Flupirtine: pharmacology and clinical applications of a nonopioid analgesic and potentially neuroprotective compound

Background: Flupirtine is a nonopioid drug without antipyretic or antiphlogistic properties and with a favorable tolerability. It constitutes a unique class within the group of nonsteroidal analgesics and displays a peculiar pharmacodynamic profile that invites the investigation of applications beyond the pain-relieving effect. Objective: This review describes and evaluates the pharmacologic and clinical literature regarding flupirtine and discusses its future potential. Methods: A search of the primary literature and conference abstracts was conducted using the keyword 'flupirtine'. Resulting articles were compiled and analyzed for this review. Results/conclusions: Although flupirtine has gained a firm place in the treatment of acute and chronic pain in various clinical settings since its introduction, a broader range of applications remains to be explored in clinical trials. Possible neuroprotective effects due to N-methyl-D-aspartate antagonistic proper-ties of flupirtine might be promising in the treatment of Creutzfeld-Jakob disease, Alzheimer's disease, and multiple sclerosis. Trials in these fields are forthcoming.