Molecule Regulators of Ferroptosis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1301:81-121. [PMID: 34370289 DOI: 10.1007/978-3-030-62026-4_6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Ferroptosis is a dedicated mode of cell death involving iron, reactive oxygen species and lipid peroxidation. Involved in processes such as glutathione metabolism, lysosomal iron retention or interference with lipid metabolism, leading either to activation or inhibition of ferroptosis. Given the implications of ferroptosis in diseases such as cancer, aging, Alzheimer and infectious diseases, new molecular mechanisms underlying ferroptosis and small molecules regulators that target those mechanisms have prompted a great deal of interest. Here, we discuss the current scenario of small molecules modulating ferroptosis and critically assess what is known about their mechanisms of action.
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Affiliation(s)
- Sylvain Debieu
- Institut Curie, 26 rue d'Ulm, 75248 Paris Cedex 05, France
- PSL Université Paris, Paris, France
- Chemical Biology of Cancer Laboratory, CNRS UMR 3666, INSERM U1143, Paris, France
| | - Stéphanie Solier
- Institut Curie, 26 rue d'Ulm, 75248 Paris Cedex 05, France
- PSL Université Paris, Paris, France
- Chemical Biology of Cancer Laboratory, CNRS UMR 3666, INSERM U1143, Paris, France
| | - Ludovic Colombeau
- Institut Curie, 26 rue d'Ulm, 75248 Paris Cedex 05, France
- PSL Université Paris, Paris, France
- Chemical Biology of Cancer Laboratory, CNRS UMR 3666, INSERM U1143, Paris, France
| | - Antoine Versini
- Institut Curie, 26 rue d'Ulm, 75248 Paris Cedex 05, France
- PSL Université Paris, Paris, France
- Chemical Biology of Cancer Laboratory, CNRS UMR 3666, INSERM U1143, Paris, France
| | - Fabien Sindikubwabo
- Institut Curie, 26 rue d'Ulm, 75248 Paris Cedex 05, France
- PSL Université Paris, Paris, France
- Chemical Biology of Cancer Laboratory, CNRS UMR 3666, INSERM U1143, Paris, France
| | - Alison Forrester
- Institut Curie, 26 rue d'Ulm, 75248 Paris Cedex 05, France
- PSL Université Paris, Paris, France
- Chemical Biology of Cancer Laboratory, CNRS UMR 3666, INSERM U1143, Paris, France
| | - Sebastian Müller
- Institut Curie, 26 rue d'Ulm, 75248 Paris Cedex 05, France
- PSL Université Paris, Paris, France
- Chemical Biology of Cancer Laboratory, CNRS UMR 3666, INSERM U1143, Paris, France
| | - Tatiana Cañeque
- Institut Curie, 26 rue d'Ulm, 75248 Paris Cedex 05, France
- PSL Université Paris, Paris, France
- Chemical Biology of Cancer Laboratory, CNRS UMR 3666, INSERM U1143, Paris, France
| | - Raphaël Rodriguez
- Institut Curie, 26 rue d'Ulm, 75248 Paris Cedex 05, France.
- PSL Université Paris, Paris, France.
- Chemical Biology of Cancer Laboratory, CNRS UMR 3666, INSERM U1143, Paris, France.
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Disko A. [Treatment and Management of Spasticity]. PRAXIS 2020; 109:794-800. [PMID: 32752967 DOI: 10.1024/1661-8157/a003480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Treatment and Management of Spasticity Abstract. In the care of neurological patients with a lesion of the first motor neuron, for example after stroke or multiple sclerosis, spasticity is a common problem with considerable impairment of quality of life. The treatment is based in the first place on therapeutic and nursing interventions. In addition, a systemic antispastic medication or, depending on the distribution of the spasticity, local injections with botulinum neurotoxin can be applied. If this is insufficient, surgical procedures may be considered.
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10
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Comparative pharmacokinetics of osmotic-controlled and immediate-release Eperisone tablet formulation in healthy human subjects using a sensitive plasma LC-ESI-MS/MS method. Sci Rep 2020; 10:1867. [PMID: 32024955 PMCID: PMC7002734 DOI: 10.1038/s41598-020-58801-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 01/14/2020] [Indexed: 11/30/2022] Open
Abstract
To evaluate and compare the pharmacokinetic (PK) characteristics of a newly developed oral osmotically controlled drug delivery system of Eperisone 150 mg tablets with Eperisone immediate release (IR) marketed tablet brand as a reference formulation. It was a single dose, two treatment, two sequence, randomized, crossover study, involving 12 healthy human subjects. A modified, sensitive LC-ESI-MS/MS method was developed and validated as per FDA guidelines for estimation of Eperisone in plasma using a simple extraction and quick protein precipitation method. Non-compartmental pharmacokinetic model was used for PK analysis. Results were statistically compared using logarithmically transformed data, where p > 0.05 was considered as non-significant with 90% CI limit of 0.8–1.25. The bio-analytical method used for estimating drug plasma concentration was found to be simple, selective, linear, accurate and precise with 0.01 ng/ml as limit of detection. The comparative PK analysis revealed an insignificant difference in AUC0-∞, AUC0-t, Vz/F, Cl/F and t1/2λz, whereas a significant difference in Cmax, Tmax and MTTs were found. The relative bioavailability of Eperisone osmotic tablet was 109.7%. The osmotic controlled release drug formulation was found to release Eperisone for an extended period with less inter individual fluctuation in pharmacokinetic variables.
