Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C10H13FN5O7P |
Molecular Weight | 365.2117 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 4 / 4 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
NC1=NC(F)=NC2=C1N=CN2[C@@H]3O[C@H](COP(O)(O)=O)[C@@H](O)[C@@H]3O
InChI
InChIKey=GIUYCYHIANZCFB-FJFJXFQQSA-N
InChI=1S/C10H13FN5O7P/c11-10-14-7(12)4-8(15-10)16(2-13-4)9-6(18)5(17)3(23-9)1-22-24(19,20)21/h2-3,5-6,9,17-18H,1H2,(H2,12,14,15)(H2,19,20,21)/t3-,5-,6+,9-/m1/s1
Fludarabine or fludarabine phosphate is a chemotherapy drug used in the treatment of hematological malignancies (cancers of blood cells such as leukemias and lymphomas). It is a purine analog, which interferes with DNA synthesis. Fludarabine phosphate is a fluorinated nucleotide analog of the antiviral agent vidarabine, 9-β-D-arabinofuranosyladenine (ara-A), that is relatively resistant to deamination by adenosine deaminase. Fludarabine (marketed as fludarabine phosphate under the trade name Fludara) is a chemotherapy drug used in the treatment of hematological malignancies. Fludarabine phosphate is rapidly dephosphorylated to 2-fluoro-ara-A and then phosphorylated intracellularly by deoxycytidine kinase to the active triphosphate, 2-fluoro-ara-ATP. This metabolite appears to act by inhibiting DNA polymerase alpha, ribonucleotide reductase and DNA primase, thus inhibiting DNA synthesis. The mechanism of action of this antimetabolite is not completely characterized and may be multi-faceted.
CNS Activity
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL1828 |
|||
Target ID: CHEMBL1830 Sources: https://www.ncbi.nlm.nih.gov/pubmed/?term=23115527 |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | FLUDARABINE PHOSPHATE Approved UseFludarabine Phosphate Injection is indicated for the treatment of adult patients with B-cell chronic lymphocytic leukemia (CLL)
who have not responded to or whose disease has progressed during treatment with at least one standard alkylating-agent containing regimen. The safety and effectiveness of Fludarabine Phosphate Injection in previously untreated or non-refractory patients with CLL have not been established. Important Limitations Fludarabine Phosphate Injection should not be used in patients with severe renal impairment (creatinine clearance less than 30 mL/min/1.73 m2). Launch Date2007 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
4.28 μM EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/17211431 |
30 mg/m² single, intravenous dose: 30 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
FLUDARABINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
21.55 μM × h EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/17211431 |
30 mg/m² single, intravenous dose: 30 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
FLUDARABINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
8.9 h EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/17211431 |
30 mg/m² single, intravenous dose: 30 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
FLUDARABINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
20 h |
25 mg/m² 1 times / day multiple, intravenous dose: 25 mg/m² route of administration: Intravenous experiment type: MULTIPLE co-administered: |
FLUDARABINE plasma | Homo sapiens population: UNHEALTHY age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
100 mg/m2 1 times / day multiple, intravenous Highest studied dose Dose: 100 mg/m2, 1 times / day Route: intravenous Route: multiple Dose: 100 mg/m2, 1 times / day Sources: |
unhealthy, 32 years (range: 19-59 years) n = 2 Health Status: unhealthy Condition: Acute Leukemia Age Group: 32 years (range: 19-59 years) Sex: M+F Population Size: 2 Sources: |
Other AEs: Leukopenia... |
40 mg/m2 1 times / day steady, intravenous MTD Dose: 40 mg/m2, 1 times / day Route: intravenous Route: steady Dose: 40 mg/m2, 1 times / day Sources: |
unhealthy, 32 years (range: 19-59 years) n = 11 Health Status: unhealthy Condition: Acute Leukemia Age Group: 32 years (range: 19-59 years) Sex: M+F Population Size: 11 Sources: |
|
20 mg/m2 1 times / day multiple, intravenous MTD Dose: 20 mg/m2, 1 times / day Route: intravenous Route: multiple Dose: 20 mg/m2, 1 times / day Sources: |
unhealthy, 55 years (range: 26-78 years) Health Status: unhealthy Age Group: 55 years (range: 26-78 years) Sex: M+F Sources: |
|
45 mg/m2 1 times / day multiple, intravenous Dose: 45 mg/m2, 1 times / day Route: intravenous Route: multiple Dose: 45 mg/m2, 1 times / day Sources: |
unhealthy, 55 years (range: 26-78 years) n = 1 Health Status: unhealthy Age Group: 55 years (range: 26-78 years) Sex: M+F Population Size: 1 Sources: |
