Avelestat, also known as AZD9668, is a novel, oral inhibitor of neutrophil elastase (NE), an enzyme implicated in the signs, symptoms, and disease progression in NE-driven respiratory diseases such as bronchiectasis, Cystic Fibrosis and chronic obstructive pulmonary disease via its role in the inflammatory process, mucus overproduction, and lung tissue damage. Its development was discontinued due to unknown reasons. Nevertheless, this drug in the phase II of clinical trial as adjunctive therapy in improving insulin sensitivity of insulin-resistant type 2 diabetic subjects. The drug's clinical profile suggests that it will be well tolerated with few, if any, side effects, and the existence of simple methods that can indirectly measure its activity in vivo.

Swainsonine is an indolizidine alkaloid found in Australian Swainsona canescens, North American plants of the genera Astragalus and Oxytropis and also in the fungus Rhizoctonia leguminocola. It is competitive inhibitor of Golgi alpha-mannosidase II and lysosomal alpha-mannosidases. This compound has been reported to be a potent antiproliferative and immunomodulatory agent. However, no evidence of anti-tumor activity of swainsonine was seen in phase II clinical trial, in patients with locally advanced or metastatic renal cell carcinoma. Adverse events such as fatigue, nausea and diarrhea were common but generally mild. Swainsonine is locoweed toxin. Locoweed poisoning is seen throughout the world and annually costs the livestock industry millions of dollars. Swainsonine inhibits lysosomal alpha-mannosidase and Golgi mannosidase II. Poisoned animals are lethargic, anorexic, emaciated, and have neurologic signs that range from subtle apprehension to seizures.

Zolertine is an alpha-adrenergic receptor antagonist that acts as an antihypertensive agent. Its effect was studied in animals in vivo and in vitro. Zolertine considerably decreased systemic blood pressure in mecamylamine hypertensive dogs in a dose-related fashion. Using the intravital microscopic method in rat's mesocygeus microvasculature a direct relationship between zolertine dosage and blockade was demonstrated as well as an inverse relationship between time of action of zolertine and percentage of vasoconstriction caused by noradrenaline. When only zolertine was applied, it caused a small vasoconstriction that decreased as its concentration increased which could be due to its ability to antagonize alpha receptor responses, but not beta responses. Zolertine is a more active alpha blocker than azapetin, a blocker used in medical practice. Competition binding experiments using the alpha1-adrenoceptor antagonist [3H] prazosin showed a zolertine pKi of 6.81 +/- 0.02 in rat liver (alpha1B-adrenoceptors) and 6.35 +/- 0.04 in rabbit liver (alpha1A-adrenoceptors) membranes. Zolertine showed higher affinity for alpha1D-adrenoceptors compared to alpha1A-adrenoceptors, while it had an intermediate affinity for alpha1B-adrenoceptors. The ability of the alpha1-adrenoceptor antagonist zolertine to block alpha1D-adrenoceptor-mediated constriction in different vessels of Wistar Kyoto (WKY) and spontaneously hypertensive (SHR) rats may explain its antihypertensive efficacy despite its low order of potency.

Rezatomidine (AGN 203818) is an alpha adrenergic receptor agonist that was developed for the treatment of chronic pain conditions. Phase II studies have evaluated the safety and effectiveness of rezatomidine in treating the pain in patients with fibromyalgia, irritable bowel syndrome, interstitial cystitis, and diabetic neuropathy. However, three studies were terminated early based on a business decision. Pancreatitis, gastric ulcer, viral infections and dehydration were reported as serious adverse events in patients when administered a 60mg dose.

Nemazoline (A-57219) is a nasal decongestant. It has alpha 1-agonist/alpha 2-antagonist activity and was more effective and long-acting than oxymetazoline on canine nasal mucosa, in-vitro and in-vivo. Upon intranasal administration to dogs, the compound was devoid of systemic effects up to a concentration 1000 times that needed for local decongestant effect (1.65 micrograms, atomized from a 1 microgram mL-1 solution) suggesting limited mucosal absorption. After nasal administration to rats for 15 days at a concentration 1000 times greater than that required for nasal decongestion, no mucosal tissue toxicity or systemic effects were seen.

Napitane [A 75200, ABT 200] is a norepinephrine uptake inhibitor and α2 adrenoceptor antagonist. It was undergoing clinical trials with Abbott in the USA as a treatment for depression. However it was discontinued later. Napitane is a potent alpha 2-adrenoceptor antagonist (Ki = 1.2 nM) with modest norepinephrine uptake-blocking activity (IC50 = 841 nM).

Imiloxan is a highly selective alpha2B adrenoceptor antagonist and was developed for depression in the 1980s. In Phase 1 clinical trials imiloxan dosing led to hypersensitivity reactions; the molecule's development was discontinued.

Indanidine is a selective and effective α2-antagonist, α1-partial agonist patented by pharmaceutical company Siegfried A.-G as a low toxic compound with direct hypotensive action. Indanidine does not penetrate the blood-brain barrier, does not induce drug-metabolizing enzymes in the liver, does not cause behavioral changes.