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

Details

Stereochemistry MIXED
Molecular Formula C22H25N2OS
Molecular Weight 365.512
Optical Activity UNSPECIFIED
Defined Stereocenters 0 / 4
E/Z Centers 0
Charge 1

SHOW SMILES / InChI
Structure of TRIMETHAPHAN

SMILES

O=C1N(CC2=CC=CC=C2)C3C[S+]4CCCC4C3N1CC5=CC=CC=C5

InChI

InChIKey=CHQOEHPMXSHGCL-UHFFFAOYSA-N
InChI=1S/C22H25N2OS/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/h1-6,8-11,19-21H,7,12-16H2/q+1

HIDE SMILES / InChI

Molecular Formula C22H25N2OS
Molecular Weight 365.512
Charge 1
Count
Stereochemistry MIXED
Additional Stereochemistry No
Defined Stereocenters 0 / 4
E/Z Centers 0
Optical Activity UNSPECIFIED

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
Brain blood flow and metabolism after global ischemia and post-insult thiopental therapy in monkeys.
1979 Sep-Oct
[The effects of controlled hypotension induced by prostaglandin E1 and trimethaphan on coronary and systemic hemodynamics and myocardial contractility (author's transl)].
1982 Apr
Autoregulation of myocardial blood flow under controlled hypotension in the dog.
1982 Jun
[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
Chronic lesion of rostral ventrolateral medulla in spontaneously hypertensive rats.
1992 Feb
[Pharmacokinetics of epidurally administered bupivacaine during prostaglandin E1- or trimetaphan-induced hypotension].
1992 May
Effects of trimetaphan-induced deliberate hypotension on human cochlear blood flow.
1998
Role of the multidomain protein spinophilin in blood pressure and cardiac function regulation.
2008 Oct
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
Substance Class Chemical
Created
by admin
on Fri Dec 15 16:19:51 GMT 2023
Edited
by admin
on Fri Dec 15 16:19:51 GMT 2023
Record UNII
6G8X656T45
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
TRIMETHAPHAN
Common Name English
TRIMETAPHAN
WHO-DD  
Common Name English
THIENO(1',2':1,2)THIENO(3,4-D)IMIDAZOLIUM, DECAHYDRO-2-OXO-1,3-BIS(PHENYLMETHYL)-
Systematic Name English
TRIMETHAPHAN CATION
Common Name English
TRIMETHAPHAN ION
Common Name English
Trimetaphan [WHO-DD]
Common Name English
1,3-DIBENZYL-2-OXODECAHYDROTHIENO(1',2':1,2)THIENO(3,4-D)IMIDAZOL-5-IUM
Systematic Name English
Classification Tree Code System Code
WHO-VATC QC02BA01
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
WHO-ATC C02BA01
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
NCI_THESAURUS C66886
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
Code System Code Type Description
FDA UNII
6G8X656T45
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
EVMPD
SUB04969MIG
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
CAS
7728-39-4
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
ALTERNATIVE
WIKIPEDIA
Trimethaphan
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
SMS_ID
100000084665
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
EPA CompTox
DTXSID8043787
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
CHEBI
9728
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
NCI_THESAURUS
C77369
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
HSDB
7676
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
DRUG CENTRAL
2752
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
PUBCHEM
23576
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
RXCUI
10828
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY RxNorm
CAS
7187-66-8
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
MESH
D014294
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
DRUG BANK
DB01116
Created by admin on Fri Dec 15 16:19:51 GMT 2023 , Edited by admin on Fri Dec 15 16:19:51 GMT 2023
PRIMARY
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