Amtolmetin guacil

Amtolmetin guacil a NSAID which is a prodrug of tolmetin sodium.

Background
Tolmetin sodium is an effective NSAID approved and marketed for the treatment of rheumatoid arthritis, osteoarthritis and juvenile rheumatoid arthritis. In humans, tolmetin sodium is absorbed rapidly with peak plasma levels observed 30 min after p.o. administration, but it is also eliminated rapidly with a mean plasma elimination t½ of approximately 1 hr. The preparation of slow release formulations or chemical modification of NSAIDs to form prodrugs has been suggested as a method to reduce the gastrotoxicity of these agents.

Amtolmetin guacil is a non-acidic prodrug of tolmetin, having similar NSAID properties like tolmetin with additional analgesic, antipyretic, and gastro protective properties. Amtolmetin is formed by amidation of tolmetin by glycine

Pharmacology

 * Almost is absorbed on oral administration. It is concentrated maximum in internal the gastric wall, and highest concentration reached in 2 hours after administration.
 * Amtolmetin guacil hydrolysed in to following metabolites Tolmetin, MED5 and Guiacol.
 * Elimination will complete in 24 hours. Happens mostly with urine in shape of gluconides products (77%), faecal (7.5 %).
 * It is advised to take the drug on empty stomach.
 * Permanent anti-inflammatory action is continued up to 72 hours, with single administration.

Mechanism of action
Amtolmetin guacil stimulates capsaicin receptors present on gastro intestinal walls, because of presence of vanillic moiety and also releases NO which is gastro protective. It also inhibits prostaglandin synthesis and cyclooxygenase (COX).