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Last update 23 Jan 2025

Esmolol Hydrochloride

Last update 23 Jan 2025

Overview

R&D Status

Clinical Result

Translational Medicine

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

(±)-esmolol, (±)-methyl p-(2-hydroxy-3-(isopropylamino)propoxy)hydrocinnamate, 3-[4-(2-Hydroxy-3-isopropylamino-propoxy)-phenyl]-propionic acid methyl ester

+ [16]

Target

β1-adrenergic receptor

Mechanism

β1-adrenergic receptor antagonists(Beta-1 adrenergic receptor antagonists)

Therapeutic Areas

Nervous System DiseasesCardiovascular DiseasesEndocrinology and Metabolic Disease+ [1]

Active Indication

Diabetic foot ulcerVentricular ArrhythmiaHypertension+ [2]

Inactive Indication-

Originator Organization

Baxter International, Inc.

Active Organization

Baxter Healthcare Corp.

Maruishi Pharmaceutical Co., Ltd.

NovaLead Pharma Pvt Ltd.

+ [1]

Inactive Organization-

Drug Highest PhaseApproved

First Approval Date

US (31 Dec 1986),

HypertensionTachycardia, SupraventricularTachycardia

Regulation-

Structure/Sequence

Molecular FormulaC16H26ClNO4

InChIKeyGEKNCWBANDDJJL-UHFFFAOYSA-N

CAS Registry81161-17-3

View All Structures (2)

180

Clinical Trials associated with Esmolol Hydrochloride

CTRI/2024/11/076120

/ Not yet recruitingNot ApplicableIIT

Comparitive study of esmolol and labetalol in attenuation of pressor response to laryngoscopy and endotracheal intubation in patients posted under general anaesthesia:a randomised double blind study. - NIL

Start Date10 Nov 2024

Sponsor / Collaborator-

NCT06635707

/ Not yet recruitingNot ApplicableIIT

The Study on the Efficacy and Safety of Using Urapidil Alone or in Combination With Esmolol for the Treatment of Acute Hypertensive Intracerebral Hemorrhage: A Prospective, Open-label, Observational, Multicenter Research

The objective of this study is to investigate the efficacy and safety of urapidil monotherapy versus the combination of esmolol in treating participants with acute hypertensive intracerebral hemorrhage through a prospective, open-label, observational, multicenter clinical trial, aiming to provide guidance for clinicians in formulating rational treatment plans.

Start Date01 Nov 2024

Sponsor / Collaborator

Qianfoshan Hospital of Shandong Province

NCT06620991

/ Not yet recruitingNot ApplicableIIT

Pre-operative Phentolamine Vs Intraoperative Esmolol Efficacy for Hypotensive Anesthesia in Functional Endoscopic Sinus Surgery

The aim of this study is to evaluate the efficacy of intra-operative phentolamine vs intraoperative esmolol for hypotensive anesthesia in functional endoscopic sinus surgery.

Start Date10 Oct 2024

Sponsor / Collaborator

Ain Shams University

100 Clinical Results associated with Esmolol Hydrochloride

100 Translational Medicine associated with Esmolol Hydrochloride

100 Patents (Medical) associated with Esmolol Hydrochloride

1,635

Literatures (Medical) associated with Esmolol Hydrochloride

01 Jan 2025·Experimental Physiology

Vascular limitations in blood pressure regulation with age in women: Insights from exercise and acute cardioselective β‐blockade

Article

Author: Pawelczyk, James A. ; Mookerjee, Swapan ; Gosalia, Jigar ; Fragin, Jason ; Proctor, David N. ; Bowlus, Christine ; Delgado Spicuzza, Jocelyn M. ; Studinski, Matthew J. ; Muller, Matthew D.

