Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C34H53NO11 |
Molecular Weight | 651.7847 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 5 / 5 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
[H][C@@]12OC3=C(O)C=CC4=C3[C@@]15CCN(CC=C)[C@H](C4)[C@]5(O)CC[C@@H]2OCCOCCOCCOCCOCCOCCOCCOC
InChI
InChIKey=XNKCCCKFOQNXKV-ZRSCBOBOSA-N
InChI=1S/C34H53NO11/c1-3-9-35-10-8-33-30-26-4-5-27(36)31(30)46-32(33)28(6-7-34(33,37)29(35)25-26)45-24-23-44-22-21-43-20-19-42-18-17-41-16-15-40-14-13-39-12-11-38-2/h3-5,28-29,32,36-37H,1,6-25H2,2H3/t28-,29+,32-,33-,34+/m0/s1
DescriptionCurator's Comment: description was created based on several sources, including
http://www.ncbi.nlm.nih.gov/pubmed/24896818; http://www.nektar.com/product_pipeline/cns_pain_oral_naloxegol_nktr118.html
Curator's Comment: description was created based on several sources, including
http://www.ncbi.nlm.nih.gov/pubmed/24896818; http://www.nektar.com/product_pipeline/cns_pain_oral_naloxegol_nktr118.html
MOVANTIK (naloxegol) is a peripherally-acting mu-opioid receptor antagonist indicated for the treatment of opioid-induced constipation (OIC) in adult patients with chronic noncancer pain. It is being investigated for the treatment of constipation as a side effect of prescription opioid pain medicines.
Originator
Curator's Comment: Naloxegol was developed using Nektar's oral small molecule polymer conjugate technology.In September 2009, AstraZeneca and Nektar Therapeutics entered into a worldwide agreement for naloxegol. Under Nektar's agreement with AstraZeneca, AstraZeneca is responsible for development and commercialization. MOVANTIK is a trademark and MOVENTIG is a registered trademark of the AstraZeneca group of companies.
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: P35372|||G8XRH8|||Q5TDA1|||Q9UN57 Gene ID: 4988.0 Gene Symbol: OPRM1 Target Organism: Homo sapiens (Human) Sources: https://www.ncbi.nlm.nih.gov/pubmed/26312011 |
7.4 nM [Ki] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Secondary | MOVANTIK Approved UseIndicated for the treatment of opioid-induced constipation (OIC) in adult patients with chronic non-cancer pain. Launch Date2014 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
81.1 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
25 mg 1 times / day multiple, oral dose: 25 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
8 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
5 mg 1 times / day multiple, oral dose: 5 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
100 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
50 mg 1 times / day multiple, oral dose: 50 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
334.8 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
25 mg 1 times / day multiple, oral dose: 25 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
39 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
5 mg 1 times / day multiple, oral dose: 5 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
403.6 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
50 mg 1 times / day multiple, oral dose: 50 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
14.1 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
25 mg 1 times / day multiple, oral dose: 25 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
17.4 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
5 mg 1 times / day multiple, oral dose: 5 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
20.3 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
50 mg 1 times / day multiple, oral dose: 50 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
6 h |
unknown, unknown |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
95.8% |
unknown, unknown |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years n = 6 Health Status: healthy Age Group: 18 - 45 years Sex: M Population Size: 6 Sources: |
Other AEs: Gastrointestinal disorder (NOS), Nausea... Other AEs: Gastrointestinal disorder (NOS) (16.7%) Sources: Nausea (16.7%) CNS disorder (NOS) (33.3%) Somnolence (16.7%) Dizziness (16.7%) |
250 mg 2 times / day steady, oral Highest studied dose Dose: 250 mg, 2 times / day Route: oral Route: steady Dose: 250 mg, 2 times / day Sources: |
healthy, 59 years (range: 18 - 65 years) n = 6 Health Status: healthy Age Group: 59 years (range: 18 - 65 years) Sex: M+F Population Size: 6 Sources: |
Other AEs: Myalgia, Restless leg syndrome... Other AEs: Myalgia (33.3%) Sources: Restless leg syndrome (16.7%) Dizziness (50%) |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Disc. AE: Diarrhea, Abdominal pain... AEs leading to discontinuation/dose reduction: Diarrhea (3.1%) Sources: Page: p. 83Abdominal pain (2.9%) Nausea (1.1%) Vomiting (0.9%) Depression (0.2%) Hypotension (0.2%) Influenza like illness (0.2%) Chills (0.2%) Abdominal pain upper (1.1%) Hyperhidrosis (0.9%) Back pain (0.4%) Myalgia (0.4%) Liver function test abnormal (0.4%) Headache (0.4%) |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 441 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 441 Sources: Page: p. 83 |
Disc. AE: Diarrhea, Abdominal pain... AEs leading to discontinuation/dose reduction: Diarrhea (0.9%) Sources: Page: p. 83Abdominal pain (0.9%) Nausea (1.1%) Vomiting (0.5%) Depression (0.2%) Hypotension (0.2%) Dizziness (0.5%) Abdominal discomfort (0.2%) |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Dizziness | 16.7% | 1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years n = 6 Health Status: healthy Age Group: 18 - 45 years Sex: M Population Size: 6 Sources: |
Gastrointestinal disorder (NOS) | 16.7% | 1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years n = 6 Health Status: healthy Age Group: 18 - 45 years Sex: M Population Size: 6 Sources: |
Nausea | 16.7% | 1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years n = 6 Health Status: healthy Age Group: 18 - 45 years Sex: M Population Size: 6 Sources: |
Somnolence | 16.7% | 1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years n = 6 Health Status: healthy Age Group: 18 - 45 years Sex: M Population Size: 6 Sources: |
CNS disorder (NOS) | 33.3% | 1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years n = 6 Health Status: healthy Age Group: 18 - 45 years Sex: M Population Size: 6 Sources: |
Restless leg syndrome | 16.7% | 250 mg 2 times / day steady, oral Highest studied dose Dose: 250 mg, 2 times / day Route: oral Route: steady Dose: 250 mg, 2 times / day Sources: |
