remimazolam
Trade name: Byfavo
Approved
Jul 2, 2020
Remimazolam, sold under the brand name Byfavo, is a medication for the induction and maintenance of procedural sedation in adults for invasive diagnostic or surgical procedures lasting 30 minutes or less. It is a benzodiazepine drug, developed by PAION AG in collaboration with several regional licensees as an alternative to the short-acting imidazobenzodiazepine midazolam, for use in the induction of anesthesia and conscious sedation for minor invasive procedures. — Wikipedia
Clinical trial activity
220 trials · 120 clinical orgs · 1 marketing orgs
Earliest trial started Mar 1, 2009 (NCT00869440)
Timeline
2000s
- Jan 1, 2009
Earliest Phase 2 Sponsor(trial)
2020s
- Jul 2, 2020
Acacia Pharma Ltd — Earliest FDA Approval
- Jul 2, 2020
Acacia Pharma Ltd — Marketing Organization
- Jul 2, 2020
Acacia Pharma Ltd — NDA Secondary Org
- Jul 2, 2020
Acacia Pharma Ltd — NDA Organization
Indications
Approved for
Studied for
- Abortion, Induced · Phase 2
- Acne Vulgaris · Phase 4
- Adult · Phase 4
- Analgesia · Phase 3
- Anesthesia · Phase 4
- Anesthesia, General · Phase 4
- Anesthesia, Intravenous · Phase 3
- Anesthesia, Spinal · Phase 4
- Anesthetics · Phase 4
- Anesthetics, General · Phase 3
- Anesthetics, Intravenous · Phase 4
- Anterior Temporal Lobectomy · Phase 1/Phase 2
- Anxiety Disorders · Phase 4
- Arrhythmias, Cardiac · Phase 4
- Arthritis · Phase 4
- Atrial Fibrillation · Phase 3
- Benzodiazepines · Phase 4
- Biological Availability · Phase 1
- Bipolar Disorder · Phase 4
- Brachial Plexus Block · Phase 4
- Bronchiectasis · Phase 4
- Bronchoscopy · Phase 4
- Burns · Phase 4
- Cognition · Phase 4
- Cognitive Dysfunction · Phase 4
- Colonoscopy · Phase 3
- Constipation · Phase 4
- Coronary Artery Disease · Phase 4
- COVID-19 · Phase 2
- Critical Illness · Phase 4
- Cryosurgery · Phase 4
- Deep Sedation · Phase 4
- Delirium · Phase 4
- Dermatology · Phase 4
- Desflurane · Phase 4
- Dexmedetomidine · Phase 4
- Drug Interactions · Early Phase 1
- Drug-Related Side Effects and Adverse Reactions · Phase 4
- Drugs, Investigational · Phase 4
- Emergence Delirium · Phase 4
- Endoscopy · Phase 4
- Esophageal and Gastric Varices · Phase 4
- Gastrectomy · Phase 4
- Gastroscopy · Phase 4
- General Surgery · Phase 4
- Healthy Volunteers · Phase 3
- Hemodynamics · Phase 4
- Hemostasis, Endoscopic · Phase 4
- Hip Fractures · Phase 4
- Hypnotics and Sedatives · Phase 4
- Hysteroscopy · Phase 4
- Intensive Care Units · Phase 4
- Intubation, Intratracheal · Phase 4
- Kidney Transplantation · Phase 1
- Laparoscopy · Phase 4
- Laryngeal Diseases · Phase 4
- Leukemia, Lymphoid · Phase 2/Phase 3
- Liver Diseases · Phase 1
- Liver Failure · Phase 4
- Lung Diseases · Phase 2
- Major Depressive Disorder · Phase 4
- Midazolam · Phase 4
- Mouth Diseases · Phase 4
- Musculoskeletal Diseases · Phase 4
- Neoplasm Metastasis · Phase 4
- Neoplasms · Phase 4
- Nervous System Diseases · Phase 4
- Neurosurgery · Phase 4
- Nose Diseases · Phase 4
- Obesity, Morbid · Phase 4
- Orthopedic Procedures · Phase 4
- Osteoarthritis, Knee · Phase 4
- Pain · Phase 3
- Parkinson Disease · Phase 2
- Perioperative Care · Phase 4
- Pharmacokinetics · Phase 4
- Pharmacological and Toxicological Phenomena · Phase 4
- Pharmacology · Phase 4
- Pharyngeal Diseases · Phase 4
- Postoperative Cognitive Complications · Phase 3
- Postoperative Complications · Phase 4
- Postoperative Nausea and Vomiting · Phase 4
