Ketazolam

Ketazolam (marketed under the brand names Anseren, Ansieten, Ansietil, Marcen, Sedatival, Sedotime, Solatran and Unakalm) is a drug which is a benzodiazepine derivative. It possesses anxiolytic, anticonvulsant, sedative and skeletal muscle relaxant properties.

Ketazolam

Clinical data
AHFS/Drugs.com	Micromedex Detailed Consumer Information
Routes of administration	Oral
ATC code	N05BA10 (WHO)
Legal status
Legal status	BR: Class B1 (Psychoactive drugs)[1] CA: Schedule IV DE: Prescription only (Anlage III for higher doses) US: Schedule IV
Pharmacokinetic data
Metabolism	Hepatic
Elimination half-life	26–200 hours
Excretion	Renal
Identifiers
IUPAC name 11-chloro-2,8-dimethyl-12b-phenyl-6H-[1,3]oxazino[3,2-d][1,4]benzodiazepine-4,7-dione[2]
CAS Number	27223-35-4 Y
PubChem CID	33746
DrugBank	DB01587 Y
ChemSpider	31110 Y
UNII	92A214MD7Y
KEGG	D04650 Y
CompTox Dashboard (EPA)	DTXSID20865350
ECHA InfoCard	100.043.937
Chemical and physical data
Formula	C20H17ClN2O3
Molar mass	368.82 g·mol−1
3D model (JSmol)	Interactive image
SMILES ClC1=CC2=C(N(C)C(CN3C(C=C(C)OC32C4=CC=CC=C4)=O)=O)C=C1
InChI InChI=1S/C20H17ClN2O3/c1-13-10-18(24)23-12-19(25)22(2)17-9-8-15(21)11-16(17)20(23,26-13)14-6-4-3-5-7-14/h3-11H,12H2,1-2H3 Y Key:PWAJCNITSBZRBL-UHFFFAOYSA-N Y
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Therapeutic uses

It is used for the treatment of anxiety and has similar effectiveness compared to diazepam. Ketazolam also appears to produce reduced levels of side effects such as sedation compared with diazepam and the side effects when they occur tend to be milder.^[3][4][5][6] Ketazolam is also an effective antispasmodic drug and is used for the treatment of spasticity.^[7][8][9]

Availability

Ketazolam is not approved for sale in Norway, Australia, United Kingdom or the United States.^[10] In South Africa, GlaxoSmithKline markets ketazolam under its Solatran brand name.^[11] In Canada, ketazolam is listed in schedule IV of the Controlled Drugs and Substances Act, along with other benzodiazepines.^[12]

Tolerance and physical dependence

Chronic use of ketazolam as with other benzodiazepines can lead to physical dependence and the appearance of the benzodiazepine withdrawal syndrome upon cessation of use or decrease in dose. Tolerance to ketazolam's therapeutic effects occurs over a period of 15 days.^[13]

Contraindications and special caution

Benzodiazepines require special precaution if used in the elderly, during pregnancy, in children, alcohol or drug-dependent individuals and individuals with comorbid psychiatric disorders.^[14]

Pharmacokinetics

Ketazolam breaks down in the blood to diazepam which breaks down to demoxepam which breaks down to desmethyldiazepam.^[15]

Warnings

The U.S. Food and Drug Administration warns that in Spain, ketazolam marketed as Marcen may sometimes be mistakenly confused with Narcan.^[16]

Legal status

Ketazolam is a List 3 drug under the Betäubungsmittelgesetz, like almost all benzodiazepines in Germany. Ketazolam is a List II drugs of the Opium Law in the Netherlands. Ketazolam is a Schedule IV drug under the Controlled Substances Act in the US.^[17]

