Delamanid

Chemical structure of Delamanid

Delamanid is an antibiotic used in the treatment of multidrug-resistant tuberculosis (MDR-TB). It is a member of the nitroimidazole class of drugs and works by inhibiting the synthesis of mycolic acids, which are essential components of the Mycobacterium tuberculosis cell wall.

Mechanism of Action

Delamanid exerts its antibacterial effects by targeting the synthesis of mycolic acids, which are long-chain fatty acids found in the cell walls of mycobacteria. By inhibiting the production of these acids, delamanid disrupts the integrity of the bacterial cell wall, leading to cell death. This mechanism is particularly effective against Mycobacterium tuberculosis, the causative agent of tuberculosis.

Clinical Use

Delamanid is specifically indicated for the treatment of pulmonary MDR-TB in combination with other antitubercular drugs. It is not used as a monotherapy due to the risk of developing resistance. The drug is administered orally and is typically part of a longer treatment regimen that may last several months.

Side Effects

Common side effects of delamanid include nausea, vomiting, and dizziness. More serious side effects can include QT prolongation, which is a measure of delayed heart repolarization that can lead to serious cardiac arrhythmias. Patients on delamanid are often monitored for changes in heart rhythm, especially if they are taking other medications that can affect the heart.

Pharmacokinetics

Delamanid is absorbed in the gastrointestinal tract and undergoes extensive metabolism in the liver. It is primarily excreted in the feces. The drug has a half-life of approximately 30 to 38 hours, allowing for once-daily dosing in most treatment regimens.

Development and Approval

Delamanid was developed by Otsuka Pharmaceutical Co., Ltd. and received its first regulatory approval in Japan in 2014. It has since been approved in several other countries for the treatment of MDR-TB. The development of delamanid was part of a broader effort to address the growing problem of drug-resistant tuberculosis, which poses a significant public health challenge worldwide.

Related Pages

• Tuberculosis
• Multidrug-resistant tuberculosis
• Antibiotic resistance
• Nitroimidazole