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Ketotifen









Ketotifen


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Ketotifen
Ketotifen.svg
Clinical data
Trade names Zaditor[1]

AHFS/Drugs.com
 Micromedex Detailed Consumer Information
MedlinePlus a604033
Pregnancy
category


  • US: C (Risk not ruled out)


Routes of
administration		 Oral (tablets), ophthalmic solution
ATC code

  • R06AX17 (WHO) S01GX08 (WHO)
Legal status
Legal status


  • US: Oral — withdrawn, was ℞-only; Eye drops — over-the-counter

Pharmacokinetic data
Bioavailability 60%
Protein binding 75%
Metabolism Hepatic
Elimination half-life
 12 hours
Identifiers
CAS Number

  • 34580-14-8 ☑Y

PubChem CID
  • 3827
IUPHAR/BPS
  • 7206
DrugBank

  • DB00920 ☑Y
ChemSpider

  • 3695 ☑Y
UNII
  • HBD503WORO
KEGG

  • D01332 ☑Y
ChEBI
  • CHEBI:92511
ChEMBL

  • ChEMBL534 ☑Y
ECHA InfoCard
100.047.348 Edit this at Wikidata
Chemical and physical data
Formula
C19H19NOS
Molar mass 309.426 g/mol
3D model (JSmol)
  • Interactive image

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Ketotifen, sold under the brand name Zaditor among others, is a first-generation noncompetitive H1-antihistamine and mast cell stabilizer. It is most commonly sold as a salt with fumaric acid, ketotifen fumarate, and is available in two forms. In its ophthalmic form, it is used to treat allergic conjunctivitis.[2] In its oral form, it is used to prevent asthma attacks or Anaphylaxis, as well as various mast cell, allergic-type disorders.[3][4][5][6][7]




Contents






  • 1 Medical uses


  • 2 Side effects


  • 3 Pharmacology


  • 4 Society and culture


    • 4.1 Brand names




  • 5 References


  • 6 External links





Medical uses[edit]


Ketotifen relieves and prevents eye itchiness and/or irritation associated with most seasonal allergies. It starts working within minutes after administering the drops. The drug has not been studied in children under three.[2] The mean elimination half life is 12 hours.[8] Besides its anti-histaminic activity, it is also a functional leukotriene antagonist and a phosphodiesterase inhibitor.


"[O]ral ketotifen has been used in patients with asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, chronic urticaria, cold-induced urticaria, cholinergic urticaria, exercise-induced urticaria, [systemic mast cell disease including mastocytosis, MCAS, allergic and nonallergic anaphylaxis, angioedema], and food allergy in Canada, Europe, and Mexico." Now available via prescription at US compounding pharmacies: "For adults and older children with asthma or allergic disease, the recommended dose of ketotifen is 1 mg twice daily." "FDA staff did recommend more extensive evaluations for management of urticaria."[5][6]


The drug may also help relieve irritable bowel syndrome.[9]



Side effects[edit]


Side effects include drowsiness, weight gain, dry mouth, irritability, and increased nosebleeds.[10]



Pharmacology[edit]


Ketotifen is a selective antihistamine – that is, an inverse agonist of the histamine H1 receptor (Ki = 0.166 nM)[11] – and mast cell stabilizer.[12] In addition, ketotifen has weak anticholinergic (Ki = 204 nM for mACh) and antiserotonergic (Ki = 38.9 nM for 5-HT2A) activity.[11][13] However, at the dosages in which it is typically used clinically, both the anticholinergic and antiserotonergic activity of ketotifen are said not to be appreciable.[14]



Society and culture[edit]



Brand names[edit]


Ketotifen is marketed under many brand names worldwide.[15]



References[edit]





  1. ^ http://www.webmd.com/drugs/2/drug-17484/zaditor-opht/details[full citation needed]


  2. ^ ab Zaditor prescribing information Archived 2011-06-09 at the Wayback Machine. Novartis