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Rabbani G, Lee EJ, Ahmad K, Baig MH, Choi I. Binding of Tolperisone Hydrochloride with Human Serum Albumin: Effects on the Conformation, Thermodynamics, and Activity of HSA. Mol Pharm 2018. [DOI: 10.1021/acs.molpharmaceut.7b00976 pmid: 29432019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Gulam Rabbani
- Department of Medical Biotechnology, Yeungnam University, 280 Daehak-ro,
Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Eun Ju Lee
- Department of Medical Biotechnology, Yeungnam University, 280 Daehak-ro,
Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Khurshid Ahmad
- Department of Medical Biotechnology, Yeungnam University, 280 Daehak-ro,
Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Mohammad Hassan Baig
- Department of Medical Biotechnology, Yeungnam University, 280 Daehak-ro,
Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Inho Choi
- Department of Medical Biotechnology, Yeungnam University, 280 Daehak-ro,
Gyeongsan, Gyeongbuk-38541, Republic of Korea
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12
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Rabbani G, Lee EJ, Ahmad K, Baig MH, Choi I. Binding of Tolperisone Hydrochloride with Human Serum Albumin: Effects on the Conformation, Thermodynamics, and Activity of HSA. Mol Pharm 2018; 15:1445-1456. [DOI: 10.1021/acs.molpharmaceut.7b00976] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Gulam Rabbani
- Department of Medical Biotechnology, Yeungnam University, 280 Daehak-ro,
Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Eun Ju Lee
- Department of Medical Biotechnology, Yeungnam University, 280 Daehak-ro,
Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Khurshid Ahmad
- Department of Medical Biotechnology, Yeungnam University, 280 Daehak-ro,
Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Mohammad Hassan Baig
- Department of Medical Biotechnology, Yeungnam University, 280 Daehak-ro,
Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Inho Choi
- Department of Medical Biotechnology, Yeungnam University, 280 Daehak-ro,
Gyeongsan, Gyeongbuk-38541, Republic of Korea
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13
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Kukushkin ML, Brylev LV, Laskov VB, Makarov NS, Pizova NV, Sokov EL, Chefranova ZY, Sholomov II, Guekht AB. [Results of a randomized double blind parallel study on the efficacy and safety of tolpersione in patients with acute nonspecific low back pain]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:69-78. [PMID: 29265090 DOI: 10.17116/jnevro201711711169-78] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AIM To evaluate the efficacy and safety of tolpersione injection and oral formulations combined with NSAID over NSAID monotherapy in acute non-specific low back pain. MATERIAL AND METHODS In this randomized double blind study 239 patients were included in the per protocol analysis. The first 5 days of treatment, patients received tolpersione or placebo injection which was followed by per os administration of tolpersione/placebo tablet up to 14 days. NSAID diclofenac tablet was used in both groups through the study. Functionality assessed by the Roland Morris Disability Questionnaire (RMDQ) at day 5 was the primary endpoint. Secondary endpoints were RMDQ at other time points, pain level change at rest and on movement assessed by the Visual Analogue Scale (VAS), the Clinical Global Impression of Improvement/Patient Global Impression of Improvement (CGI-I and PGI-I), change in the range of motion assessed by the distance from the fingertips to the floor, period of disability days, relative (%) changes in the daily dose of diclofenac from the 7th to the 14th day of therapy. RESULTS AND CONCLUSION The primary and secondary endpoints clearly demonstrated the significant superiority of tolpersione added to NSAID monotherapy over NSAID monotherapy. The safety assessment revealed no statistically significant differences between the two groups. Based on the results, tolpersione injection and per os formulations can be considered an effective and safe drugs in the combined therapy for patients with acute nonspecific back pain.
