Ethotoin

Routes of
administrationBy mouth (tablets)ATC codePharmacokinetic dataElimination half-life3–9 hoursIdentifiersCAS NumberPubChem CIDIUPHAR/BPSDrugBankChemSpiderUNIIKEGGChEBIChEMBLCompTox Dashboard (EPA)ECHA InfoCard100.001.514 Chemical and physical dataFormulaC₁₁H₁₂N₂O₂Molar mass204.229 g·mol⁻¹3D model (JSmol)  (verify)

Ethotoin (previously marketed as Peganone) is an anticonvulsant drug used in the treatment of epilepsy.^[1] It is a hydantoin, similar to phenytoin. It is not available in the United States.

Mechanism of action

The mechanism of action of ethotoin is similar to that of phenytoin.^{[citation needed]}

Approval history

• 1957 Peganone was granted Food and Drug Administration (FDA) approval to Abbott Laboratories for treatment of grand mal (tonic clonic) and partial complex (psychomotor) seizures.
• 2003 Peganone was acquired from Abbott Laboratories by Ovation Pharmaceuticals (specialty pharmaceutical company who acquire underpromoted branded pharmaceutical products).
• 2018 It was announced by Recordati Rare Diseases Inc. that due to a combination of low product demand and complex manufacturing difficulties, product manufacturing, distribution and sale was being discontinued.

Indications and usage

Ethotoin is indicated for tonic-clonic and partial complex seizures.^[2]

Dosing

Ethotoin is available in 250 mg tablets.^[3][4] It is taken orally in 4 to 6 divided doses per day, preferably after food.

Side effects

Side effects include ataxia, visual disturbances, rash, and gastrointestinal problems.^{[citation needed]}

Chemistry

Ethotoin is synthesized by the reaction of benzaldehyde oxynitrile (2) with urea or ammonium bicarbonate, which forms an intermediate urea derivative (3) which on acidic conditions cyclizes to 5-phenylhydantoin (4).^[5] Alkylation of this product using ethyl iodide leads to the formation of ethotoin (5).

References