Metaraminol Explained

Verifiedfields:verified
Verifiedrevid:462249333
Width:225px
Tradename:Aramine, Metaramin, Pressonex, others
Dailymedid:Metaraminol
Pregnancy Au:C
Routes Of Administration:Intramuscular injection, intravenous administration
Class:Norepinephrine releasing agent
Adrenergic receptor agonist; Sympathomimetic; Antihypotensive
Atc Prefix:C01
Atc Suffix:CA09
Legal Au:S4
Legal Uk:POM
Legal Us:Rx-only
Legal Us Comment:[1]
Protein Bound:45%
Metabolism:Liver
Cas Number:54-49-9
Cas Supplemental:
33402-03-8 (bitartrate)
Pubchem:5906
Iuphar Ligand:7229
Drugbank:DB00610
Chemspiderid:5695
Unii:818U2PZ2EH
Kegg:D08192
Chebi:6794
Chembl:1201319
Synonyms:Metaradrine; Hydroxynorephedrine; m-Hydroxypropadrine; m-Hydroxynorephedrine; meta-Hydroxynorephedrine; 3-Hydroxyphenylisopropanolamine; (1R,2S)-3,β-Dihydroxy-α-methylphenethylamine; (1R,2S)-3,β-Dihydroxyamphetamine
Iupac Name:(1R,2S)-3-[-2-amino-1-hydroxy-propyl]phenol
C:9
H:13
N:1
O:2
Smiles:O[C@H](c1cc(O)ccc1)[C@@H](N)C
Stdinchi:1S/C9H13NO2/c1-6(10)9(12)7-3-2-4-8(11)5-7/h2-6,9,11-12H,10H2,1H3/t6-,9-/m0/s1
Stdinchikey:WXFIGDLSSYIKKV-RCOVLWMOSA-N

Metaraminol, also known as metaradrine and sold under the brand names Aramine and Pressonex among others, is a sympathomimetic medication which is used in the prevention and treatment of hypotension (low blood pressure), particularly as a complication of anesthesia.[2] It is given by intramuscular or intravenous administration.

Side effects of metaraminol include reflex bradycardia among others. Metaraminol is a norepinephrine releasing agent and at high doses a α1-adrenergic receptor agonist with some β-adrenergic effect.[3] It is a substituted amphetamine and is closely related to phenylpropanolamine, ephedrine, and oxilofrine.

Metaraminol was first described and introduced for medical use by 1955.

Medical uses

Metaraminol is given intravenously as either a bolus (often 0.5–1 mg doses) or as an infusion, usually via peripheral intravenous access. Metaraminol is commonly available as 10 mg in 1 mL, that requires dilution prior to administration (often made up to a 0.5 mg/mL solution), however pre-prepared syringes of metaraminol for bolus use for hypotension are also commonly available.[4] [5]

Metaraminol is also used in the treatment of priapism.[6] [7] [8]

Pharmacology

Pharmacodynamics

The dominant mechanism of action for the vasopressor action of metaraminol is indirect,[9] with metaraminol displacing norepinephrine from neuronal vesicles in order for the noradrenaline to exert these effects.[10] Metaraminol at higher doses may have direct α-adrenergic agonist and β1-adrenergic agonist effects. However at doses common in clinical practice, the indirect α1-adrenergic effects predominate, such that reflex bradycardia is a common side effect.

Chemistry

Metaraminol, also known as (1R,2S)-3,β-dihydroxy-α-methylphenethylamine or as (1R,2S)-3,β-dihydroxyamphetamine, is a substituted phenethylamine and amphetamine derivative.[11] [12] It is the (1R,2S)-enantiomer of meta-hydroxynorephedrine (3,β-dihydroxyamphetamine). The drug is closely related to phenylpropanolamine ((1RS,2SR)-β-hydroxyamphetamine; norephedrine), ephedrine ((1R,2S)-β-hydroxy-N-methylamphetamine), para-hydroxynorephedrine (4,β-dihydroxyamphetamine), and oxilofrine (4,β-dihydroxy-N-methylamphetamine).

The experimental log P of metaraminol is -0.27 and its predicted log P ranges from -0.59 to 0.07.[13] [14] [15]

Metaraminol is used pharmaceutically as the bitartrate salt.

