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

Molecular Formula C10H15O4S
Molecular Weight 231.289
Charge -1
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 2 / 2
E/Z Centers 0
Optical Activity UNSPECIFIED

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
[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
Canine systemic and cerebral effects of hypotension induced by hemorrhage, trimethaphan, halothane, or nitroprusside.
1977 Mar
[Electrocardiographic changes observed during the use of trimethaphan in the treatment of malignant arterial hypertension].
1978 Aug
Postischemic brain oxygenation with barbiturate therapy in rats.
1979 Aug
[Use of methoxamine in trimethaphan-induced hypotension].
1979 Jan
Prolonged apnea following trimethaphan and succinylcholine.
1979 Jan
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
Cerebral and systemic effects of hypotension induced by trimetaphan or nitroprusside in dogs.
1982 Dec
Autoregulation of myocardial blood flow under controlled hypotension in the dog.
1982 Jun
Trimethaphan-induced hypotension: effect on renal function.
1982 Nov
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
Hemodynamics and myocardial metabolism under deliberate hypotension. An experimental study in dogs.
1983 Dec
[Effect of hypotension induced by trimethaphan and nitroglycerin on intraocular pressure in man].
1983 Feb
Profound arterial hypotension in dogs: brain electrical activity and organ integrity.
1983 Jan
Regional blood flows during induced hypotension produced by nitroprusside or trimethaphan in the rhesus monkey.
1985 Aug
The influence of trimethaphan (Arfonad)-induced hypotension with and without spine distraction on canine spinal cord blood flow.
1986 Apr
[Effect of trimethaphan-induced hypotension on pituitary-adrenocortical function].
1986 Mar
[Effect of trimethaphan-induced hypotension on carbohydrate metabolism].
1986 Oct
The effect of trimethaphan-induced hypotension on canine spinal cord blood flow. Measurement at different cord levels using radiolabelled microspheres.
1988 May
[Difference in susceptibility between auditory and equilibrium function in rabbits with experimentally-induced transient ischemic attack].
1989 Feb
Acute left bundle branch block precipitated by trimethaphan.
1989 Sep
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
Chronic lesion of rostral ventrolateral medulla in spontaneously hypertensive rats.
1992 Feb
[Effects of induced hypotensive anesthesia on the blood coagulation-fibrinolysis system measured by thrombelastography--comparison between prostaglandin E1 and trimethaphan].
1992 Jan
[Pharmacokinetics of epidurally administered bupivacaine during prostaglandin E1- or trimetaphan-induced hypotension].
1992 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.
1993 Nov
Epidural blood flow during prostaglandin E1 or trimethaphan induced hypotension.
1994 Apr
[Effect of deliberate hypotension on renal functions during epidural block plus inhalation anesthesia: a comparison of prostaglandin E1 and trimethaphan].
1994 Oct
Differential microcirculation dynamics during deliberate hypotension induced by nicardipine, PGE1 and trimethaphan in rat mesentery.
1995 Nov
Trimetaphan may cause coronary artery spasm.
1995 Sep
Effects of trimetaphan-induced deliberate hypotension on human cochlear blood flow.
1998
Cerebral blood-flow responses to induced hypotension and to CO2 inhalation in patients with major cerebral artery occlusive disease: a positron-emission tomography study.
1999 Feb
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 16:25:52 UTC 2023
Edited
by admin
on Fri Dec 15 16:25:52 UTC 2023
Record UNII
8W556014K9
Record Status Validated (UNII)
Record Version
  • Download
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 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
NCI_THESAURUS C66886
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
Code System Code Type Description
SMS_ID
100000076923
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
WIKIPEDIA
Trimetaphan camsilate
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
EVMPD
SUB11305MIG
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
RXCUI
38680
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY RxNorm
NCI_THESAURUS
C66639
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
CHEBI
9729
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
DRUG BANK
DBSALT001381
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
ECHA (EC/EINECS)
200-696-8
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
PUBCHEM
44602409
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
EPA CompTox
DTXSID3023710
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
CAS
68-91-7
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
INN
296
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
FDA UNII
8W556014K9
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
ChEMBL
CHEMBL1201329
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
MESH
C017774
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY
MERCK INDEX
m11146
Created by admin on Fri Dec 15 16:25:52 UTC 2023 , Edited by admin on Fri Dec 15 16:25:52 UTC 2023
PRIMARY Merck Index
Related Record Type Details
PARENT -> SALT/SOLVATE
Related Record Type Details
ACTIVE MOIETY