Nitrosamines in Carbamazepine?

@letsfco Thanks for the inquiry and sharing the information. I would let @fernandaw @David provide their expert comment but I’m sure the whole community would argue that the lack of alpha-hydrogen can suggest a lower risk.

That been said, I found couple articles that might be interesting for the discussion (sorry they are both in German)

  • There is a proven mechanism of nitrosation in the molecule
    Drugs from the classes of tricyclic antidepressives and antiepileptics, nitrosatable under simulated human gastric conditions
    [Article in German]
    D Ziebarth 1, T Schramm, A Töppel

Abstract

The nitrosatability of Pryleugan (imipramine), Herphonal (trimipramine), and Finlepsin (carbamazepine) was investigated under simulated human gastric conditions using a colorimetric measuring method. All of them proved to be nitrosatable even at very low nitrite concentrations. In the presence of ascorbic acid, the formation of N-nitroso compounds under model conditions was inhibited markedly. N-nitroso-dihydrodibenzazepine and N-nitroso-dibenzazepine could be identified by thin layer chromatography as main products. The biological effects of these N-nitroso compounds are not known up to now.

  • The AMES test is reported negative
    Microbial mutagenicity testing of N-nitrosoiminostilbene and N-nitrosoiminodibenzyl, the nitrosation products of the drugs carbamazepine and trimipramine hydrochloride
    [Article in German]
    D Ziebarth 1, T Schramm, R Braun

Abstract

The active agents of the drugs Finlepsin and Herphonal, carbamazepine and trimipramine, were nitrosated under simulated human gastric conditions. For both formed N-nitroso compounds, N-nitroso iminostilbene (N-nitroso-5H-dibenz(b,f)azepine) and N-nitroso iminodibenzyl (N-nitroso-10,11-dihydro-5H-dibenz(b,f)azepine), tests for mutagenic potency in the Ames-test gave negative results.

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