Journal of Medicinal Chemistry · 2012 · 18 citations · 59 references
MedicineMedicinal ChemistryPharmacologyClinical PharmacologyDrug MetabolismNeuropharmacologyDrug-metabolizing EnzymesHepatotoxicity MechanismsReactive MetabolitesAnticonvulsant PharmacologyAromatic HydroxylationCarbamazepine PharmacologyDrug BioactivationHydroxylationMetabolic Adverse Drug ReactionsRat Liver MicrosomesReactive Metabolite Adducts
The anticonvulsant carbamazepine 1 is associated with adverse drug reactions (ADRs), including hepatotoxicity; oxidative metabolism of 1 has been implicated in the pathogenesis of the ADRs. We report the synthesis and evaluation of 2-monohalo and 2,8-dihalo analogues of 1 that were intended to minimize reactive metabolite formation via arene oxidation and 10,11-epoxidation. Halo analogues were obtained either by rearrangement of halogenated N-arylindoles or from specifically halogenated iminodibenzyl derivatives. In rat hepatocytes, none of the analogues underwent oxidative dehalogenation or glutathione adduction. Some formation of the 10,11-epoxide still occurred, but aromatic hydroxylation was not seen with the exception of 2-fluoro, which allowed minor monohydroxylation. Complete inhibition of aromatic hydroxylation required at least monochlorination or difluorination of 1. In human liver microsomes, difluoro analogue 5b underwent 10,11-epoxidation but gave no arene oxidation.
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Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients
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