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Cilansetron
Systematic (IUPAC) name
(10R)-10-[(2-methyl-1H-imidazol-1-yl)methyl]-5,6,9,10
-tetrahydro-4H-pyrido(3,2,1-jk)carbazol-11-one
Identifiers
CAS number 120635-74-7
ATC code A03AE03
PubChem 65939
Chemical data
Formula C 20H21N3O 
Mol. mass 319.4 g/mol
Pharmacokinetic data
Bioavailability 87%
Metabolism Hepatic
Half life 1.6 - 1.9 hours
Excretion Renal
Therapeutic considerations
Pregnancy cat. C
Legal status Unlicensed
Routes Oral

Cilansetron (Pronounced Sil-an-set-ron) is a drug that is a 5HT-3 antagonist currently under trial phase in the EU and US it is manufactured by Solvay Pharmaceuticals INC.

5HT-3 receptors are responsible for causing many things from nausea to excess bowel movements. It is thought in conditions like irritable bowel syndrome (IBS) the receptors have become faulty or oversensitive. 5HT-3 antagonists work by blocking the nervous and chemical signals from reaching these receptors.

Studies have shown that the drug can greatly improve quality of life in men and women with diahorrea predominant IBS (1) Cilansetron is the first 5HT antagonist specifically designed for IBS that is effective in men as well as women.(1)

Solvay has had considerable difficulty with the medicines regualtors in the UK, EU and USA with regards to licensing the drug. This could possibly be due to the problems discovered after licensing with the drug Lotronex. At time of writing; Solvay had recently withdrawn its application to the U.S. Food and Drug Administration (FDA) but was continuing its talks with the MHRA in the UK and EU regulators. (2)

It is not currently known what sort of timeframe the public are looking at to be able to obtain the drug. This matter is not helped by the lack of information about cilansetron and its trials in the public domain. The regulators have also stated this in their responses.

There is no information about future trials currently available.

Some people have tried the Anti-enemtic ondansetron HCl (Zofran) as a substitute for the time being, results are mixed but noted effect has been shown some male and females (3) However; due to its license in the UK it is usually only prescribable at consultant level. Since the licensing of a generic version it is more likely an NHS prescription will be accepted as the branded version is very expensive (Official NHS pricing.) In the USA and Canada: availability often depends on insurance and the doctors personal opinion on off-label prescribing.

References

  1. http://www.drugdevelopment-technology.com/projects/cilanserton (General info on Cilansetron.)
  2. http://www.solvaypress.com/pressreleases/0,,36423-2-0,00.htm#contact (Sovay press relaase 19 November 2005.)
  3. http://www.blackwell-synergy.com/doi/abs/10.1046/j.1365-2036.1996.30172000.x (Clinical trial for 5-HT3 antagonists use in Diarrhoea-predominant IBS)
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