Mibefradil

Mibefradil
Clinical data

Trade names	Posicor
AHFS/Drugs.com	Micromedex Detailed Consumer Information
MedlinePlus	a607007
Routes of administration	By mouth (tablets)
ATC code	C08CX01 (WHO)
Legal status
Legal status	Withdrawn from market
Pharmacokinetic data
Bioavailability	70%
Protein binding	>99%
Metabolism	Liver
Biological half-life	17–25 hours
Identifiers
IUPAC name (1S,2S)-2-(2-((3-(1H-benzo[d]imidazol-2-yl)propyl) (methyl)amino)ethyl)-6-fluoro-1-isopropyl-1,2,3,4-tetrahydronaphthalen-2-yl 2-methoxyacetate
CAS Number	116644-53-2^Y
PubChem (CID)	60662
IUPHAR/BPS	2522
DrugBank	DB01388^N
ChemSpider	54673^N
UNII	27B90X776A^N
KEGG	D08217^Y
ChEMBL	CHEMBL45816^N
Chemical and physical data
Formula	C₂₉H₃₈FN₃O₃
Molar mass	495.63 g/mol
3D model (Jmol)	Interactive image
Melting point	128 °C (262 °F) (dihydrochloride salt)
SMILES CC(C)[C@H]1C2=C(CC[C@@]1(CCN(C)CCCC3=NC4=CC=CC=C4N3)OC(=O)COC)C=C(C=C2)F
InChI InChI=1S/C29H38FN3O3/c1-20(2)28-23-12-11-22(30)18-21(23)13-14-29(28,36-27(34)19-35-4)15-17-33(3)16-7-10-26-31-24-8-5-6-9-25(24)32-26/h5-6,8-9,11-12,18,20,28H,7,10,13-17,19H2,1-4H3,(H,31,32)/t28-,29-/m0/s1^N Key:HBNPJJILLOYFJU-VMPREFPWSA-N^N
^NY (what is this?) (verify)

Mibefradil (Posicor) is a drug for the treatment of hypertension and chronic angina pectoris. It belongs to a group known as calcium channel blockers.

The mechanism of action of mibefradil is characterized by the selective blockade of transient, low-voltage-activated (T-type) calcium channels over long-lasting, high-voltage-activated (L-type) calcium channels, which is probably responsible for many of its unique properties.

It is nonselective.^[1]

On June 8, 1998, Roche announced the voluntary withdrawal of the drug from the market, one year after approval by the FDA, due to the potential for drug interactions, some of them deadly, which may occur when it is taken together with some other medications.^[2]

Synthesis

Mibefradil synthesis: YU 22988 ZW 20087

References

↑ Bezprozvanny I, Tsien RW (September 1995). "Voltage-dependent blockade of diverse types of voltage-gated Ca2+ channels expressed in Xenopus oocytes by the Ca2+ channel antagonist mibefradil (Ro 40-5967)". Mol. Pharmacol. 48 (3): 540–9. PMID 7565636.
↑ Heart Drug Withdrawn as Evidence Shows It Could Be Lethal: http://www.nytimes.com/1998/06/09/us/heart-drug-withdrawn-as-evidence-shows-it-could-be-lethal.html

Ion channel modulators

Calcium (Ca²⁺)

Blockers	L-type-selective: Dihydropyridines: Amlodipine Aranidipine Azelnidipine Barnidipine Clevidipine Cronidipine Darodipine Dexniguldipine Elgodipine Elnadipine Felodipine Flordipine Furnidipine Iganidipine Isradipine Lacidipine Lemildipine Lercanidipine Levamlodipine Levniguldipine Manidipine Mepirodipine Mesudipine Nicardipine Nifedipine Niguldipine Niludipine Nilvadipine Nimodipine Nisoldipine Nitrendipine Olradipine Oxodipine Palonidipine Pranidipine Ryodipine (riodipine) Sagandipine Sornidipine Teludipine Tiamdipine Trombodipine Vatanidipine; Diltiazem derivatives: Clentiazem Diltiazem Iprotiazem Nictiazem Siratiazem; Phenylalkylamines: Anipamil Dagapamil Devapamil Dexverapamil Emopamil Etripamil Falipamil Gallopamil Levemopamil Nexopamil Norverapamil Ronipamil Tiapamil Verapamil; Others: AH-1058 Brinazarone Budiodarone Celivarone Cyproheptadine Dronedarone Fantofarone SR-33805 N-type-selective: ω-Conotoxins ω-Conotoxin GVIA Caroverine Huwentoxin XVI Leconotide (ω-conotoxin CVID) PD-173212 Ralfinamide Safinamide Z160 Ziconotide (ω-conotoxin MVIIA) P-type-selective: ω-Agatoxin IVA ω-Agatoxin IVB R-type-selective: SNX-482 T-type-selective: ABT-639 ML-218 Niflumic acid NNC 55-0396 ProTx I Z944 Zonisamide Non-selective: ω-Agatoxin TK ω-Conotoxin MVIIC Benidipine Bepridil Cilnidipine Cinnarizine Dotarizine Efonidipine Flunarizine Lamotrigine Levetiracetam Lomerizine Loperamide Mibefradil NP078585 Ruthenium red TROX-1 α₂δ subunit-selective (gabapentinoids): 4-Methylpregabalin Arbaclofen Arbaclofen placarbil Atagabalin Baclofen Gabapentin Gabapentin enacarbil Imagabalin Mirogabalin PD-200,347 PD-217,014 PD-299,685 Phenibut Pregabalin Others/unsorted: Bencyclane Berbamine Bevantolol Canadine Carboxyamidotriazole Cycleanine Dauricine Dimeditiapramine Diproteverine Enpiperate Eperisone Elpetrigine Ethadione Ethosuximide Fasudil Fendiline Fostedil JTV-519 Lidoflazine Magnesium Manoalide Mesuximide Monatepil Naftopidil Ochratoxin A Osthol Otilonium bromide Paramethadione Phensuximide Pinaverium Prenylamine Rhynchophylline Sesamodil Silperisone Sipatrigine Terodiline Tetrahydropalmatine Tetrandrine Tolperisone Trimethadione Valperinol

