Clinical data | |
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License data | |
Routes of administration | Oral |
ATC code |
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Identifiers | |
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CAS Number | |
CompTox Dashboard (EPA) | |
ECHA InfoCard | 100.207.712 |
Chemical and physical data | |
Formula | C21H19ClFNO4S |
Molar mass | 435.90 g/mol g·mol−1 |
Laropiprant (pINN; codenamed MK-0524A) is tested in combination with niacin to reduce blood cholesterol (LDL and VLDL). This combination will be marketed by Merck & Co. under the tradenames Cordaptive and Tredaptive.
Laropiprant itself has no cholesterol lowering effect, but it reduces facial flushes induced by niacin. In a trial with 1613 patients, 10.2% patients stopped taking the medication in the Cordaptive group versus 22.2% under niacin monotherapy.[1]
Method of action
Niacin in cholesterol lowering doses (500-2000 mg per day) causes facial flushes by stimulating biosynthesis of prostaglandin D2, especially in the skin. PG D2 acts as a vasodilator via DP1 receptors, increasing blood flow and thus leading to flushes.
Laropiprant acts as a DP1 antagonist, reducing the vasodilation.
Taking 650 mg of aspirin 20-30 minutes prior to taking niacin has also been proven to prevent flushing in 90% of patients, presumably by suppressing prostaglandin synthesis,[2] but this medication also increases the risk of gastrointestinal bleeding,[3] though the increased risk is less than 1 percent. [4]
References
- ^
E Lai; et al. (2007). "Suppression of Niacin-induced Vasodilation with an Antagonist to Prostaglandin D2 Receptor Subtype 1". Clinical Pharmacology & Therapeutics. 81: 849–857. doi:10.1038/sj.clpt.6100180.
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(help) - ^ The Action of Aspirin in Preventing the Niacin Flush and its Relevance to the Antischizophrenic Action of Megadose Niacin
- ^ Sørensen HT, Mellemkjaer L, Blot WJ; et al. (2000). "Risk of upper gastrointestinal bleeding associated with use of low-dose aspirin". Am. J. Gastroenterol. 95 (9): 2218–24. doi:10.1111/j.1572-0241.2000.02248.x. PMID 11007221.
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ignored (help)CS1 maint: multiple names: authors list (link) - ^ [1]