Products
Ximelagatran (Exanta, film-coated tablets) was withdrawn from the market or not approved in some countries in 2006 because liver-toxic properties had been observed in clinical trials.
Structure and properties
Ximelagatran (C24H35N5O5, Mr = 473.6 g/mol) is a prodrug that is biotransformed in the organism to the active metabolite melagatran. Melagatran was itself also commercially available as an injectable.
Effects
Ximelagatran (ATC B01AE05) has antithrombotic properties. It is a direct, competitive, and reversible thrombin inhibitor. Thrombin is a serine protease that catalyzes the conversion of fibrinogen to fibrin and plays a central role in blood clotting.
Indications
For prevention of thromboembolic disease (e.g., prophylaxis after hip or knee replacement surgery).
Adverse effects
Ximelagatran has hepatotoxic properties and may cause liver injury.