DLT: Myelosuppression... Dose limiting toxicities: Myelosuppression (1 patient) Sources: |
40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: Page: p. 61 |
unhealthy, 64 years (range: 30-75 years) n = 81 Health Status: unhealthy Age Group: 64 years (range: 30-75 years) Sex: M+F Population Size: 81 Sources: Page: p. 61 |
Disc. AE: Thrombocytopenia, Anemia hemolytic autoimmune... AEs leading to discontinuation/dose reduction: Thrombocytopenia (1 patient) Sources: Page: p. 61Anemia hemolytic autoimmune (3 patients) Pneumonia (1 patient) Anemia (1 patient) Foot drop (1 patient) Sepsis (1 patient) Bronchitis (1 patient) Rash (1 patient) Face edema (1 patient) |
25 mg/m2 1 times / day steady, intravenous Recommended Dose: 25 mg/m2, 1 times / day Route: intravenous Route: steady Dose: 25 mg/m2, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: B-cell chronic lymphocytic leukemia Age Group: adult Sources: |
Other AEs: CNS toxicity, Hemolytic anemia... Other AEs: CNS toxicity Sources: Hemolytic anemia Pulmonary toxicity |
40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: B-cell chronic lymphocytic leukemia Age Group: adult Sources: |
Other AEs: CNS toxicity, Hemolytic anemia... Other AEs: CNS toxicity Sources: Hemolytic anemia Pulmonary toxicity |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Leukopenia | 2 patients | 100 mg/m2 1 times / day multiple, intravenous Highest studied dose Dose: 100 mg/m2, 1 times / day Route: intravenous Route: multiple Dose: 100 mg/m2, 1 times / day Sources: |
unhealthy, 32 years (range: 19-59 years) n = 2 Health Status: unhealthy Condition: Acute Leukemia Age Group: 32 years (range: 19-59 years) Sex: M+F Population Size: 2 Sources: |
Myelosuppression | 1 patient DLT, Disc. AE |
45 mg/m2 1 times / day multiple, intravenous Dose: 45 mg/m2, 1 times / day Route: intravenous Route: multiple Dose: 45 mg/m2, 1 times / day Sources: |
unhealthy, 55 years (range: 26-78 years) n = 1 Health Status: unhealthy Age Group: 55 years (range: 26-78 years) Sex: M+F Population Size: 1 Sources: |
Anemia | 1 patient Disc. AE |
40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: Page: p. 61 |
unhealthy, 64 years (range: 30-75 years) n = 81 Health Status: unhealthy Age Group: 64 years (range: 30-75 years) Sex: M+F Population Size: 81 Sources: Page: p. 61 |
Bronchitis | 1 patient Disc. AE |
40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: Page: p. 61 |
unhealthy, 64 years (range: 30-75 years) n = 81 Health Status: unhealthy Age Group: 64 years (range: 30-75 years) Sex: M+F Population Size: 81 Sources: Page: p. 61 |
Face edema | 1 patient Disc. AE |
40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: Page: p. 61 |
unhealthy, 64 years (range: 30-75 years) n = 81 Health Status: unhealthy Age Group: 64 years (range: 30-75 years) Sex: M+F Population Size: 81 Sources: Page: p. 61 |
Foot drop | 1 patient Disc. AE |
40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: Page: p. 61 |
unhealthy, 64 years (range: 30-75 years) n = 81 Health Status: unhealthy Age Group: 64 years (range: 30-75 years) Sex: M+F Population Size: 81 Sources: Page: p. 61 |
Pneumonia | 1 patient Disc. AE |
40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: Page: p. 61 |
unhealthy, 64 years (range: 30-75 years) n = 81 Health Status: unhealthy Age Group: 64 years (range: 30-75 years) Sex: M+F Population Size: 81 Sources: Page: p. 61 |
Rash | 1 patient Disc. AE |
40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: Page: p. 61 |
unhealthy, 64 years (range: 30-75 years) n = 81 Health Status: unhealthy Age Group: 64 years (range: 30-75 years) Sex: M+F Population Size: 81 Sources: Page: p. 61 |
Sepsis | 1 patient Disc. AE |
40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: Page: p. 61 |
unhealthy, 64 years (range: 30-75 years) n = 81 Health Status: unhealthy Age Group: 64 years (range: 30-75 years) Sex: M+F Population Size: 81 Sources: Page: p. 61 |
Thrombocytopenia | 1 patient Disc. AE |
40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: Page: p. 61 |
unhealthy, 64 years (range: 30-75 years) n = 81 Health Status: unhealthy Age Group: 64 years (range: 30-75 years) Sex: M+F Population Size: 81 Sources: Page: p. 61 |
Anemia hemolytic autoimmune | 3 patients Disc. AE |
40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: Page: p. 61 |
unhealthy, 64 years (range: 30-75 years) n = 81 Health Status: unhealthy Age Group: 64 years (range: 30-75 years) Sex: M+F Population Size: 81 Sources: Page: p. 61 |
CNS toxicity | 25 mg/m2 1 times / day steady, intravenous Recommended Dose: 25 mg/m2, 1 times / day Route: intravenous Route: steady Dose: 25 mg/m2, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: B-cell chronic lymphocytic leukemia Age Group: adult Sources: |