References

1. Anvisa (2023-03-31). "RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 2023-04-04). Archived from the original on 2023-08-03. Retrieved 2023-08-16.
2. Vega D, Fernández D, Echeverría G (July 2001). "Ketazolam". Acta Crystallographica Section C. 57 (Pt 7): 848–850. doi:10.1107/S0108270101006175. PMID 11443263.
3. Anhalt HS, Young R, Roginsky M (November 1980). "Double-blind comparison of ketazolam, diazepam and placebo in once-a-day vs t.i.d. dosing". The Journal of Clinical Psychiatry. 41 (11): 386–392. PMID 6108319.
4. Kim KK, Sirman A, Trainor FS, Lee BY (1980). "Anxiolytic efficacy and safety of ketazolam compared with diazepam and placebo". Clinical Therapeutics. 3 (1): 9–14. PMID 6105920.
5. Fabre LF, Harris RT (1976). "Double-blind placebo-controlled efficacy study of ketazolam (U-28,774)". The Journal of International Medical Research. 4 (1): 50–54. doi:10.1177/030006057600400107. PMID 16791. S2CID 26311555.
6. Rickels K, Csanalosi I, Greisman P, Mirman MJ, Morris RJ, Weise CC, Weiss G (October 1980). "Ketazolam and diazepam in anxiety: a controlled study". Journal of Clinical Pharmacology. 20 (10): 581–589. doi:10.1002/j.1552-4604.1980.tb01673.x. PMID 6108335. S2CID 6597368.
7. Basmajian JV, Shankardass K, Russell D (August 1986). "Ketazolam once daily for spasticity: double-blind cross-over study". Archives of Physical Medicine and Rehabilitation. 67 (8): 556–557. PMID 2874780.
8. Katz RT (June 1988). "Management of spasticity". American Journal of Physical Medicine & Rehabilitation. 67 (3): 108–116. doi:10.1097/00002060-198806000-00004. PMID 3288246. S2CID 45292155.
9. Basmajian JV, Shankardass K, Russell D, Yucel V (November 1984). "Ketazolam treatment for spasticity: double-blind study of a new drug". Archives of Physical Medicine and Rehabilitation. 65 (11): 698–701. PMID 6149738.
10. "Benzodiazepine Names". The Tranquilliser Recovery and Awareness Place. Archived from the original on 8 December 2008. Retrieved 26 August 2008.
11. "SOLATRAN 15 (capsules) - SOLATRAN 30 (capsules)". South African Electronic Package Inserts. 12 November 1985. Archived from the original on 2 June 2019. Retrieved 26 August 2008.
12. "Controlled Drugs and Substances Act". laws-lois.justice.gc.ca. Archived from the original on 2013-12-15.
13. Higgitt A, Fonagy P, Lader M (1988). "The natural history of tolerance to the benzodiazepines". Psychological Medicine. Monograph Supplement. 13: 1–55. doi:10.1017/S0264180100000412. PMID 2908516. S2CID 38037200.
14. Authier N, Balayssac D, Sautereau M, Zangarelli A, Courty P, Somogyi AA, et al. (November 2009). "Benzodiazepine dependence: focus on withdrawal syndrome". Annales Pharmaceutiques Françaises. 67 (6): 408–413. doi:10.1016/j.pharma.2009.07.001. PMID 19900604.
15. Joyce JR, Bal TS, Ardrey RE, Stevens HM, Moffat AC (June 1984). "The decomposition of benzodiazepines during analysis by capillary gas chromatography/mass spectrometry". Biomedical Mass Spectrometry. 11 (6): 284–289. doi:10.1002/bms.1200110607. PMID 6743768.
16. Food and Drug Administration (January 2006). "FDA Public Health Advisory - Consumers Filling U.S. Prescriptions Abroad May Get the Wrong Active Ingredient Because of Confusing Drug Names". FDA (USA). Archived from the original on 12 August 2006. Retrieved 26 August 2006.
17. Drug Enforcement Administration (USA). "Drug Scheduling". United States Government. Archived from the original on 27 May 2018. Retrieved 26 August 2008.