Details
Stereochemistry | ACHIRAL |
Molecular Formula | C22H28N6O3S.CH4O3S |
Molecular Weight | 552.667 |
Optical Activity | NONE |
Defined Stereocenters | 0 / 0 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
CS(O)(=O)=O.CC(C)NC1=C(N=CC=C1)N2CCN(CC2)C(=O)C3=CC4=C(N3)C=CC(NS(C)(=O)=O)=C4
InChI
InChIKey=MEPNHSOMXMALDZ-UHFFFAOYSA-N
InChI=1S/C22H28N6O3S.CH4O3S/c1-15(2)24-19-5-4-8-23-21(19)27-9-11-28(12-10-27)22(29)20-14-16-13-17(26-32(3,30)31)6-7-18(16)25-20;1-5(2,3)4/h4-8,13-15,24-26H,9-12H2,1-3H3;1H3,(H,2,3,4)
Delavirdine is a nonnucleoside reverse transcriptase inhibitor (NNRTI). Delavirdine binds directly to reverse transcriptase (RT) and blocks RNA-dependent and DNA-dependent DNA polymerase activities. Delavirdine does not compete with template:primer or deoxynucleoside triphosphates. HIV-2 RT and human cellular DNA polymerases alfa, gamma, or delta are not inhibited by delavirdine. In addition, HIV-1 group O, a group of highly divergent strains that are uncommon in North America, may not be inhibited by delavirdine. Delavirdine is marketed under the trade name Rescriptor, indicated for the treatment of HIV-1 infection in combination with at least 2 other active antiretroviral agents when therapy is warranted. .
Originator
Sources: http://adisinsight.springer.com/drugs/800002084
Curator's Comment: # Pfizer
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
21.0 nM [IC50] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | RESCRIPTOR Approved UseRESCRIPTOR Tablets are indicated for the treatment of HIV-1 infection in combination with at least 2 other active antiretroviral agents when therapy is warranted. The following should be considered before initiating therapy with RESCRIPTOR in treatment-naive patients. There are insufficient data directly comparing antiretroviral regimens containing RESCRIPTOR with currently preferred 3-drug regimens for initial treatment of HIV. In studies comparing regimens consisting of 2 nucleoside reverse transcriptase inhibitors (NRTIs) (currently considered suboptimal) to RESCRIPTOR plus 2 NRTIs, the proportion of patients receiving the regimen containing RESCRIPTOR who achieved and sustained an HIV-1 RNA level <400 copies/mL over 1 year of therapy was relatively low (see DESCRIPTION OF CLINICAL STUDIES). Resistant virus emerges rapidly when RESCRIPTOR is administered as monotherapy. Therefore, RESCRIPTOR should always be administered in combination with other antiretroviral agents. Launch Date1997 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
2.18 μM EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
200 mg 3 times / day steady-state, oral dose: 200 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
N-DESISOPROPYL DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
2.88 μM EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
300 mg 3 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
N-DESISOPROPYL DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
3.23 μM EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
400 mg 3 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
N-DESISOPROPYL DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
35 μM |
400 mg 3 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
12.6 μM EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
200 mg 3 times / day steady-state, oral dose: 200 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
18.8 μM EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
300 mg 3 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
26.6 μM EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
400 mg 3 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
180 μM × h |
400 mg 3 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
4.71 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
200 mg 3 times / day steady-state, oral dose: 200 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
N-DESISOPROPYL DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
6.18 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
300 mg 3 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
N-DESISOPROPYL DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
7.5 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
400 mg 3 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
N-DESISOPROPYL DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
5.8 h |