- Postoperative Pain · Phase 3
- Procedural Sedation · Phase 4
- Propofol · Phase 4
- Psychotic Disorders · Phase 4
- Psychotropic Drugs · Phase 4
- Renal Insufficiency, Chronic · Phase 1
- Respiration, Artificial · Phase 4
- Respiratory Distress Syndrome · Phase 4
- Respiratory Insufficiency · Phase 4
- Rhinoplasty · Phase 2
- Safety · Phase 4
- Schizophrenia · Phase 4
- Sepsis · Phase 4
- Shock · Phase 2
- Sleep Apnea, Obstructive · Phase 4
- Stroke · Phase 2
- Substance-Related Disorders · Phase 1
- Tonsillectomy · Phase 4
- Tonsillitis · Phase 4
- Tooth Extraction · Phase 4
- Unconsciousness · Phase 3
- Uremia · Phase 4
- Urinary Bladder Neoplasms · Phase 4
- Ventilation · Phase 2
- Ventilators, Mechanical · Phase 4
- Vomiting · Phase 4
- Wounds and Injuries · Phase 2
Mechanism of action
- GABA-A receptorACTIVATOR
GABA-A receptor activator
- GABA-A receptor; anion channelPOSITIVE ALLOSTERIC MODULATOR
GABA-A receptor; anion channel positive allosteric modulator
No clear selectivity between GABAA receptor subtypes
Benzodiazepine site
- Gamma-aminobutyric acid receptor subunit alpha-1 (GABRA1) ↗
- Gamma-aminobutyric acid receptor subunit beta-2 (GABRB2) ↗
- Gamma-aminobutyric acid receptor subunit gamma-2 (GABRG2) ↗
- Gamma-aminobutyric acid receptor subunit beta-3 (GABRB3) ↗
- Gamma-aminobutyric acid receptor subunit alpha-4 (GABRA4) ↗
- Gamma-aminobutyric acid receptor subunit gamma-3 (GABRG3) ↗
- Gamma-aminobutyric acid receptor subunit theta (GABRQ) ↗
- Gamma-aminobutyric acid receptor subunit alpha-3 (GABRA3) ↗
- Gamma-aminobutyric acid receptor subunit pi (GABRP) ↗
- Gamma-aminobutyric acid receptor subunit delta (GABRD) ↗
- Gamma-aminobutyric acid receptor subunit gamma-1 (GABRG1) ↗
- Gamma-aminobutyric acid receptor subunit beta-1 (GABRB1) ↗
- Gamma-aminobutyric acid receptor subunit epsilon (GABRE) ↗
- Gamma-aminobutyric acid receptor subunit alpha-2 (GABRA2) ↗
- Gamma-aminobutyric acid receptor subunit alpha-5 (GABRA5) ↗
- Gamma-aminobutyric acid receptor subunit alpha-6 (GABRA6) ↗
- GABA receptor alpha-1 subunit
- GABA receptor beta-2 subunit
- GABA receptor alpha-4 subunit
- GABA receptor delta subunit
- GABA receptor alpha-5 subunit
- GABA receptor alpha-6 subunit
- GABA receptor beta-3 subunit
- GABA receptor alpha-3 subunit
- GABA receptor alpha-2 subunit
- GABA-A receptor; GABA-A site (alpha1/beta2 interface)
- GABA-A receptor; alpha-3/beta-3/gamma-2
- GABA-A receptor; alpha-1/beta-3/gamma-2
- GABA-A receptor; alpha-5/beta-3/gamma-2
- GABA-A receptor; alpha-2/beta-3/gamma-2
- GABA-A receptor; alpha-1/beta-2/gamma-2
- GABA-A receptor; alpha-6/beta-3/gamma-2
- GABA-A receptor; benzodiazepine site
- GABA-A receptor; agonist GABA site
- GABA A receptor alpha-2/beta-2/gamma-2
- GABA A receptor alpha-3/beta-2/gamma-2
- GABA A receptor alpha-6/beta-2/gamma-2
- GABA A receptor alpha-1/beta-1/gamma-2
- GABA A receptor alpha-4/beta-3/gamma-2
- Gamma-aminobutyric acid receptor subunit alpha-4/beta3/delta
- Gamma-aminobutyric acid receptor subunit alpha-1/ beta-1
- Gamma-aminobutyric acid receptor subunit alpha-2/beta-2
- Gamma-aminobutyric acid receptor subunit alpha-3/ beta-2
- Gamma-aminobutyric acid receptor subunit alpha-3/ beta-3/gamma-3
- Gamma-aminobutyric acid receptor subunit alpha-3/beta-3
- Gamma-aminobutyric acid receptor subunit alpha-3/beta-3/theta
- Gamma-aminobutyric acid receptor subunit alpha-5/beta-2
- Gamma-aminobutyric acid receptor subunit alpha-5/beta-3/gamma-3
