Rufinamide

Identification

Summary

Rufinamide is an antiepileptic drug used as adjunctive therapy to treat seizures associated with Lennox-Gastaut Syndrome (LGS).

Brand Names
Banzel, Inovelon
Generic Name
Rufinamide
DrugBank Accession Number
DB06201
Background

Rufinamide is a triazole derivative and an anticonvulsant medication to treat seizure disorders like Lennox-Gastuat syndrome, a form of childhood epilepsy. Clinical trials suggest its efficacy in the treatment of partial seizures.

Type
Small Molecule
Groups
Approved
Structure
Weight
Average: 238.1935
Monoisotopic: 238.066617308
Chemical Formula
C10H8F2N4O
Synonyms
  • Rufinamida
  • Rufinamide
  • Xilep
External IDs
  • CGP 33101
  • E 2080
  • E-2080
  • E2080
  • RUF 331

Pharmacology

Indication

Adjunct therapy for treatment of seizures associated with Lennox-Gastaut syndrome.

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Adjunct therapy in management ofLennox-gastaut syndrome••••••••••••
Contraindications & Blackbox Warnings
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Pharmacodynamics

At high concentrations will inhibit action of mGluR5 subtype receptors thus preventing the production of glutamate.

Mechanism of action

Rufinamide is a triazole derivative antiepileptic that prolongs the inactive state of voltage gated sodium channels thus stabilizing membranes, ultimately blocking the spread of partial seizure activity.

TargetActionsOrganism
USodium channel protein type 9 subunit alpha
modulator
Humans
UMetabotropic glutamate receptor 5
inhibitor
Humans
Absorption

The oral suspension and tablet are bioequivalent on a mg per mg basis. Rufinamide is well absorbed but the rate is slow and the extent of absorption decreases as dose is increases. Based on urinary excretion, the extent of absorption was at least 85% following oral administration of a single dose of 600 mg rufinamide tablet under fed conditions. Bioavailability= 70%-85% (decreases with increasing doses); Tmax, fed and fasted states= 4-6 hours; Cmax, 10 mg/kg/day= 4.01 µL/mL; Cmax, 30mg/kg/day= 8.68 µL/mL; AUC (0h-12h), 10mg/kg/day= 37.8±47 µg·h/mL; AUC (0h-12h), 30mg/kg/day= 89.3±59 µg·h/mL.

Volume of distribution

Rufinamide was evenly distributed between erythrocytes and plasma. The apparent volume of distribution is dependent upon dose and varies with body surface area. The apparent volume of distribution was about 50 L at 3200 mg/day. Volume of distribution is similar between adults and children and is non-linear.

Protein binding

26.3% - 34.8% with 90% binding to albumin (27%).

Metabolism

Rufinamide is extensively metabolized but has no active metabolites. Metabolism by carboxyesterases into inactive metabolite CGP 47292, a carboxylic acid derivative, via hydrolysis is the primary biotransformation pathway. A few minor additional metabolites were detected in urine, which appeared to be acyl-glucuronides of CGP 47292. The cytochrome P450 enzyme system or glutathiones are not involved with the metabolism of rufinamide. Rufinamide is a weak inhibitor of CYP 2E1. Rufinamide is a weak inducer of CYP 3A4 enzymes.

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Route of elimination

Renally (91%; 66% as CGP 47292, 2% as unchanged drug) and fecally (9%) eliminated.

Half-life

Elimination half-life, healthy subjects and patients with epilepsy = 6-10 hours.

Clearance

Not Available

Adverse Effects
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Toxicity

The most commonly observed adverse reactions (≥10% and greater than placebo) were headache, dizziness, fatigue, somnolence, and nausea.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
1,2-BenzodiazepineThe risk or severity of adverse effects can be increased when Rufinamide is combined with 1,2-Benzodiazepine.
AbemaciclibThe metabolism of Abemaciclib can be increased when combined with Rufinamide.
AcalabrutinibThe metabolism of Acalabrutinib can be increased when combined with Rufinamide.
AcenocoumarolThe metabolism of Acenocoumarol can be increased when combined with Rufinamide.
AcetaminophenRufinamide may increase the hepatotoxic activities of Acetaminophen.
Food Interactions
  • Take with food. Food can increase the absorption of rufinamide.

