Ethoheptazine Explained

Ethoheptazine^[1] (trade name Zactane) is an opioid analgesic from the phenazepane family. It was invented in the 1950s^[2] and is a ring expanded analogue of pethidine.^[3]

Ethoheptazine produces similar effects to other opioids, including analgesia, sedation, dizziness and nausea.^[4] It was sold by itself as Zactane, and is still available as a combination product with acetylsalicylic acid and meprobamate as Equagesic, which is used for the treatment of conditions where both pain and anxiety are present.^[5] It was also investigated for use as an antitussive.^[6]

It is no longer prescribed, as it is no longer FDA approved, and not available for United States' Pharmacy Processing. Revocation of FDA Approved Medications Status stems from a combination of efficacy vs. toxicity, and the more-varied and historically safer Benzodiazepines Class. Only reversal of the FDA's decision, allows removing the drug from the CSD. Ethoheptazine is not listed as a controlled substance under the Controlled Substances Act, 1970 in the United States. The controlled status (Schedule IV) of Equagesic was due to the meprobamate content.^{[7] [8]} Regulation elsewhere varies.

Notes and References

1. ES . 310184 . Procedure for the preparation of a new derivative of pirazolidine-hexametilenimina with therapeutic properties. .
2. Batterman RC, Golbey M, Grossman AJ, Leifer P . Analgesic effectiveness of orally administered ethoheptazine in man . The American Journal of the Medical Sciences . 234 . 4 . 413–9 . October 1957 . 13469802 . 10.1097/00000441-195710000-00004 . 32299049 .
3. Diamond J, Bruce WF, Tyson FT . Synthesis and Properties of the Analgesic DL-α-1,3-dimethyl-4-phenyl-4-propionoxyazacycloheptane (Proheptazine). . Journal of Medicinal Chemistry . 7 . 57–60 . January 1964 . 14186026 . 10.1021/jm00331a013 .
4. Cinelli P, Zucchini M . [Current pharmaco-therapeutic possiblities in the treatment of pain. Experiments with ethoeptazine] . it . Minerva Medica . 53 . 637–42 . March 1962 . 13879557 .
5. Scheiner JJ, Richards DJ . Treatment of musculoskeletal pain and associated anxiety with an ethoheptazine-aspirin-meprobamate combination (equagesic): a controlled study . Current Therapeutic Research, Clinical and Experimental . 16 . 9 . 928–36 . September 1974 . 4214668 .
6. Overton DA, Batta SK . Investigation of narcotics and antitussives using drug discrimination techniques . The Journal of Pharmacology and Experimental Therapeutics . 211 . 2 . 401–8 . November 1979 . 41087 . 8331839 .
7. PDR 1978, pp 1618
8. Web site: Conversion Factors for Controlled Substances . Diversion Control Division . Drug Enforcement Agency, U.S. Department of Justice . 2016-02-27 . 2016-03-02 . https://web.archive.org/web/20160302162948/http://deadiversion.usdoj.gov/quotas/conv_factor/index.html . dead .