Eflornithine

Structural formula
1: 1 mixture (racemate) of ( S ) -form (top) and ( R ) -form (bottom)
General
Non-proprietary name	Eflornithine
other names	( RS ) -2,5-diamino-2- (difluoromethyl) pentanoic acid ( IUPAC ) Difluoromethyl ornithine DFMO
Molecular formula	C 6 H 12 F 2 N 2 O 2
External identifiers / databases
CAS number 70052-12-9 96020-91-6 (monohydrochloride monohydrate) PubChem 3009 ChemSpider 2902 DrugBank DB06243 Wikidata Q424751
Drug information
ATC code	D11 AX16 P01 CX03
Drug class	Antiprotozoal drugs
properties
Molar mass	182.17 g mol −1
safety instructions
Please note the exemption from the labeling requirement for drugs, medical devices, cosmetics, food and animal feed GHS labeling of hazardous substances no GHS pictograms H and P phrases H: no H-phrases P: no P-phrases
As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions .

Eflornithine is a medicinal substance against sleeping sickness , the causative agent of which is Trypanosoma brucei gambiense . Its chemical name is difluoromethyl ornithine, or DFMO for short.

Eflornithine is sold as Vaniqa ^® for the treatment of unwanted hair growth ( hirsutism ) on the face in women.

history

Against the background of the toxicity of the drug and the incipient resistance problems of the already few and old trypanosome remedies, eflornithine, which comes from oncology , was viewed as a miracle drug in the 1980s. However, production was stopped in the 1990s for financial reasons despite some protests; Similar fates overtook or threatened other drugs against diseases on the African continent. It was only when eflornithine in an anti- beard growth product for women came onto the market and was heavily advertised that the public and politics became aware of the absurdity of the situation.

An agent that could save the lives of many people in Africa was not sold there, but was used as a cosmetic in the industrialized countries. The Sanofi-Aventis group , now rights holder through mergers, and the WHO finally agreed on a program to use the funds again in Africa.

effect

Eflornithine is an irreversible inhibitor of the enzyme ornithine decarboxylase (ODC), which catalyzes the conversion of ornithine into putrescine and other polyamines , which in turn are involved in the regulation of cell growth and differentiation, including in the hair follicle . This slows down the formation of hair. Vaniqa is approved for women with unwanted hair growth (hirsutism) on the face. According to the studies, Vaniqa is said to slow down the growth of facial hair significantly within eight weeks - provided it is applied to clean, dry skin twice a day with an interval of eight hours, massaged in and left there for at least four hours. Long-term treatment is necessary for long-term success, as the original condition is restored about eight weeks after the end of the therapy.

Despite its specific inhibition of ODC, eflornithine is only effective against the pathogen causing West African sleeping sickness, but not against Trypanosoma brucei rhodesiense . The reason for this is that in these cells the ODC is renewed much faster (after a few hours) than in T.brucei gambiense and therefore eflornithine can only be effective for a shorter time.

Studies on hirsutism

According to the specialist information, the effectiveness and safety were tested in two studies with almost 600 women with excessive facial hair over 24 weeks.

result

• 6% pure, almost pure
• 29% significant improvement
• 35% improvement
• 30% no improvement / deterioration

In comparison, hair growth on the basis of the cream base also improved in a third.

Generally mild acne was noted as a very common side effect (> 10%); pseudofolliculitis barbae, alopecia, tingling, itching, burning, stinging, dry skin, skin reddening, irritation, rash and were common (1% to 10%) Folliculitis.

Since Vaniqa is not a depilatory cream, conventional hair removal is still necessary. However, the intervals between hair removals should increase due to the slowed growth.

Trade names

Eflornithine is commercially available in Germany, Austria and Switzerland under the name Vaniqa.

Web links

• WHO Eflornithine in the Treatment of Sleeping Sickness ( Memento of March 25, 2006 in the Internet Archive )

Individual evidence

1. ↑ Data sheet DL-α-Difluoromethylornithine hydrochloride hydrate from Sigma-Aldrich , accessed on March 29, 2011 ( PDF ).
2. ↑ Rote Liste Service GmbH (Ed.): Rote Liste 2017 - drug directory for Germany (including EU approvals and certain medical devices) , Rote Liste Service GmbH, Frankfurt / Main, 2017, edition 57, ISBN 978-3-946057-10 -9 , p. 658.
3. ↑ Supply of sleeping sickness drugs confirmed . Retrieved March 22, 2014.
4. ↑ B. Malhotra, R. Noveck, D. Behr, M. Palmisano: Percutaneous absorption and pharmacokinetics of eflornithine HCl 13.9% cream in women with unwanted facial hair. In: Journal of clinical pharmacology. Volume 41, Number 9, September 2001, pp. 972-978, PMID 11549102 .
5. ↑ Bristol-Myers Squibb: American package insert from VANIQA (2000) online (accessed November 14, 2006; PDF; 136 kB).
6. ↑ Specialist information Vaniqa 11.5% cream (accessed on January 1, 2013; PDF; 187 kB).

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !