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| {{short description|Drug}} | |||
| {{drugbox | |||
| {{Distinguish|Alvameline}} | |||
| | UNII_Ref = {{fdacite|correct|FDA}} | |||
| {{More citations needed|date=January 2016}} | |||
| | UNII = 46TIR1560O | |||
| {{cs1 config|name-list-style=vanc|display-authors=6}} | |||
| | verifiedrevid = 443381813 | |||
| {{Drugbox | |||
| | IUPAC_name = ''N''-Ethyl-3-phenyl-''N''-(3-phenylpropyl)propan-1-amine | |||
| | Watchedfields = changed | |||
| | image = alverine.png | |||
| | verifiedrevid = 443660668 | |||
| | IUPAC_name = ''N''-Ethyl-3-phenyl-''N''-(3-phenylpropyl)propan-1-amine | |||
| | image = alverine.png | |||
| <!--Clinical data--> | |||
| | tradename = | |||
| | Drugs.com = {{drugs.com|international|alverine}} | |||
| | pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> | |||
| | pregnancy_US = <!-- A / B / C / D / X --> | |||
| | pregnancy_category = | |||
| | legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled--> | |||
| | legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII --> | |||
| | legal_UK = gsl | |||
| | legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V --> | |||
| | legal_status = | |||
| | routes_of_administration = | |||
| <!--Pharmacokinetic data--> | |||
| | bioavailability = | |||
| | protein_bound = | |||
| | metabolism = | |||
| | elimination_half-life = | |||
| | excretion = | |||
| <!--Identifiers--> | |||
| | CAS_number_Ref = {{cascite|correct|??}} | |||
| | CAS_number = 150-59-4 | |||
| | ATC_prefix = A03 | |||
| | ATC_suffix = AX08 | |||
| | PubChem = 3678 | |||
| | DrugBank_Ref = {{drugbankcite|correct|drugbank}} | |||
| | DrugBank = DB01616 | |||
| | ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}} | | ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}} | ||
| | ChemSpiderID = 3550 | | ChemSpiderID = 3550 | ||
| | UNII_Ref = {{fdacite|correct|FDA}} | |||
| | InChI = 1/C20H27N/c1-2-21(17-9-15-19-11-5-3-6-12-19)18-10-16-20-13-7-4-8-14-20/h3-8,11-14H,2,9-10,15-18H2,1H3 | |||
| | UNII = 46TIR1560O | |||
| | smiles = c1ccccc1CCCN(CC)CCCc2ccccc2 | |||
| | KEGG_Ref = {{keggcite|correct|kegg}} | |||
| | InChIKey = ZPFXAOWNKLFJDN-UHFFFAOYAL | |||
| | KEGG = D07440 | |||
| | ChEBI_Ref = {{ebicite|correct|EBI}} | |||
| | ChEBI = 518413 | |||
| | ChEMBL_Ref = {{ebicite|correct|EBI}} | | ChEMBL_Ref = {{ebicite|correct|EBI}} | ||
| | ChEMBL = 253371 | | ChEMBL = 253371 | ||
| <!--Chemical data--> | |||
| | C=20 | H=27 | N=1 | |||
| | smiles = c1ccccc1CCCN(CC)CCCc2ccccc2 | |||
| | StdInChI_Ref = {{stdinchicite|correct|chemspider}} | | StdInChI_Ref = {{stdinchicite|correct|chemspider}} | ||
| | StdInChI = 1S/C20H27N/c1-2-21(17-9-15-19-11-5-3-6-12-19)18-10-16-20-13-7-4-8-14-20/h3-8,11-14H,2,9-10,15-18H2,1H3 | | StdInChI = 1S/C20H27N/c1-2-21(17-9-15-19-11-5-3-6-12-19)18-10-16-20-13-7-4-8-14-20/h3-8,11-14H,2,9-10,15-18H2,1H3 | ||
| | StdInChIKey_Ref = {{stdinchicite|correct|chemspider}} | | StdInChIKey_Ref = {{stdinchicite|correct|chemspider}} | ||
| | StdInChIKey = ZPFXAOWNKLFJDN-UHFFFAOYSA-N | | StdInChIKey = ZPFXAOWNKLFJDN-UHFFFAOYSA-N | ||
| | CAS_number = 150-59-4 | |||
| | ATC_prefix = A03 | |||
| | ATC_suffix = AX08 | |||
| | ChEBI_Ref = {{ebicite|correct|EBI}} | |||
| | ChEBI = 518413 | |||
| | PubChem = 3678 | |||
| | DrugBank_Ref = {{drugbankcite|correct|drugbank}} | |||
