Diclofenamide

Diclofenamide
Clinical data
AHFS/Drugs.com	International Drug Names
MedlinePlus	a601233
ATC code	S01EC02 (WHO) ;
Pharmacokinetic data
Protein binding	55%
Identifiers
	IUPAC name 4,5-Dichlorobenzene-1,3-disulfonamide;
CAS Number	120-97-8 ;
PubChem CID	3038;
IUPHAR/BPS	6807;
DrugBank	DB01144 ;
ChemSpider	2930 ;
UNII	VVJ6673MHY;
KEGG	D00518 ;
ChEBI	CHEBI:101085 ;
ChEMBL	ChEMBL17 ;
CompTox Dashboard (EPA)	DTXSID1022922 ;
ECHA InfoCard	100.004.037
Chemical and physical data
Formula	C6H6Cl2N2O4S2
Molar mass	305.14 g·mol−1
3D model (JSmol)	Interactive image;
Melting point	228.5 °C (443.3 °F)
	SMILES Clc1c(cc(cc1Cl)S(=O)(=O)N)S(=O)(=O)N;
	InChI InChI=1S/C6H6Cl2N2O4S2/c7-4-1-3(15(9,11)12)2-5(6(4)8)16(10,13)14/h1-2H,(H2,9,11,12)(H2,10,13,14) ; Key:GJQPMPFPNINLKP-UHFFFAOYSA-N ;
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Diclofenamide (or dichlorphenamide) is a sulfonamide and a carbonic anhydrase inhibitor of the meta-disulfamoylbenzene class.

Uses

Diclofenamide was approved in the United States in 1958 as Daranide to treat glaucoma,^[1]^[2]^[3] Subsequently, it was found effective in cases of therapy-resistant epilepsy.^[4] In 2015, the medication was approved in the US under the name Keveyis as an orphan drug for the treatment of primary hypokalemic and hyperkalemic periodic paralysis.^[1]^[5]

Cost

In 2001, diclofenamide had a U.S. list price of $50 for a bottle of 100 pills, and was approved for glaucoma. Merck discontinued diclofenamide when better glaucoma drugs were developed. In 2010, Sun Pharmaceutical Industries bought the rights. In 2015, the F.D.A. approved it as an orphan drug, with 7-year exclusive marketing rights, for periodic paralysis, which the company estimates affects 5,000 people in the U.S. In 2016, Strongbridge Biopharma acquired Sun, which raised the price to $15,001 for 100 pills. The cost of treatment would range from $109,500 to $219,000 a year. Sun gives the drug free to patients who don't have insurance.^[5]

References

^ ^a ^b "Dichlorphenaide (Keveyis) for Periodic Paralysis". The Medical Letter. April 16, 2016. Retrieved December 19, 2017.
^ International Drug Names: Diclofenamide
^ Kanski JJ (August 1968). "Carbonic anhydrase inhibitors and osmotic agents in glaucoma. Carbonic anhydrase inhibitors". The British Journal of Ophthalmology. 52 (8): 642–3. doi:10.1136/bjo.52.8.642. PMC 506660. PMID 5724852.
^ Rucquoy M, Sorel L (1978). "Diclofenamide in the treatment of therapy-resistant epilepsy". Acta Neurologica Belgica. 78 (3): 174–82. PMID 352085.
^ ^a ^b Johnson CY (December 18, 2017). "This old drug was free. Now it's $109,500 a year". Washington Post.

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[ML-1] "Dichlorphenaide (Keveyis) for Periodic Paralysis". The Medical Letter. April 16, 2016. Retrieved December 19, 2017.

[2] International Drug Names: Diclofenamide

[3] Kanski JJ (August 1968). "Carbonic anhydrase inhibitors and osmotic agents in glaucoma. Carbonic anhydrase inhibitors". The British Journal of Ophthalmology. 52 (8): 642–3. doi:10.1136/bjo.52.8.642. PMC 506660. PMID 5724852.

[4] Rucquoy M, Sorel L (1978). "Diclofenamide in the treatment of therapy-resistant epilepsy". Acta Neurologica Belgica. 78 (3): 174–82. PMID 352085.

[WP-5] Johnson CY (December 18, 2017). "This old drug was free. Now it's $109,500 a year". Washington Post.

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