Difenoxin

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Difenoxin
Systematic (IUPAC) name
1-[3-cyano-3,3-di(phenyl)propyl]-4-phenylpiperidine- 4-carboxylic acid
Identifiers
CAS number	35607-36-4
ATC code	?
PubChem	34328
Chemical data
Formula	C28H28N2O2
Mol. mass	424.53 g/mol
SMILES	eMolecules & PubChem
Synonyms	Difenoxin, Motofen
Pharmacokinetic data
Bioavailability	?
Metabolism	?
Half life	?
Excretion	?
Therapeutic considerations
Pregnancy cat.	?
Legal status	Schedule I(US)
Routes	?

Difenoxin (Motofen) is a 4-phenylpiperidine derivative that is related to the opioid analgesic drug pethidine (meperidine).

Difenoxin is an active metabolite of the anti-diarrhea drug diphenoxylate.^[1] It is not used by itself and is a Schedule I drug in the USA, however in some countries a combination product containing difenoxin and atropine is used to treat diarrhea, in a similar way to how diphenoxylate itself is used.^[2]

Difenoxin also has some sedative and analgesic effects as with other opioids, but diphenoxylate itself is a relatively weak analgesic, and difenoxin has similarly limited analgesic effects, although it is a potent anti-diarrheal drug. Research suggests that additional non-opioid mechanisms may also be involved in the action of difenoxin, explaining its strong anti-diarrheal effects despite only limited opioid action.^[3]

[edit] References

1. ^ Jackson LS, Stafford JE. The evaluation and application of a radioimmunoassay for the measurement of diphenoxylic acid, the major metabolite of diphenoxylate hydrochloride (Lomotil), in human plasma. Journal of Pharmacological Methods. 1987 Nov;18(3):189-97.
2. ^ Innocenti P, Rossi L, Bombardieri G. Clinical effectiveness of difenoxine in patients with acute and chronic diarrhea. (Italian). Bollettino Chimico Farmaceutico. 1983 Dec;122(12):64S-68S.
3. ^ De Luca A, Coupar IM. Difenoxin and loperamide: studies on possible mechanisms of intestinal antisecretory action. Naunyn Schmiedebergs Archives of Pharmacology. 1993 Feb;347(2):231-7.

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v • d • e Antidiarrheals, intestinal anti-inflammatory/anti-infective agents (A07) Intestinal anti-infectives Antibiotics (Neomycin, Nystatin, Natamycin, Streptomycin, Polymyxin B, Paromomycin, Amphotericin B, Kanamycin, Vancomycin, Colistin, Rifaximin) Sulfonamides (Phthalylsulfathiazole, Sulfaguanidine, Succinylsulfathiazole) other (Miconazole, Broxyquinoline, Acetarsol, Nifuroxazide, Nifurzide) Intestinal adsorbents Charcoal - Bismuth - Pectin - Kaolin - Crospovidone - Attapulgite - Diosmectite Antipropulsives Diphenoxylate - Opium - Loperamide - Difenoxin - Paregoric - Laudanum - Codeine - Morphine Intestinal anti-inflammatory agents corticosteroids acting locally (Prednisolone, Hydrocortisone, Prednisone, Betamethasone, Tixocortol, Budesonide, Beclometasone) antiallergic agents, excluding corticosteroids (Cromoglicic acid) aminosalicylic acid and similar agents (Sulfasalazine, Mesalazine, Olsalazine, Balsalazide) Antidiarrheal micro-organisms Saccharomyces boulardii Other antidiarrheals Albumin tannate - Ceratonia - Racecadotril