AbstractYounger women rely on altering cardiac output () to regulate blood pressure (BP). In contrast, older women rely more on altering vascular tone. However, evidence suggests that the ability to alter systemic vascular conductance (SVC) is diminished in older women. In the present study, cardioselective β‐blockade was utilized to diminish the relative contribution of to BP regulation and thereby evaluate age‐related vascular limitations in women at rest and during large muscle dynamic exercise. Younger (n = 13, mean age 26.0 years) and older (n = 14, mean age 61.8 years) healthy women performed submaximal bouts of semi‐recumbent cycling exercise at varying intensities while receiving an intravenous infusion of esmolol, a β1‐antagonist, or saline control in a repeated‐measures crossover design. was attenuated during esmolol infusion, with greater reductions during exercise (moderate, –1.0 (95% CI, –1.6 to –0.5) L/min, P < 0.001; heavy, –2.0 (95% CI, –2.6 to –1.5) L/min, P < 0.001) than seated rest (–0.5 (95% CI, –1.1 to 0.0) L/min, P = 0.048), and this reduction was not significantly different between age groups (P = 0.122). Older women exhibited a greater attenuation in mean arterial pressure (MAP) during esmolol (–7 (95% CI, –9 to –4) mmHg, P < 0.001) relative to younger women (–2 (95% CI, –5 to 0) mmHg, P = 0.071). These changes coincided with a greater reduction of SVC in the younger women during esmolol (–15 (95% CI, –20 to –10) mL/min/mmHg, P < 0.001) compared to older women (–3 (95% CI, –9 to 2) mL/min/mmHg, P = 0.242). Together, these findings provide evidence that older, postmenopausal women have a diminished ability to adjust SVC in order to regulate MAP.

01 Jan 2025·Resuscitation Plus

Esmolol in persistent ventricular fibrillation/tachycardia with de-emphasised adrenaline – Introducing the REVIVE project

Article

Author: Owen, Peter ; Hannah, Julian ; Raitt, James ; Pike, John ; Watson, Adam ; Sidebottom, David B ; Plumb, James ; Jeffery, David ; Taylor, Matthew ; Gleeson-Hammerton, Thomas

01 Jan 2025·CHEST

Mortality in Patients With Sepsis Treated With Esmolol or Landiolol

Review

Author: Messina, Simone ; Sato, Ryota ; Scimonello, Giulia ; Sanfilippo, Filippo ; Santonocito, Cristina ; Morelli, Andrea ; Dugar, Siddharth ; Sanfilippo, Giulia ; Hasegawa, Daisuke

BACKGROUNDThe latest meta-analysis indicated potential survival benefits from ultra-short-acting β-blockers in patients with sepsis with persistent tachycardia. However, subsequent multicenter randomized controlled trials (RCTs) have reported conflicting findings, prompting the need for an updated meta-analysis to incorporate these newly published RCTs.RESEARCH QUESTIONDoes the use of ultra-short-acting β-blockers (esmolol or landiolol) in patients with sepsis with persistent tachycardia improve mortality?STUDY DESIGN AND METHODSWe conducted an updated systematic search through April 2, 2024, exploring the MEDLINE, Cochrane Central Register of Controlled Trials, and Embase databases for RCTs reporting mortality in adult patients with sepsis treated with esmolol or landiolol as compared with those treated with neither of these or receiving placebo and published in English. Meta-analyses were conducted with the random effects model. The primary outcome was mortality at the longest follow-up, with subgroup analysis separating single-center RCTS from large multicenter RCTs.RESULTSEight RCTs (885 patients) were included in the primary analysis. Ultra-short-acting β-blockers did not improve mortality significantly at the longest follow-up (risk ratio, 0.84; 95% CI, 0.68-1.02; P = .08; I² = 51%; very low certainty of the evidence) and 28-day mortality (risk ratio, 0.77; 95% CI, 0.59-1.00; P = .05; I² = 62%). Subgroup analyses of mortality outcomes pointed toward different results between single-center and multicenter RCTs. Trial sequence analyses showed that both mortality outcomes were not robust. The sensitivity analyses suggested a significant reduction in mortality by adding RCTs published in non-English languages.INTERPRETATIONIn this updated meta-analysis, the use of esmolol or landiolol did not reduce mortality in patients with sepsis with persistent tachycardia. However, results were not robust and outcomes differed between single-center and multicenter RCTs. Moreover, sensitivity analyses showed the fragility of the primary outcome. Further studies regarding ultra-short-acting β-blockers with advanced cardiac monitoring or serial echocardiography are warranted.TRIAL REGISTRYInternational Prospective Register of Systematic Reviews; No.: CRD42024503570; URL: https://www.crd.york.ac.uk/prospero/.

