Piretanide: a new synthetic fibrinolytic and anti-platelet agent

Piretanide, 4-phenoxy-3-(1-pyrrolidinyl)-5-sulfamoyl benzoic acid, a potent diuretic, enhances endogenous plasma fibrinolytic activity after a single dose of 6 mg administered orally. Acceleration of fibrinolytic activity becomes manifest within 1 h, reaches its peak in 3 h and is associated with little change in fibrinogen, however, it is accompanied with diminished urokinase excretion initially. Piretanide does not cause lysis of fibrin in vitro in any concentration. Primary platelet aggregation, induced by adenosine-diphosphate, is inhibited by piretanide, in vivo. In in vitro experiments piretanide leads to effective inhibition of ADP-induced platelet aggregation with complete inhibition at 5 mM concentration. Piretanide, after ingestion of a single dose of 6 mg, causes highly significant decrease of platelet factor-4 release.