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Affiliation(s)
- M L Kukushkin
- Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - L V Brylev
- Buyanov City Clinical Hospital, Moscow, Russia
| | - V B Laskov
- Kursk State Medical University, Kursk, Russia
| | - N S Makarov
- Razumovsky Saratov State Medical University, Saratov, Russia
| | - N V Pizova
- Yaroslavl State Medical University, Yaroslavl, Russia
| | - E L Sokov
- Russian University of Peoples' Friendship, Moscow, Russia
| | - Zh Yu Chefranova
- Saint Ioasaf Belgorod Regional Clinical Hospital, Belgorod, Russia
| | - I I Sholomov
- Razumovsky Saratov State Medical University, Saratov, Russia
| | - A B Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
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14
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Rabbani G, Baig MH, Lee EJ, Cho WK, Ma JY, Choi I. Biophysical Study on the Interaction between Eperisone Hydrochloride and Human Serum Albumin Using Spectroscopic, Calorimetric, and Molecular Docking Analyses. Mol Pharm 2017; 14:1656-1665. [DOI: 10.1021/acs.molpharmaceut.6b01124] [Citation(s) in RCA: 158] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Gulam Rabbani
- Department
of Medical Biotechnology, YeungNam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Mohammad Hassan Baig
- Department
of Medical Biotechnology, YeungNam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Eun Ju Lee
- Department
of Medical Biotechnology, YeungNam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Won-Kyung Cho
- Korean
Medicine (KM) Application Center, Korea Institute of Oriental Medicine (KIOM), Donggu, Daegu-41062, Republic of Korea
| | - Jin Yeul Ma
- Korean
Medicine (KM) Application Center, Korea Institute of Oriental Medicine (KIOM), Donggu, Daegu-41062, Republic of Korea
| | - Inho Choi
- Department
of Medical Biotechnology, YeungNam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk-38541, Republic of Korea
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15
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Rabbani G, Baig MH, Lee EJ, Cho WK, Ma JY, Choi I. Biophysical Study on the Interaction between Eperisone Hydrochloride and Human Serum Albumin Using Spectroscopic, Calorimetric, and Molecular Docking Analyses. Mol Pharm 2017. [DOI: 10.1021/acs.molpharmaceut.6b01124 pmid: 28380300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Gulam Rabbani
- Department
of Medical Biotechnology, YeungNam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Mohammad Hassan Baig
- Department
of Medical Biotechnology, YeungNam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Eun Ju Lee
- Department
of Medical Biotechnology, YeungNam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk-38541, Republic of Korea
| | - Won-Kyung Cho
- Korean
Medicine (KM) Application Center, Korea Institute of Oriental Medicine (KIOM), Donggu, Daegu-41062, Republic of Korea
| | - Jin Yeul Ma
- Korean
Medicine (KM) Application Center, Korea Institute of Oriental Medicine (KIOM), Donggu, Daegu-41062, Republic of Korea
| | - Inho Choi
- Department
of Medical Biotechnology, YeungNam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk-38541, Republic of Korea
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16
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Rolke R, Rolke S, Hiddemann S, Mücke M, Cuhls H, Radbruch L, Elsner F, Peuckmann-Post V. [Update palliative pain therapy]. Internist (Berl) 2016; 57:959-970. [PMID: 27631529 DOI: 10.1007/s00108-016-0126-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Cancer pain and pain associated with non-neoplastic diseases can be associated with pain mechanisms, such as a peripheral or central sensitization or deafferentation. The clarification allows indirect conclusions about the underlying mechanisms based on clinical signs, such as allodynia or hyperalgesia. Non-opioid analgesics are the basis of cancer pain therapy according to the World Health Organization (WHO) pain ladder. In the case of severe cancer pain, treatment can be escalated directly from level 1 to level 3. Opioids are highly effective for the treatment of cancer pain even with a neuropathic component, which can occur in up to 40 % of cases as amixed pain syndrome. Coanalgesics represent a valuable therapeutic adjunct for better pain control and can address treatment of comorbidities, such as anxiety, depression and sleep disorders. When liver and/or renal function is reduced, the dosage of many drugs has to be adapted. Treatment of multimorbid or critically ill patients with opioids and antidepressants/anticonvulsants requires consideration of numerous possible pharmacodynamic and pharmacokinetic interactions.
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Affiliation(s)
- R Rolke
- Klinik für Palliativmedizin, Universitätsklinikum RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
| | - S Rolke
- Klinik für Kardiologie, Pneumologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum RWTH Aachen, Aachen, Deutschland
| | - S Hiddemann
- Klinik für Palliativmedizin, Universitätsklinikum RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - M Mücke
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Bonn, Deutschland.,Institut für Hausarztmedizin, Medizinische Fakultät, Universität Bonn, Bonn, Deutschland.,Zentrum für Seltene Erkrankungen Bonn (ZSEB), Universitätsklinikum Bonn, Bonn, Deutschland
| | - H Cuhls
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Bonn, Deutschland
| | - L Radbruch
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Bonn, Deutschland
| | - F Elsner
- Klinik für Palliativmedizin, Universitätsklinikum RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - V Peuckmann-Post
- Klinik für Palliativmedizin, Universitätsklinikum RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
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17
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Jin X, Kataoka K, Yatabe T, Yamaguchi K, Mizuno N. Supported Gold Nanoparticles for Efficient α-Oxygenation of Secondary and Tertiary Amines into Amides. Angew Chem Int Ed Engl 2016; 55:7212-7. [DOI: 10.1002/anie.201602695] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 04/11/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Xiongjie Jin
- Department of Applied Chemistry; School of Engineering; The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Kengo Kataoka
- Department of Applied Chemistry; School of Engineering; The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Takafumi Yatabe
- Department of Applied Chemistry; School of Engineering; The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Kazuya Yamaguchi
- Department of Applied Chemistry; School of Engineering; The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Noritaka Mizuno
- Department of Applied Chemistry; School of Engineering; The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
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18
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Jin X, Kataoka K, Yatabe T, Yamaguchi K, Mizuno N. Supported Gold Nanoparticles for Efficient α-Oxygenation of Secondary and Tertiary Amines into Amides. Angew Chem Int Ed Engl 2016. [DOI: 10.1002/ange.201602695] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Xiongjie Jin
- Department of Applied Chemistry; School of Engineering; The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Kengo Kataoka
- Department of Applied Chemistry; School of Engineering; The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Takafumi Yatabe
- Department of Applied Chemistry; School of Engineering; The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Kazuya Yamaguchi
- Department of Applied Chemistry; School of Engineering; The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Noritaka Mizuno
- Department of Applied Chemistry; School of Engineering; The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
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19
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Malejko K, Graf H, Gahr M. Survival of Very High Blood Alcohol Concentration Without Consequential Damage in a Patient Without a Previous Substance Use Disorder. J Forensic Sci 2016; 61:1155-1157. [PMID: 27364303 DOI: 10.1111/1556-4029.13082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/10/2015] [Accepted: 09/20/2015] [Indexed: 11/29/2022]
Abstract
Intoxications with alcohol may lead to death depending on (maximum) blood alcohol concentration (BAC) and accompanying factors such as liver function, tolerance, and comedication. Death may occur due to ethanol-induced respiratory depression and/or aspiration of gastric content (due to an impaired gag reflex); thus, securing of the airway and ventilation is occasionally necessary. A case of a 58-year-old female patient with depression who demonstrated a very high BAC of 8.68 gm/L (0.868%) following ingestion of large amounts of alcohol with suicidal intent is presented. Intubation and ventilation were life-saving, and the patient did not develop any physical or consequential damage. As the patient had not regularly used alcohol or any other psychotropic agent, tolerance could be ruled out. This case emphasizes the necessity of rapid securing of the airway in patients with alcohol intoxication and respiratory depression and, furthermore, illustrates the large interindividual differences regarding ethanol susceptibility.
