Riluzole
Systematic (IUPAC) name
6-(trifluoromethoxy)benzothiazol-2-amine
Identifiers
CAS number	1744-22-5
ATC code	N07XX02
PubChem	5070
DrugBank	APRD00145
Chemical data
Formula	C8H5F3N2OS
Mol. mass	234.199 g/mol
Pharmacokinetic data
Bioavailability	?
Metabolism	?
Half life	?
Excretion	?
Therapeutic considerations
Pregnancy cat.	? Image File history File links Riluzole. ... Image File history File links Riluzole. ... IUPAC nomenclature is a system of naming chemical compounds and of describing the science of chemistry in general. ... CAS registry numbers are unique numerical identifiers for chemical compounds, polymers, biological sequences, mixtures and alloys. ... The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. ... A section of the Anatomical Therapeutic Chemical Classification System. ... PubChem is a database of chemical molecules. ... The DrugBank database available at the University of Alberta is a unique bioinformatics and cheminformatics resource that combines detailed drug (i. ... A chemical formula is a concise way of expressing information about the atoms that constitute a particular chemical compound. ... For other uses, see Carbon (disambiguation). ... This article is about the chemistry of hydrogen. ... Distinguished from fluorene and fluorone. ... General Name, symbol, number nitrogen, N, 7 Chemical series nonmetals Group, period, block 15, 2, p Appearance colorless gas Standard atomic weight 14. ... General Name, symbol, number oxygen, O, 8 Chemical series nonmetals, chalcogens Group, period, block 16, 2, p Appearance colorless (gas) pale blue (liquid) Standard atomic weight 15. ... This article is about the chemical element. ... The molecular mass (abbreviated Mr) of a substance, formerly also called molecular weight and abbreviated as MW, is the mass of one molecule of that substance, relative to the unified atomic mass unit u (equal to 1/12 the mass of one atom of carbon-12). ... In pharmacology, bioavailability is used to describe the fraction of an administered dose of unchanged drug that reaches the systemic circulation, one of the principal pharmacokinetic properties of drugs. ... Drug metabolism is the metabolism of drugs, their biochemical modification or degradation, usually through specialized enzymatic systems. ... The biological half-life of a substance is the time required for half of that substance to be removed from an organism by either a physical or a chemical process. ... The kidneys are important excretory organs in vertebrates. ... The pregnancy category of a pharmaceutical agent is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy. ...
Legal status
Routes	?

Riluzole is a drug used to treat amyotrophic lateral sclerosis. It delays the onset of ventilator-dependence or tracheostomy in selected patients and may increase survival by approximately two months. The regulation of therapeutic goods, that is drugs and therapeutic devices, varies by jurisdiction. ... In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body. ... This article does not cite any references or sources. ... Amyotrophic lateral sclerosis (ALS, sometimes called Lou Gehrigs Disease, Maladie de Charcot or motor neurone disease) is a progressive, fatal, neurodegenerative disease caused by the degeneration of motor neurons, the nerve cells in the central nervous system that control voluntary muscle movement. ... A medical ventilator is a device designed to provide mechanical ventilation to a patient. ... Tracheotomy is a surgical procedure used to cut a hole in the trachea through which a small tube is inserted. ... A patient having his blood pressure taken by a doctor. ...

It is marketed by Aventis Pharmaceuticals Inc with the brand name Rilutek. Aventis was formed in 1999 when Rhône-Poulenc S.A. merged with Hoechst AG. The merged company was based in Strasbourg, France. ...

Mechanism of action

Riluzole has several actions:

• Sodium channel blockade
• High-voltage calcium channel blockade
• N-methyl-D-aspartate (NMDA)/glutamate receptor antagonism

Riluzole preferentially blocks TTX-S sodium channels, which are associated with damaged neurons (Song et al 1997). This reduces influx of calcium ions and indirectly prevents stimulation of glutamate receptors. Together with direct glutamate receptor blockade, the effect of the neurotransmitter glutamate on motor neurons is greatly reduced. For sodium in the diet, see Edible salt. ... Ion channels are pore-forming proteins that help to establish and control the small voltage gradient that exists across the plasma membrane of all living cells (see cell potential) by allowing the flow of ions down their electrochemical gradient. ... For other uses, see Calcium (disambiguation). ... NMDA receptor antagonists are a class of anesthetics that work to antagonize, or inhibit the action of, the NMDA receptor (NMDAR). ... This article is about cells in the nervous system. ... This article is about the electrically charged particle. ... Chemical structure of D-aspartic acid, a common amino acid neurotransmitter. ... Glutamic acid (Glu, E), is the protonated form of glutamate (the anion). ...

