Ivabradine (CORLANOR®) is a hyperpolarization-activated cyclic nucleotide-gated channel blocker that reduces the spontaneous pacemaker activity of the cardiac sinus node by selectively inhibiting the If-current, resulting in heart rate reduction at concentrations that do not affect other cardiac ionic currents. Specific heart-rate lowering with ivabradine (CORLANOR®) reduces myocardial oxygen demand, simultaneously improving oxygen supply. It has no negative inotropic or lusitropic effects, preserving ventricular contractility, and does not change any major electrophysiological parameters unrelated to heart rate.

Indapamide is an antihypertensive and a diuretic. It contains both a polar sulfamoyl chlorobenzamide moiety and a lipid- soluble methylindoline moiety. Indapamide blocks the slow component of delayed rectifier potassium current (IKs) without altering the rapid component (IKr) or the inward rectifier current. Specifically it blocks or antagonizes the action the proteins KCNQ1 and KCNE1. Indapamide is also thought to stimulate the synthesis of the vasodilatory hypotensive prostaglandin PGE2. Indapamide is used for the treatment of hypertension, alone or in combination with other antihypertensive drugs, as well as for the treatment of salt and fluid retention associated with congestive heart failure or edema from pregnancy (appropriate only in the management of edema of pathologic origin during pregnancy when clearly needed). Also used for the management of edema as a result of various causes.

Terutroban (S18886), a specific thromboxane A2 receptor antagonist, which improves endothelial function and has an antiatherosclerotic effect. The compound is under development by Servier for the potential treatment of cardiovascular diseases and coronary artery disease. In addition, it participated in phase III clinical trials PERFORM (Prevention of cerebrovascular and cardiovascular Events of ischemic origin with teRutroban in patients with a history oF ischemic strOke or tRansient ischeMic attack), but this study was stopped, and the result was not achieved.

Alnespirone [S 20499] is a potent and full agonist at pre- and postsynaptic serotonin 1A receptors. Alnespirone is the (+)-enantiomer, S 20244 is the racemate. In animal models, alnespirone demonstrated both anxiolytic and antidepressant activity and was undergoing phase II trials in these indications with Servier in France. However, development of Alnespirone was discontinued for anxiety disorders and major depressive disorder.

LAPRAFYLLINE is a xanthine derivative with bronchodilating effect. It might exert its action by inhibiting cAMP phosphodiesterase.

S-17092, a prolyl endopeptidase inhibitor, is in phase I investigations with Servier in France for its potential in cognition disorders. Prolyl endopeptidase is involved in the metabolic breakdown of a number of neuropeptide neurotransmitters in the brain, and so inhibiting the action of the enzyme increases the activity of these neuropeptides. This produces nootropic effects which make S-17092 a promising and novel treatment for neurodegenerative conditions such as Alzheimer's disease and Parkinson's disease.

N-Demethyl Ivabradine Hydrochloride is an active metabolite of Ivabradine. Ivabradine protects myocardium in acute ischemic conditions and has favorably sustained remo- deling properties in the long term. N-dealkylated metabolite has also been shown to decrease heart rate in pre-clinical studies when administered to dogs

IVABRADINE, (-)- is an (R)-enantiomers of Ivabradine. IVABRADINE, (-)- produced a concentration-dependent block of hKv1.5 channels. S 16260 (R configuration) and S 16257 (S configuration) of Ivabradine were equipotent in reducing the spontaneous firing of rabbit sinus node preparations, but S 16260 induced significant prolongations of action potential duration of ventricular preparation (guinea pig papillary muscle and rabbit purkinje fibers), contrary to S 16257. These in vitro data have been confirmed by in vivo studies in anesthetized pigs showing the equipotence of the two isomers in reducing the heart rate, the absence of effect of S 16257 on the QT interval corrected for heart rate (QTc) in contrast with S 16260 which induced a dose-dependent increase in the QTc, indicating a direct effect on ventricular repolarization.

Perindopril arginine is a stable L-arginine salt of perindopril. Perindopril, a pro-drug, is hydrolyzed to perindoprilat, which inhibits ACE in humans and in animals. It is indicated for the treatment of hypertension, heart failure and coronary artery disease. Perindopril arginine may be used in monotherapy or in combination with other classes of antihypertensive therapy.

Strontium ranelate is composed of an organic moiety (ranelic acid) and of two atoms of stable nonradioactive strontium. In vitro, strontium ranelate increases collagen and noncollagenic proteins synthesis by mature osteoblast enriched cells. The effects of strontium ranelate on bone formation were confirmed as strontium ranelate enhanced pre-osteoblastic cell replication. The stimulation by strontium ranelate of the replication of osteoprogenitor cell and collagen, as well as noncollagenic protein synthesis in osteoblasts, provides substantial evidence to categorize strontium ranelate as a bone-forming agent. In the isolated rat osteoclast assay, a pre-incubation of bone slices with strontium ranelate induced a dose- dependent inhibition of the bone resorbing activity of treated rat osteoclast. Strontium ranelate also dose-dependently inhibited, in a chicken bone marrow culture, the expression of both carbonic anhydrase II and the alpha-subunit of the vitronectin receptor. These effects showing that strontium ranelate significantly affects bone resorption due to a direct and/or matrix-mediated inhibition of osteoclast activity and also inhibits osteoclasts differentiation, are compatible with the profile of an anti-resorptive drug. Pharmacological and clinical studies suggest that strontium ranelate optimizes bone resorption and bone formation, resulting in increased bone mass, which may be of great value in the treatment of osteoporosis. Strontium ranelate is approved by EMA for the treatment of severe osteoporosis in postmenopausal women and in adult men.