Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C22H20F2N4O2 |
Molecular Weight | 410.4166 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 2 / 2 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
CC1=NC=C(OC[C@]2(C[C@H]2C(=O)NC3=NC=C(F)C=C3)C4=CC=CC(F)=C4)C(C)=N1
InChI
InChIKey=MUGXRYIUWFITCP-PGRDOPGGSA-N
InChI=1S/C22H20F2N4O2/c1-13-19(11-25-14(2)27-13)30-12-22(15-4-3-5-16(23)8-15)9-18(22)21(29)28-20-7-6-17(24)10-26-20/h3-8,10-11,18H,9,12H2,1-2H3,(H,26,28,29)/t18-,22+/m0/s1
Lemborexant is a dual orexin receptor antagonist, which inhibits orexin by binding competitively to two subtypes of orexin receptors. During normal periods of sleep, orexin system activity is suppressed, suggesting it is possible to purposefully facilitate the initiation and maintenance of sleep by interfering with orexin neurotransmission with lemborexant. Extensive in vitro and non-clinical testing of lemborexant supported the supposition that lemborexant has a low risk of QT prolongation at therapeutic and supratherapeutic exposures in humans. A Phase III study of lemborexant in insomnia is underway, and in addition, Eisai has announced the initiation of Phase II clinical studies of lemborexant in patients with irregular sleep-wake rhythm disorder.
CNS Activity
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL240 Sources: https://www.ncbi.nlm.nih.gov/pubmed/27338807 |
6.1 µM [IC50] | ||
Target ID: CHEMBL5113 Sources: https://www.ncbi.nlm.nih.gov/pubmed/28559480 |
6.1 nM [IC50] | ||
Target ID: CHEMBL4792 Sources: https://www.ncbi.nlm.nih.gov/pubmed/28559480 |
2.6 nM [IC50] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | Unknown Approved UseUnknown |
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Primary | Unknown Approved UseUnknown |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
437 ng/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/30923834 |
10 μg/kg bw single, oral dose: 10 μg/kg bw route of administration: Oral experiment type: SINGLE co-administered: |
LEMBOREXANT plasma | Mus musculus population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
203 ng/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/27338807 |
25 mg 1 times / day steady-state, oral dose: 25 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
LEMBOREXANT plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
998 ng × h/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/30923834 |
10 μg/kg bw single, oral dose: 10 μg/kg bw route of administration: Oral experiment type: SINGLE co-administered: |
LEMBOREXANT plasma | Mus musculus population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
17 h |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
LEMBOREXANT plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
10 mg 1 times / day steady, oral Recommended Dose: 10 mg, 1 times / day Route: oral Route: steady Dose: 10 mg, 1 times / day Sources: |
unhealthy, 55 years (range: 18 - 88 years) n = 323 Health Status: unhealthy Condition: insomnia Age Group: 55 years (range: 18 - 88 years) Sex: M+F Population Size: 323 Sources: |
Disc. AE: Somnolence, Nightmares... AEs leading to discontinuation/dose reduction: Somnolence (2.9%) Sources: Nightmares (1.3%) Palpitations (0.6%) |
5 mg 1 times / day steady, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: steady Dose: 5 mg, 1 times / day Sources: |
unhealthy, 55 years (range: 18 - 88 years) n = 323 Health Status: unhealthy Condition: insomnia Age Group: 55 years (range: 18 - 88 years) Sex: M+F Population Size: 323 Sources: |
Disc. AE: Somnolence, Nightmares... AEs leading to discontinuation/dose reduction: Somnolence (1%) Sources: Nightmares (0.3%) |
200 mg single, oral Highest studied dose |
healthy n = 6 |
Other AEs: Sleep paralysis... |
75 mg 1 times / day multiple, oral Highest studied dose Dose: 75 mg, 1 times / day Route: oral Route: multiple Dose: 75 mg, 1 times / day Sources: |
healthy n = 6 Health Status: healthy Population Size: 6 Sources: |
Other AEs: Headache, Sleep paralysis... Other AEs: Headache (1 patient) Sources: Sleep paralysis (1 patient) Insomnia (1 patient) |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Palpitations | 0.6% Disc. AE |
