Monograph
N01BB09 - Ropivacaine |
Propably not porphyrinogenic |
PNP |
Rationale
Ropivacaine differs structurally from the bupivacaine only in the in the substitution of a propyl group for the N-butyl group. Sharing the structural metabolic prerequisites of the non-porphyrogenic drug bupivacaine gives theoretical grounds to classify ropivacaine as probably not porphyrinogenic.
Chemical description
Ropivacaine is a local anesthetic of the amide type. Ropivacaine is exclusively the S-(-)-enantiomer (Ekström, G. & Gunnarsson, U.B., 1996). Ropivacaine differs from bupivacaine only in the 1-substituent on the ring-nitrogen, i.e. propyl versus butyl.
Therapeutic characteristics
Local anaesthetic.
Hepatic exposure
Volume required to reach uM concentrations when injected intravenously: approximately 1.5 ml (of ropivacaine 10mg/ml).
Metabolism and pharmacokinetics
Ropivacaine is extensively metabolised in the liver, predominantly mediated by CYP1A2; the isoenzyme CYP3A4 plays a minor role in the metabolism of ropivacaine. Ropivacaine is a ligand to CYP 3A4 and may in therapeutic use reach the hepatocyte µM levels needed for activation the nuclear receptors that trigger transcription of the ALAS1 gene. However, the drug is not found to be an inducer or irreversible inhibitor of drug metabolizing cytochrome P450 species (Rendic, 2002) and is therefore most probably devoid of capacity for ALAS1-induction. CYP1A2 is the most important isozyme for the metabolism of ropivacaine. A potent inhibitor of CYP3A4 causes a minor decrease in clearance of ropivacaine, which should be of no clinical relevance (Arlander, E., Ekström, G. et al, 1998) (Ekström, G. & Gunnarsson, U.B., 1996). Ropivacaine is an inhibitor of CYP2D6, but this does not seem to be of major clinical importance (Wink J., Veering B.T. et al, 2008). Rendic (2002) reports that ropivacaine is a substrate of CYP3A4 CYP1A1, CYP1A2, CYP2B6 and 2D6.
IPNet drug reports
None.
References
# | Citation details | PMID |
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* | Scientific articles | |
1. | Rendic, S. Summery of information on human CYP enzymes: human P450 metabolism. Drug metabolism reviews 2002; 34(1&2), 83-448.
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2. | Thunell, Stig, Evidence-based porphyrogenicity assessment of seven local anasthetics (2009, to be published).
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3. | Metabolism of ropivacaine in humans is mediated by CYP1A2 and to a minor extent by CYP3A4: an interaction study with fluvoxamine and ketoconazole as in vivo inhibitors. Clin Pharmacol Ther 1998; 64(5):484-91.
Arlander E, Ekström G et al. |
9834040 |
4. | Ropivacaine, a new amide-type local anesthetic agent, is metabolized by cytochromes P450 1A and 3A in human liver microsomes. Drug Metab Dispos 1996;24(9):955-61.
Ekström G, Gunnarsson UB. |
8886604 |
5. | The effect of a long term epidural infusion of ropivacaine on CYP2D6 activity. Anesth Analg 2008; 106(1):143-6.
Wink J, Veering BT, et al. |
18165569 |
* | Drug reference publications | |
6. | Sweetman SC, editor. Martindale: The complete drug reference. Ropivacaine Hydrochloride. Pharmaceutical Press 2009.
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Tradenames and packages
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Netherlands
Naropin · Naropin 10 mg/ml, oplossing voor injectie voor perineurale en epidurale toediening · Naropin 2 mg/ml, oplossing voor injectie voor perineurale en epidurale toediening · Naropin 5 mg/ml, oplossing voor injectie voor intrathecale toediening · Naropin 7,5 mg/ml, oplossing voor injectie voor perineurale en epidurale toediening · Ropivacaine · Ropivacaine Hydrochloride Molteni 10 mg/ml, oplossing voor injectie · Ropivacaine Hydrochloride Molteni 2 mg/ml, oplossing voor infusie · Ropivacaine Hydrochloride Molteni 2 mg/ml, oplossing voor injectie · Ropivacaine Hydrochloride Molteni 5 mg/ml, oplossing voor injectie · Ropivacaine Hydrochloride Molteni 7,5 mg/ml oplossing voor injectie · Ropivacaïne · Ropivacaïne HCl Altan 2 mg/ml oplossing voor infusie · Ropivacaïne HCl B. Braun 10 mg/ml, oplossing voor injectie · Ropivacaïne HCl B. Braun 2 mg/ml, oplossing voor injectie · Ropivacaïne HCl B. Braun 7,5 mg/ml, oplossing voor injectie · Ropivacaïne HCl Fresenius Kabi 10 mg/ml oplossing voor injectie · Ropivacaïne HCl Fresenius Kabi 2 mg/ml oplossing voor infusie · Ropivacaïne HCl Fresenius Kabi 2 mg/ml oplossing voor injectie · Ropivacaïne HCl Fresenius Kabi 5 mg/ml oplossing voor injectie · Ropivacaïne HCl Fresenius Kabi 7,5 mg/ml oplossing voor injectie · Ropivacaïne HCl Noridem 10 mg/ml oplossing voor injectie · Ropivacaïne HCl Noridem 2 mg/ml oplossing voor infusie · Ropivacaïne HCl Noridem 2 mg/ml oplossing voor injectie · Ropivacaïne HCl Noridem 5 mg/ml oplossing voor injectie · Ropivacaïne HCl Noridem 7,5 mg/ml oplossing voor injectieBelgium
Naropin · Naropin 10 mg/ml sol. inj. p.dural · Naropin 10 mg/ml sol. inj. p.dural amp. · Naropin 2 mg/ml sol. inj. p.dural · Naropin 2 mg/ml sol. inj. p.dural amp. · Naropin 5 mg/ml sol. inj. i.théc. amp. · Naropin 7.5 mg/ml sol. inj. p.dural · Naropin 7.5 mg/ml sol. inj. p.dural amp. · Ropivacain · Ropivacain HCl Noridem 10 mg/ml sol. inj. i.théc. amp. · Ropivacain HCl Noridem 2 mg/ml sol. inj. i.théc. amp. · Ropivacain HCl Noridem 2 mg/ml sol. perf. p.dural · Ropivacain HCl Noridem 2 mg/ml sol. perf. p.dural flac. · Ropivacain HCl Noridem 5 mg/ml sol. inj. i.théc. amp. · Ropivacain HCl Noridem 7.5 mg/ml sol. inj. i.théc. amp. · Ropivacaine · Ropivacaine Fresenius Kabi 10 mg/ml sol. inj. p.dural amp. · Ropivacaine Fresenius Kabi 2 mg/ml sol. inj. p.dural amp. · Ropivacaine Fresenius Kabi 2 mg/ml sol. perf. p.dural · Ropivacaine Fresenius Kabi 5 mg/ml sol. inj. i.théc. amp. · Ropivacaine Fresenius Kabi 7.5 mg/ml sol. inj. p.dural amp. · Ropivacaine Readyfusor 2 mg/ml sol. perf. (système admin.) · Ropivacaïne · Ropivacaïne Altan 2 mg/ml sol. perf. p.duralUnited Kingdom
Naropin · Naropin 100mg/10ml solution for injection ampoules · Naropin 200mg/100ml infusion Polybags · Naropin 20mg/10ml solution for injection ampoules · Naropin 400mg/200ml infusion Polybags · Naropin 75mg/10ml solution for injection ampoules · Ropivacaine · Ropivacaine 100mg/10ml solution for injection ampoules · Ropivacaine 20mg/10ml solution for injection ampoules · Ropivacaine 400mg/200ml infusion bags · Ropivacaine 500mg/250ml solution for infusion administration system · Ropivacaine 75mg/10ml solution for injection ampoulesDenmark
Ropivacain · Ropivacain "B. Braun" · Ropivacain "Fresenius Kabi" · Ropivacaine · Ropivacaine "BioQ"Norway
Ropivacain Fresenius KabiPoland
Ropimol · Ropivacaine BioQ · Ropivacaine KabiLuxembourg
NAROPIN · ROPIVACAIN · ROPIVACAIN HCL B.BRAUN-10MG/ML · ROPIVACAIN HCL B.BRAUN-2MG/ML · ROPIVACAIN HCL B.BRAUN-5MG/ML · ROPIVACAIN HCL B.BRAUN-7,5MG/ML · Ropivacaine · Ropivacaine Fresenius Kabi · ROPIVACAINE NORIDEM · Ropivacaine ReadyfusORIceland
Ropivacainhydrochlorid · Ropivacainhydrochlorid SinteticaFinland
Ropivacain Fresenius Kabi · Ropivacaine BioqLatvia
Ropivacaine · Ropivacaine B.Braun · Ropivacaine Kabi
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