400 mg 3 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
2.59 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
200 mg 3 times / day steady-state, oral dose: 200 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
3.33 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
300 mg 3 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
4.12 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
400 mg 3 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
2% |
400 mg 3 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
2.3% EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
200 mg 3 times / day steady-state, oral dose: 200 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
2.3% EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
300 mg 3 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
2.3% EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9164415/ |
400 mg 3 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DELAVIRDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
400 mg 3 times / day steady, oral Highest studied dose Dose: 400 mg, 3 times / day Route: oral Route: steady Dose: 400 mg, 3 times / day Sources: |
unhealthy, >18 years n = 30 Health Status: unhealthy Condition: HIV infection Age Group: >18 years Sex: M+F Population Size: 30 Sources: |
Disc. AE: Rash, Oral lesion... Other AEs: Fever, Thrombocytopenia... AEs leading to discontinuation/dose reduction: Rash (grade 3-4, 36%) Other AEs:Oral lesion (1 patient) Function liver abnormal (2 patients) Headache (grade 4, 1 patient) Fever (grade 3, 1 patient) Sources: Thrombocytopenia (1 patient) Nausea (1 patient) Fatigue (1 patient) |
400 mg 3 times / day multiple, oral Highest studied dose Dose: 400 mg, 3 times / day Route: oral Route: multiple Dose: 400 mg, 3 times / day Sources: |
unhealthy n = 412 Health Status: unhealthy Population Size: 412 Sources: |
Disc. AE: Rash... AEs leading to discontinuation/dose reduction: Rash (3.2%) Sources: |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Fatigue | 1 patient | 400 mg 3 times / day steady, oral Highest studied dose Dose: 400 mg, 3 times / day Route: oral Route: steady Dose: 400 mg, 3 times / day Sources: |
unhealthy, >18 years n = 30 Health Status: unhealthy Condition: HIV infection Age Group: >18 years Sex: M+F Population Size: 30 Sources: |
Nausea | 1 patient | 400 mg 3 times / day steady, oral Highest studied dose Dose: 400 mg, 3 times / day Route: oral Route: steady Dose: 400 mg, 3 times / day Sources: |
unhealthy, >18 years n = 30 Health Status: unhealthy Condition: HIV infection Age Group: >18 years Sex: M+F Population Size: 30 Sources: |
Thrombocytopenia | 1 patient | 400 mg 3 times / day steady, oral Highest studied dose Dose: 400 mg, 3 times / day Route: oral Route: steady Dose: 400 mg, 3 times / day Sources: |
unhealthy, >18 years n = 30 Health Status: unhealthy Condition: HIV infection Age Group: >18 years Sex: M+F Population Size: 30 Sources: |
Oral lesion | 1 patient Disc. AE |
400 mg 3 times / day steady, oral Highest studied dose Dose: 400 mg, 3 times / day Route: oral Route: steady Dose: 400 mg, 3 times / day Sources: |
unhealthy, >18 years n = 30 Health Status: unhealthy Condition: HIV infection Age Group: >18 years Sex: M+F Population Size: 30 Sources: |
Function liver abnormal | 2 patients Disc. AE |
400 mg 3 times / day steady, oral Highest studied dose Dose: 400 mg, 3 times / day Route: oral Route: steady Dose: 400 mg, 3 times / day Sources: |
unhealthy, >18 years n = 30 Health Status: unhealthy Condition: HIV infection Age Group: >18 years Sex: M+F Population Size: 30 Sources: |
Fever | grade 3, 1 patient | 400 mg 3 times / day steady, oral Highest studied dose Dose: 400 mg, 3 times / day Route: oral Route: steady Dose: 400 mg, 3 times / day Sources: |
unhealthy, >18 years n = 30 Health Status: unhealthy Condition: HIV infection Age Group: >18 years Sex: M+F Population Size: 30 Sources: |
Rash | grade 3-4, 36% Disc. AE |
400 mg 3 times / day steady, oral Highest studied dose Dose: 400 mg, 3 times / day Route: oral Route: steady Dose: 400 mg, 3 times / day Sources: |
unhealthy, >18 years n = 30 Health Status: unhealthy Condition: HIV infection Age Group: >18 years Sex: M+F Population Size: 30 Sources: |
Headache | grade 4, 1 patient Disc. AE |
400 mg 3 times / day steady, oral Highest studied dose Dose: 400 mg, 3 times / day Route: oral Route: steady Dose: 400 mg, 3 times / day Sources: |