healthy, 59 years (range: 18 - 65 years) n = 6 Health Status: healthy Age Group: 59 years (range: 18 - 65 years) Sex: M+F Population Size: 6 Sources: |
Myalgia | 33.3% | 250 mg 2 times / day steady, oral Highest studied dose Dose: 250 mg, 2 times / day Route: oral Route: steady Dose: 250 mg, 2 times / day Sources: |
healthy, 59 years (range: 18 - 65 years) n = 6 Health Status: healthy Age Group: 59 years (range: 18 - 65 years) Sex: M+F Population Size: 6 Sources: |
Dizziness | 50% | 250 mg 2 times / day steady, oral Highest studied dose Dose: 250 mg, 2 times / day Route: oral Route: steady Dose: 250 mg, 2 times / day Sources: |
healthy, 59 years (range: 18 - 65 years) n = 6 Health Status: healthy Age Group: 59 years (range: 18 - 65 years) Sex: M+F Population Size: 6 Sources: |
Chills | 0.2% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Depression | 0.2% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Hypotension | 0.2% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Influenza like illness | 0.2% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Back pain | 0.4% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Headache | 0.4% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Liver function test abnormal | 0.4% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Myalgia | 0.4% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Hyperhidrosis | 0.9% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Vomiting | 0.9% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Abdominal pain upper | 1.1% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Nausea | 1.1% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Abdominal pain | 2.9% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Diarrhea | 3.1% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 446 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 446 Sources: Page: p. 83 |
Abdominal discomfort | 0.2% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 441 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 441 Sources: Page: p. 83 |
Depression | 0.2% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 441 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 441 Sources: Page: p. 83 |
Hypotension | 0.2% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 441 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 441 Sources: Page: p. 83 |
Dizziness | 0.5% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 441 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 441 Sources: Page: p. 83 |
Vomiting | 0.5% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 441 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 441 Sources: Page: p. 83 |
Abdominal pain | 0.9% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 441 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 441 Sources: Page: p. 83 |
Diarrhea | 0.9% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 441 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 441 Sources: Page: p. 83 |
Nausea | 1.1% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: Page: p. 83 |
unhealthy, adult n = 441 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 441 Sources: Page: p. 83 |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [Inhibition 100 uM] | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/204760Orig1s000ClinPharm.pdf#page=63 Page: 63.0 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/204760Orig1s000ClinPharm.pdf#page=63 Page: 63.0 |
no | |||
Page: 10.0 |
yes | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/204760Orig1s000ClinPharm.pdf#page=24 Page: 24.0 |
yes | yes (co-administration study) Comment: Co-administration with ketoconazole, a strong CYP3A4/P-gp inhibitor, resulted in 11-fold and ~ 12.85-fold increases in Cmax and AUC of naloxegol. Therefore dosing with such drugs is contraindicated. Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/204760Orig1s000ClinPharm.pdf#page=24 Page: 24.0 |
||
Page: 9.0 |
yes | yes (co-administration study) Comment: Co-administration with ketoconazole, a strong CYP3A4/P-gp inhibitor, resulted in 11-fold and ~ 12.85-fold increases in Cmax and AUC of naloxegol. Therefore dosing with such drugs is contraindicated. Page: 9.0 |
PubMed
Title | Date | PubMed |
---|---|---|
A phase 2, double-blind, randomized, placebo-controlled, dose-escalation study to evaluate the efficacy, safety, and tolerability of naloxegol in patients with opioid-induced constipation. | 2013 Sep |
|
Naloxegol: First oral peripherally acting mu opioid receptor antagonists for opioid-induced constipation. | 2015 Jul-Sep |
|
Naloxegol: A Novel Therapy in the Management of Opioid-Induced Constipation. | 2016 Nov |
Patents
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Classification Tree | Code System | Code | ||
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NDF-RT |
N0000175691
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WHO-VATC |
QA06AH03
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WHO-ATC |
A06AH03
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NCI_THESAURUS |
C681
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4832
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DTXSID80234684
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854601-70-0
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100000152160
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1551777
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82975
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CHEMBL2219418
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8338
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m11770
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9434
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44T7335BKE
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ZZ-128
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C97506
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Naloxegol
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DB09049
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SUB126723
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44T7335BKE
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NALOXEGOL
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56959087
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7539
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ACTIVE MOIETY
METABOLITE (PARENT)
METABOLITE (PARENT)