Phenacetin phenazone

Mokry, M. KUmes, J. Zahradnicek, M. HPLC anal3rsis of some sulfonamides in selected pharmaceutical formulations. Pharmazie, 1994, 49, 333—335 [tablets injections acetanilide (IS) simultaneous trimethoprim also phenacetin, phenazone, phenohenbital, phthalylsulfathiazole, sulfadimidine, sulfa-metho diazine, sulfamoxole, sulfisoxazole]... 

Simultaneous acetaminophen, 5-bromouracil, caffeine, 5-chlorouracU, 5-fluoroc54 sme, 5-fluorouracil, phenylethyleneglycol, theophylline Noninterfering codeine, cyclophosphamide, doxorubicin, indomethacin, methylpara-ben, phenacetin, phenazone, prednisone, triamcinolone acetate, triamcinolone... 

Phenol Antimicrobial preservative disinfectant (not oral) Camphor, menthol, thymol, acetaminophen, phenacetin, chloral hydrate, phenazone, ethyl aminobenzoate, methenamine, phenyl salicylate, resorcinol, terpin hydrate, sodium phosphate, or other eutectic formers. Phenol also softens cocoa butter in suppository mixtures... 

A systematic review included 18 case reports, two case series, and four analytical studies showing adulteration with various allopathic drugs (142). The adulterants included phenazone (aminopyrine), clobetasol propionate and other glucocorticoids, diazepam, diclofenac, glibenclamide, hydrochlorothiazide, indometacin, mefenamic acid, methylsalicy-late, phenacetin, phenylbutazone, and phenytoin. 

Phenazone nephrotoxicity is well-established, but information is limited. Experimental papillary necrosis can easily be provoked analgesic nephropathy is probably a real danger with antipyrine, especially when it is combined with a stronger inhibitor of prostaglandin sjmthesis. The effect is probably toxic, since inhibition of prostaglandins is not a marked characteristic of phenazone. Two reports have suggested a causal link between phenazone and renal carcinoma, as is well-known for phenacetin (3,4), but this has not been confirmed. 

Similarly, chloral hydrate has been shown to form complexes (mainly l l) with acetyl glycinamide, 39 j O, 4l aine, 3> j caffeine, 8,49 diazepam,50,312 535-dimethylhydantoin, 52,307 phenacetin, 3j55 phenazone. 1>56 to 51 glycine,1, glucosel< °, urea53,6o and others. 

In the presence of acetanilide, phenacetin cannot be separated by acid hydrolysis and a method for separation of phenacetin from acetanilide as well as from caflFeine and phenazone (other substances likely to be found in admixture with it) was devised by Emery. The method depends upon the fact that when phenacetin is added to a solution of iodine in potassium iodide containing a mineral acid, an iodine addition compound separates, whilst the corresponding product of acetanilide remains soluble. The details of the method are briefly ... 

If caffeine and phenazone are present, digest the mixture with dilute sulphuric acid to convert phenacetin and acetanilide to />-phenetidine sulphate and aniline sulphate respectively. Extract the phenazone and caffeine with chloroform and regenerate the others in the aqueous residues by adding an excess of sodium bicarbonate and a few drops of acetic anhydride and extracting with chloroform before proceeding to separate the phenacetin and acetanilide as above. 

Tubular reabsorption of Na, Cl", Caand Mg but not K was augmented by acetylsalicylic acid but not by ethoxy, acetyl or hydroxyorthobenzoic acid . Brown and Hardy reported that "analgesic nephritis" may be due to amidopyrine which causes papillary necrosis or phenazone which causes persistent celluria and slight kidney damage. Phenacetin was the least damaging to the kidney of the three compounds tested. 

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