unhealthy, >18 years n = 30 Health Status: unhealthy Condition: HIV infection Age Group: >18 years Sex: M+F Population Size: 30 Sources: |
Rash | 3.2% Disc. AE |
400 mg 3 times / day multiple, oral Highest studied dose Dose: 400 mg, 3 times / day Route: oral Route: multiple Dose: 400 mg, 3 times / day Sources: |
unhealthy n = 412 Health Status: unhealthy Population Size: 412 Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
negligible | ||||
yes [Inhibition 16.7 uM] | ||||
yes [Inhibition 16.7 uM] | ||||
yes [Inhibition 16.7 uM] | ||||
yes [Ki 12.8 uM] | ||||
yes [Ki 2.6 uM] | ||||
yes [Ki 24 uM] | ||||
yes [Ki 9.5 uM] | yes (co-administration study) Comment: coadministration of amprenavir with delavirdine resulted in an approximately 4-fold increase in amprenavir AUC to infinity (AUC∞) and a 6-fold increase in amprenavir Cmin Page: 3.0 |
|||
Sources: https://pubmed.ncbi.nlm.nih.gov/12180537/ |
yes | |||
Sources: https://aac.asm.org/content/48/4/1073 |
yes |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 3.0 |
likely | |||
Sources: https://aac.asm.org/content/48/4/1073 |
no | |||
Page: 3.0 |
yes | yes (co-administration study) Comment: Coadministration of RESCRIPTOR and drugs that induce CYP3A, such as rifampin, may decrease delavirdine plasma concentrations and reduce its therapeutic effect. With rifampin: 97% decrease in AUC Page: 3.0 |
PubMed
Title | Date | PubMed |
---|---|---|
Argentine plant extracts active against polymerase and ribonuclease H activities of HIV-1 reverse transcriptase. | 1999 May |
|
Synthesis and structure-activity relationships of the (alkylamino)piperidine-containing BHAP class of non-nucleoside reverse transcriptase inhibitors: effect of 3-alkylpyridine ring substitution. | 1999 Oct 7 |
|
N-[2-(1-cyclohexenyl)ethyl]-N'-[2-(5-bromopyridyl)]-thiourea and N'-[2-(1-cyclohexenyl)ethyl]-N'-[2-(5-chloropyridyl)]-thiourea as potent inhibitors of multidrug-resistant human immunodeficiency virus-1. | 1999 Sep 20 |
|
Long-term exposure of HIV type 1-infected cell cultures to combinations of the novel quinoxaline GW420867X with lamivudine, abacavir, and a variety of nonnucleoside reverse transcriptase inhibitors. | 2000 Apr 10 |
|
Prevalence and characteristics of multinucleoside-resistant human immunodeficiency virus type 1 among European patients receiving combinations of nucleoside analogues. | 2000 Aug |
|
Presence of 2',5'-Bis-O-(tert-butyldimethylsilyl)-3'-spiro-5"-(4"-amino-1",2"-oxath iole-2",2"-dioxide) (TSAO)-resistant virus strains in TSAO-inexperienced HIV patients. | 2000 Jun 10 |
|
Novel 1,5-diphenylpyrazole nonnucleoside HIV-1 reverse transcriptase inhibitors with enhanced activity versus the delavirdine-resistant P236L mutant: lead identification and SAR of 3- and 4-substituted derivatives. | 2000 Mar 9 |
|
Mutational analysis of trp-229 of human immunodeficiency virus type 1 reverse transcriptase (RT) identifies this amino acid residue as a prime target for the rational design of new non-nucleoside RT inhibitors. | 2000 May |
|
Stereochemistry of halopyridyl and thiazolyl thiourea compounds is a major determinant of their potency as nonnucleoside inhibitors of HIV-1 reverse transcriptase. | 2000 Sep 18 |
|
A single amino acid change at Leu-188 in the reverse transcriptase of HIV-2 and SIV renders them sensitive to non-nucleoside reverse transcriptase inhibitors. | 2001 |
|
The emerging roles of non-nucleoside reverse transcriptase inhibitors in antiretroviral therapy. | 2001 |
|
High prevalence of genotypic and phenotypic HIV-1 drug-resistant strains among patients receiving antiretroviral therapy in Abidjan, Côte d'Ivoire. | 2001 Apr 15 |
|
Antiviral drugs: current state of the art. | 2001 Aug |
|
Site-directed mutagenesis of human immunodeficiency virus type 1 reverse transcriptase at amino acid position 138. | 2001 Feb 1 |
|
Anti-HIV activity of aromatic and heterocyclic thiazolyl thiourea compounds. | 2001 Feb 26 |
|
Inhibition of human cytochrome P450 isoforms by nonnucleoside reverse transcriptase inhibitors. | 2001 Jan |
|
Interaction of delavirdine with human liver microsomal cytochrome P450: inhibition of CYP2C9, CYP2C19, and CYP2D6. | 2001 Jan |
|
Impact of clinical reverse transcriptase sequences on the replication capacity of HIV-1 drug-resistant mutants. | 2001 Jul 5 |
|
