Perhexiline maleate regulates coronary vasodilatation and blocks exercise-induced tachycardia. It is used to treat angina pectoris and variant angina. Perhexiline maleate functions as a cardiac metabolic agent. It is associated with peripheral neuropathy, high intracranial pressure with papilledema and proximal myopathy.

Perhexiline maleate salt has been used as a stock for worm lifespan assay. It has also been used to block fatty acid oxidation.

Perhexiline maleate salt has been used to block fatty acid oxidation. It has also been used as 5′ adenosine monophosphate-activated protein kinase (AMPK) activator and in worm lifespan assay.

Anti-anginal metabolic modulator; carnitine palmitoyltransferase inhibitor

Perhexiline maleate is an anti-anginal metabolic modulator. It inhibits the mitochondrial enzyme carnitine palmitoyltransferase CPT-1 and to a lesser extent CPT-2. This causes a shift in myocardial substrate utilisation from long chain fatty acids to carbohydrates, resulting in increased glucose and lactate utilization and increased ATP production for the same O2 consumption as before and consequently increases myocardial efficiency. Perhexiline maleate was also recently found to inhibit the activity of mTORC1.