History

Metaraminol was first described and introduced for medical use by 1955.[16] [17]

Society and culture

Names

Metaraminol is the generic name of the drug and its and, while its is métaraminol and its is metaraminolo.[18] As the bitartrate salt, its generic name is metaraminol bitartrate and this is its and, while metaraminol tartrate is its . A synonym of metaraminol is metaradrine. Brand names of metaraminol include Aramin, Aramine, and Pressonex, among others.

Availability

Metaraminol appears to remain available in Argentina, Australia, Brazil, China, and Thailand. It was previously marketed in many more countries, including the United States and United Kingdom, but seems to have been discontinued in these countries. However, one formulation still remains available in the United States as of August 2024.[19]

External links

Notes and References

  1. Web site: Injection : Aramine (Metaraminol Bitartrate). U.S. Food and Drug Administration (FDA) . 12 March 2022.
  2. https://www.accessdata.fda.gov/drugsatfda_docs/label/2001/009509s026lbl.pdf
  3. Kee VR . Aug 2003 . Hemodynamic pharmacology of intravenous vasopressors . Crit Care Nurse . 23 . 4. 79–82 . 12961786 . 10.4037/ccn2003.23.4.79 .
  4. Web site: Metaraminol 0.5 mg/ml, Solution for Injection in pre-filled syringe - Summary of Product Characteristics (SmPC) - (emc) . 2022-10-19 . www.medicines.org.uk.
  5. Goodrick N, Wentrup T, Messer G, Gleeson P, Culwick M, Goulding G . Pre-filled emergency drugs: The introduction of pre-filled metaraminol and ephedrine syringes into the main operating theatres of a major metropolitan centre . Australasian Anaesthesia . 21 August 2020 . 2013 . 127–134 .
  6. McDonald M, Santucci R . Successful management of stuttering priapism using home self-injections of the alpha-agonist metaraminol. . Int Braz J Urol . 30 . 2 . 121–122 . 2004 . 15703094 . 10.1590/S1677-55382004000200007. free .
  7. Koga S, Shiraishi K, Saito Y . Post-traumatic priapism treated with metaraminol bitartrate: case report. . J Trauma . 30 . 12 . 1591–3 . 1990 . 2258979 . 10.1097/00005373-199012000-00029.
  8. Block T, Sturm W, Ernst G, Staehler G, Schmiedt E . [Metaraminol in therapy of various forms of priapism] . Urologe A . 27 . 4 . 225–9 . 1988 . 3140463.
  9. Web site: Metaraminol . Deranged Physiology . 2022-10-19 . en.
  10. Harrison DC, Chidsey CA, Braunwald E . Studies on the Mechanism of Action of Metaraminol (Aramine) . Annals of Internal Medicine . 59 . 3. 297–305 . September 1963 . 14065947 . 10.7326/0003-4819-59-3-297 .
  11. Book: Elks, J. . The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies . Springer US . 2014 . 978-1-4757-2085-3 . 2024-08-31 . 62.
  12. Book: Schweizerischer Apotheker-Verein . Index Nominum 2000: International Drug Directory . Medpharm Scientific Publishers . Index nominum . 2000 . 978-3-88763-075-1 . 31 August 2024 . 660.
  13. Web site: Metaraminol . PubChem . 1 September 2024.
  14. Web site: Metaraminol: Uses, Interactions, Mechanism of Action . DrugBank Online . 1 July 2024 . 1 September 2024.
  15. Web site: Metaraminol . ChemSpider . 2024-09-01 . 2024-09-01.
  16. Weil MH, Spink WW . Clinical studies on a vasopressor agent: metaraminol (aramine). I. Observations in normotensive subjects . Am J Med Sci . 229 . 6 . 661–669 . June 1955 . 14376394 . 10.1097/00000441-195506000-00008 .
  17. Weil MH . Clinical studies on a vasopressor agent: metaraminol (aramine). II. Observations on its use in the management of shock . Am J Med Sci . 230 . 4 . 357–369 . October 1955 . 13258566 . 10.1097/00000441-195510000-00001 .
  18. https://web.archive.org/web/20160303210434/https://www.drugs.com/international/metaraminol.html
  19. Web site: Drugs@FDA: FDA-Approved Drugs . accessdata.fda.gov . 1 September 2024.