Openers	L-type-selective: Bay K8644

Potassium (K⁺)

Blockers	3,4-Diaminopyridine (amifampridine) 4-Aminopyridine (fampridine/dalfampridine) Adekalant Almokalant Amiodarone Azimilide Bretylium Bunaftine Charybdotoxin Clamikalant Conotoxins Dalazatide Dendrotoxin Dofetilide Dronedarone E-4031 Hanatoxin HgeTx1 HsTx1 Ibutilide Inakalant Kaliotoxin Linopirdine Lolitrem B Maurotoxin Nifekalant Notoxin Paxilline Pinokalant ShK-186 Sotalol Tedisamil Terikalant Tetraethylammonium Vernakalant GIRK blockers: Barium Caramiphen Cloperastine Clozapine Dextromethorphan Ethosuximide Ifenprodil Tertiapin Tipepidine hERG blockers: Ajmaline Amiodarone AmmTX3 Astemizole Azaspiracid AZD1305 Azimilide Bedaquiline BeKm-1 BmTx3 BRL-32872 Chlorpromazine Cisapride Clarithromycin Darifenacin Dextropropoxyphene Diallyl trisulfide Domperidone E-4031 Ergtoxins Erythromycin Gigactonine Haloperidol Ketoconazole Norpropoxyphene Orphenadrine Pimozide PNU-282,987 Promethazine Ranolazine Roxithromycin Sertindole Solifenacin Tamulotoxin Terodiline Terfenadine Thioridazine Tolterodine Vanoxerine Vernakalant K_ATP blockers: Acetohexamide Carbutamide Chlorpropamide Glibenclamide (glyburide) Glibornuride Glicaramide Gliclazide Glimepiride Glipizide Gliquidone Glisoxepide Glyclopyramide Glycyclamide Metahexamide Mitiglinide Nateglinide Repaglinide Tolazamide Tolbutamide

Openers	K_ATP openers: Aprikalim Bimakalim Cromakalim Emakalim Levcromakalim Mazokalim Rilmakalim Sarakalim Others: Diazoxide Flupirtine Minoxidil ML-297 Naminidil Nicorandil Pinacidil Retigabine Rottlerin

Sodium (Na⁺)

Blockers	VGSC blockers: Antianginals: Ranolazine; Antiarrhythmics (class I): Ajmaline Aprindine Disopyramide Dronedarone Encainide Flecainide Lidocaine Lorajmine Lorcainide Mexiletine Moricizine Pilsicainide Prajmaline Procainamide Propafenone Quinidine Sparteine Tocainide; Anticonvulsants: Acetylpheneturide Carbamazepine Cenobamate Chlorphenacemide Elpetrigine Eslicarbazepine acetate Ethotoin Fosphenytoin Lacosamide Licarbazepine Mephenytoin Oxcarbazepine Oxitriptyline Phenacemide Pheneturide Phenytoin Rufinamide Sipatrigine Topiramate Sodium valproate Valnoctamide Valproate pivoxil Valproate semisodium Valproic acid Valpromide Zonisamide; Diuretics: Amiloride Benzamil Triamterene; Local anesthetics: pFBT Amylocaine Articaine Benzocaine Bupivacaine (Levobupivacaine, Ropivacaine) Butacaine Butamben Chloroprocaine Cinchocaine Cocaine Cyclomethycaine Dimethocaine Diphenhydramine Etidocaine Hexylcaine Iontocaine Lidocaine Mepivacaine Meprylcaine Metabutoxycaine Orthocaine Piperocaine Prilocaine Procaine Propoxycaine Proxymetacaine Risocaine Tetracaine Trimecaine; Analgesics: AZD-3161 DSP-2230 Funapide GDC-0276 NKTR-171 PF-04531083 PF-05089771 Ralfinamide Raxatrigine RG7893 (GDC-0287); Toxins: Conotoxins Neosaxitoxin Saxitoxin Tetrodotoxin; Others: Buprenorphine Evenamide Menthol Safinamide Tricyclic antidepressants

Openers	VGSC openers: Atracotoxins (Robustoxin, Versutoxin) Ciguatoxins ENaC openers: Solnatide

Chloride (Cl⁻)

Blockers	Bumetanide DIDS Flufenamic acid Furosemide Glibenclamide Lonidamine Meclofenamic acid Mefenamic acid Mepacrine Niflumic acid Piretanide Talniflumate Tolfenamic acid Trifluoperazine

Openers	CFTR openers: 1,7-Phenanthroline 1,10-Phenanthroline 4,7-Phenanthroline 7,8-Benzoquinoline Phenanthridine

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