| Stereochemistry | ABSOLUTE |
| Molecular Formula | C66H83N17O13 |
| Molecular Weight | 1322.4739 |
| Optical Activity | UNSPECIFIED |
| Defined Stereocenters | 9 / 9 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
CC(C)C[C@H](NC(=O)[C@@H](CC1=CC2=C(C=CC=C2)C=C1)NC(=O)[C@H](CC3=CC=C(O)C=C3)NC(=O)[C@H](CO)NC(=O)[C@H](CC4=CNC5=CC=CC=C45)NC(=O)[C@H](CC6=CNC=N6)NC(=O)[C@@H]7CCC(=O)N7)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N8CCC[C@H]8C(=O)NCC(N)=O
InChI
InChIKey=RWHUEXWOYVBUCI-ITQXDASVSA-N
InChI=1S/C66H83N17O13/c1-36(2)25-48(58(89)76-47(13-7-23-71-66(68)69)65(96)83-24-8-14-54(83)64(95)73-33-55(67)86)77-60(91)50(28-38-15-18-39-9-3-4-10-40(39)26-38)78-59(90)49(27-37-16-19-43(85)20-17-37)79-63(94)53(34-84)82-61(92)51(29-41-31-72-45-12-6-5-11-44(41)45)80-62(93)52(30-42-32-70-35-74-42)81-57(88)46-21-22-56(87)75-46/h3-6,9-12,15-20,26,31-32,35-36,46-54,72,84-85H,7-8,13-14,21-25,27-30,33-34H2,1-2H3,(H2,67,86)(H,70,74)(H,73,95)(H,75,87)(H,76,89)(H,77,91)(H,78,90)(H,79,94)(H,80,93)(H,81,88)(H,82,92)(H4,68,69,71)/t46-,47-,48-,49-,50+,51-,52-,53-,54-/m0/s1
Nafarelin acetate (brand name Synarel) is a synthetic agonist of gonadotrophin-releasing hormone (GnRH) [luteinising hormone-releasing hormone (LH-RH), which is indicated for management of endometriosis, including pain relief and reduction of endometriotic lesions and for the treatment of central precocious puberty (CPP). Nafarelin has also been used effectively in in vitro fertilisation programmes, and in hirsute women and those with uterine leiomyoma, particularly to induce preoperative fibroid shrinkage. Side effects are related to the low estrogen state and include hot flashes, vaginal dryness, headaches, mood changes, and decreased interest in sex.
Approval Year
Cmax
AUC
Doses
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as victim
Sourcing
Sample Use Guides
For the treatment of central precocious puberty (CPP), the recommended daily dose is 1600 µg. The dose can be increased to 1800 µg daily if adequate suppression cannot be achieved at 1600 µg/day. The 1600 µg dose is achieved by two sprays (400 µg) into each nostril in the morning (4 sprays) and two sprays into each nostril in the evening (4 sprays), a total of 8 sprays per
day. The 1800 µg dose is achieved by 3 sprays (600 µg) into alternating nostrils three times a day, a total of 9 sprays per day. The patient’s head should be tilted back slightly, and 30 seconds should elapse between sprays.
Route of Administration:
Nasal
The binding of LHRH and [6-(3-(2-naphthyl)-D-Ala]LHRH (nafarelin acetate), a highly potent LHRH agonist, to plasma proteins was investigated in vitro by equilibrium dialysis at 4 degrees C with fresh plasma from normal human subjects, female rhesus monkeys, and female rats. Over a wide range of concentrations (10(-8) to 10(-5) M), 78-84% of nafarelin acetate and only 22-25% of LHRH were bound to undiluted plasma. With 10% plasma, the extent of binding was 31-37%, and 0.9-4.2% for nafarelin acetate and LHRH, respectively.
ACTIVE MOIETY
SALT/SOLVATE (PARENT)