News (Medical) associated with Esmolol Hydrochloride

04 Jan 2024

·www.biospace.com

Amneal Launched Record Number of 39 New Retail and Injectable Products in 2023, Including 13 in Q4 2023

More new product innovations in 2023, as compared to 26 in 2022 13 new products launched in the fourth quarter of 2023 BRIDGEWATER, N.J.--(BUSINESS WIRE)-- Amneal Pharmaceuticals, Inc. (Nasdaq: AMRX) (“Amneal”) today announces that it has launched 39 new retail and injectable medicines in 2023, as compared to 26 new launches in 2022. In the fourth quarter of 2023, Amneal launched 13 new products, including 5 injectables. New injectable products added include potassium phosphate vials, tranexamic acid and esmolol intravenous bags. These launches provide a strong foundation for higher injectable revenues going forward. In addition, Amneal launched several key new retail products in the fourth quarter, including spironolactone suspension with 180-day exclusivity, valsartan and hydrochlorothiazide tablets, and icosapent capsules. “We are pleased to have brought an impressive number of new products to market in 2023,” said Dr. Srinivas Kone, Senior Vice President, Generics R&D. “Our R&D portfolio prioritizes complex and high-value products that provide better access to affordable medicines for providers and patients.” About Amneal Amneal Pharmaceuticals, Inc. (Nasdaq: AMRX), headquartered in Bridgewater, NJ, is a fully integrated global pharmaceuticals company. We make healthy possible through the development, manufacturing, and distribution of a diverse portfolio of over 270 pharmaceutical products, primarily within the United States. In its Generics segment, the Company is expanding across a broad range of complex product categories and therapeutic areas, including injectables and biosimilars. In its Specialty segment, Amneal has a growing portfolio of branded pharmaceuticals focused primarily on central nervous system and endocrine disorders, with a pipeline focused on unmet needs. Through its AvKARE segment, the Company is a distributor of pharmaceuticals and other products for the U.S. federal government, retail, and institutional markets. For more information, please visit . Cautionary Statement on Forward-Looking Statements Certain statements contained herein, regarding matters that are not historical facts, may be forward-looking statements (as defined in the U.S. Private Securities Litigation Reform Act of 1995). Such forward-looking statements include statements regarding management’s intentions, plans, beliefs, expectations, financial results, or forecasts for the future, including among other things: discussions of future operations, including international expansion; expected or estimated operating results and financial performance; the Company’s growth prospects and opportunities as well as its strategy for growth; product development and launches; the successful commercialization and market acceptance of new products, and other non-historical statements. Words such as “plans,” “expects,” “will,” “anticipates,” “estimates,” and similar words, or the negatives thereof, are intended to identify estimates and forward-looking statements. The reader is cautioned not to rely on these forward-looking statements. These forward-looking statements are based on current expectations of future events, including with respect to future market conditions, company performance and financial results, operational investments, business prospects, new strategies and growth initiatives, the competitive environment, and other events. If the underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of the Company. Such risks and uncertainties include, but are not limited to: our ability to successfully develop, license, acquire and commercialize new products on a timely basis; the competition we face in the pharmaceutical industry from brand and generic drug product companies, and the impact of that competition on our ability to set prices; our ability to obtain exclusive marketing rights for our products; our ability to manage our growth through acquisitions and otherwise; our revenues are derived from the sales of a limited number of products, a substantial portion of which are through a limited number of customers; the continuing trend of consolidation of certain customer groups; our dependence on third-party suppliers and distributors for raw materials for our products and certain finished goods; our ability to complete the proposed holding company reorganization on the anticipated timeline or at all and to realize the expected benefits of such reorganization; our substantial amount of indebtedness and our ability to generate sufficient cash to service our indebtedness in the future, and the impact of interest rate fluctuations on such indebtedness; our ability to secure satisfactory terms when negotiating a refinancing or other new indebtedness; our dependence on third-party agreements for a portion of our product offerings; legal, regulatory and legislative efforts by our brand competitors to deter competition from our generic alternatives; risks related to federal regulation of arrangements between manufacturers of branded and generic products; our reliance on certain licenses to proprietary technologies from time to time; the significant amount of resources we expend on research and development; the risk of product liability and other claims against us by consumers and other third parties; risks related to changes in the regulatory environment, including U.S. federal and state laws related to healthcare fraud abuse and health information privacy and security and changes in such laws; changes to Food and Drug Administration product approval requirements; the impact of healthcare reform and changes in coverage and reimbursement levels by governmental authorities and other third-party payers; our potential expansion into additional international markets subjecting us to increased regulatory, economic, social and political uncertainties, including recent events affecting the financial services industry; our ability to identify, make and integrate acquisitions or investments in complementary businesses and products on advantageous terms; the impact of global economic, political or other catastrophic events; our ability to attract, hire and retain highly skilled personnel; our obligations under a tax receivable agreement may be significant; and the high concentration of ownership of our Class A Common Stock and the fact that we are controlled by the Amneal Group. The forward-looking statements contained herein are also subject generally to other risks and uncertainties that are described from time to time in the Company’s filings with the Securities and Exchange Commission, including under Item 1A, “Risk Factors” in the Company’s most recent Annual Report on Form 10-K and in its subsequent reports on Forms 10-Q and 8-K. Investors are cautioned not to place undue reliance on any such forward-looking statements, which speak only as of the date they are made. Forward-looking statements included herein speak only as of the date hereof and we undertake no obligation to revise or update such statements to reflect the occurrence of events or circumstances after the date hereof. View source version on businesswire.com: Contacts Investors: Anthony DiMeo Head of Investor Relations anthony.dimeo@amneal.com Source: Amneal Pharmaceuticals, Inc. View this news release online at:

