It may be used alone or as an adjunct to other therapy giving the possibility of increased therapeutic effect with little risk of interaction.
In some markets, the drug is supplied as an over-the-counter cream (Lonol in Mexico from Boehringer Ingelheim) used for topical treatment of musculoskeletal system disorders: sprains, strains, bursitis, tendinitis, synovitis, myalgia, periarthritis.
There are no contraindications to the use of benzydamine except for known hypersensitivity.
Benzydamine is well tolerated. Occasionally oral tissue numbness or stinging sensations may occur, as well as itching, a skin rash, skin swelling or redness, difficulty breathing and wheezing.
It selectively binds to inflamed tissues (Prostaglandin synthetase inhibitor) and is normally free of adverse systemic effects. Unlike other NSAIDs, it does not inhibit cyclooxygenase or lipooxygenase, and is not ulcerogenic.
Benzydamine has been used recreationally. In overdosages it acts a deliriant and CNS stimulant. Such use, particularly among teenagers, has been reported in Poland, Brazil and Romania.
An interesting alternative synthesis of this substance starts by sequential reaction of N-benzylaniline with phosgene, and then with sodium azide to product the corresponding carbonyl azide. On heating, nitrogen is evolved and a separatable mixture of nitrene insertion product and the desired ketoindazole # results. The latter reaction appears to be a Curtius rearrangement type product to produce an N-isocyanate #, which then cyclizes. Alkylation of the enol with sodium methoxide and 3-dimethylaminopropyl chloride gives benzydamine.
Alternatively, use of chloroacetamide in the alkylation step followed by acid hydrolysis produces bendazac instead.
^Turnbull, R. S. (1995). "Benzydamine Hydrochloride (Tantum) in the management of oral inflammatory conditions". Journal (Canadian Dental Association)61 (2): 127–134. PMID7600413.
^Fanaki NH, el-Nakeeb MA. Antimicrobial activity of benzydamine, a non-steroid anti-inflammatory agent. J Chemother. 1992 Dec;4(6):347-52. PMID 1287137
^Fanaki NH, el-Nakeeb MA. Antibacterial activity of benzydamine and antibiotic-benzydamine combinations against multifold resistant clinical isolates. Arzneimittelforschung. 1996 Mar;46(3):320-3. PMID 8901158
^ abcAnand, J. S.; Lukasik–Glębocka, M.; Korolkiewicz, R. P. (2007). "Letter to the Editor: Recreational abuse with benzydamine hydrochloride (tantum rosa)". Clinical Toxicology45 (2): 198–199. doi:10.1080/15563650600981210. PMID17364645.
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