Nitroso‐Containing Pharmaceuticals: Targets, Pharmacological Activities, and Their Metabolic Mechanisms

Nitroso-containing drugs represent a unique class of therapeutic agents in which the nitroso (-NO) group is integral to their pharmacological activity. In this review, we systematically categorize these compounds into four major classes-nitrosoureas, NO donors, nitrosopyrimidines, and acyl/acyloxy nitroso compounds-based on their core scaffolds and modes of action. A primary focus is placed on elucidating and comparing their metabolic mechanisms, which are critical for understanding their activation, efficacy, and toxicity profiles. By integrating structural features with metabolic pathways, this analysis provides valuable insights for the rational design and optimization of next-generation nitroso-based pharmaceuticals, highlighting their untapped potential in drug discovery and clinical translation.