2-Hydroxy-4-azoniaspiro[3.5]nonane Chloride is used as a reagent in the synthesis of polyfunctional phosphorodithioates and its derivatives via nucleophilic ring opening of azetidinium ions. 2-Hydroxy-4-azoniaspiro[3.5]nonane Chloride is also a reagent in the synthesis of Arimoclomol Maleic Acid (A771270); an orally administered drug used to treat amyotrophic lateral sclerosis.