| | DrugBank = DB01616 | |||
| | KEGG_Ref = {{keggcite|correct|kegg}} | |||
| | KEGG = D07440 | |||
| | C=20|H=27|N=1 | |||
| | molecular_weight = 281.44 g/mol | |||
| | bioavailability = | |||
| | protein_bound = | |||
| | metabolism = | |||
| | elimination_half-life = | |||
| | excretion = | |||
| | pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> | |||
| | pregnancy_US = <!-- A / B / C / D / X --> | |||
| | pregnancy_category= | |||
| | legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled--> | |||
| | legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII --> | |||
| | legal_UK = <!-- GSL, P, POM, CD, or Class A, B, C --> | |||
| | legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V --> | |||
| | legal_status = | |||
| | routes_of_administration = | |||
| }} | }} | ||
| '''Alverine''' is a drug used for ]s. | '''Alverine''' is a drug used for ]s. Alverine is a ] relaxant. Smooth muscle is a type of muscle that is not under voluntary control; it is the muscle present in places such as the ] and ]. | ||
| ==Adverse effects== | |||
| The side effects of Alverine include:<ref>{{Cite web|title = Alverine capsules - Spasmonal, Audmonal. Side effects; dosage {{!}} Patient|url = http://patient.info/medicine/alverine-capsules-audmonal-spasmonal|website = Patient|access-date = 2015-12-06|language = en-GB}}</ref><ref>{{Cite web|url=http://www.medicines.org.uk/emcmobile/PIL.30546.latest.pdf|title=Alverine Citrate Patient Information Leaflet|date=2014|website=Medicines.org.uk|archive-url=https://web.archive.org/web/20171201042120/http://www.medicines.org.uk/emcmobile/PIL.30546.latest.pdf|archive-date=2017-12-01|url-status=dead}}</ref> | |||
| *Difficulties in breathing or shortness of breath, wheezing, swelling of the face or other parts of the body (associated with serious ]) | |||
| *Yellowing of the whites of the eyes and the skin, due to liver inflammation | |||
| * A feeling of ] or ] | |||
| * ] | |||
| * Minor allergic reaction (skin rash/itching) | |||
| It was reported that alverine may induce toxic ].<ref name="pmid16378311">{{cite journal | vauthors = Durakoğlu Z, Boztaş G, Sezgil A, Kaymakoğlu S, Dinçer D, Ozdil S, Beşişik F, Mungan Z, Okten A | title = Alverine induced toxic hepatitis: a case report | journal = The Turkish Journal of Gastroenterology | volume = 13 | issue = 4 | pages = 226–8 | date = December 2002 | pmid = 16378311 | url = http://www.turkjgastroenterol.org/sayilar/269/buyuk/2391.pdf | archive-url = https://web.archive.org/web/20181123152301/http://www.turkjgastroenterol.org/sayilar/269/buyuk/2391.pdf | archive-date = 2018-11-23 }}</ref><ref>{{cite journal | vauthors = Arhan M, Koklu S, Koksal AS, Yolcu OF, Koruk S, Koruk I, Kayacetin E | title = Alverine citrate induced acute hepatitis | journal = World Journal of Gastroenterology | volume = 10 | issue = 15 | pages = 2303–4 | date = August 2004 | pmid = 15259090 | pmc = 4724969 | doi = 10.3748/wjg.v10.i15.2303 | doi-access = free }}</ref> | |||
| ==Mechanism of action== | |||
