Methadone is a frequently employed agent for the treatment of drug addiction and the treatment of pain. Methadone prolongs the cardiac action potential, which on the surface electrocardiogram is represented by QT prolongation. This QT prolongation is known to increase the risk for the development of cardiac arrhythmias, especially the form of ventricular tachycardia known as Torsade de Pointes. For this reason, the FDA has inserted a “black box” warning for potential life threatening arrhythmias. The invention described in this application is the surprising finding that the R-isomer of methadone causes less inhibition of the potassium channel, IKr and thus would have less of a chance of causing life threatening arrhythmias. What is claimed is a method of chirally separating methadone with one isomer having less QT prolongation and more analgesic action that would make a superior pharmacologic agent than the racemate R,S methadone.
美沙酮是一种常用药物,用于治疗药物成瘾和疼痛。
美沙酮延长心脏动作电位,在表面心电图上表现为QT间期延长。已知这种QT间期延长会增加心律失常的风险,特别是一种称为扭转型室速的心室心律失常。因此,美国食品药品监督管理局(FDA)已经对潜在的危及生命的心律失常发布了“黑盒子”警告。本申请所描述的发明是发现
美沙酮的R-异构体对
钾通道IKr的抑制作用较小,因此较少引起危及生命的心律失常的意外发现。所要求的是一种手性分离
美沙酮的方法,其中一种异构体具有较少的QT间期延长和更多的镇痛作用,使其成为比混合物R,S-
美沙酮更优越的药理剂。