|
Hemolytic anemia | 25 mg/m2 1 times / day steady, intravenous Recommended Dose: 25 mg/m2, 1 times / day Route: intravenous Route: steady Dose: 25 mg/m2, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: B-cell chronic lymphocytic leukemia Age Group: adult Sources: |
|
Pulmonary toxicity | 25 mg/m2 1 times / day steady, intravenous Recommended Dose: 25 mg/m2, 1 times / day Route: intravenous Route: steady Dose: 25 mg/m2, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: B-cell chronic lymphocytic leukemia Age Group: adult Sources: |
|
CNS toxicity | 40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: B-cell chronic lymphocytic leukemia Age Group: adult Sources: |
|
Hemolytic anemia | 40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: B-cell chronic lymphocytic leukemia Age Group: adult Sources: |
|
Pulmonary toxicity | 40 mg/m2 1 times / day steady, oral Recommended Dose: 40 mg/m2, 1 times / day Route: oral Route: steady Dose: 40 mg/m2, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: B-cell chronic lymphocytic leukemia Age Group: adult 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 |
---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/022273s000_ClinPharmR.pdf#page=41 Page: 41.0 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/022273s000_ClinPharmR.pdf#page=41 Page: 41.0 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/022273s000_ClinPharmR.pdf#page=27 Page: 27.0 |
weak |
PubMed
Title | Date | PubMed |
---|---|---|
In vitro biological activity of 9-beta-D-arabinofuranosyl-2-fluoroadenine and the biochemical actions of its triphosphate on DNA polymerases and ribonucleotide reductase from HeLa cells. | 1982 Mar |
|
Neurotoxicity associated with fludarabine and cytosine arabinoside chemotherapy for acute leukemia and myelodysplasia. | 1993 Mar |
|
Fludarabine and arabinosylcytosine therapy of refractory and relapsed acute myelogenous leukemia. | 1993 Mar |
|
Apoptosis induction with three nucleoside analogs on freshly isolated B-chronic lymphocytic leukemia cells. | 1994 Dec |
|
Fludarabine + Ara-C + G-CSF: cytotoxic effect and induction of apoptosis on fresh acute myeloid leukemia cells. | 1994 Dec |
|
Increased p21/WAF-1 and p53 protein levels following sequential three drug combination regimen of fludarabine, cytarabine and docetaxel induces apoptosis in human leukemia cells. | 1998 Jul-Aug |
|
Caspase 8 activation independent of Fas (CD95/APO-1) signaling may mediate killing of B-chronic lymphocytic leukemia cells by cytotoxic drugs or gamma radiation. | 2001 Nov 1 |
|
Drug-loaded red blood cell-mediated clearance of HIV-1 macrophage reservoir by selective inhibition of STAT1 expression. | 2003 Nov |
|
Interactions of nucleoside analogs, caffeine, and nicotine with human concentrative nucleoside transporters 1 and 2 stably produced in a transport-defective human cell line. | 2004 Apr |
|
Adenine deoxynucleotides fludarabine and cladribine induce apoptosis in a CD95/Fas receptor, FADD and caspase-8-independent manner by activation of the mitochondrial cell death pathway. | 2004 Dec 16 |
|
9-beta-D-arabinofuranosyl-2-fluoroadenine inhibits expression of vascular endothelial growth factor through hypoxia-inducible factor-1 in human ovarian cancer cells. | 2004 Jul |
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A phase I and pharmacodynamic study of fludarabine, carboplatin, and topotecan in patients with relapsed, refractory, or high-risk acute leukemia. | 2004 Oct 15 |
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Functional characterization of novel human and mouse equilibrative nucleoside transporters (hENT3 and mENT3) located in intracellular membranes. | 2005 Apr 22 |
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Recurrent chemotherapy-induced tumor lysis syndrome (TLS) with renal failure in a patient with chronic lymphocytic leukemia - successful treatment and prevention of TLS with low-dose rasburicase. | 2005 Dec |
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Resistance to 9-beta-D-arabinofuranosyl-2-fluoroadenine due to reduced incorporation into DNA from competition by excess deoxyadenosine triphosphate: implications for different sensitivities to nucleoside analogues. | 2005 Jun |
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A highly sensitive high-performance liquid chromatography-mass spectrometry method for quantification of fludarabine triphosphate in leukemic cells. | 2005 Jun 25 |
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Alteration of DNA methylation status in K562 and MCF-7 cancer cell lines by nucleoside analogues. | 2006 |
