Carbazochrome

Carbazochrome
Clinical data
Trade names	Toxivenol
AHFS/Drugs.com	International Drug Names
Routes of; administration	P/O, I/M
ATC code	B02BX02 (WHO) ;
Identifiers
	IUPAC name [(3-Hydroxy-1-methyl-6-oxo-2,3-dihydroindol-5-ylidene)amino]urea;
CAS Number	69-81-8;
PubChem CID	5360410;
DrugBank	DB09012 ;
ChemSpider	4514501;
UNII	81F061RQS4;
ChEMBL	ChEMBL2051960;
CompTox Dashboard (EPA)	DTXSID3048310 ;
ECHA InfoCard	100.000.652
Chemical and physical data
Formula	C10H12N4O3
Molar mass	236.231 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES O=C(N)N/N=C1/C=C2\C(=C/C1=O)N(CC2O)C;
	InChI InChI=1S/C10H12N4O3/c1-14-4-9(16)5-2-6(12-13-10(11)17)8(15)3-7(5)14/h2-3,9,16H,4H2,1H3,(H3,11,13,17)/b12-6-; Key:XSXCZNVKFKNLPR-SDQBBNPISA-N;
	(verify)

Carbazochrome is an antihemorrhagic, or hemostatic, agent that will cease blood flow by causing the aggregation and adhesion of platelets in the blood to form a platelet plug, ceasing blood flow from an open wound. It is hoped that this drug can be used in the future for preventing excessive blood flow during surgical operations and the treatment of hemorrhoids, but research on its effectiveness and the severity of possible side effects remains to be fairly inconclusive.

With troxerutin, it has been investigated for use in the treatment of hemorrhoids.[1][2]

Indications

Capillary and parenchymal hemorrhage (trauma, tonsillectomy, during surgery), intestinal bleeding, thrombocytopenic purpura.

Mechanism of action

Carbazochrome, the semicarbazone of adrenochrome, that interacts with α-adrenoreceptors on surface of platelets, which are coupled to Gq protein and initiate PLC IP3/DAG pathway to increase intracellular free calcium concentration with these subsequent actions:

Activates PLA2 and induce arachidonic acid pathway to synthesize endoperoxides (TxA2, thromboxane A2)
Calcium binds to calmodulin which then binds and activates myosin light-chain kinase, that will enable the myosin crossbridge to bind to the actin filament and allow contraction to begin. This will change platelet's shape and induce release of serotonin, ADP, vWF (Von Willebrand factor), PAF (Platelet-activating factor) to promote further aggregation and adhesion.

References

Basile M, Gidaro S, Pacella M, Biffignandi PM, Gidaro GS (2001). "Parenteral troxerutin and carbazochrome combination in the treatment of post-hemorrhoidectomy status: a randomized, double-blind, placebo-controlled, phase IV study". Curr Med Res Opin. 17 (4): 256–61. doi:10.1185/030079901753403144. PMID 11922398.
Squadrito F, Altavilla D, Oliaro Bosso S (2000). "Double-blind, randomized clinical trial of troxerutin-carbazochrome in patients with hemorrhoids". Eur Rev Med Pharmacol Sci. 4 (1–2): 21–4. PMID 11409185.

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[pmid11922398-1] Basile M, Gidaro S, Pacella M, Biffignandi PM, Gidaro GS (2001). "Parenteral troxerutin and carbazochrome combination in the treatment of post-hemorrhoidectomy status: a randomized, double-blind, placebo-controlled, phase IV study". Curr Med Res Opin. 17 (4): 256–61. doi:10.1185/030079901753403144. PMID 11922398.

[pmid11409185-2] Squadrito F, Altavilla D, Oliaro Bosso S (2000). "Double-blind, randomized clinical trial of troxerutin-carbazochrome in patients with hemorrhoids". Eur Rev Med Pharmacol Sci. 4 (1–2): 21–4. PMID 11409185.