Pharmacology · Neuroprotective agents for ALS
Edaravone !
A free-radical scavenger given in intravenous cycles (or by mouth) that modestly slowed functional decline in early ALS. Contains a sulfite.
Updated 2026-11-01
Mechanism of action
Edaravone is a small molecule that scavenges free radicals and may reduce oxidative stress in motor neurons. The exact mechanism of its benefit in ALS is unknown. It was first used in Japan for acute stroke.
- Edaravone reacts with and neutralizes free radicals
- Oxidative damage to motor neurons may fall
- Functional decline in early ALS may slow
Pharmacokinetics
- Metabolism
- Conjugated to a glucuronide and a sulfate; not expected to cause major CYP interactions
- Elimination
- Mainly in the urine as the glucuronide
- Half-life
- Terminal half-life about 4.5 to 6 hours
Indications
- Amyotrophic lateral sclerosis Amyotrophic lateral sclerosis →
Adverse effects
Common
- Bruising (contusion)
- Gait disturbance
- Headache
Contraindications
- History of hypersensitivity to edaravone or any ingredient
Key interactions
- Major CYP and UGT inhibitors or inducers
- No substantial effect on edaravone is expected
What is monitored
- Signs of allergy during and after each infusion (hives, wheeze, swelling, low blood pressure)
- Function scale and breathing over time
- Venous access site
Administration and safety
- Given as an intravenous infusion in cycles of treatment days followed by drug-free periods; an oral suspension also exists
- Ask about sulfite allergy and asthma before the first infusion
- Long courses often need planned venous access
Nursing care
- Observe for allergic reactions during the infusion and stop it if they occur
- Teach the cycle calendar to patient and caregivers
- Assess falls and bruising
Pregnancy and breastfeeding
There are no adequate human data; animal studies showed developmental harm at clinically relevant doses.
Test yourself
Think of the answer, then tap the question to see it.
What kind of drug is edaravone?
A free-radical scavenger (antioxidant) used in ALS.
Which excipient of the edaravone infusion can cause allergic reactions?
Sodium bisulfite, a sulfite; people with asthma are more susceptible.
How is intravenous edaravone scheduled?
In cycles of daily infusions followed by drug-free periods.
Related drugs
Related conditions
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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - EDARAVONE injection, solution (DailyMed (U.S. National Library of Medicine), 2025); Edaravone Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2022); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 21 (McGraw Hill, 2023).
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Representative model, for educational purposes only.