Cardiovascular, metabolic, and endocrine drugs

Dalteparin sodium

Dalteparin sodium (Fragmin) is a low-molecular-weight heparin anticoagulant approved in the US in 1994, dosed by weight subcutaneously; it treats cancer-associated VTE, provides surgical and medical thromboprophylaxis, and covers unstable angina and dialysis circuits.

Danaparoid sodium

Danaparoid sodium (Orgaran) is a non-heparin heparinoid mixture of glycosaminoglycans from porcine mucosa, an antithrombin-mediated factor Xa inhibitor (anti-Xa:anti-IIa 22:1) used for HIT treatment and DVT prophylaxis; withdrawn from the US in 2002.

Dapagliflozin

Dapagliflozin, sold as Farxiga and Forxiga, is an SGLT2 inhibitor drug for type 2 diabetes, heart failure, and chronic kidney disease, first approved in 2014.

Daprodustat

Daprodustat (Jesduvroq, GSK1278863) is an oral HIF prolyl hydroxylase inhibitor approved in 2023 by the FDA for anemia of chronic kidney disease in adults on dialysis, with a boxed thrombotic-event warning.

Darapladib

Darapladib (SB-480848, CHEMBL204021) is an oral selective Lp-PLA2 inhibitor developed by GSK for atherosclerosis. Its phase 3 trials STABILITY and SOLID-TIMI 52 failed to reduce cardiovascular events despite about 65% enzyme inhibition.

Darexaban

Darexaban (YM150, darexaban maleate) is an oral direct factor Xa inhibitor developed by Astellas Pharma for VTE prophylaxis, atrial fibrillation, and acute coronary syndrome; its active glucuronide metabolite YM-222714 carries its anticoagulant effect, and development was discontinued in September 2011.

Darusentan

Darusentan (LU 135252, ABT-627) is an investigational selective endothelin ETA receptor antagonist for resistant hypertension; effective in phase 2 and DORADO trials but discontinued over fluid retention and a failed DORADO-AC endpoint, never approved.

Dbpr-108

DBPR108 (prusogliptin) is a once-daily DPP-4 inhibitor for type 2 diabetes, developed by Taiwan's NHRI and approved by China's NMPA in January 2025; phase 3 trials showed HbA1c reductions of about 0.6-0.7%, non-inferior to sitagliptin.

Defibrotide

Defibrotide (Defitelio), a porcine-mucosal-DNA-derived oligonucleotide mixture, is the approved antithrombotic/profibrinolytic drug for hepatic veno-occlusive disease with renal or pulmonary dysfunction after HSCT (US, 2016) and severe VOD/SOS (EU).

Delapril

Delapril (地拉普利) is a lipophilic nonsulfhydryl ACE inhibitor prodrug launched by Takeda in 1989 for hypertension, converted to two active diacid metabolites and marketed in fixed combinations with manidipine and indapamide.

Deserpidine

Deserpidine, a Rauwolfia alkaloid antihypertensive related to reserpine, ATC C02AA05/C02LA03, formula C32H38N2O8, first approved 1957; brands Harmonyl, Oreticyl, Enduronyl; depletes catecholamines.

Desidustat

Desidustat (Oxemia) is an oral HIF prolyl hydroxylase inhibitor for anemia in chronic kidney disease, developed by Zydus Lifesciences and first approved in India in 2022.

Desirudin

Desirudin (Revasc, Iprivask) is a recombinant 65-amino-acid hirudin analogue and direct thrombin inhibitor for DVT prophylaxis after hip or knee replacement; EU authorization withdrawn 2014.

Deslanoside

Deslanoside (deacetyllanatoside C, Cedilanid-D) is a Digitalis lanata cardiac glycoside for heart failure and supraventricular arrhythmias; Na-K-ATPase inhibitor, half-life 38-77 h, discontinued in the US but available in Brazil, China, and Japan.

