Ecothiopate iodide

Systematic (IUPAC) name
2-diethoxyphosphorylsulfanylethyl-trimethyl-ammonium iodide
Identifiers
CAS number	6736-03-4
ATC code	S01EB03
PubChem	10547
DrugBank	APRD00942
Chemical data
Formula	C9H23INO3PS
Mol. mass	383.228 g/mol
Pharmacokinetic data
Bioavailability	?
Metabolism	?
Half life	?
Excretion	?
Therapeutic considerations
Pregnancy cat.	?
Legal status
Routes	Topical (eye drops)

Ecothiopate iodide (INN, also known as echothiophate) is a parasympathomimetic and organophosphate. It is a cholinesterase inhibitor.^[1]

[edit] Uses

It is used as an ocular antihypertensive in the treatment of chronic glaucoma and, in some cases, accommodative esotropia. It is available under several trade names such as Phospholine Iodide (Wyeth-Ayerst).

Ecothiopate binds irreversibly to cholinesterase. Because of the very slow rate at which echothiophate is hydrolyzed by cholinesterase, its effects can last a week or more. Adverse effects include muscle spasm and other systemic effects.

[edit] Shortage

Wyeth Pharmaceuticals stopped manufacturing ecothiopate iodide (phospholine iodide) in the US in 2003. After contacting the American Academy of Ophthalmology (AAO), Wyeth rescinded their decision and, according to AAO public relations representative Michelle Stephens, the AAO and Wyeth were in talks for about a year about manufacturing it. ^[2]

In the meantime, a worldwide shortage of the drug has occurred.

[edit] Sources

1. ^ Gabelt BT, Hennes EA, Seeman JL, Tian B, Kaufman PL (August 2004). "H-7 effect on outflow facility after trabecular obstruction following long-term echothiophate treatment in monkeys". Invest. Ophthalmol. Vis. Sci. 45 (8): 2732–6. doi:10.1167/iovs.04-0083. PMID 15277498. http://www.iovs.org/cgi/pmidlookup?view=long&pmid=15277498. 
2. ^ Eurotimes article: "Echothiophate iodide shortage leaves US specialists struggling to find alternative for acute cases"

• Brenner, G. M. (2000). Pharmacology. Philadelphia, PA: W.B. Saunders Company. ISBN 0-7216-7757-6.
• Canadian Pharmacists Association (2000). Compendium of Pharmaceuticals and Specialties (25th ed.). Toronto, ON: Webcom. ISBN 0-919115-76-4.
• Rang, H. P. (2003). Pharmacology. Edinburgh: Churchill Livingstone, p. 146. ISBN 0-443-07145-4.

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