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Characterization of the rat Na+/nucleoside cotransporter 2 and transport of nucleoside-derived drugs using electrophysiological methods. | 2006 Dec |
|
Phase I and pharmacokinetic study of oral fludarabine phosphate in relapsed indolent B-cell non-Hodgkin's lymphoma. | 2006 Feb |
|
Chronic lymphocytic leukaemia, synchronous small cell carcinoma and squamous neoplasia of the urinary bladder in a paraplegic man following long-term phenoxybenzamine therapy. | 2006 Mar |
|
MDM2 antagonists activate p53 and synergize with genotoxic drugs in B-cell chronic lymphocytic leukemia cells. | 2006 May 15 |
|
Functional integrity of the p53-mediated apoptotic pathway induced by the nongenotoxic agent nutlin-3 in B-cell chronic lymphocytic leukemia (B-CLL). | 2006 May 15 |
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Role of fludarabine in hematological malignancies. | 2006 Sep |
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Fludarabine, cyclophosphamide, and mitoxantrone as initial therapy of chronic lymphocytic leukemia: high response rate and disease eradication. | 2008 Jan 1 |
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Differential effects of chemotherapeutic drugs versus the MDM-2 antagonist nutlin-3 on cell cycle progression and induction of apoptosis in SKW6.4 lymphoblastoid B-cells. | 2008 May 15 |
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Oral fludarabine and cyclophosphamide as front-line chemotherapy in patients with chronic lymphocytic leukemia. The impact of biological parameters in the response duration. | 2008 Nov |
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Fatal acute liver failure due to reactivation of hepatitis B following treatment with fludarabine/cyclophosphamide/rituximab for low grade non-Hodgkin's lymphoma. | 2008 Oct 27 |
|
Fludarabine in the treatment of chronic lymphocytic leukemia: a review. | 2009 Feb |
|
Valproate synergizes with purine nucleoside analogues to induce apoptosis of B-chronic lymphocytic leukaemia cells. | 2009 Jan |
|
Systems pharmacological analysis of drugs inducing stevens-johnson syndrome and toxic epidermal necrolysis. | 2015 May 18 |
Sample Use Guides
Chronic Lymphocytic Leukemia (CLL): The recommended adult dose is 25 mg/m2 administered intravenously over a period of approximately 30 minutes daily for five consecutive days. Each 5-day course of treatment should commence every 28 days.
Route of Administration:
Intravenous
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/21223714
The growth of RPMI8226 and KM3 cells was suppressed by fludarabine treatment in a dose and time-dependent manner. After treatment with fludarabine for 24 h, the IC(50) for RPMI8226 cells was 2.13 µg/ml, and 0.36 µg/ml for KM3 cells. Apoptotic cells of RPMI8226 and KM3 increased in a dose- dependent manner after exposure to fludarabine for 24 h. Western blot analysis showed the activation of caspase-3 and PARP in the MM cells treated with fludarabine.
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Classification Tree | Code System | Code | ||
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NCI_THESAURUS |
C1556
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FDA ORPHAN DRUG |
35889
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FDA ORPHAN DRUG |
250607
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FDA ORPHAN DRUG |
27688
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NCI_THESAURUS |
C2150
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DB01073
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SUB13897MIG
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1X9VK9O1SC
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m5427
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25102
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75607-67-9
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C1102
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312887
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1X9VK9O1SC
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30751
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328002
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T-29
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DTXSID2023060
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100000090025
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CHEMBL1096882
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1189
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63599
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1272204
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ACTIVE MOIETY
SUBSTANCE RECORD