Ethotoin

Ethotoin (previously marketed as Peganone) is an anticonvulsant drug used in the treatment of epilepsy. It is a hydantoin, similar to phenytoin. It is not available in the United States.

Ethotoin
Clinical data
AHFS/Drugs.comConsumer Drug Information
MedlinePlusa682022
Pregnancy
category
  • C
Routes of
administration		By mouth (tablets)
ATC code
Pharmacokinetic data
Elimination half-life3–9 hours
Identifiers
IUPAC name
  • 3-Ethyl-5-phenyl-imidazolidine-2,4-dione
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.001.514
Chemical and physical data
FormulaC11H12N2O2
Molar mass204.229 g·mol−1
3D model (JSmol)
SMILES
  • O=C2NC(c1ccccc1)C(=O)N2CC
InChI
  • InChI=1S/C11H12N2O2/c1-2-13-10(14)9(12-11(13)15)8-6-4-3-5-7-8/h3-7,9H,2H2,1H3,(H,12,15) Y
  • Key:SZQIFWWUIBRPBZ-UHFFFAOYSA-N Y
  (verify)

Mechanism of action

Similar to phenytoin.

Approval history
  • 1957 Peganone was granted Food and Drug Administration (FDA) approval to Abbott Laboratories for treatment of grand mal (tonic clonic) and partial complex (psychomotor) seizures.
  • 2003 Peganone was acquired from Abbott Laboratories by Ovation Pharmaceuticals (specialty pharmaceutical company who acquire underpromoted branded pharmaceutical products).
  • 2018 It was announced by Recordati Rare Diseases Inc. that due to a combination of low product demand and complex manufacturing difficulties, product manufacturing, distribution and sale was being discontinued.

Indications and usage

Ethotoin is indicated for tonic-clonic and partial complex seizures.

Dosing

Ethotoin is available in 250 mg tablets. It is taken orally in 4 to 6 divided doses per day, preferably after food.

Side effects

Ataxia, visual disturbances, rash and gastrointestinal problems.

Chemistry

Ethotoin, 3-ethyl-5-phenylimidazolidine-2,4-dione, is synthesized by the reaction of benzaldehyde oxynitrile, with urea or ammonium hydrocarbonate, which forms an intermediate urea derivative which on acidic conditions cyclizes to 5-phenylhydantoin. Alkylation of this product using ethyliodide leads to the formation of ethotoin.

A. Pinner, Chem. Ber., 21, 2324 (1888); W.J. Close, U.S. Patent 2,793,157 (1946).

References
  • Schwade ED, Richards RK, Everett GM (May 1956). "Peganone, a new antiepileptic drug". Dis Nerv Syst. 17 (5): 155–8. PMID 13317788.
  • Shorvon, S.D.; Fish, David R.; Perucca, Emilio; Dodson, W. Edwin, eds. (2004). The Treatment of Epilepsy. Blackwell Publishing. ISBN 0-632-06046-8.
  • Drugs.com: Ethotoin
  • PEGANONE 250 mg Ethotoin Tablets, USP (PDF)
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