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Astemizole: Wikis


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Systematic (IUPAC) name
1-[(4-fluorophenyl)methyl]- N-[1-[2-(4-methoxyphenyl)ethyl]- 4-piperidyl]benzoimidazol-2-amine
CAS number 68844-77-9
ATC code R06AX11
PubChem 2247
DrugBank APRD00585
ChemSpider 2160
Chemical data
Formula C28H31FN4O 
Mol. mass 458.571
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability  ?
Metabolism Hepatic
Half life 24 hours
Excretion Fecal
Therapeutic considerations
Pregnancy cat. C (USA)
Legal status Unscheduled
Routes Oral
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Astemizole (marketed under the brand name Hismanal) was a second generation antihistamine drug which has a long duration of action. Astemizole was discovered by Janssen Pharmaceutica in 1977. It has been withdrawn from the market in most countries because of rare but potentially fatal side effects.



It is metabolized by CYP3A4.[1]

It has been withdrawn from the market in most countries because of rare but potentially fatal interactions with CYP3A4 enzyme inhibitors (e.g. erythromycin, grapefruit juice).


Astemizole is an histamine H1-receptor antagonist. It is structurally similar to terfenadine and haloperidol (a butyrophenone antipsychotic). It has anticholinergic and antipruritic effects.

Astemizole competitively binds to histamine H1-receptor sites in the gastrointestinal tract, uterus, blood vessels, and bronchial muscle. This suppresses the formation of edema and pruritus (caused by histamine).

Astemizole does not cross the blood-brain barrier, and H1 receptor binding is mostly in the peripheral rather than central nervous system (CNS depression is thus minimal). Astemizole may also act on histamine H3 receptors, thereby producing adverse effects.

Astemizole is rapidly absorbed from the gastrointestinal tract; protein binding is around 96%.


Astemizole has an oral LD50 of approximately 2052mg/kg (in mice).


It has been reported that this drug might prevent much of the muscle wasting (atrophy) that occurs in immobile, bedridden patients.[2] An experiment on a small number of mice showed that astemizole blocked the activity of a protein present in muscle that is involved in muscle atrophy.[3] However the concerns for the drug's longterm effects on the heart preclude its routine use in humans for this indication.

Astemizole has recently been found to be a potent treatment for malaria. It has a mechanism of action similar to chloroquine but has activity even in chloroquine-resistant parasites.[4]

External links


  1. ^ Matsumoto S, Yamazoe Y (February 2001). "Involvement of multiple human cytochromes P450 in the liver microsomal metabolism of astemizole and a comparison with terfenadine". British journal of clinical pharmacology 51 (2): 133–42. PMID 11259984. PMC 2014443. 
  2. ^ "Purdue researchers find 'switch' for skeletal-muscle atrophy". Purdue University. 2006-05-24. Retrieved 2009-06-22. 
  3. ^ Wang X, Hockerman GH, Green Iii HW, Babbs CF, Mohammad SI, Gerrard D, Latour MA, London B, Hannon KM, Pond AL (May24 2006). "Merg1a K+ channel induces skeletal muscle atrophy by activating the ubiquitin proteasome pathway". FASEB J 20: 1531. doi:10.1096/fj.05-5350fje. PMID 16723379. 
  4. ^ Chong CR, Chen X, Shi L, Liu JO, Sullivan DJ (2006). "A clinical drug library screen identifies astemizole as an antimalarial agent". Nat Chem Biol 2: 415–16. doi:10.1038/nchembio806. PMID 16816845. 

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