Rufinamide

Rufinamide is an anticonvulsant medication. It is used in combination with other medication and therapy to treat Lennox–Gastaut syndrome[2] and various other seizure disorders. Rufinamide, a triazole derivative, was developed in 2004 by Novartis Pharma, AG, and is manufactured by Eisai.

Rufinamide
Clinical data
Trade namesBanzel, Inovelon
AHFS/Drugs.comMonograph
MedlinePlusa609001
License data
Pregnancy
category
  • AU: B3
Routes of
administration
By mouth (tablets)
ATC code
Legal status
Legal status
  • UK: POM (Prescription only)
  • US: ℞-only [1]
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability85% (under fed conditions); tmax = 4–6 hours
Protein binding34%
MetabolismCarboxylesterase-mediated hydrolysis (CYP not involved)
MetabolitesInactive
Elimination half-life6–10 hours
ExcretionUrine (85%)[1]
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
ChemSpider
UNII
KEGG
ChEMBL
CompTox Dashboard (EPA)
Chemical and physical data
FormulaC10H8F2N4O
Molar mass238.198 g·mol−1
3D model (JSmol)
 NY (what is this?)  (verify)

Rufinamide was approved by the US Food and Drug Administration (FDA) on November 14, 2008, as adjunctive treatment of seizures associated with Lennox-Gastaut syndrome in children four years and older and adults. Its official FDA-approved labeling does not mention use in the treatment of partial seizures inasmuch as clinical trials submitted to the FDA were marginal. However, several recent clinical trials suggest that the drug has efficacy for partial seizures [3] It is marketed under the brand name Banzel.[4] It is also marketed in the European Union under the brand name Inovelon.[5]

The mechanism of action of rufinamide is not fully understood. There is some evidence that rufinamide can modulate the gating of voltage-gated sodium channels,[6][7] a common target for antiepileptic drugs.[8] A recent study indicates subtle effects on the voltage-dependence of gating and the time course of inactivation in some sodium channel isoforms that could reduce neuronal excitability.[9] However, this action cannot explain the unique spectrum of activity of rufinamide.

References

  1. "Banzel- rufinamide tablet, film coated Banzel- rufinamide suspension". DailyMed. 15 April 2020. Retrieved 21 October 2020.
  2. Hakimian S, Cheng-Hakimian A, Anderson GD, Miller JW (August 2007). "Rufinamide: a new anti-epileptic medication". Expert Opin Pharmacother. 8 (12): 1931–40. doi:10.1517/14656566.8.12.1931. PMID 17696794. S2CID 19522242.
  3. Brodie MJ, Rosenfeld WE, Vazquez B, Sachdeo R, Perdomo C, Mann A, Arroyo S (August 2009). "Rufinamide for the adjunctive treatment of partial seizures in adults and adolescents: a randomized placebo-controlled trial". Epilepsia. 50 (8): 1899–909. doi:10.1111/j.1528-1167.2009.02160.x. PMID 19490053. S2CID 38485532.
  4. FDA press release - FDA Approves New Drug to Treat Severe Form of Epilepsy
  5. European Public Assessment Report for rufinamide (INOVELON)
  6. Rogawski, M. A. (2006). "Diverse mechanisms of antiepileptic drugs in the development pipeline". Epilepsy Research. 69 (3): 273–94. doi:10.1016/j.eplepsyres.2006.02.004. PMC 1562526. PMID 16621450.
  7. Striano, P.; McMurray, R.; Santamarina, E.; Falip, M. (2018). "Rufinamide for the treatment of Lennox-Gastaut syndrome: Evidence from clinical trials and clinical practice". Epileptic Disorders : International Epilepsy Journal with Videotape. 20 (1): 13–29. doi:10.1684/epd.2017.0950. PMID 29313492.
  8. Rogawski, A.; Löscher, W. (Jul 2004). "The neurobiology of antiepileptic drugs". Nature Reviews. Neuroscience. 5 (7): 553–564. doi:10.1038/nrn1430. ISSN 1471-003X. PMID 15208697. S2CID 2201038.
  9. Gilchrist, J; Dutton, S; Diaz-Bustamante, M; McPherson, A; Olivares, N; Kalia, J; Escayg, A; Bosmans, F (2014). "Nav1.1 modulation by a novel triazole compound attenuates epileptic seizures in rodents". ACS Chemical Biology. 9 (5): 1204–12. doi:10.1021/cb500108p. PMC 4027953. PMID 24635129.
  • "Rufinamide". Drug Information Portal. U.S. National Library of Medicine.
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