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Flosequinan is a small molecule vasodilator of the quinoline class that was developed by Boots UK for the treatment of chronic heart failure. It was marketed under the brand name Manoplax and approved in both the USA and UK in 1992, but was withdrawn after about a year due to increased mortality observed in patients with chronic heart failure. The drug acts as a direct arterial and venous vasodilator, with studies suggesting its mechanism involves interference with the inositol-triphosphate/protein kinase C pathway—an important mediator of vasoconstriction—and possible inhibition of phosphodiesterase 3 (PDE3) activity. Flosequinan produces sustained hemodynamic benefits by dilating both peripheral arteries and veins, but its use was discontinued due to safety concerns[1][3][4][5][6].
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