Ethotoin

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.

Ethotoin
Skeletal formula of ethotoin
Clinical data
AHFS/Drugs.comConsumer Drug Information
MedlinePlusa682022
Pregnancy
category
  • C
Routes of
administration		By mouth (tablets)
ATC code
Pharmacokinetic data
Elimination half-life3–9 hours
Identifiers
  • 3-Ethyl-5-phenyl-imidazolidine-2,4-dione
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.001.514
Chemical and physical data
FormulaC11H12N2O2
Molar mass204.229 g·mol−1
3D model (JSmol)
  • O=C2NC(c1ccccc1)C(=O)N2CC
  • InChI=1S/C11H12N2O2/c1-2-13-10(14)9(12-11(13)15)8-6-4-3-5-7-8/h3-7,9H,2H2,1H3,(H,12,15) checkY
  • Key:SZQIFWWUIBRPBZ-UHFFFAOYSA-N checkY
  (verify)

Mechanism of action

The mechanism of action of ethotoin is similar to that of phenytoin.

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.

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).

Synthesis of ethotoin

References
  1. Schwade ED, Richards RK, Everett GM (May 1956). "Peganone, a new antiepileptic drug". Dis Nerv Syst. 17 (5): 155–8. PMID 13317788.
  2. Shorvon, S.D.; Fish, David R.; Perucca, Emilio; Dodson, W. Edwin, eds. (2004). The Treatment of Epilepsy. Blackwell Publishing. ISBN 0-632-06046-8.
  3. "Ethotoin". drugs.com.
  4. "PEGANONE 250 mg Ethotoin Tablets, USP" (PDF).
  5. A. Pinner, Chem. Ber., 21, 2324 (1888); W.J. Close, U.S. patent 2,793,157 (1946)
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