Nortilidine[1] is the major active metabolite of tilidine. It is formed from tilidine by demethylation in the liver. The racemate has opioid analgesic effects roughly equivalent in potency to that of morphine.[2] The (1R,2S)-isomer has NMDA antagonist activity. The drug also acts as a dopamine reuptake inhibitor.[3] The reversed-ester of nortilidine is also known, as is the corresponding analogue with the cyclohexene ring replaced by cyclopentane,[4] which have almost identical properties to nortilidine.[5]
Use
Nortilidine has been sold as a designer drug, first being identified in Poland in May 2020.[6][7]
See also
Desmetramadol, another opioid metabolite with additional (non-opioid) mechanisms of analgesia, which has also been sold as a designer drug
^US 3792080, "Process for Substituted Cyclohexenes its Products"
^Hajda JP, Jähnchen E, Oie S, Trenk D (November 2002). "Sequential first-pass metabolism of nortilidine: the active metabolite of the synthetic opioid drug tilidine". Journal of Clinical Pharmacology. 42 (11): 1257–61. doi:10.1177/009127002762491352. PMID12412825. S2CID12390653.
^"EU Early Warning System Situation Report. Situation report 2". European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). 10 August 2020. {{cite web}}: Missing or empty |url= (help)