Chlorpropamide

 Chlorpropamide is a drug in the sulfonylurea class used to treat diabetes mellitus type 2. It is a long-acting first-generation sulfonylurea.

Chlorpropamide
Chlorpropamide.svg
Chlorpropamide ball-and-stick.png
Clinical data
Trade namesDiabinese
AHFS/Drugs.comMonograph
MedlinePlusa682479
License data
  • US FDAChlorpropamide
Pregnancy
category
  • AU: C
Routes of
administration
Oral
ATC code
  • A10BB02 (WHO)
Legal status
Legal status
  • AU: S4 (Prescription only)
  • CA℞-only
  • UK: POM (Prescription only)
  • US: ℞-only
Pharmacokinetic data
Bioavailability>90%
Protein binding90%
Metabolism<1%
Elimination half-life36 hours
ExcretionRenal (glomerular filtration → reabsorption → tubular secretion)
Identifiers
IUPAC name
  • 4-chloro-N-(propylcarbamoyl)benzenesulfonamide
CAS Number
  • 94-20-2 check
PubChem CID
  • 2727
IUPHAR/BPS
  • 6801
DrugBank
  • DB00672 check
ChemSpider
  • 2626 check
UNII
  • WTM2C3IL2X
KEGG
  • D00271 check
ChEBI
  • CHEBI:3650 check
ChEMBL
  • ChEMBL498 check
CompTox Dashboard (EPA)
  • DTXSID9020322 Edit this at Wikidata
ECHA InfoCard100.002.104 Edit this at Wikidata
Chemical and physical data
FormulaC10H13ClN2O3S
Molar mass276.74 g·mol−1
3D model (JSmol)
  • Interactive image
Melting point126 to 130 °C (259 to 266 °F)
SMILES
  • O=S(=O)(c1ccc(Cl)cc1)NC(=O)NCCC
InChI
  • InChI=1S/C10H13ClN2O3S/c1-2-7-12-10(14)13-17(15,16)9-5-3-8(11)4-6-9/h3-6H,2,7H2,1H3,(H2,12,13,14) check
  • Key:RKWGIWYCVPQPMF-UHFFFAOYSA-N check
  (verify)

Mechanism of actionEdit

Like other sulfonylureas, chlorpropamide acts to increase the secretion of insulin, so it is only effective in patients who have some pancreatic beta cell function. It can cause relatively long episodes of hypoglycemia; this is one reason why shorter-acting sulfonylureas such as gliclazide or tolbutamide are used instead. The risk of hypoglycemia makes this drug a poor choice for the elderly and patients with mild to moderate hepatic and renal impairment. Chlorpropamide is also used in partial central diabetes insipidus.[1]

PharmacokineticsEdit

Maximal plasma concentrations are reached 3 to 5 hours after quick and nearly complete (>90%) resorption from the gut. Plasma half life is 36 hours; the drug is effective for about 24 hours, longer than other sulfonylureas. A stable plasma level is only reached after three days of continuous application. 90% of the drug are bound to plasma proteins; at least two albumin binding sites exist. More than 99% of chlorpropamide are excreted unchanged via the kidneys. It is first filtrated in the glomeruli, then reabsorbed, and finally secreted into the tubular lumen.[1]

Cautions and contraindicationsEdit

Chlorpropamide and other sulfonylureas encourage weight gain, so they are generally not favored for use in very obese patients. Metformin (Glucophage) is considered a better drug for these patients. Sulfonylureas should be used with caution or generally avoided in patients with hepatic and renal impairment, patients with porphyria, patients who are breastfeeding, patients with ketoacidosis, and elderly patients.[1][2] Chlorpropamide, while effective in the treatment of diabetics in patients of Chinese descent, should never be used in people of Mongolian descent.[citation needed]

Other side effectsEdit

The most common side effects are skin related, such as rashesphotoallergy and (in rare cases) Stevens–Johnson syndrome.[1] Less common side effects of chlorpropamide include gastrointestinal symptoms such as nauseavomiting, and diarrhea.[2] It may cause facial flushing after the ingestion of alcohol.[3] In very high doses it can increase secretion of antidiuretic hormone (ADH), which can lead to hyponatremia.[1] It also markedly raises the serum level of alkaline phosphatase.[citation needed]

Chemical propertiesEdit

Chlorpropamide is a white crystalline powder with no characteristic taste or smell. It exhibits polymorphism. Its acid dissociation constant pKa is 5.0 at 20 °C.[1]

SolubilityEdit

SolventSolubility[1]
Water, pH 61:450
Water, pH 7.3insoluble
Acetone1:5
Dichlormethane1:9
Ethanol1:12
Diethylether1:200

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 Metasyntactic variable, which is released under the 
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