Article: Tacrine

Tacrine
Systematic (IUPAC) name
1,2,3,4-tetrahydroacridin-9-amine
Identifiers
CAS number	321-64-2
ATC code	N06AA18 N06DA01
PubChem	1935
DrugBank	APRD00690
Chemical data
Formula	C13H14N2
Mol. weight	198.264 g/mol
Pharmacokinetic data
Bioavailability	2.4–36% (oral)
Protein binding	55%
Metabolism	Hepatic (CYP1A2)
Half life	2–4 hours
Excretion	Renal
Therapeutic considerations
Pregnancy cat.	C (Au), C (U.S.)
Legal status	S4 (Au), POM (UK), ℞-only (U.S.)
Routes	Oral, rectal

Tacrine is a parasympathomimetic and a centrally acting cholinesterase inhibitor (anticholinesterase). It was the first centrally-acting cholinesterase inhibitor approved for the treatment of Alzheimer's disease, and was marketed under the trade name Cognex. Tacrine was first synthesised by Adrien Albert at the University of Sydney.

Clinical use

Tacrine was the prototypical cholinesterase inhibitor for the treatment of Alzheimer's disease. Studies have found that it may have a small beneficial effect on cognition and other clinical measures, though adequate study data is limited and the clinical relevance of these findings is unclear.^[1][2].

The use of tacrine is limited by poor oral bioavailability, the necessity for four-times daily dosing, and considerable adverse drug reactions (including nausea, diarrhoea, urinary incontinence and hepatotoxicity) such that few patients could tolerate therapeutic doses.^[3]

Other newer cholinesterase inhibitors, such as donepezil, are now preferred over tacrine.