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Affiliation(s)
- Kathrin Malejko
- Department of Psychiatry and Psychotherapy III, Ulm University, Leimgrubenweg 12-14, 89075, Ulm, Germany
| | - Heiko Graf
- Department of Psychiatry and Psychotherapy III, Ulm University, Leimgrubenweg 12-14, 89075, Ulm, Germany
| | - Maximilian Gahr
- Department of Psychiatry and Psychotherapy III, Ulm University, Leimgrubenweg 12-14, 89075, Ulm, Germany
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20
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Rivera-Arconada I, Roza C, Lopez-Garcia JA. Spinal Reflexes and Windup In Vitro: Effects of Analgesics and Anesthetics. CNS Neurosci Ther 2015; 22:127-34. [PMID: 26384473 DOI: 10.1111/cns.12446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 07/31/2015] [Accepted: 08/05/2015] [Indexed: 01/19/2023] Open
Abstract
The spinal cord is the first relay center for nociceptive information. Following peripheral injury, the spinal cord sensitizes. A sign of spinal sensitization is the hyper-reflexia which develops shortly after injury and can be detected in the isolated spinal cord as a "memory of pain." In this context, it is easy to understand that many analgesic compounds target spinally located sites of action to attain analgesia. In vitro isolated spinal cord preparations have been used for a number of years, and experience on the effects of compounds of diverse pharmacological families on spinal function has accumulated. Recently, we have proposed that the detailed study of spinal segmental reflexes in vitro may produce data relevant to the evaluation of the analgesic potential of novel compounds. In this review, we describe the main features of segmental reflexes obtained in vitro and discuss the effects of compounds of diverse chemical nature and pharmacological properties on such reflexes. Our aim was to compare the different profiles of action of the compounds on segmental reflexes in order to extract clues that may be helpful for pharmacological characterization of novel analgesics.
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Affiliation(s)
- Ivan Rivera-Arconada
- Department of Systems Biology, University of Alcala, Alcala de Henares, Madrid, Spain
| | - Carolina Roza
- Department of Systems Biology, University of Alcala, Alcala de Henares, Madrid, Spain
| | - Jose A Lopez-Garcia
- Department of Systems Biology, University of Alcala, Alcala de Henares, Madrid, Spain
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21
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Martos V, Hofer KE, Rauber-Lüthy C, Schenk-Jaeger KM, Kupferschmidt H, Ceschi A. Acute toxicity profile of tolperisone in overdose: Observational poison centre-based study. Clin Toxicol (Phila) 2015; 53:470-6. [PMID: 25772423 DOI: 10.3109/15563650.2015.1022896] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Tolperisone is a centrally acting muscle relaxant that acts by blocking voltage-gated sodium and calcium channels. There is a lack of information on the clinical features of tolperisone poisoning in the literature. The aim of this study was to investigate the demographics, circumstances and clinical features of acute overdoses with tolperisone. METHODS An observational study of acute overdoses of tolperisone, either alone or in combination with one non-steroidal anti-inflammatory drug in a dose range not expected to cause central nervous system effects, in adults and children (< 16 years), reported to our poison centre between 1995 and 2013. RESULTS 75 cases were included: 51 females (68%) and 24 males (32%); 45 adults (60%) and 30 children (40%). Six adults (13%) and 17 children (57%) remained asymptomatic, and mild symptoms were seen in 25 adults (56%) and 10 children (33%). There were nine adults (20%) with moderate symptoms, and five adults (11%) and three children (10%) with severe symptoms. Signs and symptoms predominantly involved the central nervous system: somnolence, coma, seizures and agitation. Furthermore, some severe cardiovascular and respiratory signs and symptoms were reported. The minimal dose for seizures and severe symptoms in adults was 1500 mg. In 11 cases the latency between the ingestion and the onset of symptoms was known and was reported to be 0.5-1.5 h. CONCLUSIONS The acute overdose of tolperisone may be life-threatening, with a rapid onset of severe neurological, respiratory and cardiovascular symptoms. With alternative muscle relaxants available, indications for tolperisone should be rigorously evaluated.
