Hypotensive effect of Oxacom® containing a dinitrosyl iron complex with glutathione: Animal studies and clinical trials on healthy volunteers

A comparative study of hypotensive effects of binuclear forms of dinitrosyl iron complexes (DNICs) with glutathione, S-nitrosoglutathione (GS-NO) and sodium nitrite (NaNO2) on rats has been carried out. The latter appeared to be the least efficient, viz., mean arterial pressure (MAP) decreased by 10 and 30 mm Hg at 25 and 100 mu moles/kg of NaNO2. In contrast, DNIC and GS-NO produced an appreciable hypotensive effect when used at much lower concentrations. GS-NO reduced MAP to the same extent, viz., to 90 mm Hg, on a hundredfold dose scale (from 0.4 up to 50 mu moles/kg) with subsequent restoration of MAP within the next 6-15 min. A similar effect was observed for DNIC except that the amplitude of the MAP drop was lower and the duration of hypotension was essentially greater. DNIC with glutathione were selected as a basic material for pilot-scale production of a hypotensive drug (commercial name Oxacom (R)). Preliminary pharmacological testing of Oxacom did not establish any adverse or deleterious side effects. Clinical trials of Oxacom (R) were performed on 14 healthy male volunteers in whom single intravenous infusion of the drug (5 mg/kg or 0.2 mu moles/kg of DNIC, respectively) evoked a characteristic response manifested as a 3-4 min drop by 24-27 mm Hg of both diastolic and systolic AP with its subsequent slow restoration within the next 8-10 h. The heart rate was quickly normalized after an initial increase. Cardiac output was unchanged despite reduced cardiac filling. A comprehensive analysis of clinical and biochemical data failed to establish any significant pathological changes in these parameters. The data obtained suggest that Oxacom (R) can be recommended for the second phase of clinical trials. (C) 2012 Elsevier Inc. All rights reserved.