Studies of efficacy

A Cochrane Library review states a 9% gain in the probability of surviving one year. In secondary analyses of survival at separate time points, there was a significant survival advantage with riluzole 100 mg at six, nine, 12 and 15 months, but not at three or 18 months (Miller RG et al 2005). There was a small beneficial effect on both bulbar and limb function, but not on muscle strength. There were no data on quality of life, but patients treated with riluzole remained in a more moderately affected health state significantly longer than placebo-treated patients. The Cochrane Library is a collection of databases in medicine and other healthcare specialties provided by the Cochrane Collaboration. ... The corticobulbar (or corticonuclear) tract is a white matter pathway connecting the cerebral cortex to the brainstem (the term bulbar referring to the brainstem). ... For other uses of Muscles, see Muscles (disambiguation). ... This article is about the economic and philosophical concept. ...

Clinical use

While riluzole has been proven to slow down ALS, patients do not report any subjective improvement. Approximately 10% of patients experience side effects such as nausea and fatigue which lead them to discontinue treatment. Safety monitoring includes regular liver function tests and people with liver disease such as hepatitis should be monitored especially carefully. For other uses, see Nausea (disambiguation). ... Liver function tests (LFTs or LFs), are groups of clinical biochemistry laboratory blood assays designed to give a doctor or other health professional information about the state of a patients liver. ... Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. ...

In the UK riluzole has been available through the NHS since 1997 at a standard dosage of 50mg twice daily. There has been some evidence to show that higher doses might produce more significant improvements in ALS patients but at £5 a tablet it is at risk of being prohibitively expensive given the modest benefit to patients. One study in the Netherlands found that riluzole is metabolised differently by males and females, and its levels in plasma are decreased in patients who smoke cigarettes (van Kan et al 2005). NHS redirects here. ... Blood plasma is the liquid component of blood, in which the blood cells are suspended. ... A cigarette will burn to ash on one end. ...

A number of recent case studies have also indicated that riluzole may have clinical use in mood and anxiety disorders. It has been shown to have antidepressant properties in the treatment of refractory depression (Zarate et al 2004) and as an anxiolytic in Obsessive-compulsive disorder (Coric et al 2005) and in GAD (Mathew et al 2005). Prozac, a selective serotonin reuptake inhibitor (SSRI) Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant, is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia (milder depression). ... On the Threshold of Eternity. ... Generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive, uncontrollable and often irrational worry about everyday things, which is disproportionate to the actual source of worry. ...

References

• Song JH, Huang CS, Nagata K, Yeh JZ, Narahashi T. Differential action of riluzole on tetrodotoxin-sensitive and tetrodotoxin-resistant sodium channels J Pharmacol Exp Ther 1997;282:707-14. Fulltext PMID 9262334.
• Coric V, Taskiran S, Pittenger C, Wasylink S, Mathalon DH, Valentine G, Saksa J, Wu YT, Gueorguieva R, Sanacora G, Malison RT, Krystal JH. Riluzole augmentation in treatment-resistant obsessive-compulsive disorder: an open-label trial. Biol Psychiatry 2005. PMID 15993857.
• Mathew SJ, Amiel JM, Coplan JD, Fitterling HA, Sackeim HA, Gorman JM. "Riluzole in generalized anxiety disorder: an open-label trial." Am J Psychiatry 2005; 162:2379-2381.
• Miller RG, Mitchell JD, Lyon M, Moore DH. Riluzole for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND). The Cochrane Database of Systematic Reviews 2002;2:CD001447. DOI 10.1002/14651858.CD001447.
• van Kan HJ, Groeneveld GJ, Kalmijn S, Spieksma M, van den Berg LH, Guchelaar HJ. Association between CYP1A2 activity and riluzole clearance in patients with amyotrophic lateral sclerosis. Br J Clin Pharmacol 2005;59:310-3. PMID 15752377.
• Zarate CA Jr, Payne JL, Quiroz J, Sporn J, Denicoff KK, Luckenbaugh D, Charney DS, Manji HK. An open-label trial of riluzole in patients with treatment-resistant major depression. Am J Psychiatry 2004;161:171-4. Fulltext. PMID 14702270.

External links

• National Institute for Health and Clinical Excellence (NICE) guidelines for prescription of riluzole in the UK [1]
• Riluzole (manufacturer's website)
• Riluzole (patient information)