Question

Why was bretylium tosylate discontinued?

Answer 1

The American Heart Association removed bretylium tosylate from their guidelines because of "ongoing supply problems".

Explanation:

The manufacturers could not provide a reliable supply of the drug.

The structure of bretylium tosylate [(o-bromobenzyl)ethyldimethylammonium
p-toluenesulfonate] is

You can probably imagine the difficulty of carrying out an electrophilic aromatic substitution that puts two bulky groups next to each other on a benzene ring.

If you can devise an efficient synthesis of bretylium tosylate for the pharmaceutical companies, you will become a rich person.