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Other names | (Z)-Doxepin; cis-Doxepin; P-4599 |
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Formula | C19H21NO |
Molar mass | 279.383 g·mol−1 |
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Cidoxepin (former developmental code name P-4599), also known as cis-doxepin or (Z)-doxepin, is a tricyclic antidepressant which was developed in the 1960s but was never marketed.[1][2] It is the cis or (Z) stereoisomer of doxepin, a mixture of (E) and (Z) isomers that is used commercially in a ratio of approximately 85:15 with cidoxepin as a relatively minor constituent.[1][3] However, the drug has similar activity to that of doxepin, acting as a serotonin–norepinephrine reuptake inhibitor, H1 receptor antagonist, and anticholinergic, and notably is thought to have more antidepressant activity than trans-doxepin.[3][4][5] The central anticholinergic activity of cidoxepin has been reported to be 3-fold greater than that of the trans isomer in mice.[5]
Cidoxepin has recently been reinvestigated and is now currently under development as an antihistamine by Elorac, Inc. for the treatment of chronic urticaria (hives).[4] As of 2017, it is in phase II clinical trials for this indication.[4] The drug was also under investigation for the treatment of allergic rhinitis (hay fever), atopic dermatitis (atopic eczema), and contact dermatitis, but development for these indications was discontinued.[4]