  3. ^ Sokol, Kristin C.; Amar, Neil K.; Starkey, Jonathan; Grant, J. Andrew (2013). "Ketotifen in the management of chronic urticaria: Resurrection of an old drug". Annals of Allergy, Asthma & Immunology. 111 (6): 433–6. doi:10.1016/j.anai.2013.10.003. PMC 4309375. PMID 24267353..mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"""""""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/9px-Lock-green.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Lock-gray-alt-2.svg/9px-Lock-gray-alt-2.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/a/aa/Lock-red-alt-2.svg/9px-Lock-red-alt-2.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}


  4. ^ Shawky, Rabah M.; Seifeldin, Neveen S. (2015). "The relation between antihistamine medication during early pregnancy & birth defects". Egyptian Journal of Medical Human Genetics. 16 (4): 287–90. doi:10.1016/j.ejmhg.2015.04.003.


  5. ^ ab Zuberbier, Torsten (2012). "A Summary of the New International EAACI/GA2LEN/EDF/ WAO Guidelines in Urticaria". World Allergy Organization Journal. 5 (1): S1–S5. doi:10.1186/1939-4551-5-S1-S1.


  6. ^ ab Zuberbier, T.; Asero, R.; Bindslev-Jensen, C.; Walter Canonica, G.; Church, M. K.; Giménez-Arnau, A. M.; Grattan, C. E. H.; Kapp, A.; Maurer, M.; Merk, H. F.; Rogala, B.; Saini, S.; Sánchez-Borges, M.; Schmid-Grendelmeier, P.; Schünemann, H.; Staubach, P.; Vena, G. A.; Wedi, B. (2009). "EAACI/GA²LEN/EDF/WAO guideline: Management of urticaria". Allergy. 64 (10): 1427–43. doi:10.1111/j.1398-9995.2009.02178.x. PMID 19772513.


  7. ^ Li, Zhenhong; Celestin, Jocelyn (February 23, 2015). Ketotifen: A Role in the Treatment of Idiopathic Anaphylaxis. American Academy of Allergy, Asthma & Immunology Annual Meeting. Houston.


  8. ^ Grahnén, A.; Lönnebo, A.; Beck, O.; Eckernäs, S-Å; Dahlström, B.; Lindström, B. (1992). "Pharmacokinetics of ketotiffn after oral administration to healthy male subjects". Biopharmaceutics & Drug Disposition. 13 (4): 255–62. doi:10.1002/bdd.2510130404. PMID 1600111.


  9. ^ Klooker, T. K.; Braak, B.; Koopman, K. E.; Welting, O.; Wouters, M. M.; Van Der Heide, S.; Schemann, M.; Bischoff, S. C.; Van Den Wijngaard, R. M.; Boeckxstaens, G. E. (2010). "The mast cell stabiliser ketotifen decreases visceral hypersensitivity and improves intestinal symptoms in patients with irritable bowel syndrome". Gut. 59 (9): 1213–21. doi:10.1136/gut.2010.213108. PMID 20650926.


  10. ^ "Zaditen - MIMS online". www.mims.co.uk.


  11. ^ ab Kakiuchi M, Ohashi T, Musoh K, Kawamura K, Morikawa K, Kato H (1997). "Studies on the novel antiallergic agent HSR-609: its penetration into the central nervous system in mice and guinea pigs and its selectivity for the histamine H1-receptor". Jpn. J. Pharmacol. 73 (4): 291–8. PMID 9165365.


  12. ^ Thomas L. Lemke; David A. Williams (2008). Foye's Principles of Medicinal Chemistry. Lippincott Williams & Wilkins. pp. 1019–. ISBN 978-0-7817-6879-5.


  13. ^ V Alagarsamy (16 June 2012). Textbook of Medicinal Chemistry Vol II - E-Book. Elsevier Health Sciences. pp. 38–. ISBN 81-312-3259-X.


  14. ^ Jürgen Drews (6 December 2012). Immunopharmacology: Principles and Perspectives. Springer Science & Business Media. pp. 282–. ISBN 978-3-642-75561-3.


  15. ^ drugs.com International availability of ketofin Page accessed April 21, 2015




External links[edit]



  • Zaditor web site

  • Alaway web site














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