Otilonium bromide

Otilonium bromide is a drug used to treat abdominal pain caused by irritable bowel syndrome. It is an antispasmodic, which is useful to treat the symptoms of irritable bowel syndrome by reducing abdominal spasms (colic), bloating, pain, and gut motility.

Otilonium bromide

Clinical data
Trade names	Spasmoctyl 40, Doralin, Menoctyl
AHFS/Drugs.com	International Drug Names
ATC code	A03AB06 (WHO)
Identifiers
IUPAC name N,N-Diethyl-N-methyl-2-(4-[2-(octyloxy)benzamido]benzoyloxy)ethanaminium bromide
CAS Number	26095-59-0 Y
PubChem CID	72092
ChemSpider	65077 N
UNII	21HN3N72PV
KEGG	D07083 Y
CompTox Dashboard (EPA)	DTXSID0046357
ECHA InfoCard	100.043.128
Chemical and physical data
Formula	C29H43BrN2O4
Molar mass	563.577 g·mol−1
3D model (JSmol)	Interactive image
SMILES CCCCCCCCOC1=CC=CC=C1C(=O)NC2=CC=C(C=C2)C(=O)OCC[N+](C)(CC)CC.[Br-]
InChI InChI=1S/C29H42N2O4.BrH/c1-5-8-9-10-11-14-22-34-27-16-13-12-15-26(27)28(32)30-25-19-17-24(18-20-25)29(33)35-23-21-31(4,6-2)7-3;/h12-13,15-20H,5-11,14,21-23H2,1-4H3;1H N Key:VWZPIJGXYWHBOW-UHFFFAOYSA-N N
NY (what is this?)  (verify)

It is an antimuscarinic and calcium channel blocker used to relieve spasmodic pain of the gut, especially in irritable bowel syndrome.^[1] This means it works in the gut themselves, by relaxing the small muscles of the intestines, which results in relieving cramps and therefore reduces pain.

Medical uses

A pooled analysis of three clinical trials suggest that otilonium bromide is more effective than placebo for the treatment of irritable bowel syndrome.^[2]

Pharmacology

Otilonium bromide binds to both muscarinic receptors and tachykinin NK₂ receptors.^[3] It has been shown to inhibit L-type and T-type calcium channels, actions which may contribute to or determine its effects in the gut.^[4][5]

When taken orally, very little of the drug is absorbed into the rest of the body,^[6] which means that most of its actions remain confined to the gastrointestinal system.

Adverse effects

Otilonium bromide is generally well tolerated and does not have the side-effects observed with similar classes of drugs. ^[7] A case of cardiovascular toxicity was reported due to an overdose. ^[8][9]