Products

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Product Images
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
BanzelTablet200 mgOralEisai Limited2011-08-29Not applicableCanada flag
BanzelTablet, film coated400 mg/1OralEisai Inc.2008-11-14Not applicableUS flag
BanzelSuspension40 mg / mLOralEisai LimitedNot applicableNot applicableCanada flag
BanzelTablet100 mgOralEisai Limited2011-10-20Not applicableCanada flag
BanzelTablet, film coated200 mg/1OralEisai Inc.2008-11-14Not applicableUS flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
RufinamideTablet, film coated200 mg/1OralHikma Pharmaceuticals USA Inc.2021-05-30Not applicableUS flag
RufinamideTablet400 mg/1OralMicro Labs Limited2023-07-01Not applicableUS flag
RufinamideTablet, film coated400 mg/1OralGlenmark Pharmaceuticals Inc., USA2016-05-16Not applicableUS flag
RufinamideTablet, film coated200 mg/1OralAurobindo Pharma Limited2023-06-16Not applicableUS flag
RufinamideSuspension40 mg/1mLOralHikma Pharmaceuticals USA Inc.2020-11-01Not applicableUS flag

Categories

ATC Codes
N03AF03 — Rufinamide
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as 2-heteroaryl carboxamides. These are compounds containing a heteroaromatic ring that carries a carboxamide group.
Kingdom
Organic compounds
Super Class
Organic acids and derivatives
Class
Carboxylic acids and derivatives
Sub Class
Carboxylic acid derivatives
Direct Parent
2-heteroaryl carboxamides
Alternative Parents
Fluorobenzenes / Aryl fluorides / Vinylogous amides / Triazoles / Heteroaromatic compounds / Primary carboxylic acid amides / Azacyclic compounds / Organopnictogen compounds / Organooxygen compounds / Organonitrogen compounds
show 3 more
Substituents
1,2,3-triazole / 2-heteroaryl carboxamide / Aromatic heteromonocyclic compound / Aryl fluoride / Aryl halide / Azacycle / Azole / Benzenoid / Fluorobenzene / Halobenzene
show 14 more
Molecular Framework
Aromatic heteromonocyclic compounds
External Descriptors
Not Available
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
WFW942PR79
CAS number
106308-44-5
InChI Key
POGQSBRIGCQNEG-UHFFFAOYSA-N
InChI
InChI=1S/C10H8F2N4O/c11-7-2-1-3-8(12)6(7)4-16-5-9(10(13)17)14-15-16/h1-3,5H,4H2,(H2,13,17)
IUPAC Name
1-[(2,6-difluorophenyl)methyl]-1H-1,2,3-triazole-4-carboxamide
SMILES
NC(=O)C1=CN(CC2=C(F)C=CC=C2F)N=N1

References

Synthesis Reference

Emanuele ATTOLINO, Lino COLOMBO, Ilaria MORMINO, Pietro ALLEGRINI, "METHOD FOR THE PREPARATION OF RUFINAMIDE." U.S. Patent US20100234616, issued September 16, 2010.

