Chiral drugs : one drug or two? : Clinical pharmacology through the looking glass : reflections on the racemate vs enantiomer debate

Abstract

Most of the synthetic chiral agents administered as drugs are still marketed as racemic mixtures. Such drug enantiomers can differ substantially in their pharmacological, pharmacokinetic and toxic properties. The development of enantiomerically pure drugs would lead to better therapeutic indices, and less complex interactions. Thus, the re-realisation of the importance of stereochemistry in pharmacology has an important contribution to make to the development and use of safer and more effective medicines. The impact of chirality on drug development and registration policies is discussed.