Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/18 04:10:34」(JST)

wiki en

Phenformin is an antidiabetic drug from the biguanide class. It was marketed as DBI by Ciba-Geigy, but was withdrawn from most markets in the late 1970s due to a high risk of lactic acidosis, which was fatal in 50% of cases.

Phenformin was discovered in 1957 by Ungar, Freedman and Seymour Shapiro, working for the US Vitamin Corporation. Clinical trials begun in 1958 showed it to be effective, but with gastrointestinal side effects.^[1]

Toxicity

Phenformin sales began to decline in the US from 1973 due to negative trial studies and reports of lactic acidosis. By October 1976, the FDA Endocrinology and Metabolism Advisory Committee recommended phenformin be removed from the market. The FDA began formal proceedings in May 1977, leading to its eventual withdrawal on November 15, 1978.^[2]

In 1977, 385,000 patients with early-stage diabetes were taking phenformin in the US. Ralph Nader's Health Research Group put the US government under pressure to ban the drug. Ciba-Geigy Corp resisted, claiming there was no satisfactory alternative for many patients. However, in July the FDA declared the drug an "imminent hazard to the public health" and gave doctors 90 days to switch to an alternative treatment (such as insulin, dietary restrictions or other drugs).^[3] As of 2008, phenformin was still legally available in Italy, Brazil, Uruguay, China, Poland, Greece and Portugal. Cases of phenformin-induced lactic acidosis continue to be reported worldwide.^[4] In Hong Kong, where phenformin is banned, cases of phenformin-induced lactic acidosis have occurred after taking Chinese proprietary medicines, claiming to be herbal, which were adulterated with phenformin.^[5] In the US, the FDA has recalled Chinese "herbal products" containing phenformin.^[6]

The related drug metformin is considerably safer than phenformin, with three cases of lactic acidosis per 100,000 patient-years compared to 64 cases per 100,000 patient-years, and those are mostly confined to patients with impaired renal function.^[7]

Cimetidine may reduce renal clearance of phenformin and increase lactic acidosis risk. There is also increased risk of lactic acidosis with alcohol, nephrotoxic drugs.

Chemistry and pharmacokinetics

Phenformin hydrochloride is a white crystalline powder, with a melting point of 175 to 178 °C; it is soluble at 1 in 8 parts of water and 1 in 15 of ethanol, and practically insoluble in chloroform and ether. Its dissociation constant (pKa) is 2.7, 11.8 (at 32 °C), and partition coefficient (log P in octanol/water) = –0.8. Phenformin is well absorbed after oral administration. The major metabolic reaction is aromatic hydroxylation to form 4–hydroxyphenformin, which is then conjugated with glucuronic acid. Up to about 50% of a dose is excreted in the urine in 24 h, about two–thirds in the form of unchanged drug and one–third as the hydroxy metabolite. Following a single oral dose of 50 mg to eight subjects, peak plasma concentrations of 0.08 to 0.18 mg/l (mean 0.13) were attained in about 3 h; plasma concentrations were higher in four subjects who were poor metabolisers of debrisoquine in comparison with the four extensive metabolisers. Following daily oral doses of 50 mg three times a day to 8 subjects, plasma concentrations of 0.10 to 0.24 mg/l (mean 0.18) were reported 2 h after a dose. Plasma half–life of phenformin is 10 to 15 h. Phenformin protein-binding in plasma is about 12 to 20%.^[8]

Dosage

When given orally for type 2 diabetes mellitus, the dosage is 200–400 mg, twice daily, for adults.

Anticancer properties

Phenformin, along with buformin and metformin, inhibits the growth and development of cancer. Respective studies were initiated by Vladimir Dilman (see f.e.^[9]^[10]^[11]^[12]^[13]^[14] The anticancer property of these drugs may be due to their ability to disrupt the Warburg effect and revert the cytosolic glycolysis characteristic of cancer cells to normal oxidation of pyruvate by the mitochondria.^[15] Metformin reduces liver glucose production in diabetics and disrupts the Warburg effect in cancer by AMPK activation and inhibition of the mTor pathway.^[16]

