Phenytoin

drug
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Also known as DilantinDilantin-125Dilantin-30DiphenylhydantoinDilabidEpaminFenitoinaHydantolLepitoinNSC-8722PHENYTOIN COMPONENT OF SM-88PhenytoinePhenytoinumPhentytoinZentropilPhenantoinSID11111069SID11532994SID17389903

Summary

Phenytoin (CHEMBL16) is an approved small-molecule anticonvulsant (ATC N03AB02) targeting SCN2A; indicated across 18 conditions including epilepsy and visual epilepsy.

At a glance

  • Status: Approved (max clinical phase 4)
  • Modality: Small molecule
  • ATC class: N03AB02 (+1 more)
  • Targets: 1 (SCN2A)
  • Indications: 18 conditions
  • Clinical trials: 63
  • Chemistry: 252.27 Da · C15H12N2O2

Identifiers

Drug identity and classification

FieldValue
ChEMBL IDCHEMBL16
NamePhenytoin
TypeSmall molecule
Max phase4
FDA approvedyes
PubChem CID1775
ChEBICHEBI:8107
ATCN03AB02, N03AB52
Molecular formulaC15H12N2O2
Molecular weight252.27
InChIKeyCXOFVDLJLONNDW-UHFFFAOYSA-N

SMILES: C1=CC=C(C=C1)C2(C(=O)NC(=O)N2)C3=CC=CC=C3

IUPAC name: 5,5-diphenylimidazolidine-2,4-dione

ChEBI definition: A imidazolidine-2,4-dione that consists of hydantoin bearing two phenyl substituents at position 5.

Pharmacological roles (ChEBI): anticonvulsant, teratogenic agent, drug allergen, sodium channel blocker.

Also known as: Dilantin, Dilantin-125, Dilantin-30, Diphenylhydantoin, Dilabid, Epamin, Fenitoina, Hydantol, Lepitoin, NSC-8722, Phenytoin, PHENYTOIN COMPONENT OF SM-88

Parent form; salt/anhydrous children: CHEMBL1611, CHEMBL553532, CHEMBL3274483

Patent coverage: 16,104 distinct patent families (53,375 SureChEMBL compound mentions), from 1 matched compound structure(s). Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).

GeneTargetActionpAffinityCancer dependencyUniProt
SCN2ANav1.2Pore blocker4.90.1%Q99250

Broader ChEMBL bioactivity targets: 20 (assay-derived). Sample: Microtubule-associated protein tau, Nuclear receptor ROR-gamma, Fructose-bisphosphate aldolase, RecQ-like DNA helicase BLM, Inositol monophosphatase 1, Endonuclease 4, Peripheral myelin protein 22, Sodium channel protein type 5 subunit alpha, Sodium channel protein type 4 subunit alpha, Sodium channel alpha subunits; brain (Types I, II, III), Voltage-gated L-type calcium channel, Sodium channel alpha subunits; brain (Types I, II, III), 5-hydroxytryptamine receptor 2A, Histamine H1 receptor, Voltage-gated inwardly rectifying potassium channel KCNH2, Muscarinic acetylcholine receptor M1, Cytochrome P450 2C9, Sodium channel protein type 2 subunit alpha, Aldehyde dehydrogenase 1A1, Sodium channel protein type 2 subunit alpha.

Bioactivity

ChEMBL activities: 11 potent at pChembl ≥ 5 of 30 total. Top 100 by potency (10 = 0.1 nM, 6 = 1 µM):

TargetpChemblTypeValueUnitActivity ID
BLM8.66Potency2.2nMCHEMBL_ACT_4750049
BLM8.66Potency2.2nMCHEMBL_ACT_4941792
P084825.85Potency1412nMCHEMBL_ACT_4807516
P976975.3Potency5012nMCHEMBL_ACT_4420320
CYP2C95.22Ki6000nMCHEMBL_ACT_371809
HRH15.21AC506100nMCHEMBL_ACT_25212189
HTR2A5.2AC506262nMCHEMBL_ACT_25173505
P514505.2Potency6310nMCHEMBL_ACT_4955883
P0A6C15.1Potency7943nMCHEMBL_ACT_4069617
CYP2C95Ki10000nMCHEMBL_ACT_1119262
P084825Potency10000nMCHEMBL_ACT_4857827

Target pathways

Aggregated over 1 target gene(s): SCN2A.