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Affiliation(s)
- Viktor Martos
- National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich , Zurich , Switzerland
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22
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Tekes K. Basic aspects of the pharmacodynamics of tolperisone, a widely applicable centrally acting muscle relaxant. THE OPEN MEDICINAL CHEMISTRY JOURNAL 2014; 8:17-22. [PMID: 25132868 PMCID: PMC4133921 DOI: 10.2174/1874104501408010017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 03/26/2014] [Accepted: 06/26/2014] [Indexed: 11/22/2022]
Abstract
Tolperisone (2-methyl-1-(4-methylphenyl)-3-piperidin-1-ylpropan-1-one hydro-chloride) was introduced in the
clinical practice more than forty years ago and is still evaluated as a widely applicable compound in pathologically elevated
skeletal muscle tone (spasticity) and related pains of different origin. In the present review, basic pharmacodynamic
effects measured on whole animals, analyses of its actions on cell and tissue preparations and molecular mechanism of action
on sodium and calcium channels are summarized as recently significantly new data were reported.
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Affiliation(s)
- Kornelia Tekes
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
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23
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Kocsis P, Gajári D, Deli L, Gőcze KZ, Pozsgay Z, Tihanyi K. Effect of tolperisone on the resting brain and on evoked responses, an phMRI BOLD study. Brain Res Bull 2013; 99:34-40. [PMID: 24099980 DOI: 10.1016/j.brainresbull.2013.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 09/20/2013] [Accepted: 09/23/2013] [Indexed: 01/10/2023]
Abstract
Tolperisone is a voltage gated sodium channel blocker, centrally acting muscle relaxant drug, with a very advantageous side effect profile. Like other sodium channel blockers, it has weak affinity to the resting state and high affinity to the open/inactivated state of the channel. In this paper, its effect on BOLD responses in rat brain were elucidated both on the resting brain and paw stimulation evoked BOLD responses. Tolperisone did not exert any visible effect on resting brain, but strongly inhibited the paw stimulation evoked BOLD responses, showing somewhat higher efficacy in brain areas involved in pain sensation. This finding is in a good agreement with its sodium channel blocking profile. In the resting brain, most of the channels are in resting state. Electric train stimuli of the paw results in over activated neurons, where most sodium channels are in open or inactivated state. These data suggest that the very advantageous profile of tolperisone can be explained by its selective action on open or inactivated sodium channels of over-activated neurons in various brain regions rather than by a selective effect in the spinal cord as suggested previously.
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Affiliation(s)
- Pál Kocsis
- Preclinical Imaging Center, Gedeon Richter Ltd., POB: 27, Budapest 10, H-1475, Hungary.
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24
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Abstract
Palliative care patients do not only suffer from cancer pain but also from painful muscle spasticity due to multiple sclerosis, amyotrophic lateral sclerosis, after stroke or due to dementia if damage of the pyramidal motor system is present. Centrally active muscle relaxants can be helpful also when used as coanalgesics for cancer pain. In addition to opioids other coanalgesics, such as tricyclic antidepressants or serotonin/noradrenalin reuptake inhibitors as well as anticonvulsants (sodium channel and calcium channel blockers) can be helpful if neuropathic cancer pain is present. Idiopathic Parkinsonism or multiple system atrophy leads more to a painful rigor and pain control should be supported here by optimal adjustment of L-DOPA or DOPA agonist therapy. However, pain treatment should always address the psychological, social and spiritual demands of the patient.
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25
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Raju TVR, Seshadri RK, Arutla S, Mohan TSSJ, Rao IM, Nittala SR. Development and Validation of a Precise, Single HPLC Method for the Determination of Tolperisone Impurities in API and Pharmaceutical Dosage Forms. Sci Pharm 2013; 81:123-38. [PMID: 23641333 PMCID: PMC3617673 DOI: 10.3797/scipharm.1209-17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 11/05/2012] [Indexed: 11/22/2022] Open
Abstract
A novel, sensitive, stability-indicating HPLC method has been developed for the quantitative estimation of Tolperisone-related impurities in both bulk drugs and pharmaceutical dosage forms. Effective chromatographic separation was achieved on a C18 stationary phase with a simple mobile phase combination delivered in a simple gradient programme, and quantitation was by ultraviolet detection at 254 nm. The mobile phase consisted of a buffer and acetonitrile delivered at a flow rate 1.0 ml/min. The buffer consisted of 0.01 M potassium dihydrogen phosphate with the pH adjusted to 8.0 by using diethylamine. In the developed HPLC method, the resolution between Tolperisone and its four potential impurities was found to be greater than 2.0. Regression analysis showed an R value (correlation coefficient) of greater than 0.999 for the Tolperisone impurities. This method was capable of detecting all four impurities of Tolperisone at a level of 0.19 μg/mL with respect to the test concentration of 1000 μg/mL for a 10 µl injection volume. The tablets were subjected to the stress conditions of hydrolysis, oxidation, photolysis, and thermal degradation. Considerable degradation was found to occur in base hydrolysis, water hydrolysis, and oxidation. The stress samples were assayed against a qualified reference standard and the mass balance was found to be close to 100%. The established method was validated and found to be linear, accurate, precise, specific, robust, and rugged.
