Benzydamine Explained

Verifiedrevid:414278352
Iupac Name:3-(1-benzyl-1H-indazol-3-yloxy)-N,N-dimethylpropan-1-amine
Tradename:Maxtra Gargle, Difflam, Tantum
Pregnancy Au:B2
Legal Br:C1
Legal Br Comment:[1]
Legal Uk:GSL
Legal Eu:OTC
Routes Of Administration:Oral, topical
Protein Bound:<20%
Elimination Half-Life:13 hours
Excretion:Kidney
Cas Number:642-72-8
Atc Prefix:A01
Atc Suffix:AD02
Atc Supplemental:



Pubchem:12555
Chemspiderid:12036
Chebi:94563
Unii:4O21U048EF
Kegg:D07516
Chembl:12610
C:19
H:23
N:3
O:1
Smiles:n2c(OCCCN(C)C)c1ccccc1n2Cc3ccccc3
Stdinchi:1S/C19H23N3O/c1-21(2)13-8-14-23-19-17-11-6-7-12-18(17)22(20-19)15-16-9-4-3-5-10-16/h3-7,9-12H,8,13-15H2,1-2H3
Stdinchikey:CNBGNNVCVSKAQZ-UHFFFAOYSA-N

Benzydamine (also known as Tantum Verde and branded in some countries as Maxtra Gargle, Difflam and Septabene), available as the hydrochloride salt, is a locally acting nonsteroidal anti-inflammatory drug (NSAID) with local anaesthetic and analgesic properties for pain relief and anti-inflammatory treatment of inflammatory conditions of the mouth and throat.[2] It falls under class of chemicals known as indazole.

History

It was synthesized in Italy in 1964 and marketed in 1966.[3]

Uses

Medical

It may be used alone or as an adjunct to other therapy giving the possibility of increased therapeutic effect with little risk of interaction.

In some markets, the drug is supplied as an over-the-counter cream (Lonol in Mexico from Boehringer Ingelheim) used for topical treatment of musculoskeletal system disorders: sprains, strains, bursitis, tendinitis, synovitis, myalgia, periarthritis.

Recreational

Benzydamine has been used recreationally. In overdosages it acts as a deliriant and CNS stimulant. Such use, particularly among teenagers, has been reported in Brazil,[4] [5] Poland, Romania, and Turkey.

Contraindications

There are no contraindications to the use of benzydamine except for known hypersensitivity.

Side effects

Benzydamine is well tolerated. Occasionally oral tissue numbness or stinging sensations may occur, as well as itching, a skin rash, skin swelling or redness, difficulty breathing and wheezing.

Pharmacology

It selectively binds to inflamed tissues (Prostaglandin synthetase inhibitor) and is normally free of adverse systemic effects.Unlike other NSAIDs, it does not inhibit cyclooxygenase or lipooxygenase, and is not ulcerogenic.[6] [7] It has powerful reinforcing effect and has cross sensitization with drugs of abuse such as heroin and cocaine in animals. It is hypothesized that it has cannabinoid agonistic activity.

Pharmacokinetic

Benzydamine is poorly absorbed through skin[8] and vagina.[9]

Synthesis

Synthesis starts with the reaction of the N-benzyl derivative from methyl anthranilate with nitrous acid to give the N-nitroso derivative. Reduction by means of sodium thiosulfate leads to the transient hydrazine (3), which undergoes spontaneous internal hydrazide formation. Treatment of the enolate of this amide with 3-chloro-1-dimethylamino propane gives benzydamine (5). Please note there is an error in this section: US3318905 states that the nitroso derivative is reduced with sodium hydrosulfite (sodium dithionite) and not with sodium hyposulfite (sodium thiosulfate), as shown in the above scheme and stated in text. An interesting alternative synthesis of this substance starts by sequential reaction of N-benzylaniline with phosgene, and then with sodium azide to product the corresponding carbonyl azide. On heating, nitrogen is evolved and a separatable mixture of nitrene insertion product and the desired ketoindazole # results. The latter reaction appears to be a Curtius rearrangement type product to produce an N-isocyanate #, which then cyclizes. Alkylation of the enol with sodium methoxide and 3-dimethylaminopropyl chloride gives benzydamine.

