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Also known as: 5011-34-7, 1-(2,3,4-trimethoxybenzyl)piperazine, 1-[(2,3,4-trimethoxyphenyl)methyl]piperazine, 1-(2,3,4-trimethoxy-benzyl)-piperazine, Piperazine, 1-((2,3,4-trimethoxyphenyl)methyl)-, N9a0a0r9s8
Molecular Formula
C14H22N2O3
Molecular Weight
266.34  g/mol
InChI Key
UHWVSEOVJBQKBE-UHFFFAOYSA-N
FDA UNII
N9A0A0R9S8

CAS 5011-34-7
A vasodilator used in angina of effort or ischemic heart disease.
1 2D Structure

CAS 5011-34-7

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
1-[(2,3,4-trimethoxyphenyl)methyl]piperazine
2.1.2 InChI
InChI=1S/C14H22N2O3/c1-17-12-5-4-11(13(18-2)14(12)19-3)10-16-8-6-15-7-9-16/h4-5,15H,6-10H2,1-3H3
2.1.3 InChI Key
UHWVSEOVJBQKBE-UHFFFAOYSA-N
2.1.4 Canonical SMILES
COC1=C(C(=C(C=C1)CN2CCNCC2)OC)OC
2.2 Other Identifiers
2.2.1 UNII
N9A0A0R9S8
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Centrophne

2. Dihydrochloride, Trimetazidine

3. Idaptan

4. Trimtazidine Irex

5. Trimetazidine Dihydrochloride

6. Vasartel

7. Vastarel

2.3.2 Depositor-Supplied Synonyms

1. 5011-34-7

2. 1-(2,3,4-trimethoxybenzyl)piperazine

3. 1-[(2,3,4-trimethoxyphenyl)methyl]piperazine

4. 1-(2,3,4-trimethoxy-benzyl)-piperazine

5. Piperazine, 1-((2,3,4-trimethoxyphenyl)methyl)-

6. N9a0a0r9s8

7. Trimetazidine (inn)

8. Trimetazidine [inn]

9. Piperazine, 1-[(2,3,4-trimethoxyphenyl)methyl]-

10. Trimetazidina

11. Trimetazidinum

12. Mls001240268

13. Trimetazidinum [inn-latin]

14. Trimetazidina [inn-spanish]

15. Trimetazidine [inn:ban:dcf]

16. Ncgc00016697-01

17. Smr000674573

18. Einecs 225-690-2

19. Cas-13171-25-0

20. Unii-n9a0a0r9s8

21. Preductal

22. Vasorel

23. Preductal Mb

24. Dilatan (tn)

25. Bas 06612844

26. Prestwick0_000549

27. Prestwick1_000549

28. Prestwick2_000549

29. Prestwick3_000549

30. Trimetazidine [mi]

31. Oprea1_279550

32. Piperazine,1-[(2,3,4-trimethoxyphenyl)methyl]-

33. Bspbio_000597

34. Mls001331735

35. Schembl230374

36. Spbio_002518

37. Trimetazidine [who-dd]

38. Bpbio1_000657

39. Chembl203266

40. Dtxsid2048531

41. Bdbm80613

42. Chebi:94789

43. Cid_9926449

44. Hy-b0968a

45. Hms2230l07

46. Hms3374d04

47. Albb-004703

48. Bcp16534

49. Bbl013084

50. Mfcd00868263

51. S5779

52. Stk315643

53. Zinc19358638

54. Akos000308094

55. 4-(2,3,4-trimethoxybenzyl)piperazine

56. Db09069

57. Sb75326

58. 1-(2,3,4-trimethoxy Benzyl)piperazine

59. Ncgc00016697-02

60. Smr000814701

61. 1-(2,3,4-trimethoxyphenyl)methylpiperazine

62. 1-(2,3,4-trimethoxyphenylmethyl)piperazine

63. Db-051731

64. Bb 0220635

65. Cs-0099250

66. En300-14439

67. 71t250

68. D08642

69. A827982

70. A837947

71. Q674703

72. 1-(2,3,4-trimethoxybenzyl)piperazine;hydrochloride

73. 1-[2,3,4-trimethoxybenzyl] Piperazine Dihydrochloride

74. Brd-k88366685-300-03-7

75. Brd-k88366685-300-04-5

76. Z99601262

77. 1-[(2,3,4-trimethoxyphenyl)methyl]piperazine;hydrochloride

78. 127881-54-3

2.4 Create Date
2005-03-27
3 Chemical and Physical Properties
Molecular Weight 266.34 g/mol
Molecular Formula C14H22N2O3
XLogP31
Hydrogen Bond Donor Count1
Hydrogen Bond Acceptor Count5
Rotatable Bond Count5
Exact Mass266.16304257 g/mol
Monoisotopic Mass266.16304257 g/mol
Topological Polar Surface Area43 Ų
Heavy Atom Count19
Formal Charge0
Complexity259
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Indication