10 mg 1 times / day steady, oral Recommended Dose: 10 mg, 1 times / day Route: oral Route: steady Dose: 10 mg, 1 times / day Sources: |
unhealthy, 55 years (range: 18 - 88 years) n = 323 Health Status: unhealthy Condition: insomnia Age Group: 55 years (range: 18 - 88 years) Sex: M+F Population Size: 323 Sources: |
Nightmares | 1.3% Disc. AE |
10 mg 1 times / day steady, oral Recommended Dose: 10 mg, 1 times / day Route: oral Route: steady Dose: 10 mg, 1 times / day Sources: |
unhealthy, 55 years (range: 18 - 88 years) n = 323 Health Status: unhealthy Condition: insomnia Age Group: 55 years (range: 18 - 88 years) Sex: M+F Population Size: 323 Sources: |
Somnolence | 2.9% Disc. AE |
10 mg 1 times / day steady, oral Recommended Dose: 10 mg, 1 times / day Route: oral Route: steady Dose: 10 mg, 1 times / day Sources: |
unhealthy, 55 years (range: 18 - 88 years) n = 323 Health Status: unhealthy Condition: insomnia Age Group: 55 years (range: 18 - 88 years) Sex: M+F Population Size: 323 Sources: |
Nightmares | 0.3% Disc. AE |
5 mg 1 times / day steady, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: steady Dose: 5 mg, 1 times / day Sources: |
unhealthy, 55 years (range: 18 - 88 years) n = 323 Health Status: unhealthy Condition: insomnia Age Group: 55 years (range: 18 - 88 years) Sex: M+F Population Size: 323 Sources: |
Somnolence | 1% Disc. AE |
5 mg 1 times / day steady, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: steady Dose: 5 mg, 1 times / day Sources: |
unhealthy, 55 years (range: 18 - 88 years) n = 323 Health Status: unhealthy Condition: insomnia Age Group: 55 years (range: 18 - 88 years) Sex: M+F Population Size: 323 Sources: |
Sleep paralysis | moderate, 1 patient | 200 mg single, oral Highest studied dose |
healthy n = 6 |
Headache | 1 patient | 75 mg 1 times / day multiple, oral Highest studied dose Dose: 75 mg, 1 times / day Route: oral Route: multiple Dose: 75 mg, 1 times / day Sources: |
healthy n = 6 Health Status: healthy Population Size: 6 Sources: |
Insomnia | 1 patient | 75 mg 1 times / day multiple, oral Highest studied dose Dose: 75 mg, 1 times / day Route: oral Route: multiple Dose: 75 mg, 1 times / day Sources: |
healthy n = 6 Health Status: healthy Population Size: 6 Sources: |
Sleep paralysis | 1 patient | 75 mg 1 times / day multiple, oral Highest studied dose Dose: 75 mg, 1 times / day Route: oral Route: multiple Dose: 75 mg, 1 times / day Sources: |
healthy n = 6 Health Status: healthy Population Size: 6 Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
major | yes (co-administration study) Comment: The effect of fluconazole (a moderate CYP3A inhibitor) on the PK of lemborexant was evaluated in Study 012 The lemborexant Cmax, AUC0-t and AUC0-inf values increased by approximately 1.6-, 3.8 and 4.2-fold, respectively, as compared with lemborexant alone Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/212028Orig1s000MultidisciplineR.pdf#page=47 Page: 47.0 |
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minor | yes (co-administration study) Comment: The effect of fluconazole (a moderate CYP3A inhibitor) on the PK of lemborexant was evaluated in Study 012 The lemborexant Cmax, AUC0-t and AUC0-inf values increased by approximately 1.6-, 3.8 and 4.2-fold, respectively, as compared with lemborexant alone Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/212028Orig1s000MultidisciplineR.pdf#page=47 Page: 47.0 |
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no | ||||
no | ||||
no | ||||
no | ||||
poor | ||||
yes |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sample Use Guides
In Vivo Use Guide
Sources: https://clinicaltrials.gov/ct2/show/NCT02952820
5 mg or 10 mg before the time the participant intends to try to sleep
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/27338807
The effect of lemborexant on the slow component of delayed rectifier potassium current (IKs) was examined using KCNQ1/KCNE1-CHO cells and a small, not-concentration-dependent inhibition was noted with a peak inhibitory effect of 24% at 10 (uM, and a smaller effect (13%) at 30 uM.
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DEA NO. |
2245
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ACTIVE MOIETY