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Efficacy of Dichloroacetate as a Lactate‐Lowering Drug
Author(s) -
Stacpoole Peter W.,
Nagaraja Nelamangala V.,
Hutson Alan D.
Publication year - 2003
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1177/0091270003254637
Subject(s) - lactic acidosis , lactate dehydrogenase , lactic acid , drug , medicine , acidosis , pharmacology , anesthesia , chemistry , biochemistry , enzyme , biology , bacteria , genetics
Dichloroacetate (DCA) decreases blood, cerebral spinal fluid, and intracellular lactate concentrations by activating the mitochondrial pyruvate dehydrogenase enzyme complex. The authors reviewed the efficacy of this investigational drug in the treatment of acquired or congenital forms of lactic acidosis from data in 40 English‐language publications. The hypolactatemic effect of DCA occurs over a broad range of pretreatment lactate concentrations and is directly related to the baseline lactate level. The maximum lactate‐lowering effect of the drug is dependent on its dose but independent of time following its administration. Recent clinical studies of acquired lactic acidosis suggest that DCA could be rapidly effective in reducing this risk factor of mortality in patients with mild hyperlactatemeia.