Trimetazidine is indicated for the symptomatic treatment of stable angina pectoris in patients inadequately controlled or intolerant to first line therapies.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Trimetazidine is indicated for the symptomatic treatment of stable angina pectoris in patients inadequately controlled or intolerant to first line therapies. Patients should be counselled regarding the risk of use with reduced renal or hepatic function, worsening of extrapyramidal symptoms or other movement disorders, and risk of falls.


5.2 MeSH Pharmacological Classification

Vasodilator Agents

Drugs used to cause dilation of the blood vessels. (See all compounds classified as Vasodilator Agents.)


5.3 ATC Code

C01EB15

S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355


C - Cardiovascular system

C01 - Cardiac therapy

C01E - Other cardiac preparations

C01EB - Other cardiac preparations

C01EB15 - Trimetazidine


5.4 Absorption, Distribution and Excretion

Absorption

In elderly patients, a 35 mg oral modified release tablet reaches a mean Cmax of 115 g/L, with a Tmax of 2.0-5.0 hours, and a mean AUC0-12 of 1104 h\*g/L. In young, healthy patients, the same dose reaches a mean Cmax of 91.2 g/L, with a Tmax of 2.0-6.0 hours, and an AUC0-12h 720 h\*g/L.


Route of Elimination

Trimetazidine is 79-84% eliminated in the urine, with 60% as the unchanged parent compound. In a study of 4 healthy subjects, individual metabolites made up 0.01-1.4% of the dose recovered in urine. In the urine, 2-desmethyltrimetazidine made up 0-1.4% of the recovered dose, 3- and 4-desmethyltrimetazidine made up 0.039-0.071% each, N-methyltrimetazidine made up 0.015-0.11%, trimetazidine ketopiperazine made up 0.011-0.4%, N-formyltrimetazidine made up 0.035-0.42%, N-acetyltrimetazidine made up 0.016-0.19%, desmethyl trimetazidine O-sulphate made up 0.01-0.65%, and an unknown metabolite made up0.026-0.67%.


Volume of Distribution

The volume of distribution of trimetazidine is 4.8 L/kg.


Clearance

Trimetazidine clearance is strongly correlated with creatinine clearance. In eldery patients with a creatinine clearance of 72 8 mL/min, trimetazidine clearance was 15.69 L/h. In young, healthy patients with a creatinine clearance of 134 18 mL/min, trimetazidine clearance was 25.2 L/h.


5.5 Metabolism/Metabolites

Trimetazidine can be oxidized at the piperazine ring to form trimetazidine ketopiperazine. Trimetazidine can also be N-formylated, N-acetylated, or N-methylated at the piperazine ring to form N-formyltrimetazidine, N-acetyltrimetazidine, and N-methyltrimetazidine respectively. Alternatively, trimetazidine can be demethylated at the 2, 3, or 4 position of the 2,3,4-trimethoxybenzyl moiety to form 2-desmethyltrimetazidine, 3-desmethyltrimetazidine, or 4-desmethyltrimetazidine. The desmethyltrimetazidine metabolites can undergo sulfate conjugation or glucuronidation prior to elimination.


5.6 Biological Half-Life

In young, healthy subjects, the half life of trimetazidine is 7.81 hours. In patients over 65, the half life increases to 11.7 hours.


5.7 Mechanism of Action

During myocardial ischemia, anaerobic metabolism takes over, increasing levels of lactic acid. The decreased intracellular pH and increased concentration of protons activates sodium-hydrogen and sodium-calcium antiport systems, raising intracellular calcium concentrations, finally leading to decreased contractility. This injury to the myocardium raises concentrations of catecholamines, which activate hormone sensitive lipase, and increasing fatty acid concentrations in plasma. When the myocardium is repurfused, fatty acid oxidation becomes the dominant form of ATP production, maintaining an acidic pH, and further exacerbating the injury. The mechanism of action of trimetazidine is not fully understood. Trimetazidine may inhibit mitochondrial 3-ketoacyl coenzyme A thiolase, decreasing long chain fatty acid -oxidation but not glycolysis in the myocardium. The decreased long chain fatty acid -oxidation is compensated for by increased use of glucose, preventing a lowered myocardial pH, and further decreases in contractility. However, another study suggests that 3-ketoacyl coenzyme A thiolase may not be trimetazidine's target, and that this mechanism may be incorrect.


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