| Alverine acts directly on the muscle in the gut, causing it to relax. Alverine is a 5HT1A antagonist, which reduces rectal hypersensitivity.<ref>{{cite journal | vauthors = Coelho AM, Jacob L, Fioramonti J, Bueno L | title = Rectal antinociceptive properties of alverine citrate are linked to antagonism at the 5-HT1A receptor subtype | journal = The Journal of Pharmacy and Pharmacology | volume = 53 | issue = 10 | pages = 1419–1426 | date = October 2001 | pmid = 11697552 | doi = 10.1211/0022357011777783 }}</ref> This prevents the ] which occur in the gut in conditions such as ] and ].<ref>{{Cite news|url=https://casadesante.com/blogs/low-fodmap-life/common-myths-about-ibs|title=Detailed Info About Irritable bowel syndrome|access-date=2017-07-26}}</ref> Diverticular disease is a condition in which small pouches form in the gut lining. These pouches can trap particles of food and become inflamed and painful. In irritable bowel syndrome, the normal activity of the gut muscle is lost. The muscle spasms result in symptoms such as ] and ], ] or ]. By relaxing the gut muscle, alverine citrate relieves the symptoms of this condition. Alverine also relaxes the smooth muscle in the womb (uterus). It is therefore also used to treat painful menstruation, which is caused by muscle spasms in the uterus (]). | |||
| Alverine capsules<ref>{{Cite web|title = Alverine Citrate 60 mg Hard Capsules |url = https://www.drugs.com/uk/alverine-citrate-60-mg-hard-capsules-leaflet.html| work = Drugs.com |access-date = 2015-12-06}}</ref> are now available in the market. There are two strengths of capsule - 60 mg and 120 mg. The common dosage for adults and children over 12 years is 60–120 mg taken one, two or three a day, either before or after meals. Alverine is not suitable for those aged under 12 years. Women who are pregnant or breast-feeding should follow the instruction of doctors for the drug. | |||
| ==Development and marketing== | |||
| A combination of alverine citrate and ] (ACS) for irritable bowel syndrome therapy were compared with placebo in a phase IV ].<ref>{{ClinicalTrialsGov|NCT00542295|Efficacy and Safety of Meteospasmyl® in Irritable Bowel Syndrome}}</ref> At week 4, the alverine citrate and simeticone group had lower VAS scores for abdominal pain/discomfort (median: 40 mm vs. 50 mm, P = 0.047) and higher responder rate (46.8% vs. 34.3%, OR = 1.3; P = 0.01) as compared with the ] group.<ref>{{cite journal | vauthors = Wittmann T, Paradowski L, Ducrotté P, Bueno L, Andro Delestrain MC | title = Clinical trial: the efficacy of alverine citrate/simeticone combination on abdominal pain/discomfort in irritable bowel syndrome--a randomized, double-blind, placebo-controlled study | journal = Alimentary Pharmacology & Therapeutics | volume = 31 | issue = 6 | pages = 615–24 | date = March 2010 | pmid = 20003095 | doi = 10.1111/j.1365-2036.2009.04216.x | s2cid = 35881469 | doi-access = free }}</ref> | |||
| The drug was firstly authorized for marketing on 03/06/2014. The marketing authorisation holder is Dr. Reddy's Laboratories (UK) Ltd.<ref>{{Cite web|title = Alverine citrate 60 mg hard capsules - Summary of Product Characteristics (SPC) - (eMC)|url = https://www.medicines.org.uk/emc/medicine/30562|website = www.medicines.org.uk|access-date = 2015-12-06}}</ref> | |||
| == References == | |||
| {{Reflist}} | |||
| {{Drugs for functional gastrointestinal disorders}} | {{Drugs for functional gastrointestinal disorders}} | ||
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| ] | ] | ||
| ] | ] | ||
| {{Amine-stub}} | |||
| {{gastrointestinal-drug-stub}} | |||
| ] | |||