Riluzole

Last updated

Riluzole
Riluzole2DACS.svg
Riluzole ball-and-stick model.png
Clinical data
Trade names Rilutek, Tiglutik, Exservan, others
AHFS/Drugs.com Monograph
MedlinePlus a696013
Pregnancy
category
  • AU:B3
Routes of
administration
By mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability 60±18% [4]
Protein binding 97% [4]
Metabolism Hepatic (CYP1A2) [4]
Elimination half-life 9–15 hours [4]
Excretion Urine (90%) [4]
Identifiers
  • 6-(trifluoromethoxy)benzothiazol-2-amine
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard 100.124.754 OOjs UI icon edit-ltr-progressive.svg
Chemical and physical data
Formula C8H5F3N2OS
Molar mass 234.20 g·mol−1
3D model (JSmol)
  • FC(F)(F)Oc1ccc2nc(sc2c1)N
  • InChI=1S/C8H5F3N2OS/c9-8(10,11)14-4-1-2-5-6(3-4)15-7(12)13-5/h1-3H,(H2,12,13) Yes check.svgY
  • Key:FTALBRSUTCGOEG-UHFFFAOYSA-N Yes check.svgY
   (verify)

Riluzole is a medication used to treat amyotrophic lateral sclerosis and other motor neuron diseases. Riluzole delays the onset of ventilator-dependence or tracheostomy in some people and may increase survival by two to three months. [5] Riluzole is available in tablet and liquid form.

Contents

Medical use

Amyotrophic lateral sclerosis

Riluzole was approved in the United States for the treatment of ALS by the U.S. Food and Drug Administration (FDA) in 1995. [6] A Cochrane Library review states a 9% gain in the probability of surviving one year. [5]

Adverse effects

Overdose

Symptoms of overdose include: neurological and psychiatric symptoms, acute toxic encephalopathy with stupor, coma and methemoglobinemia. [4] Severe methemoglobinemia may be rapidly reversible after treatment with methylene blue. [4]

Contraindications

Contraindications for riluzole include: known prior hypersensitivity to riluzole or any of the excipients inside the preparations, liver disease, pregnancy or lactation. [4]

Interactions

CYP1A2 substrates, inhibitors and inducers would probably interact with riluzole, due its dependency on this cytochrome for metabolism. [4]

Mechanism of action

Riluzole preferentially blocks TTX-sensitive sodium channels, which are associated with damaged neurons. [9] [10] Riluzole has also been reported to directly inhibit the kainate and NMDA receptors. [11] The drug has also been shown to postsynaptically potentiate GABAA receptors via an allosteric binding site. [12] 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. [13] [14] 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. [15] [16] In addition to its role in accelerating glutamate clearance from the synapse, riluzole may also prevent glutamate release from presynaptic terminals. [17] Since CK1δ plays a key role in TDP-43 proteinopathy, a pathological hallmark of ALS, this could help to better decipher drug mechanism of action.

Synthesis

Riluzole can be prepared beginning with the reaction of 4-(trifluoromethoxy)aniline with potassium thiocyanate followed by reaction with bromine, forming the thiazole ring. [18] [19] [20]

Riluzole synthesis Riluzole synthesis.png
Riluzole synthesis

Society and culture

Riluzole was approved for medical use in the European Union in October 1996. [3]

Research

A number of case studies and randomized controlled trials have indicated that riluzole, which is neuroprotective and a glutamate modulator, may have use in mood and anxiety disorders. [21] [22] [23] However, it failed in trials of Huntington's disease and Parkinson's disease. [23]

Riluzole has been investigated in rodent models for its potential ability to protect against noise-induced hearing loss (NIHL) and cisplatin-induced ototoxicity. These protective effects are believed to be caused by riluzole's antioxidant and anti-apoptotic properties, but other mechanisms, including modulation of glutamate signaling, are also being investigated. [24] [25] However, further research, especially in human trials, is necessary to confirm these findings and establish riluzole's clinical efficacy for treating hearing loss.

A sublingual reformulation of riluzole that originated at Yale University and is known by the code name BHV-0223 [26] is under development[ when? ] for the treatment of generalized anxiety disorder and mood disorders by Biohaven Pharmaceuticals. [27] [28] A prodrug formulation of riluzole, troriluzole, has been researched as a potential treatment for several different conditions. [29] [30]

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References

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