Phenotypic hypersusceptibility to non-nucleoside reverse transcriptase inhibitors in treatment-experienced HIV-infected patients: impact on virological response to efavirenz-based therapy. | 2001 Jun 15 |
|
International perspectives on antiretroviral resistance. Nonnucleoside reverse transcriptase inhibitor resistance. | 2001 Mar 1 |
|
A randomized trial of nelfinavir, ritonavir, or delavirdine in combination with saquinavir-SGC and stavudine in treatment-experienced HIV-1-infected patients. | 2001 Mar-Apr |
|
New developments in anti-HIV chemotherapy. | 2001 Nov |
|
Anti-human immunodeficiency virus drugs are ineffective against Pneumocystis carinii in vitro and in vivo. | 2001 Nov 15 |
|
Mismatched double-stranded RNA (polyI-polyC(12)U) is synergistic with multiple anti-HIV drugs and is active against drug-sensitive and drug-resistant HIV-1 in vitro. | 2001 Sep |
|
Evolution of anti-HIV drug candidates. Part 3: Diarylpyrimidine (DAPY) analogues. | 2001 Sep 3 |
|
Evolution of anti-HIV drug candidates. Part 1: From alpha-anilinophenylacetamide (alpha-APA) to imidoyl thiourea (ITU). | 2001 Sep 3 |
|
Non-nucleoside HIV-1 reverse transcriptase (RT) inhibitors: past, present, and future perspectives. | 2002 |
|
Rhabdomyolysis with acute renal failure probably related to the interaction of atorvastatin and delavirdine. | 2002 Apr 15 |
|
Determination of delavirdine in very small volumes of plasma by high-performance liquid chromatography with fluorescence detection. | 2002 Apr 5 |
|
Genotypic and phenotypic resistance patterns in early-stage HIV-1-infected patients failing initial therapy with stavudine, didanosine and nevirapine. | 2002 Dec |
|
Differential modulation of P-glycoprotein expression and activity by non-nucleoside HIV-1 reverse transcriptase inhibitors in cell culture. | 2002 Jul |
|
Genetic divergence of human immunodeficiency virus type 1 Ethiopian clade C reverse transcriptase (RT) and rapid development of resistance against nonnucleoside inhibitors of RT. | 2002 Jul |
|
New developments in anti-HIV chemotherapy. | 2002 Jul 18 |
|
Delavirdine increases drug exposure of ritonavir-boosted protease inhibitors. | 2002 Mar 29 |
|
New anti-HIV agents and targets. | 2002 Nov |
|
Delavirdine malabsorption in HIV-infected subjects with spontaneous gastric hypoacidity. | 2003 Feb |
|
Pharmacokinetic interaction between amprenavir and delavirdine after multiple-dose administration in healthy volunteers. | 2003 Jan |
|
A V106M mutation in HIV-1 clade C viruses exposed to efavirenz confers cross-resistance to non-nucleoside reverse transcriptase inhibitors. | 2003 Jan 3 |
|
Effects of imatinib mesylate (STI571, Glivec) on the pharmacokinetics of simvastatin, a cytochrome p450 3A4 substrate, in patients with chronic myeloid leukaemia. | 2003 Nov 17 |
|
Modest decreases in NNRTI susceptibility do not influence virological outcome in patients receiving initial NNRTI-containing triple therapy. | 2003 Oct |
|
Identification and prediction of promiscuous aggregating inhibitors among known drugs. | 2003 Oct 9 |
|
Pfizer announces free drug program. | 2003 Sep |
|
Susceptibility of HIV-2, SIV and SHIV to various anti-HIV-1 compounds: implications for treatment and postexposure prophylaxis. | 2004 Feb |
|
Roles of conformational and positional adaptability in structure-based design of TMC125-R165335 (etravirine) and related non-nucleoside reverse transcriptase inhibitors that are highly potent and effective against wild-type and drug-resistant HIV-1 variants. | 2004 May 6 |
Patents
Sample Use Guides
In Vivo Use Guide
Sources: https://www.drugs.com/ppa/delavirdine.html
HIV-1 infection (part of combination): Oral: 400 mg 3 times/day
Route of Administration:
Oral
In vitro anti-HIV-1 activity of delavirdine was assessed by infecting cell lines of lymphoblastic and monocytic origin and peripheral blood lymphocytes
with laboratory and clinical isolates of HIV-1. IC50 and IC90 values (50% and 90% inhibitory concentrations) for laboratory isolates (n = 5) ranged from 0.005 to 0.030 uM and 0.04 to 0.10 uM, respectively. Mean IC50 of clinical isolates (n = 74) was 0.038 uM (range: 0.001 to 40 0.69 uM); 73 of 74 clinical isolates had an IC50 =0.18 uM. The IC90 of 24 of these clinical isolates ranged from 0.05 to 0.10 uM.
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C97453
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ACTIVE MOIETY
SUBSTANCE RECORD