TABLE 1

Are clinically effective medicines inverse agonists?

Based on sales in the USA in 2002, a significant number of the top one hundred selling medicines target GPCRs. Those that are antagonists/inverse agonists are listed along with some examples where they have been assessed as potential inverse agonists at either the wild-type or constitutively active mutants of GPCRs.

Generic Name (Trade Name) Therapeutic Area Receptor Target Inverse Agonist? Reference
Olanzapine Antipsychotic 5-HT2C/5-HT2A/others Yes Herrick-Davis et al., 2000
Losartan Cardiovascular AT1 Yes Groblewski et al., 1997, Miserey-Lenkei et al., 2002
Risperidone Antipsychotic 5-HT2/dopamine D2, D3 Yes Vanhauwe et al., 1999; Herrick-Davis et al., 2000
Fexofenadine Respiratory histamine H1 Probably Leurs et al., 2002.
Clopidogrel Thrombosis P2Y12 Unclear Conley and Delaney, 2003
Valsartan Hypertension At1 Unclear
Montelukast Respiratory CysLT1 Unclear
Loratidine Respiratory Histamine H1 Probably Leurs et al., 2002.
Quetiapine Anti-Psychotic Dopamine D2/5-HT2C/5HT2A Unclear Rauser et al., 2001
Cetirizine Respiratory Histamine H1 Probably Leurs et al., 2002
Metoprolol Cardiovascular β1-Adrenoceptor Yes Engelhardt et al., 2001; Levin et al., 2002
Tolterodine Genitourinary Muscarinic M3/M2 Unclear
Famotidine Gastrointestinal Histamine H2 Yes Alewijnse et al., 1998.