Etilefrine, sold under the brand name Effortil among others, is a sympathomimetic medication used as an antihypotensive agent to treat orthostatic hypotension.
of etilefrine include nausea, , and , among others.
Etilefrine was first described and introduced for medical use by 1949.
Medical uses
Etilefrine is used to treat orthostatic hypotension and as a nasal decongestant.
It has also been used
off-label use to treat
priapism.
Side effects
of etilefrine include
nausea,
, and
, among others.
Pharmacology
Pharmacodynamics
Etilefrine is an
agonist of the α
1-adrenergic receptor.
It is a
vasoconstrictor and antihypotensive agent.
It has also been described as a β
1-adrenergic receptor agonist with some agonistic actions at the α- and β
2-adrenergic receptors.
Intravenous infusion of this compound increases cardiac output, stroke volume, venous return, and blood pressure in humans and animals, suggesting stimulation of both α- and β-adrenergic receptors.
Intravenous etilefrine increases the pulse rate, cardiac output, stroke volume, central venous pressure, and mean arterial pressure of healthy individuals. Peripheral vascular resistance falls during the infusion of 1 to 8mg etilefrine but begins to rise at higher dosage. Marked falls in pulse rate, cardiac output, stroke volume, and peripheral blood flow, accompanied by rises in mean arterial pressure, occur when etilefrine is infused after administration of intravenous propranolol 2.5mg. These findings indicate that etilefrine has both β1- and α1-adrenergic receptor actions in humans.
Pharmacokinetics
Absorption
Etilefrine is rapidly absorbed with oral administration.
The oral
bioavailability of etilefrine is approximately 50%.
Peak concentrations of etilefrine occur after 30minutes.
Distribution
The plasma protein binding of etilefrine is 23%.
About 8.5% is bound to albumin.
Etilefrine is a peripherally selective drug.
Metabolism
Etilefrine is
drug metabolism by conjugation, for instance
glucuronidation, in the
liver and gastrointestinal tract.
There appears to be significant first-pass metabolism.
About 3% is metabolized into hydroxymandelic acid.
Elimination
The elimination of etilefrine is dependent on route of administration.
Regardless of route, about 80% is
excretion in
urine within 24hours.
With oral administration, 7% is eliminated unchanged in urine and 73% as conjugates.
Conversely, with intravenous administration, 28% is eliminated unchanged in urine and 44% as conjugates.
Chemistry
Etilefrine, also known as 3,β-dihydroxy-
N-ethylphenethylamine, is a substituted phenethylamine derivative.
It is an analogue of epinephrine (3,4,β-trihydroxy-
N-methylphenethylamine), of
phenylephrine ((
R)-β,3-dihydroxy-
N-methylphenethylamine), of
metaterol (3,β-dihydroxy-
N-isopropylphenethylamine), and of
norfenefrine (3,β-dihydroxyphenethylamine), as well as of
metaraminol ((1
R,2
S)-3,β-dihydroxy-α-methylphenethylamine).
Etilefrine pivalate (K-30052) is the 3-pivalate ester of etilefrine.
History
Etilefrine was first described and introduced for medical use by 1949.
Society and culture
Names
Etilefrine is the
generic term of the drug and its and , while
étiléfrine is its and
etilefrina is its .
In the case of the
hydrochloride salt, its generic name is
etilefrine hydrochloride and this is its and .
Synonyms of etilefrine include
ethylnorphenylephrine,
ethylphenephrine,
etiladrianol,
aethyladrianol, and
M-I-36.
Brand names of the drug include
Effortil,
Circupon,
Apocretin,
Palsamin,
Kertasin,
Pressoton,
Effoless, and
Sanlephrin.