- Gamma-aminobutyric acid receptor subunit alpha-6/beta-3
- GABA-A receptor alpha-1/beta-3
- Gamma-aminobutyric acid receptor subunit alpha-1/beta-2/delta
- Gamma-aminobutyric acid receptor subunit alpha-4/beta-2/delta
- Gamma-aminobutyric acid receptor subunit beta-1/beta-2
- Gamma-aminobutyric acid receptor subunit alpha-5/beta-3
- Gamma-aminobutyric acid receptor subunit alpha-2/beta-3
- Gamma-aminobutyric acid receptor subunit alpha-1/alpha-2/beta-2/gamma-2
- Gamma-aminobutyric acid receptor subunit alpha-1/gamma-2
- Gamma-aminobutyric acid receptor subunit alpha-4/beta-2/gamma-2
- Gamma-aminobutyric acid receptor subunit alpha-4/beta-1/delta
- Gamma-aminobutyric acid receptor subunit alpha-5/beta-2/gamma-2
- GABA receptor beta-1 subunit
- Gamma-aminobutyric acid receptor subunit alpha-2/beta-1/gamma-2
Approval history
- approvedJul 2, 2020
Chemistry & pharmacology
SMILES
COC(=O)CC[C@@H]1N=C(c2ccccn2)c2cc(Br)ccc2-n2c(C)cnc21.Cc1ccc(S(=O)(=O)O)cc1- Mol. weight
- 611.52 g/mol
- Lipinski Ro5
- Pass
- Rule of 3
- No
- Chirality
- Single Stereoisomer
- Inorganic
- No
- Polymer
- No
- Availability
- Prescription Only
Oral
No
Parenteral
No
Topical
No
Sources
- WikipediaRemimazolam ↗
- ChEMBLCHEMBL4594301 ↗
- ChEMBLCHEMBL4297526 ↗
- ChEMBLCHEMBL4297324 ↗
Also known as
- cns 7056
- cns 7056
- cns 7056
- methyl 3-(8-bromo-1-methyl-6-(2-pyridinyl)-4h-imidazo(1,2-a)(1,4)benzodiazepin-4-yl)propanoate
- ono2745
- ono 2745
- ono-2745
- ono-2745
- ono-2745
- remimazolam
- remimazolam
- remimazolam
- remimazolam
Clinical trials
| NCT ID | Phase | Start date | Sponsor(s) |
|---|---|---|---|
| NCT07290205 | Early Phase 1 (Phase 1) | Mar 1, 2026 | National Institute of General Medical Sciences (NIGMS), University of Pittsburgh |
| NCT07251101 | N/A | Jan 2, 2026 | Ilsan Hospital |
| NCT07265050 | N/A | Jan 1, 2026 | Seoul National University |
| NCT07303985 | Phase 4 | Dec 31, 2025 | Fudan University |
| NCT07277881 | Phase 4 | Dec 31, 2025 | Medical University of Gdansk |
| NCT07265128 | Phase 4 | Dec 31, 2025 | Yonsei University |
| NCT06810843 | N/A | Dec 31, 2025 | Shandong first medical University, Shandong Province Qianfoshan Hospital |
| NCT07269808 | Phase 3 | Dec 1, 2025 | Harvard University |
| NCT07213544 | Phase 4 | Nov 12, 2025 | Medical University of South Carolina |
| NCT07194109 | Phase 4 | Oct 1, 2025 | Anhui Medical University |
| NCT07155265 | Phase 3 | Oct 1, 2025 | Yancheng First People's Hospital |
| NCT07113483 | Phase 3 | Oct 1, 2025 | Romanian Society for Enteral and Parenteral Nutrition |
| NCT07118579 | Phase 4 | Sep 23, 2025 | Huazhong University of Science and Technology |
| NCT07161297 | Phase 4 | Sep 1, 2025 | Humanitas University |
| NCT07086911 | Phase 1/Phase 2 (Phase 2) | Aug 31, 2025 | Kunming Medical University |
| NCT07094945 | Phase 4 | Aug 15, 2025 | Huazhong University of Science and Technology |
| NCT06793358 | Phase 4 | Jul 31, 2025 | Indiana University |
| NCT07036419 | Phase 2 | Jul 10, 2025 | Hengrui Therapeutics, Inc. |
| NCT07045467 | Phase 1 | Jul 1, 2025 | Shandong Province Qianfoshan Hospital |
| NCT07012902 | Early Phase 1 (Phase 1) | Jun 12, 2025 | Shanxi Medical University |
Organizations
Research & Development (120)
Marketing (3)
| Organization | Org type | Relationship | Date |
|---|---|---|---|
| Acacia Pharma Ltd | For profit | MKTG | Jul 2, 2020 |
| Acacia Pharma Ltd | For profit | NDA2 | Jul 2, 2020 |
| Acacia Pharma Ltd | For profit | NDA | Jul 2, 2020 |