Nortilidine represents the primary active metabolite derived from tilidine, arising through liver demethylation. The racemic form of nortilidine exhibits opioid analgesic effects that are approximately equivalent in potency to morphine. Notably, the (1R,2S) isomer of nortilidine displays NMDA antagonist activity. Furthermore, this compound also functions as a dopamine reuptake inhibitor. Variants of nortilidine include the reversed-ester form and an analogue where the cyclohexene ring is substituted with cyclopentane, both of which exhibit nearly identical properties to the original nortilidine compound.

IUPAC name
CAS Number38677-94-0
PubChem CID162321
CompTox Dashboard (EPA)DTXSID10191256
Chemical and physical data
Molar mass259.349 g·mol−1


1. What is nortilidine?

  • Nortilidine is the primary active metabolite of the medication tilidine. It is formed when tilidine undergoes demethylation in the liver.

2. What are the effects of nortilidine?

  • The racemic form of nortilidine possesses opioid analgesic effects that are roughly equivalent in potency to morphine. This means it can provide pain relief similar to that of morphine.

3. Are there any specific properties associated with nortilidine isomers?

  • Yes, the (1R,2S) isomer of nortilidine has NMDA antagonist activity. This characteristic sets it apart from the racemic form and may have implications for its clinical use.

4. Does nortilidine have any additional pharmacological actions?

  • Nortilidine also acts as a dopamine reuptake inhibitor. This means it can affect the levels of dopamine in the brain, potentially influencing mood and other neurological processes.

5. Are there variations or analogues of nortilidine?

  • Yes, there is a reversed-ester form of nortilidine and an analogue in which the cyclohexene ring is replaced by cyclopentane. These variations have properties that are very similar to nortilidine.

6. Is nortilidine commonly used in medical practice?

  • Nortilidine is primarily known for its role as a metabolite of tilidine, a medication used for pain management. However, its clinical use may vary by region, and it is important to follow medical guidance when using any opioid-related substances.

7. Is nortilidine available as a standalone medication?

  • Nortilidine is typically encountered in the context of tilidine. It is not commonly available as a standalone medication.

8. Are there any specific precautions or warnings associated with nortilidine use?

  • As an opioid-related substance, nortilidine should be used with caution and under the guidance of a healthcare professional. Misuse or overuse can lead to adverse effects and addiction. Always follow medical advice and prescribed dosages.

9. Is nortilidine regulated by authorities or subject to legal restrictions?

  • The regulatory status of nortilidine may vary by country. It is essential to be aware of local laws and regulations regarding its use, as misuse can have legal consequences.

10. Can nortilidine cause side effects?

  • Like other opioids, nortilidine may have side effects, including drowsiness, constipation, and potential addiction. Please consult with a healthcare provider for information about the possible side effects and risks associated with its use.


  1. US 3792080, “Process for Substituted Cyclohexenes its Products”
  2. Hajda JP, Jähnchen E, Oie S, Trenk D (November 2002) conducted research on the “Sequential first-pass metabolism of nortilidine: the active metabolite of the synthetic opioid drug tilidine” in the Journal of Clinical Pharmacology, Volume 42, Issue 11, with pages 1257–1261.
  3. Schifano F, Orsolini L, Duccio Papanti G, Corkery JM (February 2015) discussed “Novel psychoactive substances of interest for psychiatry” in World Psychiatry, Volume 14, Issue 1, with pages 15–26.
  4. US 4291059, “Cycloaromatic compounds, analgesic Properties thereof and Method of use thereof as analgesic”
  5. Personal Communication with Derek P. Reynolds.
  6. “EU Early Warning System Situation Report. Situation report 2” from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), published on August 10, 2020.
  7. Catalani V, Arillotta D, Corkery JM, Guirguis A, Vento A, Schifano F (2020) explored “Identifying New/Emerging Psychoactive Substances at the Time of COVID-19; A Web-Based Approach” in Frontiers in Psychiatry, Volume 11, with article number 632405.

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