20 Dec 2022

·www.biospace.com

Amneal Announces 26 Generic New Product Launches in 2022 and First Injection Large Volume Bag Approval

- 8 new product launches in Q4 closes out another successful year of innovation - First approval of a large volume bag product signals further expansion of injectables business BRIDGEWATER, N.J.--(BUSINESS WIRE)-- Amneal Pharmaceuticals, Inc. (NYSE: AMRX) (“Amneal” or the “Company”) today announced that the Company has successfully launched 26 new generic products in 2022. In the fourth quarter of 2022, the Company launched 8 new generic products, including clindamycin phosphate gel 1%, ipratropium bromide nasal sprays, and prednisolone sodium phosphate oral solution. “2022 was another successful year of innovation for Amneal. Across the portfolio we continue to innovate, further expand our portfolio of essential medicines, and drive incremental impact and benefit for health care professions and their patients. Looking to 2023, we expect more than 30 new product launches,” said Chirag Patel and Chintu Patel, Amneal Co-Chief Executive Officers. In addition, Amneal also announced it received Abbreviated New Drug Application approval from the U.S. Food and Drug Administration (“FDA”) for its first large volume bag, esmolol hydrochloride in sodium chloride injection. Harsher Singh, SVP for Amneal Biosciences, stated, “We are seeing continued momentum in expanding our injectables business. We are excited about this first ready to use bag approval utilizing one of our new manufacturing sites and look forward to more over the coming months.” Esmolol hydrochloride in sodium chloride injection is indicated for tachycardia. For full prescribing information, see package insert located here. According to IQVIA®, U.S. annual sales for this product for the 12 months ended October 2022 were $57 million. About Amneal Amneal Pharmaceuticals, Inc. (NYSE: AMRX), headquartered in Bridgewater, NJ, is a fully integrated essential medicines company. We make healthy possible through the development, manufacturing, and distribution of generic and specialty pharmaceuticals, primarily within the United States. The Company has a diverse portfolio of over 250 products in its Generics segment and is expanding across a broad range of complex products and therapeutic areas, including injectables and biosimilars. In its Specialty segment, Amneal has a growing portfolio of branded pharmaceutical products focused primarily on central nervous system and endocrine disorders, with a pipeline focused on unmet needs. Through its AvKARE segment, the Company is a distributor of pharmaceuticals and other products for the U.S. federal government, retail, and institutional markets. For more, please visit . Cautionary Statement on Forward-Looking Statements Certain statements contained herein, regarding matters that are not historical facts, may be forward-looking statements (as defined in the U.S. Private Securities Litigation Reform Act of 1995). Such forward-looking statements include statements regarding management’s intentions, plans, beliefs, expectations or forecasts for the future, including among other things: discussions of future operations; expected or estimated operating results and financial performance, the Company’s growth prospects and opportunities as well as its strategy for growth; product development and launches; the successful commercialization and market acceptance of new products, and expenditures. Words such as “plans,” “expects,” “will,” “anticipates,” “estimates,” and similar words are intended to identify estimates and forward-looking statements. The reader is cautioned not to rely on these forward-looking statements. These forward-looking statements are based on current expectations of future events. If the underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of the Company. Such risks and uncertainties include, but are not limited to: our ability to successfully develop, license, acquire and commercialize new products on a timely basis; the competition we face