US20100234616
General References
  1. Arroyo S: Rufinamide. Neurotherapeutics. 2007 Jan;4(1):155-62. [Article]
  2. Hakimian S, Cheng-Hakimian A, Anderson GD, Miller JW: Rufinamide: a new anti-epileptic medication. Expert Opin Pharmacother. 2007 Aug;8(12):1931-40. [Article]
  3. Authors unspecified: Rufinamide: CGP 33101, E 2080, RUF 331, Xilep. Drugs R D. 2005;6(4):249-52. [Article]
  4. Wier HA, Cerna A, So TY: Rufinamide for pediatric patients with Lennox-Gastaut syndrome: a comprehensive overview. Paediatr Drugs. 2011 Apr 1;13(2):97-106. doi: 10.2165/11586920-000000000-00000. [Article]
KEGG Drug
D05775
PubChem Compound
129228
PubChem Substance
175427055
ChemSpider
114471
RxNav
69036
ChEBI
134966
ChEMBL
CHEMBL1201754
ZINC
ZINC000000007782
PharmGKB
PA166131606
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Rufinamide
FDA label
Download (562 KB)
MSDS
Download (76.7 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4Unknown StatusTreatmentEpilepsy1
3CompletedTreatmentEpilepsy1
3CompletedTreatmentLennox-Gastaut Syndrome3
3TerminatedTreatmentRefractory Partial Onset Seizures1
3WithdrawnTreatmentRefractory Partial Onset Seizures1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
SuspensionOral40 mg / mL
TabletOral100 mg
TabletOral200 mg
TabletOral400 mg
Tablet, film coatedOral200 mg/1
Tablet, film coatedOral400 mg/1
SuspensionOral40 MG/ML
Tablet, film coatedOral
Tablet, film coatedOral100 MG
Tablet, film coatedOral400 MG
Tablet, film coatedOral200 mg
Tablet, coatedOral400 mg
SuspensionOral40 mg/1mL
TabletOral200 mg/1
TabletOral400 mg/1
Tablet, film coatedOral100 mg/1
Tablet, coatedOral200 mg
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US7750028Yes2010-07-062019-04-19US flag
US8076362Yes2011-12-132018-12-08US flag
US6740669Yes2004-05-252023-05-14US flag

Properties

State
Solid
Experimental Properties
PropertyValueSource
water solubilityInsoluble FDA label
logP0.835MSDS
Predicted Properties
PropertyValueSource
Water Solubility0.642 mg/mLALOGPS
logP0.95ALOGPS
logP1.27Chemaxon
logS-2.6ALOGPS
pKa (Strongest Acidic)12.64Chemaxon
pKa (Strongest Basic)-1Chemaxon
Physiological Charge0Chemaxon
Hydrogen Acceptor Count3Chemaxon
Hydrogen Donor Count1Chemaxon
Polar Surface Area73.8 Å2Chemaxon
Rotatable Bond Count3Chemaxon
Refractivity67.07 m3·mol-1Chemaxon
Polarizability20.42 Å3Chemaxon
Number of Rings2Chemaxon
Bioavailability1Chemaxon
Rule of FiveYesChemaxon
Ghose FilterYesChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleNoChemaxon
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption+1.0
Blood Brain Barrier+0.9777
Caco-2 permeable-0.5301
P-glycoprotein substrateNon-substrate0.7407
P-glycoprotein inhibitor INon-inhibitor0.9422
P-glycoprotein inhibitor IINon-inhibitor0.9633
Renal organic cation transporterNon-inhibitor0.6685
CYP450 2C9 substrateNon-substrate0.8452
CYP450 2D6 substrateNon-substrate0.8723
CYP450 3A4 substrateNon-substrate0.5567
CYP450 1A2 substrateNon-inhibitor0.5
CYP450 2C9 inhibitorNon-inhibitor0.8201
CYP450 2D6 inhibitorNon-inhibitor0.8454
CYP450 2C19 inhibitorNon-inhibitor0.5561
CYP450 3A4 inhibitorNon-inhibitor0.7995
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.5438
Ames testAMES toxic0.6126
CarcinogenicityNon-carcinogens0.8415
BiodegradationNot ready biodegradable0.9945
Rat acute toxicity2.5067 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9484
hERG inhibition (predictor II)Non-inhibitor0.7869
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
LC-MS/MS Spectrum - LC-ESI-qTof , PositiveLC-MS/MSsplash10-004i-2920000000-3337dbd96c7fe51848b9
LC-MS/MS Spectrum - LC-ESI-qTof , PositiveLC-MS/MSsplash10-004i-3900000000-ba447bc09eda637e577b
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-004i-0910000000-a314da5a33a86592abf7
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-004i-0900000000-781e2b7783abce7a674e
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-004i-0900000000-bca7363efb0d671e2fb1
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-004i-0900000000-669fadc72a03a956a9eb
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-004i-0900000000-f083b635f8c982b0967a
LC-MS/MS Spectrum - LC-ESI-QFT , positiveLC-MS/MSsplash10-004i-0900000000-2e6c721563aec618517e
MS/MS Spectrum - , positiveLC-MS/MSsplash10-004i-2920000000-3337dbd96c7fe51848b9
MS/MS Spectrum - , positiveLC-MS/MSsplash10-004i-3900000000-ba447bc09eda637e577b
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSsplash10-000i-0090000000-1c0c69c4cffdce856479
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSsplash10-000i-2090000000-63040a036977d1e607b4
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSsplash10-000i-0190000000-5a4152a6a1bd4bd983e9
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSsplash10-000f-9060000000-92b52b26962803ee4ba5
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSsplash10-00bc-1910000000-d2999f880f8dd033a5b8
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSsplash10-0006-9300000000-1b78c102808d673cfe70
Predicted 1H NMR Spectrum1D NMRNot Applicable
Predicted 13C NMR Spectrum1D NMRNot Applicable
Chromatographic Properties
Collision Cross Sections (CCS)
AdductCCS Value (Å2)Source typeSource
[M-H]-150.44136
predicted
DeepCCS 1.0 (2019)
[M+H]+152.81679
predicted
DeepCCS 1.0 (2019)
[M+Na]+158.89249
predicted
DeepCCS 1.0 (2019)

