Mechanisms of Action
Fasudil Hydrochloride is an isoquinoline sulfonamide derivative which can relax separated cerebral blood vessels, inhibit the shrinkage of separated blood vessels caused by calcium influx, inhibit different mechanisms of brain blood vessel contraction from contractile agents, and inhibit intracellular calcium ion activity without reducing calcium ion concentration. Fasudil Hydrochloride is an RHO kinase inhibitor which dilates vessels, reduces tension of endothelial cells, and improves microcirculation of brain tissue without producing or exacerbating diversion of blood to the brain, by increasing activity of myosin light chain phosphatase. At the same time, it can protect nerves against apoptosis and promote their regeneration. Fasudil Hydrochloride promotes recovery of neural function and reduces clinical symptoms.
Asahi Chemical (Japan)
vasodilator, potent Rho-kinase inhibitor
Fasudil hydrochloride, a novel calcium antagonistic vasodilator, was marketed
for the treatment of cerebral vasospasm following subarachnoid hemorrhage
(SAH). Fasudil is also a potent inhibitor of myosin light chain kinase and protein kinase
C. In contrast to other calcium channel blockers, which regulate the influx of calcium
ions through the cell membrane but not involved in the intracellular regulatory
mechanism of the calcium, fasudil was suggested to have an intracellular mode of
action in relaxing vascular smooth muscle. In patients with neurological deficits due to
vasospasm, fasudil decreased the occurrence of angiographic severe and
symptomatic vasospasm and cerebral infarction without decreasing systemic blood
pressure. Fasudil is reportedly in clinical trials for acute ischemic stroke, sequelae of
cerebral vascular diseases and angina pectoris.
Warnings and Precautions
Patients with intracranial hemorrhage or possibility thereof, or low blood pressure, should not use. Patients with diabetes mellitus, cerebral arterial sclerosis, severe disturbance of consciousness, subarachnoid hemorrhages with cerebrovascular disorders, and liver or kidney dysfunction, or those over 70 years old, pregnant, or children should use with caution. Breastfeeding women should stop while using the drug. Fasudil Hydrochloride can only be administered via intravenous drip.
Indications and Usage
Fasudil Hydrochloride is a new drug with a wide range of pharmacological effects, developed by Asahi Kasei Corporation (Japan.) It is a cardiovascular and cerebrovascular drug which improves symptoms of ischemic cerebrovascular disease such as cerebral vasospasm following subarachnoid hemorrhage. It has significant neuroprotective and therapeutic effects for ischemic cerebrovascular disease, and is suited for clinical use, particularly at the grassroots level to reduce mortality and improve quality of life.
Adverse reactions after use can include intracranial hemorrhage, gastrointestinal bleeding, pulmonary hemorrhage, nasal bleeding, subcutaneous bleeding, and loss of consciousness, etc., as well as abnormal liver function. Low blood pressure, anemia, leukopenia, renal dysfunction, polyuria, rashes, and fever, etc. occur occasionally.