U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry MIXED
Molecular Formula C22H25N2OS.C10H15O4S
Molecular Weight 596.8
Optical Activity UNSPECIFIED
Defined Stereocenters 2 / 6
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of TRIMETHAPHAN CAMSYLATE

SMILES

CC1(C)[C@@H]2CC[C@@]1(CS([O-])(=O)=O)C(=O)C2.O=C3N(CC4=CC=CC=C4)C5C[S+]6CCCC6C5N3CC7=CC=CC=C7

InChI

InChIKey=HALWUDBBYKMYPW-STOWLHSFSA-M
InChI=1S/C22H25N2OS.C10H16O4S/c25-22-23(14-17-8-3-1-4-9-17)19-16-26-13-7-12-20(26)21(19)24(22)15-18-10-5-2-6-11-18;1-9(2)7-3-4-10(9,8(11)5-7)6-15(12,13)14/h1-6,8-11,19-21H,7,12-16H2;7H,3-6H2,1-2H3,(H,12,13,14)/q+1;/p-1/t;7-,10-/m.1/s1

HIDE SMILES / InChI
Trimethaphan (or Trimethaphan camsylate), a ganglionic blocking agent and an antihypertensive drug, was marketed under the brand name Arfonad. Arfonad is indicated to induce systemic arterial hypotension in patients undergoing major surgery and to treat severe systemic hypertension, and in the emergency treatment of pulmonary edema in patients with pulmonary hypertension associated with systemic hypertension. Trimethaphan prevents stimulation of postsynaptic receptors by competing with acetylcholine for these receptor sites. Additional effects may include direct peripheral vasodilation and release of histamine. This drug was discontinued because of the competition from newer drugs that are more selective in their actions and effects.

Approval Year

Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
ARFONAD

Approved Use

Hypotension, controlled (induction and maintenance) - Trimethaphan is indicated for production of controlled hypotension during surgery to reduce bleeding into the surgical field. Hypertension (treatment) - Trimethaphan is indicated for rapid reduction of blood pressure in the treatment of hypertensive emergencies, especially in patients with acute dissecting aneurysm, and in the emergency treatment of pulmonary edema in patients with pulmonary hypertension associated with systemic hypertension.
Doses

Doses

DosePopulationAdverse events​
9 mg/min 1 times / day multiple, intravenous (mean)
Studied dose
Dose: 9 mg/min, 1 times / day
Route: intravenous
Route: multiple
Dose: 9 mg/min, 1 times / day
Sources:
unhealthy, 23 to 66 years
n = 4
Health Status: unhealthy
Condition: hypertension
Age Group: 23 to 66 years
Sex: M+F
Population Size: 4
Sources:
Disc. AE: Respiratory arrest...
AEs leading to
discontinuation/dose reduction:
Respiratory arrest
Sources:
0.115 mg/kg 1 times / day single, intravenous (mean)
Studied dose
Dose: 0.115 mg/kg, 1 times / day
Route: intravenous
Route: single
Dose: 0.115 mg/kg, 1 times / day
Sources:
pregnant, adult
n = 56
Health Status: pregnant
Age Group: adult
Sex: F
Population Size: 56
Sources:
Other AEs: Yawning, Sensation of warmth...
Other AEs:
Yawning
Sensation of warmth
Nausea
Vomiting
Pallor
Dizziness
Sources:
AEs

AEs

AESignificanceDosePopulation
Respiratory arrest Disc. AE
9 mg/min 1 times / day multiple, intravenous (mean)
Studied dose
Dose: 9 mg/min, 1 times / day
Route: intravenous
Route: multiple
Dose: 9 mg/min, 1 times / day
Sources:
unhealthy, 23 to 66 years
n = 4
Health Status: unhealthy
Condition: hypertension
Age Group: 23 to 66 years
Sex: M+F
Population Size: 4
Sources:
Dizziness
0.115 mg/kg 1 times / day single, intravenous (mean)
Studied dose
Dose: 0.115 mg/kg, 1 times / day
Route: intravenous
Route: single
Dose: 0.115 mg/kg, 1 times / day
Sources:
pregnant, adult
n = 56
Health Status: pregnant
Age Group: adult
Sex: F
Population Size: 56
Sources:
Nausea
0.115 mg/kg 1 times / day single, intravenous (mean)
Studied dose
Dose: 0.115 mg/kg, 1 times / day
Route: intravenous
Route: single
Dose: 0.115 mg/kg, 1 times / day
Sources:
pregnant, adult
n = 56
Health Status: pregnant
Age Group: adult
Sex: F
Population Size: 56
Sources:
Pallor
0.115 mg/kg 1 times / day single, intravenous (mean)
Studied dose
Dose: 0.115 mg/kg, 1 times / day
Route: intravenous
Route: single
Dose: 0.115 mg/kg, 1 times / day
Sources:
pregnant, adult
n = 56
Health Status: pregnant
Age Group: adult
Sex: F
Population Size: 56
Sources:
Sensation of warmth
0.115 mg/kg 1 times / day single, intravenous (mean)
Studied dose
Dose: 0.115 mg/kg, 1 times / day
Route: intravenous
Route: single
Dose: 0.115 mg/kg, 1 times / day
Sources:
pregnant, adult
n = 56
Health Status: pregnant
Age Group: adult
Sex: F
Population Size: 56
Sources:
Vomiting
0.115 mg/kg 1 times / day single, intravenous (mean)
Studied dose
Dose: 0.115 mg/kg, 1 times / day
Route: intravenous
Route: single
Dose: 0.115 mg/kg, 1 times / day
Sources:
pregnant, adult
n = 56
Health Status: pregnant
Age Group: adult
Sex: F
Population Size: 56
Sources:
Yawning
0.115 mg/kg 1 times / day single, intravenous (mean)
Studied dose
Dose: 0.115 mg/kg, 1 times / day
Route: intravenous
Route: single
Dose: 0.115 mg/kg, 1 times / day
Sources:
pregnant, adult
n = 56
Health Status: pregnant
Age Group: adult
Sex: F
Population Size: 56
Sources:
PubMed