Top Reactome pathways

11 total, by targets touching each:

PathwayTargetsGenes
Developmental Biology1SCN2A
L1CAM interactions1SCN2A
Muscle contraction1SCN2A
Axon guidance1SCN2A
Interaction between L1 and Ankyrins1SCN2A
Cardiac conduction1SCN2A
Phase 0 - rapid depolarisation1SCN2A
Nervous system development1SCN2A
Sensory Perception1SCN2A
Sensory perception of taste1SCN2A
Sensory perception of sweet, bitter, and umami (glutamate) taste1SCN2A

Dominant GO biological processes

GO termTargets
sodium ion transport1
nervous system development1
memory1
intrinsic apoptotic signaling pathway in response to osmotic stress1
neuronal action potential1
sodium ion transmembrane transport1
myelination1
neuron apoptotic process1
cellular response to hypoxia1
cardiac muscle cell action potential involved in contraction1
action potential1
regulation of heart rate1
monoatomic ion transport1
monoatomic ion transmembrane transport1
regulation of membrane potential1

Indications & clinical

Indications

2 approved indications. FDA phase 4, plus an anticancer drug’s labelled cancer uses (which ChEMBL often logs at phase 3).

IndicationPhaseMONDOEFO
epilepsy4MONDO:0005027EFO:0000474
visual epilepsy4MONDO:0001386HP:0001250

15 diseases in clinical trials (phase 1–3, investigational — not approved indications). Highest ChEMBL trial phase per disease; a non-cancer approved use is occasionally logged at phase 3 here.

Disease (in trials)PhaseMONDOEFO
anxiety3MONDO:0011918EFO:0005230
dementia3MONDO:0001627HP:0000726
depressive disorder3MONDO:0002050MONDO:0002050
injury2MONDO:0021178EFO:0000546
optic neuritis2MONDO:0005885EFO:0007405
thalassemia2MONDO:0000984EFO:1001996
exocrine pancreatic carcinoma2MONDO:0005192EFO:0002618
polyneuropathy2MONDO:0001824EFO:0009562
sickle cell disease2MONDO:0011382MONDO:0011382
cocaine dependence1MONDO:0005186EFO:0002610
leukemia1MONDO:0005059EFO:0000565
lymphoma1MONDO:0005062EFO:0000574
neuroblastoma1MONDO:0005072EFO:0000621
anemia1MONDO:0002280EFO:0004272
immune system disorder1MONDO:0005046EFO:0000540

1 further indication record had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 63.

Phase distribution

PhaseTrials
PHASE121
PHASE412
Not specified12
PHASE28
PHASE34
PHASE2/PHASE33
PHASE1/PHASE22
EARLY_PHASE11

Top trials by phase / activity

NCTPhaseStatusTitle
NCT07072624PHASE4RECRUITINGEarly Post-Traumatic Seizures Prevention Trial (E-PTS Trial)
NCT00146237PHASE4COMPLETEDPhenytoin as an Augmentation for SSRI Failures
NCT00366067PHASE4COMPLETEDStudy of Efficacy of Phenytoin in Therapy of Children With Bronchial Asthma
NCT00510783PHASE4COMPLETEDIV Keppra in the Emergency Department for Prevention of Early Recurrent Seizures
NCT00581893PHASE4COMPLETEDPhenytoin and Driving Safety: A Randomized, Controlled Cross-Over Study
NCT00610532PHASE4TERMINATEDEvaluating the Transporter Protein Inhibitor Probenecid In Patients With Epilepsy
NCT00618436PHASE4COMPLETEDAssess Safety and Efficacy of Levetiracetam(LEV;Keppra)for Seizure Prevention
NCT01478035PHASE4TERMINATEDStudy on the Efficacy of Phenytoin in the Prophylaxis of Seizures of Patients With Pneumococcal Meningitis at Least 50 Yrs Old.
NCT02409433PHASE4TERMINATEDComparative Trial of IV Lacosamide Versus Phenytoin for Seizure Management
NCT04176887PHASE4UNKNOWNLevetiracetam Versus Phenytoin in Management of Pediatric Status Epilepticus
NCT04967326PHASE4COMPLETEDRole of Clinical Pharmacists in Epilepsy Management
NCT05697614PHASE4UNKNOWNThe Benefit and Safety of Older Generation Anti-Epileptic Drugs (AEDs) in Drug-Resistant Epilepsy Children
NCT04573803PHASE3NOT_YET_RECRUITINGPharmacological Management of Seizures Post Traumatic Brain Injury
NCT07590375PHASE2/PHASE3NOT_YET_RECRUITINGTopical Phenytoin for Management of Gingival Recession
NCT00004817PHASE3COMPLETEDPhase III Double Blind Trial of Valproate Sodium for Prophylaxis of Post Traumatic Seizures
NCT00210782PHASE3COMPLETEDA Comparison of the Effectiveness and Safety of Topiramate and Phenytoin in Patients With New Onset Epilepsy Requiring Rapid Initiation of Antiepileptic Drug Treatment
NCT02374567PHASE3TERMINATEDPharmacovigilance in Gerontopsychiatric Patients
NCT03512756PHASE2/PHASE3TERMINATEDA Randomized Phase 2/3 Multi-Center Study of SM-88 in Participants With Metastatic Pancreatic Cancer
NCT04647877PHASE2/PHASE3COMPLETEDPhenytoin Cream for the Treatment of Neuropathic Pain
NCT05637086PHASE2RECRUITINGClinical Study Evaluating Safety of Pentoxifylline and Celecoxib in Patients With Grand-Mal Epilepsy Treated by Phenytoin Monotherapy
NCT00040469PHASE2TERMINATEDBone Marrow Transplant From Related Donor for Patients With High Risk Hemoglobinopathies
NCT00245037PHASE1/PHASE2COMPLETEDBusulfan, Fludarabine, and Total-Body Irradiation in Treating Patients Who Are Undergoing a Donor Stem Cell Transplant for Hematologic Cancer
NCT00801931PHASE1/PHASE2TERMINATEDDouble Cord Blood Transplant for Patients With Malignant and Non-malignant Disorders
NCT01187719PHASE2COMPLETEDThe Effect of Phenytoin on the Pharmacokinetics of Nevirapine and the Development of Nevirapine Resistance
NCT01451593PHASE2COMPLETEDNeuroprotection With Phenytoin in Optic Neuritis
NCT01730313PHASE2WITHDRAWNTreatment of Nodding Syndrome - A Randomized Blinded Placebo-Controlled Crossover Trial of Oral Pyridoxine and Conventional Anti-Epileptic Therapy, in Northern Uganda - 2012
NCT02088957PHASE2TERMINATEDEfficacy Evaluation of Intravenous Brivaracetam and Phenytoin in Subjects With Nonconvulsive Electrographic Seizures
NCT02413658PHASE2UNKNOWNPhenytoin in the Healing of Clean Surgical Wounds
NCT02939937PHASE2COMPLETEDEffect of Phenytoin on the Ganglion Cell Layer in Patients With Optic Neuritis
NCT07590102PHASE1NOT_YET_RECRUITINGA Study to Investigate the Effect of the CYP3A Inducer Phenytoin and the CYP3A Inhibitor Itraconazole on the Pharmacokinetics of BGB-58067 in Healthy Participants
NCT00000285PHASE1COMPLETEDEffects of Phenytoin on Cocaine Use in Humans - 2