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Affiliation(s)
- Thummala Veera Raghava Raju
- Analytical Research and Development, Integrated Product Development, Dr. Reddy’s Laboratories Ltd., Bachupally, Hyderabad-500072, India
| | - Raja Kumar Seshadri
- Analytical Research and Development, Integrated Product Development, Dr. Reddy’s Laboratories Ltd., Bachupally, Hyderabad-500072, India
| | - Srinivas Arutla
- Analytical Research and Development, Integrated Product Development, Dr. Reddy’s Laboratories Ltd., Bachupally, Hyderabad-500072, India
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26
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Inubushi H, Kondo H, Lesbani A, Miyachi M, Yamanoi Y, Nishihara H. Direct synthesis of alkylsilanes by platinum-catalyzed coupling of hydrosilanes and iodoalkanes. Chem Commun (Camb) 2013; 49:134-6. [DOI: 10.1039/c2cc35150a] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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27
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Cozzi NV, Brandt SD, Daley PF, Partilla JS, Rothman RB, Tulzer A, Sitte HH, Baumann MH. Pharmacological examination of trifluoromethyl ring-substituted methcathinone analogs. Eur J Pharmacol 2012. [PMID: 23178523 DOI: 10.1016/j.ejphar.2012.11.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Cathinones are a class of drugs used to treat various medical conditions including depression, obesity, substance abuse, and muscle spasms. Some "designer" cathinones, such as methcathinone, mephedrone, and methylone, are used nonclinically for their stimulant or entactogenic properties. Given the recent rise in nonmedical use of designer cathinones, we aimed to improve understanding of cathinone pharmacology by investigating analogs of methcathinone with a CF(3) substituent at the 2-, 3-, or 4-position of the phenyl ring (TFMAPs). We compared the TFMAPs with methcathinone for effects on monoamine uptake transporter function in vitro and in vivo, and for effects on locomotor activity in rats. At the serotonin transporter (SERT), 3-TFMAP and 4-TFMAP were 10-fold more potent than methcathinone as uptake inhibitors and as releasing agents, but 2-TFMAP was both a weak uptake inhibitor and releaser. At the norepinephrine and dopamine transporters (NET and DAT), all TFMAP isomers were less potent than methcathinone as uptake inhibitors and releasers. In vivo, 4-TFMAP released 5-HT, but not dopamine, in rat nucleus accumbens and did not affect locomotor activity, whereas methcathinone increased both 5-HT and dopamine and produced locomotor stimulation. These experiments reveal that TFMAPs are substrates for the monoamine transporters and that phenyl ring substitution at the 3- or 4-position increases potency at SERT but decreases potency at NET and DAT, resulting in selectivity for SERT. The TFMAPs might have a therapeutic value for a variety of medical and psychiatric conditions and may have lower abuse liability compared to methcathinone due to their decreased DAT activity.
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Affiliation(s)
- Nicholas V Cozzi
- Neuropharmacology Laboratory, 2695 Medical Sciences Center, Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, 1300 University Avenue, Madison, WI 53706, USA.
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Bhattacharjya B, Naser SM, Biswas A, Kamal F, Banerjee K. Effectiveness of Tolperisone Hydrochloride with Aceclofenac as Combined Therapy in Acute Low Back Pain. ACTA ACUST UNITED AC 2012. [DOI: 10.5005/ijopmr-23-2-74] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract
Objective
An open label, non-randomised, prospective study was conducted to evaluate the effectiveness of tolperisone hydrochloride 150mg thrice daily with aceclofenac 100mg twice daily compared to aceclofenac 100mg twice daily alone for the treatment of acute low back pain (LBP) for 14 days. total (n=242) patients recruited for the study were divided into two treatment groups. One of the group (n=124) received oral tolperisone plus aceclofenac and the other (n=118) Aceclofenac alone. The pain intensity was assessed by visual analogue scale. Patients were informed to report any adverse effect encountered during the study period. The overall effect of the drug (global assessment of the study medication) on pain and adverse effects were assessed by the patients at the end of the trial on a categorical scale. There was significant reduction in pain score in the tolperisone group than aceclofenac group with insignificant adverse effects which didn't require discontinuation of the study. Tolperisone when added with aceclofenac can be more effective than aceclofenac alone for relief of acute LBP with minimum adverse effects.
