Mepacrine
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Pharmacokinetic data | |
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Protein binding | 80–90% |
Elimination half-life | 5–14 days |
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Mepacrine, also called quinacrine or by the trade names Atabrine or Atebrin (german), is a medication with several uses. It is related to
Medical uses
The main uses of mepacrine are as an
Antiprotozoal use include targeting giardiasis, where mepacrine is indicated as a primary agent for patients with metronidazole-resistant giardiasis and patients who should not receive or cannot tolerate metronidazole. Giardiasis that is very resistant may even require a combination of mepacrine and metronidazole.[2]
Mepacrine is also used off-label for the treatment of
As an intrapleural sclerosing agent, it is used as pneumothorax prophylaxis in patients at high risk of recurrence, e.g., cystic fibrosis patients.[2]
Mepacrine is not the drug of choice because side effects are common, including toxic psychosis, and may cause permanent damage. See mefloquine for more information.
In addition to medical applications, mepacrine is an effective in vitro research tool for the epifluorescent visualization of cells, especially platelets. Mepacrine is a green fluorescent dye taken up by most cells. Platelets store mepacrine in dense granules.[4]
Mechanism
Its mechanism of action against
History
Antiprotozoal
Mepacrine was initially approved in the 1930s as an
This
Scientists at Bayer in Germany first synthesised mepacrine in 1931. The product was one of the first synthetic substitutes for quinine although later superseded by chloroquine.
Anthelmintics
In addition it has been used for treating
Creutzfeldt–Jakob disease
Mepacrine has been shown to bind to the prion protein and prevent the formation of prion aggregates in vitro,[8] and full clinical trials of its use as a treatment for Creutzfeldt–Jakob disease are under way in the United Kingdom and the United States. Small trials in Japan have reported improvement in the condition of patients with the disease,[9] although other reports have shown no significant effect,[10] and treatment of
Non-surgical sterilization for women
The use of mepacrine for non-surgical sterilization for women has also been studied. The first report of this method claimed a first year failure rate of 3.1%.[14] However, despite a multitude of clinical studies on the use of mepacrine and female sterilization, no randomized, controlled trials have been reported to date and there is some controversy over its use.[2]
In the United States, this method has undergone Phase I clinical testing. The FDA has waived the necessity for Phase II clinical trials because of the extensive data pertaining to other uses of mepacrine. The next step in the FDA approval process in the United States is a Phase III large multi-center clinical trial. The method is currently used off-label.
Many peer reviewed studies suggest that
Skin dye
During the Second Sino-Japanese War, American Sino-American Cooperative Organization operatives yellowed their skin using mepacrine tablets in order to more closely match the skin color of their Chinese peers.[19]
See also
References
- ^ "Quinacrine Shortage & What the ACR Is Doing about It". 13 March 2019 [8 February 2019]. Retrieved 24 August 2020.
- ^ a b c d e Drugs.com: Quinacrine. Retrieved on August 24, 2009.
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- ^ "quinacrine" at Dorland's Medical Dictionary
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- ^ Sokal, D.C., Kessel. E., Zipper. J., and King. T. (1994). "Quinacrine: Clinical experience". Background Paper for the World Health Organization Consultation on the Development of New Technologies for Female Sterilization: 25–7.
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: CS1 maint: multiple names: authors list (link) - S2CID 15179539.)
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: CS1 maint: multiple names: authors list (link - ^ George, Nirmala (July 25, 1998). "Govt drags feet on quinacrine threat". Indian Express..