Hydroxy-phenylbutazone (Tanderil) in the treatment of ocular disease. A preliminary survey.

HYDROXY-PHENYLBUTAZONE (Tanderil) having proved in many cases an efficacious and less toxic substitute for phenylbutazone (Butazolidin) (Hart and Burley, 1959; Mason and Cramer, 1959), and having been noted by a rheumatologist (O'Reilly, 1958) to have a beneficial effect on iritis associated with rheumatic conditions, Messrs. Geigy have made a quantity available to me for the treatment of ocular diseases. Svane-Knudsen (1959) described fifteen cases of ocular disease treated with phenylbutazone with rapid analgesic effect and acceleration of absorption of exudates. He remarked, however, on the necessity for caution in its use, owing to unpleasant side-effects including leucopenia and gastric ulceration. Neither of these complications has been seen in any of my patients treated with the hydroxy derivative, even after a number of months, and temporary water retention in two cases has been-only a minor inconvenience. Chemical Composition.-Tanderil is a naturally-occurring metabolite of phenylbutazone. It was isolated in the urine of patients receiving the drug by Burns, Rose, Goodwin, Reichenthal, Horning, and Brodie (1955), and later synthesized in the laboratories of Messrs. J. R. Geigy in Basel (Pfister and Hiifliger, 1957). The compound has a hydroxyl group in the pa?a position of benzine ring A of the phenylbutazone molecule. The structural formula of Tanderil and that of the parent substance phenylbutazone are given below: