Limaprost (as Limaprost alfadex; CAS number 88852-12-4) is an oral prostaglandin E1 analog. Prostaglandins act on a variety of cells such as vascular smooth muscle cells causing constriction or dilation, on platelets causing aggregation or disaggregation and on spinal neurons causing pain. Prostaglandins have a wide variety of actions, including, but not limited to muscular constriction and mediation of inflammation. Limaprost alfadex has been shown to improve peripheral circulatory failure with a vasodilator action and an antithrombotic effect. It also improves poor blood flow in the nerve tissue in cervical spondylosis and normalizes nerve function. Limaprost alfadex was discovered from collaborative research between Ono Pharmaceutical (Ono) and Dainippon Sumitomo Pharma (DSP). It was approved for the treatment of ischemic symptoms such as skin ulcer, pain and coldness accompanying thromboangiitis obliterans in 1988; and for the treatment of subjective symptoms such as pain and numbness in the lower leg and walking disability associated with acquired lumbar spinal canal stenosis as an additional indication in 2001. The drug has been sold under the trade name of Opalmon® Tablets by Ono and Prorenal® Tablets by DSP. In 2011, Ono and DSP initiated Phase II clinical trials in Japan for the treatment of carpal tunnel syndrome. In 2013, these trials were discontinued because the study failed to demonstrate efficacy. Ono and DSP also discontinued the development of limaprost alfadex for the additional indication of cervical spondylosis in 2008 due to the failure to demonstrate the anticipated efficacy in a Phase II study in patients with the disease. However, it was verified by Seoul National University Hospital in November of 2014 that the study on the efficacy of oral limaprost alfadex after surgery for cervical myelopathy was still ongoing.
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Limaprost
Drug Overview
What is Limaprost?
To derive PDE/ADE, OEL, and OEB values, Masuu Global follows a scientifically justified, risk-based toxicological assessment approach in accordance with internationally recognized guidelines and industry best practices that are widely accepted by regulatory authorities, including European Medicines Agency (EMA), Pharmaceutical Inspection Co-operation Scheme (PIC/S), and Agência Nacional de Vigilância Sanitária (ANVISA).
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Regulatory Framework
Assessment Methodology
Masuu Global follows a scientifically justified, risk-based toxicological approach aligned with internationally recognized guidelines accepted by EMA, PIC/S, and ANVISA.
EMA – Guideline on Setting Health-Based Exposure Limits (HBELs)
Provides the framework for establishing scientifically justified PDE/ADE values for use in shared manufacturing facilities.
PIC/S – Shared Facilities and Contamination Control Guidance
Supports the application of HBEL-based approaches for cross-contamination prevention and cleaning validation.
ICH Q9 – Quality Risk Management
Provides a structured methodology for risk identification, assessment, control, communication, and review.
ICH M7 – Assessment and Control of DNA-Reactive (Mutagenic) Impurities (where applicable)
Applied for compounds with potential mutagenic or genotoxic concerns.
Risk-Based Toxicological Assessment
Comprehensive evaluation of available toxicological and pharmacological data, including NOAEL, LOAEL, BMDL, pharmacological potency, carcinogenicity, reproductive and developmental toxicity, sensitization potential, and target organ toxicity.
Weight-of-Evidence (WoE) Approach
Integration and critical review of all relevant data sources, including non-clinical studies, clinical studies, human exposure data, pharmacological information, post-marketing safety data, and structure–activity relationship (SAR/QSAR) assessments.
How We Work
Report Preparation Process
Every assessment moves through a rigorous five-stage workflow — from data gathering to regulatory-ready delivery.
Comprehensive Data Review
Assessment of pharmacology, toxicology, clinical data, literature, and available regulatory information.
Scientific Evaluation
Identification of critical endpoints and selection of appropriate exposure limits.
PDE / HBEL Derivation
Transparent and scientifically justified calculations aligned with global toxicological principles.
Ex-Agency Expert Review (Our Differentiator)
Reports are reviewed with an ex-agency perspective, bringing regulatory expectations, inspection readiness, and practical implementation into every assessment.
Final Report Delivery
Regulatory-ready reports with scientific rationale, calculations, and clear recommendations by certified toxicologists (ERT, UKRT and DABT).
Ex-Agency Advantage
Why Masuu Global?
Our ex-agency toxicologists bring a practical regulatory perspective that transforms how assessments are built, reviewed, and defended.
Regulatory expectation–driven assessments aligned with how authorities actually evaluate submissions.
Inspection-ready reports — scientifically defensible and audit-prepared from day one.
Faster review cycles with direct decision support from certified toxicologists (ERT, UKRT, DABT).
Practical implementation recommendations that translate science into actionable contamination control.
Reduced internal effort — offload complex assessments without sacrificing quality or defensibility.
Global reach across PDE/ADE, HBEL, OEL, OEB, cleaning validation, and impurity assessments.
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