NCT00627575PHASE1COMPLETEDAED/Statin Interaction Study
NCT01122953PHASE1COMPLETEDBioequivalence Study Of PHENYTOIN Suspension Made By Pfizer, Versus EPAMIN® Made By McNeil LA LLC In Healthy Volunteers Under Fasting Conditions
NCT01635829PHASE1COMPLETEDA Study to Investigate the Potential Pharmacokinetic Interactions Between Phenytoin or Carbamazepine and Telaprevir
NCT01680042PHASE1UNKNOWNClinical Effect of Phenytoin Mucoadhesive Paste on Wound Healing After Oral Biopsy
NCT01878578PHASE1TERMINATEDThe Effect of BIA 2-093 on the Steady-state Pharmacokinetic Profile of Phenytoin in Patients
NCT02283827PHASE1COMPLETEDOpen-label Drug Interaction Study Between Eslicarbazepine Acetate and Phenytoin.
NCT02707965PHASE1COMPLETEDCharacterization of Epilepsy Patients BEEP 2b
NCT04845646PHASE1COMPLETEDDDI Study of ASC41 in HV and the PK, Safety and Tolerability in Subjects With NAFLD.
NCT04981704PHASE1COMPLETEDA Study to Evaluate the Effect of Multiple Doses of Itraconazole, Phenytoin, and Paroxetine on the Single-Dose Pharmacokinetics of Poziotinib in Healthy Adult Participants
NCT05901714PHASE1COMPLETEDA Study to Assess the Effect of Phenytoin on the Drug Levels of Afimetoran and the Effect of Afimetoran on the Drug Levels of Midazolam
NCT05995249PHASE1COMPLETEDA Study of the Interaction of TAK-279 With Substances That Have an Impact on Metabolism in Healthy Adults
NCT06466473PHASE1COMPLETEDA Study to Learn How Different Forms of The Study Medicine Called Phenytoin Are Taken up Into the Blood in Healthy Adults
NCT06543043PHASE1COMPLETEDA Study to Evaluate the Effects of Phenytoin and Itraconazole on Sonrotoclax (BGB-11417) in Healthy Volunteers
NCT06633185PHASE1COMPLETEDEffect of Phenytoin Cream on Wound Healing After Anal Fissure Surgery.
NCT06719557PHASE1COMPLETEDA Study of the Effect of Itraconazole and Phenytoin on Calderasib (MK-1084) in Healthy Adults (MK-1084-008)
NCT06903715PHASE1COMPLETEDA Clinical Study of Belzutifan (MK-6482) Alone or With Phenytoin in Healthy Participants (CA46602/MK-6482-035)
NCT06906809PHASE1COMPLETEDEffect of Phenytoin or Itraconazole on How BGB-16673 is Absorbed and Removed From the Body in Healthy Participants
NCT06919991PHASE1COMPLETEDDrug-Drug Interaction Study of Casdatifan in Healthy Adult Participants (ARC-29)
NCT07066722PHASE1COMPLETEDA Study to Evaluate VH4524184 Tablet Absorption, Effects of Food, and Interactions With Other Drugs in Healthy Adults
NCT00598923EARLY_PHASE1TERMINATEDPreventing Epilepsy After Traumatic Brain Injury With Topiramate
NCT00162474Not specifiedRECRUITINGDeterminants of Warfarin Metabolism
NCT00004403Not specifiedCOMPLETEDRandomized Study of Albendazole in Patients With Epilepsy Due to Neurocysticercosis
NCT00226538Not specifiedCOMPLETEDPrediction of Drug Interactions With CYP2C9 Substrates
NCT00333931Not specifiedUNKNOWNPilot Trial of Neural Correlates of Response to Treatment of PTSD-Associated Impulsive Aggression
NCT00774306Not specifiedTERMINATEDAntiepileptic Drugs and Vascular Risk Markers
NCT03096522Not specifiedUNKNOWNRandomized Trial on the Effect of Topical Phenytoin on Healing After Fistulotomy
NCT03196466Not specifiedCOMPLETEDPopulation Pharmacokinetics of Antiepileptic in Pediatrics
NCT03269214Not specifiedCOMPLETEDUse of Topical Phenytoin in Bisphosphonate-related Osteonecrosis of the Mandible
NCT03632915Not specifiedCOMPLETEDPharmacokinetics of Antiepileptics in Patients on CRRT
NCT05542589Not specifiedCOMPLETEDEfficacy of Phenytoin Phonophoresis on Pressure Ulcer Healing
NCT06067412Not specifiedCOMPLETEDEfficacy of Phenytoin vs Levetiracetam in Status Epilepticus at Institute of Child Health,Faisalabad
NCT06312254Not specifiedCOMPLETEDPharmacological Modulation of Peripheral Nerve Excitability