in the pharmaceutical industry, in general, specifically from brand and generic drug product companies, and the impact of that competition on our ability to set prices; our ability to obtain exclusive marketing rights for our products; our substantial amount of indebtedness and our ability to generate sufficient cash to service our indebtedness in the future, and the impact of interest rate fluctuations on such indebtedness; our ability to manage our growth through acquisitions and otherwise; our dependence on the sales of a limited number of products for a substantial portion of our total revenues; the continuing trend of consolidation of certain customer groups; our dependence on third-party suppliers and distributors for raw materials for our products and certain finished goods and any associated supply chain disruptions; existing and future legal proceedings, the outcome of which are uncertain and may divert management resources and require us to incur substantial defense or settlement payments and costs; legal, regulatory and legislative efforts by our brand competitors to deter competition from our generic alternatives; the impact of severe weather; the impact of the ongoing COVID-19 pandemic, and the emergence of variant strains; risks related to federal regulation of arrangements between manufacturers of branded and generic products; our reliance on certain licenses to proprietary technologies from time to time; the significant amount of resources we expend on research and development; the risk of product liability and other claims against us by consumers and other third parties; risks related to changes in the regulatory environment, including U.S. federal and state laws related to healthcare fraud abuse and health information privacy and security and changes in such laws; changes to FDA product approval requirements; the impact of healthcare reform and changes in coverage and reimbursement levels by governmental authorities and other third-party payers; our dependence on third-party agreements for a portion of our product offerings; the impact of global economic conditions, including any economic effects stemming from adverse geopolitical events, an economic downturn, inflation and rising interest rates; our ability to identify, make and integrate acquisitions or investments in complementary businesses and products on advantageous terms; our obligations under a tax receivable agreement may be significant; and the high concentration of ownership of our Class A Common Stock and the fact that we are controlled by the Amneal Group. The forward-looking statements contained herein are also subject generally to other risks and uncertainties that are described from time to time in the Company’s filings with the Securities and Exchange Commission, including under Item 1A, “Risk Factors” in the Company’s most recent Annual Report on Form 10-K and in its subsequent reports on Forms 10-Q and 8-K. Investors are cautioned not to place undue reliance on any such forward-looking statements, which speak only as of the date they are made. Forward-looking statements included herein speak only as of the date hereof and we undertake no obligation to revise or update such statements to reflect the occurrence of events or circumstances after the date hereof.

Drug Approval

100 Deals associated with Esmolol Hydrochloride

External Link

KEGG	Wiki	ATC	Drug Bank
D00644	Esmolol Hydrochloride	C07AB09	DB00187

R&D Status

Approved

10 top approved records.

to view more data

Indication	Country/Location	Organization	Date
Diabetic foot ulcer	IN	NovaLead Pharma Pvt Ltd.	24 Apr 2024
Ventricular Arrhythmia	JP	Maruishi Pharmaceutical Co., Ltd.	08 Oct 2002
Hypertension	US	Baxter Healthcare Corp.	31 Dec 1986
Tachycardia	US	Baxter Healthcare Corp.	31 Dec 1986
Tachycardia, Supraventricular	US	Baxter Healthcare Corp.	31 Dec 1986

Developing

10 top R&D records.

to view more data

Indication	Highest Phase	Country/Location	Organization	Date
Diabetic foot ulcer	Discovery	US	NovaLead Pharma Pvt Ltd.	20 Feb 2014