References

^ McKendry JB, Kuwayti K, Rado PP; Kuwayti; Rado (May 1959). "Clinical Experience with DBI (Phenformin) in the Management of Diabetes". Can Med Assoc J 80 (10): 773–8. PMC 1831029. PMID 13652024.
^ Tonascia, Susan; Meinert, Curtis L. (1986). Clinical trials: design, conduct, and analysis. Oxford [Oxfordshire]: Oxford University Press. pp. 53–54, 59. ISBN 0-19-503568-2.
^ UPI (July 26, 1977). "Diabetic drug linked to deaths banned". Boca Raton News.
^ Fimognari FL, Corsonello A, Pastorelli R, Antonelli Incalzi R; Corsonello; Pastorelli; Antonelli Incalzi (December 2008). "Older age and phenformin therapy: a dangerous association". Intern Emerg Med 3 (4): 401–3. doi:10.1007/s11739-008-0154-y. PMID 18415028.
^ Ching CK, Lai CK, Poon WT, et al. (February 2008). "Hazards posed by a banned drug--phenformin is still hanging around" (pdf). Hong Kong Med J 14 (1): 50–4. PMID 18239244.
^ <Please add first missing authors to populate metadata.> (July 2001). "Herbs for health, but how safe are they?". Bulletin of the World Health Organization (Geneva) 79 (7): 691–692. doi:10.1590/S0042-96862001000700025 (inactive 2015-01-09). PMC 2566478.
^ Crofford OB (August 1995). "Metformin". N. Engl. J. Med. 333 (9): 588–9. doi:10.1056/NEJM199508313330910. PMID 7623910.
^ Phenformin in Analysis of Drugs and Poisons
^ Dilman, VM; Berstein, LM; Zabezhinski, MA; Alexandrov, VA; Bobrov, JF; Pliss, GB (1978). "Inhibition of DMBA-induced carcinogenesis by phenformin in the mammary gland of rats". Arch Geschwulstforsch 48 (1): 1–8.
^ Caracia, Filippo; Chisari, Mariangela; Frasca, Giuseppina; Chiechio, Santina; Salomone, Salvatore; Pinto, Antonio; Angela Sortino, Maria; Bianchi, Alfredo (2003). "Effects of phenformin on the proliferation of human tumor cell lines". Life Sciences 74 (5): 643–650. doi:10.1016/j.lfs.2003.07.015.
^ Anisimov, Vladimir N. (2003). "Insulin/IGF-1 signaling pathway driving aging and cancer as a target for pharmacological intervention". Experimental Gerontology 38 (10): 1041–1049. doi:10.1016/s0531-5565(03)00169-4.
^ Alexandrov, Valery A.; Anisimov, Vladimir N.; Belous, Natalia M.; Vasilyeva, Inna A.; Mazon, Vera B. (1980). "The inhibition of the transplacental blastomogenic effect of nitrosomethylurea by postnatal administration of buformin to rats". Carcinogenesis 1 (12): 975–978. doi:10.1093/carcin/1.12.975.
^ Anisimov, VN; Ostroumova, MN; Dil'man, VM (1980). "Inhibition of the blastomogenic effect of 7,12-dimethylbenz(a)anthracene in female rats by buformin, diphenin, a polypeptide pineal extract and L-DOPA". Bulletin of Experimental Biology and Medicine 89 (6): 819–822. doi:10.1007/bf00836263.
^ Anisimov, Vladimir N.; Berstein, Lev M.; Popovich, Irina G.; Zabezhinski, Mark A.; Egormin, Peter A.; Tyndyk, Margarita L.; Anikin, Ivan V.; Semenchenko, Anna V.; Yashin, Anatoli I. (2005). "Central and Peripheral Effects of Insulin/IGF-1 Signaling in Aging and Cancer: Antidiabetic Drugs as Geroprotectors and Anticarcinogens". Annals of the New York Academy of Sciences 1057: 220–234. doi:10.1196/annals.1356.017.
^ Vander Heiden, Matthew G.; Cantley, Lewis C.; Thompson, Craig B. (2009). "Understanding the Warburg Effect: The Metabolic Requirements of Cell Proliferation". Science 324 (5930): 1029–1033. doi:10.1126/science.1160809.
^ Shaw, RJ; Lamia, KA; Vasquez, D; Koo, SH; Bardeesy, N; Depinho, RA; Montminy, M; Cantley, LC (Dec 2005). "The kinase LKB1 mediates glucose homeostasis in liver and therapeutic effects of metformin". Science 310 (5754): 1642–6. doi:10.1126/science.1120781.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 成人の2型糖尿病治療におけるメトホルミン metformin in the treatment of adults with type 2 diabetes mellitus
2. 乳酸アシドーシスの原因 causes of lactic acidosis
3. メトホルミン中毒 metformin poisoning
4. 持久性隆起性紅斑 erythema elevatum diutinum

English Journal

Effects of metformin, buformin, and phenformin on the post-initiation stage of chemically induced mammary carcinogenesis in the rat.