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

PharmGKB dosing guidelines (3) — CPIC / DPWG genotype-guided dosing for this drug (drug × pharmacogene):

GuidelineSourceGene(s)DosingRecommendation
Annotation of DPWG Guideline for phenytoin and CYP2C9DPWGCYP2C9yesyes
Annotation of CPIC Guideline for fosphenytoin, phenytoin and CYP2C9, HCPICCYP2C9;HLA-Byesyes
Annotation of DPWG Guideline for phenytoin and HLA-BDPWGHLA-Byes

PharmGKB also curates 36 clinical and 302 variant annotation(s) for this drug (gene-keyed; see PharmGKB).

Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.

134 molecules share ≥1 primary target. Top 100 by shared-target count:

MoleculeSourceStatusShared targets
AMIODARONEChEMBL + PubChemPhase 4 (approved)SCN2A
AMITRIPTYLINEChEMBL + PubChemPhase 4 (approved)SCN2A
BROMPHENIRAMINEChEMBL + PubChemPhase 4 (approved)SCN2A
CHLORPHENIRAMINEChEMBL + PubChemPhase 4 (approved)SCN2A
CHLORPROMAZINEChEMBL + PubChemPhase 4 (approved)SCN2A
COCAINEChEMBL + PubChemPhase 4 (approved)SCN2A
CYPROHEPTADINEChEMBL + PubChemPhase 4 (approved)SCN2A
DESIPRAMINEChEMBL + PubChemPhase 4 (approved)SCN2A
DIBUCAINEChEMBL + PubChemPhase 4 (approved)SCN2A
DICYCLOMINEChEMBL + PubChemPhase 4 (approved)SCN2A
DILTIAZEMChEMBL + PubChemPhase 4 (approved)SCN2A
DIPHENHYDRAMINEChEMBL + PubChemPhase 4 (approved)SCN2A
DROPERIDOLChEMBL + PubChemPhase 4 (approved)SCN2A
FELODIPINEChEMBL + PubChemPhase 4 (approved)SCN2A
FLUPHENAZINEChEMBL + PubChemPhase 4 (approved)SCN2A
HALOPERIDOLChEMBL + PubChemPhase 4 (approved)SCN2A
IMIPRAMINEChEMBL + PubChemPhase 4 (approved)SCN2A
LAMOTRIGINEChEMBL + PubChemPhase 4 (approved)SCN2A
LEVORPHANOLChEMBL + PubChemPhase 4 (approved)SCN2A
LOPERAMIDEChEMBL + PubChemPhase 4 (approved)SCN2A
MEXILETINEChEMBL + PubChemPhase 4 (approved)SCN2A
NIFEDIPINEChEMBL + PubChemPhase 4 (approved)SCN2A
NISOLDIPINEChEMBL + PubChemPhase 4 (approved)SCN2A
PHENOXYBENZAMINEChEMBL + PubChemPhase 4 (approved)SCN2A
PHENTOLAMINEChEMBL + PubChemPhase 4 (approved)SCN2A
PIMOZIDEChEMBL + PubChemPhase 4 (approved)SCN2A
PRAMOXINEChEMBL + PubChemPhase 4 (approved)SCN2A
PRAZOSINChEMBL + PubChemPhase 4 (approved)SCN2A
PRILOCAINEChEMBL + PubChemPhase 4 (approved)SCN2A
PROMETHAZINEChEMBL + PubChemPhase 4 (approved)SCN2A
PROPARACAINEChEMBL + PubChemPhase 4 (approved)SCN2A
QUINIDINEChEMBL + PubChemPhase 4 (approved)SCN2A