Alternatively, use of chloroacetamide in the alkylation step followed by acid hydrolysis produces bendazac instead.

Research

Studies indicate that benzydamine has notable in vitro antibacterial activity and also shows synergism in combination with other antibiotics, especially tetracyclines, against antibiotic-resistant strains of Staphylococcus aureus and Pseudomonas aeruginosa.[10] [11]

It also has some cannabinoid activity in rats but has not been tested in humans.[12] It is also hypothesized to act on 5-HT2A receptors due to its structural similarity with serotonin.

See also

External links

Notes and References

  1. Web site: Anvisa . Brazilian Health Regulatory Agency . 2023-03-31 . RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial . Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control. live . https://web.archive.org/web/20230803143925/https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 . 2023-08-03 . 2023-08-16 . . pt-BR . 2023-04-04.
  2. Turnbull RS . Benzydamine Hydrochloride (Tantum) in the management of oral inflammatory conditions . Journal . 61 . 2 . 127–34 . February 1995 . 7600413 .
  3. Web site: DEXTROMETHORPHAN AND BENZYDAMINE'S USE AND MISUSE. Flipper.diff.org. 25 June 2022.
  4. Opaleye ES, Noto AR, Sanchez Z, Moura YG, Galduróz JC, Carlini EA . Recreational use of benzydamine as a hallucinogen among street youth in Brazil . Revista Brasileira de Psiquiatria . 31 . 3 . 208–13 . September 2009 . 19784487 . 10.1590/S1516-44462009000300005 . free.
  5. Mota DM, Costa AA, Teixeira C, Bastos AA, Dias MF . Use abusive of benzydamine in Brazil: an overview in pharmacovigilance . pt . Ciencia & Saude Coletiva . 15 . 3 . 717–24 . May 2010 . 20464184 . 10.1590/S1413-81232010000300014 . free.
  6. Anand JS, Glebocka ML, Korolkiewicz RP . Recreational abuse with benzydamine hydrochloride (tantum rosa) . Clinical Toxicology . 45 . 2 . 198–9 . 2007 . 17364645 . 10.1080/15563650600981210 . free.
  7. Müller-Peddinghaus R . New pharmacologic and biochemical findings on the mechanism of action of the non-steroidal antiphlogistic, benzydamine. A synopsis . German . . 37 . 5A . 635–45 . May 1987 . 3304305.
  8. Baldock GA, Brodie RR, Chasseaud LF, Taylor T, Walmsley LM, Catanese B . Pharmacokinetics of benzydamine after intravenous, oral, and topical doses to human subjects . . 12 . 7 . 481–92 . October 1991 . 1932611 . 10.1002/bdd.2510120702. 42167110 .
  9. Maamer M, Aurousseau M, Colau JC . Concentration of benzydamine in vaginal mucosa following local application: an experimental and clinical study . . 9 . 2 . 135–45 . 1987 . 3610512.
  10. Fanaki NH, el-Nakeeb MA . Antimicrobial activity of benzydamine, a non-steroid anti-inflammatory agent . Journal of Chemotherapy . 4 . 6 . 347–52 . December 1992 . 1287137 . 10.1080/1120009X.1992.11739190 .
  11. Fanaki NH, El-Nakeeb MA . Antibacterial activity of benzydamine and antibiotic-benzydamine combinations against multifold resistant clinical isolates . Arzneimittel-Forschung . 46 . 3 . 320–3 . March 1996 . 8901158 .
  12. Avvisati R, Meringolo M, Stendardo E, Malavasi E, Marinelli S, Badiani A . Intravenous self-administration of benzydamine, a non-steroidal anti-inflammatory drug with a central cannabinoidergic mechanism of action . . 23 . 2 . 610–619 . March 2018 . 28429885 . 10.1111/adb.12516 . 206970991 .