Clotiazepam
Systematic (IUPAC) name | |
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5-(2-chlorophenyl)-7-ethyl-1-methyl-3H-thieno[2,3-e][1,4]diazepin-2-one
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Clinical data | |
Trade names | Veratran, Rize, Clozan |
AHFS/Drugs.com | International Drug Names |
Legal status |
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Routes of administration |
Oral, sublingual, liquid drops |
Pharmacokinetic data | |
Bioavailability | ~90% |
Metabolism | Hepatic |
Biological half-life | 6–18 hours |
Excretion | Renal |
Identifiers | |
CAS Number | 33671-46-4 |
ATC code | N05BA21 (WHO) |
PubChem | CID: 2811 |
DrugBank | DB01559 |
ChemSpider | 2709 |
UNII | ZCN055599V |
KEGG | D01328 |
ChEMBL | CHEMBL1697737 |
Chemical data | |
Formula | C16H15ClN2OS |
Molecular mass | 318.8 g/mol |
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Clotiazepam[1] (marketed under brand name Clozan, Distensan, Trecalmo, Rize, Rizen and Veratran) is a thienodiazepine drug which is a benzodiazepine analog. The clotiazepam molecule differs from most other benzodiazepines in that the benzene ring has been replaced by a thiophene ring.[2] It possesses anxiolytic,[3] skeletal muscle relaxant,[4] anticonvulsant, sedative properties.[5] Stage 2 NREM sleep is significantly increased by clotiazepam.[6]
Contents
Indications
Clotiazepam has been trialed and found to be effective in the short-term management of anxiety.[7] Clotiazepam is also used as a premedicant in minor surgery in France and Japan, where the drug is commercially available under the brand names Veratran and Rize, respectively.[8][9]
Pharmacokinetics
A cross-over study in six healthy volunteers (median age 28 years) was conducted using single-dose pharmacokinetics of 5 mg clotiazepam drops, oral tablets, and sublingual tablets. The formulations had similar systemic availability. Compared with oral tablets, the sublingual route gave a lower peak concentration and a delayed peak time, while drops gave a greater maximum concentration with a similar peak time. The use of drops is suggested for a more marked initial effect and the sublingual route for easier administration, especially in the elderly.[10]
Pharmacology
Similar to other benzodiazepines clotiazepam has anxiolytic, sedative, hypnotic, amnesic, anticonvulsant and muscle relaxant pharmacological properties.[5] Clotiazepam binds to the benzodiazepine site of the GABAA receptor where it acts as a full agonist; this action results in an enhanced GABA inhibitory effect at the GABAA receptor which results in the pharmacological effects of clotiazepam.[11]
Clotiazepam has a relatively short elimination half-life and is less prone to accumulation after repeated dosing compared to longer-acting benzodiazepine agents. It is metabolised via oxidation.[12] Clotiazepam is metabolised to hydroxy-clotiazepam and desmethyl-clotiazepam. After oral ingestion of a single 5 mg dose of clotiazepam by three healthy volunteers the drug was rapidly absorbed.[13] The elimination half-life of the drug and its metabolites range from 6.5 hours to 18 hours. Clotiazepam is 99 percent bound to plasma protein.[13] In elderly men the elimination half-life is longer and in elderly women the volume of distribution is increased.[14] Individuals with liver impairment have a reduced volume of distribution as well as a reduced total clearance of clotiazepam; renal impairment does not affect the kinetics of clotiazepam.[15]
Side effects
Drowsiness and asthenia are common side effects.[16] There has been a report of hepatitis caused by clotiazepam.[17]
Abuse
Clotiazepam is a recognised drug of abuse.[18]
See also
References
- ↑ DE Patent 2107356
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- ↑ Official Japanese Drug Information Sheet (Kusuri-no-Shiori)
- ↑ French Guide to Medicines - Clotiazepam (Veratran)
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