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Sporkert F, Brunel C, Augsburger MP, Mangin P. Fatal tolperisone poisoning: autopsy and toxicology findings in three suicide cases. Forensic Sci Int 2011; 215:101-4. [PMID: 21683537 DOI: 10.1016/j.forsciint.2011.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 05/19/2011] [Accepted: 05/20/2011] [Indexed: 10/18/2022]
Abstract
Tolperisone (Mydocalm) is a centrally acting muscle relaxant with few sedative side effects that is used for the treatment of chronic pain conditions. We describe three cases of suicidal tolperisone poisoning in three healthy young subjects in the years 2006, 2008 and 2009. In all cases, macroscopic and microscopic autopsy findings did not reveal the cause of death. Systematic toxicological analysis (STA) including immunological tests, screening for volatile substances and blood, urine and gastric content screening by GC-MS and HPLC-DAD demonstrated the presence of tolperisone in all cases. In addition to tolperisone, only the analgesics paracetamol (acetaminophen), ibuprofen and naproxen could be detected. The blood ethanol concentrations were all lower than 0.10 g/kg. Tolperisone was extracted by liquid-liquid extraction using n-chlorobutane as the extraction solvent. The quantification was performed by GC-NPD analysis of blood, urine and gastric content. Tolperisone concentrations of 7.0 mg/l, 14 mg/l and 19 mg/l were found in the blood of the deceased. In the absence of other autopsy findings, the deaths in these three cases were finally explained as a result of lethal tolperisone ingestion. To the best of our knowledge, these three cases are the first reported cases of suicidal tolperisone poisonings.
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Affiliation(s)
- Frank Sporkert
- University Centre of Legal Medicine Lausanne-Geneva, Rue du Bugnon 21, CH-1011 Lausanne, Switzerland.
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Selective killing of K-ras mutant cancer cells by small molecule inducers of oxidative stress. Proc Natl Acad Sci U S A 2011; 108:8773-8. [PMID: 21555567 DOI: 10.1073/pnas.1105941108] [Citation(s) in RCA: 187] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Activating K-RAS mutations are the most frequent oncogenic mutations in human cancer. Numerous downstream signaling pathways have been shown to be deregulated by oncogenic K-ras. However, to date there are still no effective targeted therapies for this genetically defined subset of patients. Here we report the results of a small molecule, synthetic lethal screen using mouse embryonic fibroblasts derived from a mouse model harboring a conditional oncogenic K-ras(G12D) allele. Among the >50,000 compounds screened, we identified a class of drugs with selective activity against oncogenic K-ras-expressing cells. The most potent member of this class, lanperisone, acts by inducing nonapoptotic cell death in a cell cycle- and translation-independent manner. The mechanism of cell killing involves the induction of reactive oxygen species that are inefficiently scavenged in K-ras mutant cells, leading to oxidative stress and cell death. In mice, treatment with lanperisone suppresses the growth of K-ras-driven tumors without overt toxicity. Our findings establish the specific antitumor activity of lanperisone and reveal oxidative stress pathways as potential targets in Ras-mediated malignancies.
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Human pharmacokinetics of the muscle relaxant, eperisone hydrochloride by liquid chromatography–electrospray tandem mass spectrometry. Eur J Drug Metab Pharmacokinet 2011; 36:71-8. [DOI: 10.1007/s13318-011-0034-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2010] [Accepted: 03/07/2011] [Indexed: 10/18/2022]
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Poulin P, Ekins S, Theil FP. A hybrid approach to advancing quantitative prediction of tissue distribution of basic drugs in human. Toxicol Appl Pharmacol 2010; 250:194-212. [PMID: 21034759 DOI: 10.1016/j.taap.2010.10.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Revised: 09/29/2010] [Accepted: 10/18/2010] [Indexed: 01/01/2023]
Abstract
A general toxicity of basic drugs is related to phospholipidosis in tissues. Therefore, it is essential to predict the tissue distribution of basic drugs to facilitate an initial estimate of that toxicity. The objective of the present study was to further assess the original prediction method that consisted of using the binding to red blood cells measured in vitro for the unbound drug (RBCu) as a surrogate for tissue distribution, by correlating it to unbound tissue:plasma partition coefficients (Kpu) of several tissues, and finally to predict volume of distribution at steady-state (V(ss)) in humans under in vivo conditions. This correlation method demonstrated inaccurate predictions of V(ss) for particular basic drugs that did not follow the original correlation principle. Therefore, the novelty of this study is to provide clarity on the actual hypotheses to identify i) the impact of pharmacological mode of action on the generic correlation of RBCu-Kpu, ii) additional mechanisms of tissue distribution for the outlier drugs, iii) molecular features and properties that differentiate compounds as outliers in the original correlation analysis in order to facilitate its applicability domain alongside the properties already used so far, and finally iv) to present a novel and refined correlation method that is superior to what has been previously published for the prediction of human V(ss) of basic drugs. Applying a refined correlation method after identifying outliers would facilitate the prediction of more accurate distribution parameters as key inputs used in physiologically based pharmacokinetic (PBPK) and phospholipidosis models.
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Stiedl B, Kovács-Kiss D, Ludányi K, Bódis A, Klebovich I, Antal I. LC-UV Assay of Tolperisone HCl from Sustained Release Matrix Tablets. Chromatographia 2010. [DOI: 10.1365/s10337-010-1525-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Orgován G, Tihanyi K, Noszál B. NMR analysis, protonation equilibria and decomposition kinetics of tolperisone. J Pharm Biomed Anal 2009; 50:718-23. [PMID: 19577875 DOI: 10.1016/j.jpba.2009.05.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 05/28/2009] [Accepted: 05/29/2009] [Indexed: 11/16/2022]
Abstract
The rate constants of spontaneous and hydroxide-catalyzed decomposition and the tautomer-specific protonation constants of tolperisone, a classical muscle relaxant were determined. A solution NMR method without any separation techniques was elaborated to quantitate the progress of decomposition. All the rate and equilibrium constants were determined at four different temperatures and the activation parameters were calculated. The molecular mechanism of decomposition is proposed.
