Almitrine bismesylate is a pharmacologically unique respiratory stimulant. It enhances respiration after both acute and chronic administration by acting as an agonist of peripheral chemoreceptors located on the carotid bodies. In comparison with traditional central-acting respiratory stimulants, almitrine has advantages of oral activity, prolonged duration of effect, and an improved adverse effect profile. Almitrine is generally well tolerated, with headache and minor gastrointestinal disturbances being the most frequently observed side effects. This investigational agent has been shown to increase arterial oxygen tension while decreasing arterial carbon dioxide tension in patients with chronic obstructive pulmonary disease both at rest and during exercise through increased ventilation and improved ventilation/perfusion matching. It may also prove useful in the treatment of nocturnal oxygen desaturation because of its ability to reduce the frequency and severity of nocturnal hypoxemia without impairing the quality of sleep. Additional research is needed to further define the role of almitrine in the relief of hypoxemia.
Nocturnal Oxygen Therapy Trial Group.Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease.Ann Intern Med1980; 93: 391–8.
2.
Medical Research-Council Working Party.Long-term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema.Lancet1981; 1: 681–6.
3.
PiersonDJ. Respiratory stimulants: a review of the literature and assessment of current status.Heart Lung1973; 2: 726–31.
MÉLOTC, NaeijeR, RothschildT, MertensP, MolsP, HallemansR. Improvement in ventilation-perfusion matching by almitrine in COPD.Chest1983; 83: 528–33.
7.
MacleodCN, ThomasRW, BartleyEA, ParkhurstGW, BachandRT. Effects and handling of almitrine bismesylate in healthy subjects.Eur J Respir Dis1983; 64(suppl 126): 275–89.
8.
De BackerW, BogaertE, Van MaeleR. Effect of almitrine bismesylate on arterial blood gases and ventilatory drive in patients with severe chronic air-flow obstruction and bilateral carotid body resection.Eur J Respir Dis1983; 64(suppl 126): 239–42.
9.
MÉLOTC, NaeijeR, HallemansR, MolsP, LejeuneP. Beneficial effects of almitrine bismesylate on pulmonary gas exchange in COPD.Eur J Respir Dis1983; 64(suppl 126): 249–54.
10.
MacneeW, ConnaughtonJJ, RhindGB. A comparison of the effects of almitrine or oxygen breathing on pulmonary arterial pressure and right ventricular ejection fraction in hypoxic chronic bronchitis and emphysema.Am Rev Respir Dis1986; 134: 559–65.
11.
PowlesACP, TuxenDV, MahoodCB, PugsleySO, CampbellEJM. The effect of intravenously administered almitrine, a peripheral chemoreceptor agonist, on patients with chronic air-flow obstruction.Am Rev Respir Dis1983; 127: 284–9.
12.
SimonneauG, MeignanM, DenjeanA, RaffestinB, HarfA, ProstJF. Cardiopulmonary effects of a single oral dose of almitrine at rest and on exercise in patients with hypoxic chronic air-flow obstruction.Chest1986; 89: 174–9.
13.
NaeueR, Melotc, MolsP. Effects of almitrine in decompensated chronic respiratory insufficiency.Bull Eur Physiopathol Respir1981; 17: 153–61.
14.
StradlingJR, NichollCG, CoverD, DaviesEE, HughesJMB, PrideNB. The effects of oral almitrine on pattern of breathing and gas exchange in patients with chronic obstructive pulmonary disease.Clin Sci1984; 66: 435–42.
15.
StradlingJR, BarnesP, PrideNB. The effects of almitrine on the ventilatory response to hypoxia and hypercapnia in normal subjects.Clin Sci1982; 63: 401–4.
16.
StanleyNN, PieczoraJA, PaulyN. Effects of almitrine bismesylate on chemosensitivity in patients with chronic airways obstruction.Eur J Respir Dis1983; 64(suppl 126): 233–7.
17.
BrometN, CourteS, AubertY, BauneA, BalemMP, Du VignaudP. Pharmacokinetics of almitrine bismesylate: studies in patients.Eur J Respir Dis1983; 64(suppl 126): 363–75.
18.
CampbellDB, GordonB, TaylorA, TaylorD, WilliamsJ. The biodisposition of almitrine bismesylate in man: a review.Eur J Respir Dis1983; 64(suppl 126): 337–48.
19.
BellRC, MullinsRC, WestLG, BachandRT, JohansonWG. The effect of almitrine bismesylate on hypoxemia in chronic obstructive pulmonary disease.Ann Intern Med1986; 105: 342–6.
20.
ArnaudF, BertrandA, CharpinJ. Long term almitrine bismesylate treatment in patients with chronic bronchitis and emphysema: a multicentre double-blind placebo controlled study.Eur J Respir Dis1983; 64: (suppl 126): 323–30.
21.
GherardiR, BenvenutiC, LejoncJL. Peripheral neuropathy in patients treated with almitrine dimesylate.Lancet1985; 1: 1247–50.
LouarnF, GherardiR. Almitrine and peripheral neuropathy (letter).Lancet1985; 2: 1068.
24.
GodardPH, BognieM, EvrardY, JaberH, SellesJP, MichelFB. Effect of almitrine bismesilate on theophylline pharmacokinetics in chronic bronchitis (abstract).Am Rev Respir Dis1985; 131(suppl): A99.
25.
EscourrouP, SimonneauG, AnsquerJC, DurouxP, LockhartA. A single orally administered dose of almitrine improves pulmonary gas exchange during exercise in patients with chronic air-flow obstruction.Am Rev Respir Dis1986; 133: 562–7.
26.
ConnaughtonJJ, DouglasNJ, MorganAD. Almitrine improves oxygenation when both awake and asleep in patients with hypoxia and carbon dioxide retention caused by chronic bronchitis and emphysema.Am Rev Respir Dis1985; 132: 206–10.
