Ethyl loflazepate[2] (marketed under the brand names Meilax, Ronlax and Victan)[3][4][5] is a drug which is a benzodiazepine derivative. It possesses anxiolytic, anticonvulsant, sedative and skeletal muscle relaxant properties.[6] In animal studies it was found to have low toxicity, although in rats evidence of pulmonary phospholipidosis occurred with pulmonary foam cells developing with long-term use of very high doses.[7] Its elimination half-life is 51–103 hours.[8] Its mechanism of action is similar to other benzodiazepines. Ethyl loflazepate also produces an active metabolite which is stronger than the parent compound.[9] Ethyl loflazepate was designed to be a prodrug for descarboxyloflazepate, its active metabolite. It is the active metabolite which is responsible for most of the pharmacological effects rather than ethyl loflazepate.[10] The main metabolites of ethyl loflazepate are descarbethoxyloflazepate, loflazepate and 3-hydroxydescarbethoxyloflazepate.[11] Accumulation of the active metabolites of ethyl loflazepate are not affected by those with kidney failure or impairment.[12] The symptoms of an overdose of ethyl loflazepate include sleepiness, agitation and ataxia. Hypotonia may also occur in severe cases. These symptoms occur much more frequently and severely in children.[13] Death from therapeutic maintenance doses of ethyl loflazepate taken for 2 – 3 weeks has been reported in 3 elderly patients. The cause of death was asphyxia due to benzodiazepine toxicity.[14] High doses of the antidepressant fluvoxamine may potentiate the adverse effects of ethyl loflazepate.[15]
Ethyl loflazeplate is commercialized in Mexico, under the trade name Victan. It is officially approved for the following conditions:[16][17]
^Ba BB, Iliadis A, Durand A, Berger Y, Cano JP (October 1988). "New approach in bioavailability study of two formulations of ethyl loflazepate". Arzneimittel-Forschung. 38 (10): 1486–1489. PMID2904268.
^Ba BB, Iliadis A, Cano JP (1989). "Pharmacokinetic modeling of ethyl loflazepate (Victan) and its main active metabolites". Annals of Biomedical Engineering. 17 (6): 633–646. doi:10.1007/BF02367467. PMID2574017. S2CID31310535.
^Mazue G, Berthe J, Newmann AJ, Brunaud M (October 1981). "A toxicologic evaluation of ethyl fluclozepate (CM 6912)". International Journal of Clinical Pharmacology, Therapy, and Toxicology. 19 (10): 453–472. PMID6116677.
^Cautreels W, Jeanniot JP (November 1980). "Quantitative analysis of CM 6912 (ethyl loflazepate) and its metabolites in plasma and urine by chemical ionization gas chromatography mass spectrometry. Application to pharmacokinetic studies in man". Biomedical Mass Spectrometry. 7 (11–12): 565–571. doi:10.1002/bms.1200071124. PMID6112027.
^Chambon JP, Perio A, Demarne H, Hallot A, Dantzer R, Roncucci R, Bizière K (1985). "Ethyl loflazepate: a prodrug from the benzodiazepine series designed to dissociate anxiolytic and sedative activities". Arzneimittel-Forschung. 35 (10): 1573–1577. PMID2866771.
^Davi H, Guyonnet J, Sales Y, Cautreels W (1985). "Metabolism of ethyl loflazepate in the rat, the dog, the baboon and in man". Arzneimittel-Forschung. 35 (7): 1061–1065. PMID2864933.
^Ba BB, Iliadis A, Durand A, Berger Y, Necciari J, Cano JP (1989). "Effect of renal failure on the pharmacokinetics of ethyl loflazepate (Victan) in man". Fundamental & Clinical Pharmacology. 3 (1): 11–17. doi:10.1111/j.1472-8206.1989.tb00025.x. PMID2714728. S2CID2850707.
^Pulce C, Mollon P, Pham E, Frantz P, Descotes J (April 1992). "Acute poisonings with ethyle loflazepate, flunitrazepam, prazepam and triazolam in children". Veterinary and Human Toxicology. 34 (2): 141–143. PMID1354907.
^Kamijo Y, Hayashi I, Nishikawa T, Yoshimura K, Soma K (March 2005). "Pharmacokinetics of the active metabolites of ethyl loflazepate in elderly patients who died of asphyxia associated with benzodiazepine-related toxicity". Journal of Analytical Toxicology. 29 (2): 140–144. doi:10.1093/jat/29.2.140. PMID15902983.