Desmopressin

Desmopressin (DDAVP, 1-deamino-8-D-arginine vasopressin), synthetic V2-agonist analog of vasopressin synthesized 1967; treats central diabetes insipidus, enuresis, nocturia, and bleeding disorders; main risk hyponatremia.

Desmoteplase

Desmoteplase (DSPAα1), a fibrin-selective plasminogen activator from vampire bat (Desmodus rotundus) saliva, was developed as a 3-9 hour window stroke thrombolytic; trials showed recanalization gains but no functional benefit.

Desoxycorticosterone acetate

Desoxycorticosterone acetate (DOCA, deoxycorticosterone acetate) is a synthetic mineralocorticoid ester synthesized in 1937, introduced as an oily injection for Addison's disease in 1939, later superseded by fludrocortisone.

Dexamethasone

Dexamethasone: potent synthetic glucocorticoid (Decadron), ATC H02AB02, 0.75 mg equals 5 mg prednisone; RECOVERY trial 6 mg daily cut COVID-19 mortality in oxygen-requiring patients; WHO-recommended for severe COVID-19.

Dexfenfluramine

Dexfenfluramine (Redux) is the purified d-enantiomer of fenfluramine, a serotonergic appetite suppressant approved in 1996 for obesity and withdrawn in 1997 over heart valve disease.

Dextrothyroxine

Dextrothyroxine (D-thyroxine, Choloxin) is the D-enantiomer of thyroxine, an antihyperlipidemic approved in 1967 and withdrawn after the Coronary Drug Project showed excess deaths in its dextrothyroxine arm.

Dienestrol

Dienestrol (dienoestrol, Estraguard, Ortho Dienestrol), synthetic non-steroidal stilbestrol estrogen, C18H18O2, CAS 84-17-3, prepared by Dodds in 1938; used as 0.01% vaginal cream for atrophic vaginitis; FDA-approved 1947, later discontinued.

Dienogest

Dienogest (Visanne) is a fourth-generation progestin, 2 mg daily oral therapy for endometriosis pain, first approved in Japan in 2008; also used with estradiol in contraceptives like Natazia, with irregular bleeding as its main side effect.

Digoxin

Digoxin, a cardiac glycoside from Digitalis lanata, treats mild to moderate heart failure and controls ventricular rate in chronic atrial fibrillation; neutral mortality in trials, narrow therapeutic window.

Dihydralazine

Dihydralazine (Nepresol), a hydralazine-family direct arteriolar vasodilator, half-life 4-5 h, used mainly for severe hypertension in pregnancy in Germany; declining due to frequent adverse effects.

Dihydrotachysterol

Dihydrotachysterol (DHT, A.T. 10) is a half-synthetic vitamin D analog from ergosterol, introduced in 1933 for hypoparathyroidism; it needs no renal hydroxylation and is no longer sold in the US.

Diltiazem

Diltiazem (Cardizem, Tiazac) is a benzothiazepine, nondihydropyridine calcium channel blocker synthesized in 1971 by Tanabe and FDA-approved in 1982, used for hypertension, angina, and atrial fibrillation rate control, contraindicated in HFrEF.

Dipivefrin

Dipivefrin (dipivalyl epinephrine, brand Propine) is an epinephrine prodrug eye drop for glaucoma; 0.1% twice daily, 17-fold better corneal penetration, discontinued in the US.

Distigmine

Distigmine (Ubretid), distigmine bromide, is a long-acting reversible carbamate cholinesterase inhibitor approved in Japan in 1967 for myasthenia gravis and underactive bladder, with 72-hour half-life and cholinergic crisis as its key risk.

Diuretic

Diuretic: drug that increases renal sodium and water excretion. Classes include loop diuretics (furosemide, NKCC2), thiazides (chlorthalidone, NCC), and potassium-sparing agents; used for hypertension, heart failure, and edema since chlorothiazide's 1958 introduction.