Perhexiline

Perhexiline

Clinical data
AHFS/Drugs.com	International Drug Names
Routes of administration	Oral
ATC code	C08EX02 (WHO)
Pharmacokinetic data
Bioavailability	Dose Dependent
Metabolism	Saturable Hepatic
Elimination half-life	Dose Dependent
Identifiers
IUPAC name 2-(2,2-dicyclohexylethyl)piperidine
CAS Number	6621-47-2 Y
PubChem CID	4746
DrugBank	DB01074 Y
ChemSpider	4584 Y
UNII	KU65374X44
KEGG	D08340 Y
ChEBI	CHEBI:35553 Y
ChEMBL	ChEMBL75880 Y
CompTox Dashboard (EPA)	DTXSID7023439
ECHA InfoCard	100.026.881
Chemical and physical data
Formula	C19H35N
Molar mass	277.496 g·mol−1
3D model (JSmol)	Interactive image
SMILES N3C(CC(C1CCCCC1)C2CCCCC2)CCCC3
InChI InChI=1S/C19H35N/c1-3-9-16(10-4-1)19(17-11-5-2-6-12-17)15-18-13-7-8-14-20-18/h16-20H,1-15H2 Y Key:CYXKNKQEMFBLER-UHFFFAOYSA-N Y
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Perhexiline (Pexsig) is a prophylactic antianginal agent used primarily in Australia and New Zealand. Perhexiline is thought to act by inhibiting mitochondrial carnitine palmitoyltransferase-1. This shifts myocardial metabolism from fatty acid to glucose utilisation which results in increased ATP production for the same O₂ consumption and consequently increases myocardial efficiency. Its clinical use has been limited by its narrow therapeutic index and high inter- and intra-individual pharmacokinetic variability. It was outlawed in many countries due to its adverse effects on poor metabolisers (PM). The product has been reintroduced for patients who have contraindications, or have not responded to other treatments for angina.