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Affiliation(s)
- Gábor Orgován
- Department of Pharmaceutical Chemistry, Semmelweis University, Research Group of Drugs of Abuse and Doping Agents, Hungarian Academy of Sciences, Budapest H-1092, Hogyes Endre u. 9, Hungary
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Abstract
INTRODUCTION Eperisone hydrochloride has been recently proposed as a muscle relaxant for the treatment of muscle contracture and chronic low back pain (LBP) as it is devoid of clinically relevant sedative effects on the central nervous system (CNS). We tested this hypothesis by performing a study of patients with LBP and muscle contracture who were treated with full-dose eperisone. METHODS Patients with moderate to severe, acute, or relapsing LBP received eperisone 100 mg three times daily for 10 consecutive days. Assessments included: spontaneous pain, pain on movement, resistance to passive movement, antalgic rigidity, and tolerability. RESULTS In total, 100 patients were enrolled into the study. The treatment achieved a consistent analgesic and muscle relaxant activity across all patients. Both spontaneous pain and pain on movement were significantly decreased, as was resistance encountered by the investigator to passive movements, antalgic rigidity, and muscle contracture. As a consequence, treatment with eperisone resulted in a lower rigidity of the lower back and an improved motility for patients. Only seven adverse reactions were reported, including light-headedness (1), occasional vertigo and/or loss of equilibrium (3), mild somnolence (2), and epigastric pain (1). In almost all cases, there was no need to interrupt the treatment and the adverse reaction resolved spontaneously. CONCLUSIONS Eperisone had an analgesic and muscle relaxant effect in patients with LBP. It should be noted that while it is common practice in rheumatology to combine a pain killer with a muscle relaxant in order to achieve a satisfactory result on both symptoms, the present results with eperisone were achieved with a single drug. With an improved tolerability profile compared with nonsteroidal anti-inflammatory drugs, and a lack of significant adverse effects on the CNS, eperisone hydrochloride represents a valuable alternative to traditional analgesics and muscle relaxants for the treatment of LBP.
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Quasthoff S, Möckel C, Zieglgänsberger W, Schreibmayer W. Tolperisone: a typical representative of a class of centrally acting muscle relaxants with less sedative side effects. CNS Neurosci Ther 2008; 14:107-19. [PMID: 18482024 DOI: 10.1111/j.1527-3458.2008.00044.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Tolperisone, a piperidine derivative, is assigned to the group of centrally acting muscle relaxants and has been in clinical use now for decades. The review summarizes the known pharmacokinetics, pharmacodynamics, toxicology and side effects in humans and the clinical use of tolperisone. A future perspective for further exploration of this drug is given.
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Řezanka T, Sigler K. Biologically Active Compounds Of Semi-Metals. BIOACTIVE NATURAL PRODUCTS (PART O) 2008. [DOI: 10.1016/s1572-5995(08)80018-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Bölcskei H, Tarnawa I, Kocsis P. Voltage-gated sodium channel blockers, 2001-2006: An overview. Med Chem Res 2007. [DOI: 10.1007/s00044-007-9071-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Abstract
Silperisone is a tolperisone like organosilicon compound with centrally acting muscle relaxant properties. Studies in mice showed that silperisone may have less propensity to cause CNS depressant or motor side effects than tolperisone or other antispastic drugs. In cats and rats, silperisone was an effective suppressant of monosynaptic and polysynaptic spinal reflexes and decerebrate rigidity. Its suppressant effect on the spinal reflexes was also demonstrated in the isolated hemisected rat spinal cord in vitro. The in vivo potency and efficacy of silperisone by i.v administration were similar to those of tolperisone and eperisone. However, in cats by intraduodenal administration and in mice by oral administration its duration of action was much longer and its functional bioavailability much higher than of the other two drugs. With regard to its profile of actions silperisone was similar to tolperisone with minor differences. The most striking difference was in pontine facilitation and bulbar inhibition of the patellar reflex. Tolperisone depressed both, whereas silperisone inhibited only the former. The mechanism underlying the spinal reflex depressant effects of silperisone involves the blockade of voltage gated neuronal sodium and calcium channels leading to a decreased release of excitatory transmitter and reduced neuronal excitability. In addition, silperisone has potassium channel blocking effect, which is stronger than that of tolperisone. Silperisone is absorbed rapidly and is extensively metabolized in rats. However, its metabolism in dogs and particularly in humans is much less extensive. The elimination half-life of silperisone in humans is 12 to 16 h, so that it can be administered once or twice daily. Phase I clinical studies with silperisone at doses up to 150 mg/day failed to detect any adverse effects at plasma concentrations considered to be effective in the preclinical tests. These findings suggested that silperisone might be a useful antispastic drug. However, findings in chronic animal toxicity studies led to the discontinuation of silperisone's development.
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Affiliation(s)
- Sándor Farkas
- Pharmacological and Drug Safety Research Division, Gedeon Richter Ltd., Budapest, Hungary.
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