Zhu Z1, Jiang W1, Thompson MD2, Echeverria D1, McGinley JN1, Thompson HJ3.
Cancer prevention research (Philadelphia, Pa.).Cancer Prev Res (Phila).2015 Jun;8(6):518-27. doi: 10.1158/1940-6207.CAPR-14-0121. Epub 2015 Mar 24.
Metformin is a widely prescribed drug for the treatment of type II diabetes. Although epidemiologic data have provided a strong rationale for investigating the potential of this biguanide for use in cancer prevention and control, uncertainty exists whether metformin should be expected to have an imp
PMID 25804611

Oncometabolic mutation IDH1 R132H confers a metformin-hypersensitive phenotype.

Cuyàs E1,2, Fernández-Arroyo S3, Corominas-Faja B1,2, Rodríguez-Gallego E3, Bosch-Barrera J2,4, Martin-Castillo B2,5, De Llorens R6, Joven J3, Menendez JA1,2.
Oncotarget.Oncotarget.2015 May 20;6(14):12279-96.
Metabolic flexibility might be particularly constrained in tumors bearing mutations in isocitrate dehydrogenase 1 (IDH1) leading to the production of the oncometabolite 2-hydroxygluratate (2HG). To test the hypothesis that IDH1 mutations could generate metabolic vulnerabilities for therapeutic inter
PMID 25980580

Immunohistochemical localization of OCT2 in the cochlea of various species.

Hellberg V1, Gahm C, Liu W, Ehrsson H, Rask-Andersen H, Laurell G.
The Laryngoscope.Laryngoscope.2015 Apr 17. doi: 10.1002/lary.25304. [Epub ahead of print]
OBJECTIVE: To locate the organic cation transporter 2 (OCT2) in the cochlea of three different species and to modulate the ototoxicity of cisplatin in the guinea pig by pretreatment with phenformin, having a known affinity for OCT2.STUDY DESIGN: Immunohistochemical and in vivo study.METHODS: Section
PMID 25892279

Japanese Journal

Analysis of Drugs Illegally Added into Chinese Traditional Patent Medicine Using Surface-enhanced Raman Scattering

ZHANG Yan,HUANG Xiaoyan,LIU Wenfang,CHENG Zeneng,CHEN Chuanpin,YIN Lihui
Analytical Sciences 29(10), 985-990, 2013
… In this report, a surface-enhanced Raman scattering (SERS) analysis method for five kinds of illegally added drugs (rosiglitazone maleate, phenformin hydrochloride, metformin hydrochloride, pioglitazone hydrochloride and sibutramine hydrochloride) in Chinese traditional patent medicine (CTPM) has been demonstrated, including simultaneous detections of drug mixtures with CTPM. …
NAID 130004442154

フェンホルミンのミトコンドリア毒性に対する有機カチオン輸送系の関与

則岡美咲,設楽悦久,堀江利治
日本薬物動態学会年会講演要旨集 24(0), 115-115, 2009
NAID 130004639485

Comparison of gene expression changes induced by biguanides in db/db mice liver

Heishi Masayuki,Hayashi Koji,Ichihara Junji [他],Ishikawa Hironori,Kawamura Takao,Kanaoka Masaharu,Taiji Mutsuo,Kimura Toru
Journal of toxicological sciences 33(3), 339-347, 2008-08-01
… By contrast, another biguanide, phenformin, has been withdrawn from major markets because of a high incidence of serious adverse effects. … To gain insight into the different modes of action of the two drugs, we performed global gene expression pro filing using the livers of obese diabetic db/db mice after a single administration of phenformin or metformin at levels sufficient to cause a significant reduction in blood glucose level. …
NAID 110006862210

Related Pictures

★リンクテーブル★

リンク元

「フェンホルミン」

Phenformin
Systematic (IUPAC) name
	2-(N-phenethylcarbamimidoyl)guanidine
Clinical data
AHFS/Drugs.com	International Drug Names
Identifiers
CAS Number	114-86-3
ATC code	A10BA01
PubChem	CID: 8249
DrugBank	DB00914
ChemSpider	7953
UNII	DD5K7529CE
KEGG	D08351
ChEBI	CHEBI:8064
ChEMBL	CHEMBL170988
Chemical data
Formula	C10H15N5
Molecular mass	205.26 g/mol
	SMILES N(=C(/N=C(\N)N)N)\CCc1ccccc1 ;
	InChI InChI=1S/C10H15N5/c11-9(12)15-10(13)14-7-6-8-4-2-1-3-5-8/h1-5H,6-7H2,(H6,11,12,13,14,15) ; Key:ICFJFFQQTFMIBG-UHFFFAOYSA-N ;
(what is this?) (verify)

　　[★]

英: phenformin
同: フェネチルビグアニド phenethylbiguanide
関: 経口糖尿病薬

[McKendry1959-1] McKendry JB, Kuwayti K, Rado PP; Kuwayti; Rado (May 1959). "Clinical Experience with DBI (Phenformin) in the Management of Diabetes". Can Med Assoc J 80 (10): 773–8. PMC 1831029. PMID 13652024.