PubMed

TitleDatePubMed
[The effects of sodiumnitroprusside and trimethaphan induced hypotension on haemodynamics and myocardial oxygen consumption (author's transl)].
1976 Jan
Pyramidal tract responses (PTR) during hypoxia and hypotension.
1976 Sep-Oct
Cerebral energy levels during trimethaphan-induced hypotension in the rat: effects of light versus deep halothane anesthesia.
1979 Jan
Altered osmotic threshold for vasopressin release and impaired thirst sensation: additional abnormalities in Kallmann's syndrome.
1982 Oct
Changes in cardiac output and systemic arterial pressure after insertion of acrylic cement during trimetaphan, sodium nitroprusside and glycerol trinitrate-induced hypotension. A comparison with changes during normotension.
1983 Aug
Regional blood flows during induced hypotension produced by nitroprusside or trimethaphan in the rhesus monkey.
1985 Aug
[Effect of trimethaphan-induced hypotension on pituitary-adrenocortical function].
1986 Mar
[Difference in susceptibility between auditory and equilibrium function in rabbits with experimentally-induced transient ischemic attack].
1989 Feb
The hemodynamic and metabolic changes in prostaglandin E1-induced hypotension in dogs--a comparative study with trimetaphan-induced hypotension.
1989 Sep 1
[Baroreceptor reflex response to acute blood loss during induced hypotension--a comparison of sodium nitroprusside, prostaglandin E1 and trimethaphan].
1990 May
Effects of ischemia duration on neurological outcome, CA1 histopathology, and nonmatching to sample learning in monkeys.
1992 Oct
Epidural blood flow during prostaglandin E1 or trimethaphan induced hypotension.
1994 Apr
Cerebral blood flow distribution during induced hypotension with haemorrhage, trimetaphan or nitroprusside in rats.
1995 Jun
Trimetaphan may cause coronary artery spasm.
1995 Sep
Patents

Patents

Sample Use Guides

Controlled hypotension during surgery: Initial: Intravenous infusion, 3 to 4 mg per minute, adjusted according to response. Maintenance: Intravenous infusion, 300 mcg (0.3 mg) to 6 mg per minute. Hypertensive emergency: Initial: Intravenous infusion, 500 mcg (0.5 mg) to 1 mg per minute, adjusted according to response. Maintenance: Intravenous infusion, 1 to 5 mg per minut
Route of Administration: Intravenous
Name Type Language
TRIMETHAPHAN CAMSYLATE
MI   ORANGE BOOK   VANDF  
Common Name English
ARFONAD
Brand Name English
THIENO(1',2':1,2)THIENO(3,4-D)IMIDAZOL-5-IUM, DECAHYDRO-2-OXO-1,3-BIS(PHENYLMETHYL)-, SALT WITH (+)-7,7-DIMETHYL-2-OXOBICYCLO(2.2.1)HEPTANE-1-METHANESULFONIC ACID (1:1)
Common Name English
TRIMETAPHAN CAMSILATE [JAN]
Common Name English
TRIMETHAPHAN CAMSYLATE [ORANGE BOOK]
Common Name English
Trimetaphan camsilate [WHO-DD]
Common Name English
TRIMETAPHAN CAMSYLATE
Common Name English
TRIMETHAPHAN CAMSYLATE [MI]
Common Name English
TRIMETAPHAN CAMSILATE
INN   JAN   MART.   WHO-DD  
INN  
Official Name English
(+)-1,3-DIBENZYLDECAHYDRO-2-OXOIMIDAZO(4,5-C)THIENO(1,2-A)-THIOLIUM 2-OXO-10-BORNANESULFONATE (1:1)
Systematic Name English
NU-2222
Code English
trimetaphan camsilate [INN]
Common Name English
TRIMETAPHAN CAMSILATE [MART.]
Common Name English
TRIMETHAPHAN CAMSYLATE [VANDF]
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C270
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
NCI_THESAURUS C66886
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
Code System Code Type Description
SMS_ID
100000076923
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
WIKIPEDIA
Trimetaphan camsilate
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
EVMPD
SUB11305MIG
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
RXCUI
38680
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY RxNorm
NCI_THESAURUS
C66639
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
CHEBI
9729
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
DRUG BANK
DBSALT001381
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
ECHA (EC/EINECS)
200-696-8
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
PUBCHEM
44602409
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
EPA CompTox
DTXSID3023710
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
CAS
68-91-7
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
INN
296
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
FDA UNII
8W556014K9
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
ChEMBL
CHEMBL1201329
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
MESH
C017774
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY
MERCK INDEX
m11146
Created by admin on Fri Dec 15 16:25:52 GMT 2023 , Edited by admin on Fri Dec 15 16:25:52 GMT 2023
PRIMARY Merck Index