Fasudil hydrochloride, a novel calcium antagonistic vasodilator, was marketed
for the treatment of cerebral vasospasm following subarachnoid hemorrhage
(SAH). Fasudil is also a potent inhibitor of myosin light chain kinase and protein kinase
C. In contrast to other calcium channel blockers, which regulate the influx of calcium
ions through the cell membrane but not involved in the intracellular regulatory
mechanism of the calcium, fasudil was suggested to have an intracellular mode of
action in relaxing vascular smooth muscle. In patients with neurological deficits due to
vasospasm, fasudil decreased the occurrence of angiographic severe and
symptomatic vasospasm and cerebral infarction without decreasing systemic blood
pressure. Fasudil is reportedly in clinical trials for acute ischemic stroke, sequelae of
cerebral vascular diseases and angina pectoris.