Targets

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Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Modulator
General Function
Voltage-gated sodium channel activity
Specific Function
Mediates the voltage-dependent sodium ion permeability of excitable membranes. Assuming opened or closed conformations in response to the voltage difference across the membrane, the protein forms a...
Gene Name
SCN9A
Uniprot ID
Q15858
Uniprot Name
Sodium channel protein type 9 subunit alpha
Molecular Weight
226370.175 Da
References
  1. Suter MR, Kirschmann G, Laedermann CJ, Abriel H, Decosterd I: Rufinamide attenuates mechanical allodynia in a model of neuropathic pain in the mouse and stabilizes voltage-gated sodium channel inactivated state. Anesthesiology. 2013 Jan;118(1):160-72. doi: 10.1097/ALN.0b013e318278cade. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Glutamate receptor activity
Specific Function
G-protein coupled receptor for glutamate. Ligand binding causes a conformation change that triggers signaling via guanine nucleotide-binding proteins (G proteins) and modulates the activity of down...
Gene Name
GRM5
Uniprot ID
P41594
Uniprot Name
Metabotropic glutamate receptor 5
Molecular Weight
132467.635 Da
References
  1. Wier HA, Cerna A, So TY: Rufinamide for pediatric patients with Lennox-Gastaut syndrome: a comprehensive overview. Paediatr Drugs. 2011 Apr 1;13(2):97-106. doi: 10.2165/11586920-000000000-00000. [Article]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Triglyceride lipase activity
Specific Function
Involved in the detoxification of xenobiotics and in the activation of ester and amide prodrugs. Hydrolyzes aromatic and aliphatic esters, but has no catalytic activity toward amides or a fatty acy...
Gene Name
CES1
Uniprot ID
P23141
Uniprot Name
Liver carboxylesterase 1
Molecular Weight
62520.62 Da
References
  1. Williams ET, Carlson JE, Lai WG, Wong YN, Yoshimura T, Critchley DJ, Narurkar M: Investigation of the metabolism of rufinamide and its interaction with valproate. Drug Metab Lett. 2011 Dec;5(4):280-9. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Steroid hydroxylase activity
Specific Function
Metabolizes several precarcinogens, drugs, and solvents to reactive metabolites. Inactivates a number of drugs and xenobiotics and also bioactivates many xenobiotic substrates to their hepatotoxic ...
Gene Name
CYP2E1
Uniprot ID
P05181
Uniprot Name
Cytochrome P450 2E1
Molecular Weight
56848.42 Da
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inducer
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
References
  1. Perucca E, Cloyd J, Critchley D, Fuseau E: Rufinamide: clinical pharmacokinetics and concentration-response relationships in patients with epilepsy. Epilepsia. 2008 Jul;49(7):1123-41. doi: 10.1111/j.1528-1167.2008.01665.x. [Article]
  2. FDA Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers [Link]

Carriers

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Toxic substance binding
Specific Function
Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloid...
Gene Name
ALB
Uniprot ID
P02768
Uniprot Name
Serum albumin
Molecular Weight
69365.94 Da

Drug created at March 19, 2008 16:17 / Updated at March 18, 2024 16:48