Clinical Result

Indication

Phase

Evaluation

View All Results

Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT04356352 (CTgov)	Phase 2/3	Pain \| Injection Site Reaction	33	Lidocaine (Lidocaine)	lsvpfyysxe(pklsykdfaf) = smvmektpqe ptkjmeoqjn (kpyxmsxzub, zvhsykvxdu - shrdsoyasr) View more	-	19 Sep 2024
				Esmolol (Esmolol)	lsvpfyysxe(pklsykdfaf) = wccdiprbpo ptkjmeoqjn (kpyxmsxzub, qfvlixgilx - lduqotgjaz) View more
NCT01113515 (CTgov)	Phase 1/2	Diabetic foot ulcer	44	Placebo gel (Placebo)	alydgilafb(dulycyqztw) = urudnhairc srdweekmck (aymcoqivjx, urrdumakop - nwbblnnnyf) View more	-	20 May 2024
				Esmolol hydrochloride (Galnobax 20% QD)	alydgilafb(dulycyqztw) = pfciortftf srdweekmck (aymcoqivjx, akvundlzzj - vtheryxzob) View more
NCT03998436 (CTR/2018/11/016295 \| ###DELETE, CTgov)	Phase 3	Diabetic foot ulcer	176	Esmolol Hydrochloride (Galnobax® 14% Gel Plus SoC)	eloudtvwfe(pygochwqpy) = pgorttuyid htonsdgydk (pyjefbfutp, njgsizzrgj - kykvolyymz) View more	-	22 Sep 2023
				Only Standard of Care (SoC Only)	eloudtvwfe(pygochwqpy) = mrtwiyvznd htonsdgydk (pyjefbfutp, kyjggiumpq - jdhxfjkxko) View more
CTRI/2013/07/003838 \| NCT01113515 (Pubmed)	Phase 1/2	Diabetic foot ulcer	-	Galnobax 14%	diosgaqryf(ktdesnocjz) = rohcensong yqsnrzfnfu (sejsytoidd ) View more	-	16 Oct 2022
				Galnobax 20%	diosgaqryf(ktdesnocjz) = vymvotdjmq yqsnrzfnfu (sejsytoidd ) View more
NCT02369900 (Pubmed)	Phase 2	Shock, Septic	40	Esmolol	(picojbebrd) = jepjttnowf vzgiptshva (olfscayiar )	-	27 Dec 2021
				Placebo	(picojbebrd) = gcpyvyurab vzgiptshva (olfscayiar )
ERS2021	Not Applicable	Heart Failure	-	Landiolol	(edrwvhpvmp) = kmtkxvkgxq idvaxnjglc (tgopfbckye )	Positive	05 Sep 2021
				Esmolol	(edrwvhpvmp) = ktvykssvxk idvaxnjglc (tgopfbckye )
NCT02369900 (CTgov)	Phase 2	Shock, Septic \| Hypotension \| Tachycardia	40	Esmolol (Esmolol Infusion)	jkxpfedytp(ruvsrlgbcp) = nxdcrrcclv epomtoxvvn (zmrozpiudl, qtdhkvvdfo - jeliyoxvgg) View more	-	28 Jun 2021
				saline (Standard Care, Saline)	jkxpfedytp(ruvsrlgbcp) = plraeqrsog epomtoxvvn (zmrozpiudl, xuunqxgqbj - sobqjrckgw) View more
NCT02466542 (Pubmed \| Eur J Anaesthesiol)	Phase 4	-	-	Esmolol infusion	(gigyjogvru) = vcdquawszu fcvjkmnrxa (nvwxhphrlg, -13.4 to -0.31)	Positive	08 Apr 2021
NCT03661346 (CTgov)	Phase 2	Hemorrhage \| Chronic sinusitis	28	Esmolol (Esmolol)	hsdmzlfdfo(yhsnepqbku) = maqtkzufyw achauerczw (ipuuioarvy, uyimjhxjnu - cxxgukpcgf) View more	-	08 Feb 2021
				Labetalol (Labetalol)	hsdmzlfdfo(yhsnepqbku) = hwcudpnnmg achauerczw (ipuuioarvy, odwjvcrsgn - gyytybnxar) View more
NCT02068287 (ESMOSEPSIS, Pubmed \| Crit Care) Manual	Phase 2	Shock, Septic	9	Esmolol	gnzbwerfks(algtxuawsu) = decrease from 4.2 to 2.9 l/min/m-2 liwozdwgco (wfnxubncxt ) View more	Positive	07 Jan 2021

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Esmolol Hydrochloride

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