Description
Bezafibrate is a non-selective agonist of peroxisome proliferator-activated receptors (PPARs; EC
50s = 50, 60, and 20 μM for human PPARα, PPARγ, and PPARδ, respectively).
1 It reduces triglyceride levels and the size of lipid droplets in an oleic acid-induced HepaRG hepatocyte model of steatosis when used at a concentration of 25 μM.
2 Bezafibrate (10 mg/kg per day) reduces plasma VLDL and LDL mass and triglyceride and free fatty acid levels in a high-fructose plus lard diet-induced rat model of insulin resistance.
3
Chemical Properties
Off-White Solid
Originator
Bezafibrate,Eipico Co.
Uses
anti-hyperlipoproteinemic
Definition
ChEBI: Bezafibrate is a monocarboxylic acid amide obtained by the formal condensation of the carboxy group of 4-chlorobenzoic acid with the amino group of 2-[4-(2-aminoethyl)phenoxy]-2-methylpropanoic acid. Benafibrate is used for the treatment of hyperlipidaemia. It has a role as a xenobiotic, an environmental contaminant, a geroprotector and an antilipemic drug. It is a monocarboxylic acid, an aromatic ether, a member of monochlorobenzenes and a monocarboxylic acid amide. It is functionally related to a propionic acid.
Manufacturing Process
0.292 moles p-chlorobenzoyl chloride and 50 ml dry pyridine were added
dropwise to 0.146 moles tyramine in 60 ml dry pyridine for 10 minutes. Then
the mixture was poured in about 500 g of ice with water. The fallen-out
crystals was filtered off, washed with diluted HCl, water and NaHCO3 solution
and dried. It was recrystallized from acetone to give di(4-chlorobenzoyl)
tyramine; yield 98 %; MP: 203°-205°C.
0.11 moles above product in 400 ml methanol was mixed with 130 ml 2 N
KOH and heated at 40°-45°C for 1 hour. On cooling 130 ml 2 N HCl was
added. The fallen-out precipitate was filtered off, filtrate was distilled off to
dryness. The residue was washed with water, NaHCO3 solution and
recrystallized from ethanol to give N-(4-chlorobenzoyl)tyramine; yield 91%;
MP: 174°-176°C.
2.14 g sodium was dissolved in 50 ml of absolute methanol and mixed with
0.93 mole N-(4-chlorobenzoyl)tyramine. Methanol was removed in vacuum to
dryness. The residue was slurried in 100 ml absolute toluene and 0.137 moles
2-bromo-2-methylpropionic acid ethyl ester was added. The suspension was
heated for 25 hours at 80°C. Then it was distilled in vacuum to dryness and
the residue was dissolved in CH2Cl2, washed with diluted HCl, NaOH and
water, and dried over CaCl2. On removing of the solvent, the crude 2-{4-[2-
(4-chlorobenzoylamino)ethyl]phenoxy}-2-methylpropionic acid ethyl ester was
obtained. After recrystallization from ether/ ligroin and acetone it had MP:
96°-97°C; yield 67 %.
0.1 mole above ester in 1.5 L of dioxane was slowly mixed with 200 ml 1 N
KOH at ambient temperature and stood for 2 hours, then it was heated at
40°C for 1 hour. The substance was dissolved completely. On cooling the
mixture was neutralized with 200 ml 1 N HCl. The solvents were removed in
vacuum. The residue was washed with water and recrystallized from acetone
to give 2-{4-[2-(4-chlorobenzoylamino)ethyl]phenoxy}-2-methylpropionic
acid; yield 84%; MP: 186°C.
Therapeutic Function
Antihyperlipidemic
Biochem/physiol Actions
The peroxisome proliferator-activated receptor (PPAR) is a member of the steroid nuclear receptor superfamily. Bezafibrate is a peroxisome proliferator-activated receptor agonist for PPARα, PPARδ, and PPARγ. Lipoprotein lipase (LPL) activator.PPARgamma agonists, including Bezafibrate, have beneficial effects in the suppression of the inflammatory response during RSV infection and therefore might have clinical efficacy in the course of severe RSV-infection.
Clinical Use
Hyperlipidaemia
Drug interactions
Potentially hazardous interactions with other drugs
Antibacterials: increased risk of myopathy with
daptomycin - try to avoid concomitant use.
Anticoagulants: enhances effect of coumarins and
phenindione; dose of anticoagulant should be
reduced by up to 50% and adjusted by monitoring
INR.
Antidiabetics: may improve glucose tolerance
and have an additive effect with insulin or
sulphonylureas.
Ciclosporin: may increase nephrotoxicity and reduce
ciclosporin levels.
Colchicine: possible increased risk of myopathy.
Lipid-regulating drugs: increased risk of myopathy in
combination with statins and ezetimibe - avoid with
ezetimibe; do not exceed 10 mg of simvastatin and
20 mg of rosuvastatin.
Metabolism
50% of the administered bezafibrate dose is recovered
in the urine as unchanged drug and 20% in the form of
glucuronides.
Elimination is rapid, with excretion almost exclusively
renal. 95% of the activity of the [14C]-labelled drug is
recovered in the urine and 3% in the faeces within 48
hours.