QUININEChEMBL + PubChemPhase 4 (approved)SCN2A
RESERPINEChEMBL + PubChemPhase 4 (approved)SCN2A
TETRABENAZINEChEMBL + PubChemPhase 4 (approved)SCN2A
TETRACAINEChEMBL + PubChemPhase 4 (approved)SCN2A
THIORIDAZINEChEMBL + PubChemPhase 4 (approved)SCN2A
TRIFLUOPERAZINEChEMBL + PubChemPhase 4 (approved)SCN2A
VERAPAMILChEMBL + PubChemPhase 4 (approved)SCN2A
ARTICAINEChEMBLPhase 4 (approved)SCN2A
BENOXINATEChEMBLPhase 4 (approved)SCN2A
BEPRIDILChEMBLPhase 4 (approved)SCN2A
BUPIVACAINEChEMBLPhase 4 (approved)SCN2A
CINNARIZINEChEMBLPhase 4 (approved)SCN2A
DIPHENIDOLChEMBLPhase 4 (approved)SCN2A
ETIDOCAINEChEMBLPhase 4 (approved)SCN2A
HEXYLCAINEChEMBLPhase 4 (approved)SCN2A
MIANSERINChEMBLPhase 4 (approved)SCN2A
MIBEFRADILChEMBLPhase 4 (approved)SCN2A
PHENIRAMINEChEMBLPhase 4 (approved)SCN2A
PRENYLAMINEChEMBLPhase 4 (approved)SCN2A
PROMAZINEChEMBLPhase 4 (approved)SCN2A
PROPOXYCAINEChEMBLPhase 4 (approved)SCN2A
QUINACRINEChEMBLPhase 4 (approved)SCN2A
RILUZOLEChEMBLPhase 4 (approved)SCN2A
SERTINDOLEChEMBLPhase 4 (approved)SCN2A
YOHIMBINEChEMBL + PubChemPhase 3 (approved)SCN2A
AJMALINEChEMBLPhase 3SCN2A
ELECLAZINEChEMBLPhase 3SCN2A
NITRENDIPINEChEMBLPhase 3SCN2A
OXETHAZAINEChEMBLPhase 3SCN2A
TEDISAMILChEMBLPhase 3SCN2A
TETRODOTOXINChEMBLPhase 3SCN2A
VIXOTRIGINEChEMBLPhase 3SCN2A
AZACYCLONOLChEMBLPhase 2SCN2A
BUTACAINEChEMBLPhase 2SCN2A
BUTACLAMOLChEMBLPhase 2SCN2A
BUTOXAMINEChEMBLPhase 2SCN2A
CARCAINIUM CHLORIDEChEMBLPhase 2SCN2A
CIFENLINEChEMBLPhase 2SCN2A
COLFORSINChEMBLPhase 2SCN2A
CYCLOMETHYCAINEChEMBLPhase 2SCN2A
DEXPROPRANOLOLChEMBLPhase 2SCN2A
DEXTRORPHANChEMBLPhase 2SCN2A
DILAZEPChEMBLPhase 2SCN2A
DIMETHISOQUINChEMBLPhase 2SCN2A
DIPERODONChEMBLPhase 2SCN2A
DS-1971ChEMBLPhase 2SCN2A
ELPETRIGINEChEMBLPhase 2SCN2A
FLUNARIZINEChEMBLPhase 2SCN2A
FLUPERAMIDEChEMBLPhase 2SCN2A
FUNAPIDEChEMBLPhase 2SCN2A
GALLOPAMILChEMBLPhase 2SCN2A
HEXOBENDINEChEMBLPhase 2SCN2A
LEVOPROPRANOLOLChEMBLPhase 2SCN2A
MEPRYLCAINEChEMBLPhase 2SCN2A
PARETHOXYCAINEChEMBLPhase 2SCN2A
PF-05089771ChEMBLPhase 2SCN2A
PHENACAINEChEMBLPhase 2SCN2A
PIPEROCAINEChEMBLPhase 2SCN2A
PIPEROXANChEMBLPhase 2SCN2A
PROADIFENChEMBLPhase 2SCN2A
SIPATRIGINEChEMBLPhase 2SCN2A
SPIPERONEChEMBLPhase 2SCN2A
TIAPAMILChEMBLPhase 2SCN2A
ZOLAMINEChEMBLPhase 2SCN2A
BaclofenPubChemApprovedSCN2A
BenzocainePubChemApprovedSCN2A
BuspironePubChemApprovedSCN2A
CaffeinePubChemApprovedSCN2A