[Tonascia1986-2] Tonascia, Susan; Meinert, Curtis L. (1986). Clinical trials: design, conduct, and analysis. Oxford [Oxfordshire]: Oxford University Press. pp. 53–54, 59. ISBN 0-19-503568-2.

[Boca-3] UPI (July 26, 1977). "Diabetic drug linked to deaths banned". Boca Raton News.

[Fimognari2008-4] Fimognari FL, Corsonello A, Pastorelli R, Antonelli Incalzi R; Corsonello; Pastorelli; Antonelli Incalzi (December 2008). "Older age and phenformin therapy: a dangerous association". Intern Emerg Med 3 (4): 401–3. doi:10.1007/s11739-008-0154-y. PMID 18415028.

[Ching2008-5] Ching CK, Lai CK, Poon WT, et al. (February 2008). "Hazards posed by a banned drug--phenformin is still hanging around" (pdf). Hong Kong Med J 14 (1): 50–4. PMID 18239244.

[WHO-6] <Please add first missing authors to populate metadata.> (July 2001). "Herbs for health, but how safe are they?". Bulletin of the World Health Organization (Geneva) 79 (7): 691–692. doi:10.1590/S0042-96862001000700025 (inactive 2015-01-09). PMC 2566478.

[Crofford1995-7] Crofford OB (August 1995). "Metformin". N. Engl. J. Med. 333 (9): 588–9. doi:10.1056/NEJM199508313330910. PMID 7623910.

[8] Phenformin in Analysis of Drugs and Poisons

[9] Dilman, VM; Berstein, LM; Zabezhinski, MA; Alexandrov, VA; Bobrov, JF; Pliss, GB (1978). "Inhibition of DMBA-induced carcinogenesis by phenformin in the mammary gland of rats". Arch Geschwulstforsch 48 (1): 1–8.

[10] Caracia, Filippo; Chisari, Mariangela; Frasca, Giuseppina; Chiechio, Santina; Salomone, Salvatore; Pinto, Antonio; Angela Sortino, Maria; Bianchi, Alfredo (2003). "Effects of phenformin on the proliferation of human tumor cell lines". Life Sciences 74 (5): 643–650. doi:10.1016/j.lfs.2003.07.015.

[11] Anisimov, Vladimir N. (2003). "Insulin/IGF-1 signaling pathway driving aging and cancer as a target for pharmacological intervention". Experimental Gerontology 38 (10): 1041–1049. doi:10.1016/s0531-5565(03)00169-4.

[12] Alexandrov, Valery A.; Anisimov, Vladimir N.; Belous, Natalia M.; Vasilyeva, Inna A.; Mazon, Vera B. (1980). "The inhibition of the transplacental blastomogenic effect of nitrosomethylurea by postnatal administration of buformin to rats". Carcinogenesis 1 (12): 975–978. doi:10.1093/carcin/1.12.975.

[13] Anisimov, VN; Ostroumova, MN; Dil'man, VM (1980). "Inhibition of the blastomogenic effect of 7,12-dimethylbenz(a)anthracene in female rats by buformin, diphenin, a polypeptide pineal extract and L-DOPA". Bulletin of Experimental Biology and Medicine 89 (6): 819–822. doi:10.1007/bf00836263.

[14] Anisimov, Vladimir N.; Berstein, Lev M.; Popovich, Irina G.; Zabezhinski, Mark A.; Egormin, Peter A.; Tyndyk, Margarita L.; Anikin, Ivan V.; Semenchenko, Anna V.; Yashin, Anatoli I. (2005). "Central and Peripheral Effects of Insulin/IGF-1 Signaling in Aging and Cancer: Antidiabetic Drugs as Geroprotectors and Anticarcinogens". Annals of the New York Academy of Sciences 1057: 220–234. doi:10.1196/annals.1356.017.

[15] Vander Heiden, Matthew G.; Cantley, Lewis C.; Thompson, Craig B. (2009). "Understanding the Warburg Effect: The Metabolic Requirements of Cell Proliferation". Science 324 (5930): 1029–1033. doi:10.1126/science.1160809.

[16] Shaw, RJ; Lamia, KA; Vasquez, D; Koo, SH; Bardeesy, N; Depinho, RA; Montminy, M; Cantley, LC (Dec 2005). "The kinase LKB1 mediates glucose homeostasis in liver and therapeutic effects of metformin". Science 310 (5754): 1642–6. doi:10.1126/science.1120781.

匿名

検索

案内

案内

phenformin