Details
Stereochemistry | ACHIRAL |
Molecular Formula | C23H22ClN5O3 |
Molecular Weight | 451.905 |
Optical Activity | NONE |
Defined Stereocenters | 0 / 0 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
COC1=CC(C(=O)NC2=CC=C(Cl)C=N2)=C(NC(=O)C3=CC=C(C=C3)C(=N)N(C)C)C=C1
InChI
InChIKey=XHOLNRLADUSQLD-UHFFFAOYSA-N
InChI=1S/C23H22ClN5O3/c1-29(2)21(25)14-4-6-15(7-5-14)22(30)27-19-10-9-17(32-3)12-18(19)23(31)28-20-11-8-16(24)13-26-20/h4-13,25H,1-3H3,(H,27,30)(H,26,28,31)
DescriptionSources: https://www.ncbi.nlm.nih.gov/pubmed/24344662
Sources: https://www.ncbi.nlm.nih.gov/pubmed/24344662
Betrixaban is an anticoagulant drug which acts as a direct factor Xa inhibitor. Betrixaban is now being developed by Portola Pharmaceuticals. Oral, once-daily Factor Xa inhibitor anticoagulant that directly inhibits the activity of Factor Xa, an important validated target in the blood coagulation pathway, to prevent life-threatening thrombosis. U.S. Food and Drug Administration granted Fast Track designation to betrixaban for extended-duration prevention of venous thromboembolism (VTE; blood clots) in acute medically ill patients (i.e., those who are hospitalized for serious medical conditions, such as heart failure, stroke, infection and pulmonary disease). Has the potential to become the first oral Factor Xa inhibitor anticoagulant approved for hospital-to-home prevention of VTE in acute medically ill patients.
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL244 |
4.5 nM [IC50] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Preventing | BEVYXXA Approved UseBEVYXXA is indicated for the prophylaxis of venous thromboembolism (VTE) in adult patients hospitalized for an acute medical illness who are at risk for thromboembolic complications due to moderate or severe restricted mobility and other risk factors for VTE. Launch Date2017 |
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Preventing | Unknown Approved UseUnknown |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
23.2 ng/mL |
40 mg 2 times / day multiple, oral dose: 40 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
73.1 ng/mL |
80 mg 2 times / day multiple, oral dose: 80 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
122 ng/mL |
120 mg 2 times / day multiple, oral dose: 120 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
38 ng/mL |
80 mg single, oral dose: 80 mg route of administration: Oral experiment type: SINGLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
58.2 ng/mL |
120 mg single, oral dose: 120 mg route of administration: Oral experiment type: SINGLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
9.37 ng/mL |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
179 ng × h/mL |
40 mg 2 times / day multiple, oral dose: 40 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
488 ng × h/mL |
80 mg 2 times / day multiple, oral dose: 80 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
821 ng × h/mL |
120 mg 2 times / day multiple, oral dose: 120 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
393 ng × h/mL |
80 mg single, oral dose: 80 mg route of administration: Oral experiment type: SINGLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
600 ng × h/mL |
120 mg single, oral dose: 120 mg route of administration: Oral experiment type: SINGLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
83.1 ng × h/mL |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
39.7 h |
40 mg 2 times / day multiple, oral dose: 40 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
37.3 h |
80 mg 2 times / day multiple, oral dose: 80 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
35.9 h |
120 mg 2 times / day multiple, oral dose: 120 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
40% |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
BETRIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
Doses
Dose | Population | Adverse events |
---|---|---|
550 mg 1 times / day single, oral Highest studied dose Dose: 550 mg, 1 times / day Route: oral Route: single Dose: 550 mg, 1 times / day Sources: Page: dexxience-epar-refusal-public-assessment-report_.pdf - p.50 |
healthy, adult n = 59 Health Status: healthy Age Group: adult Sex: M Population Size: 59 Sources: Page: dexxience-epar-refusal-public-assessment-report_.pdf - p.50 |
Other AEs: Electrocardiogram QTc interval prolonged... Other AEs: Electrocardiogram QTc interval prolonged (grade 1, 3.4%) Sources: Page: dexxience-epar-refusal-public-assessment-report_.pdf - p.50 |
360 mg 1 times / day single, oral MTD Dose: 360 mg, 1 times / day Route: oral Route: single Dose: 360 mg, 1 times / day Sources: Page: dexxience-epar-refusal-public-assessment-report_.pdf - p.50 |
healthy, adult n = 59 Health Status: healthy Age Group: adult Sex: M Population Size: 59 Sources: Page: dexxience-epar-refusal-public-assessment-report_.pdf - p.50 |
Sources: Page: dexxience-epar-refusal-public-assessment-report_.pdf - p.50 |
80 mg 1 times / day multiple, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: multiple Dose: 80 mg, 1 times / day Sources: |
unhealthy, median age 76.6 years n = 3716 Health Status: unhealthy Condition: Venous thromboembolism Age Group: median age 76.6 years Sex: M+F Population Size: 3716 Sources: |
Disc. AE: Haemorrhage, Pulmonary embolism... AEs leading to discontinuation/dose reduction: Haemorrhage (2.4%) Sources: Pulmonary embolism Thrombosis venous deep |
80 mg 1 times / day steady, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: Page: 208383Orig1s000MedR.pdf - p.76 |
unhealthy, median age 76.6 years n = 3716 Health Status: unhealthy Condition: Venous thromboembolism Age Group: median age 76.6 years Sex: M+F Population Size: 3716 Sources: Page: 208383Orig1s000MedR.pdf - p.76 |
Other AEs: Gastrointestinal bleeding, Intracranial hemorrhage... Other AEs: Gastrointestinal bleeding (major, 19 patients) Sources: Page: 208383Orig1s000MedR.pdf - p.76Intracranial hemorrhage (major, 2 patients) Bleeding (grade 5, 1 patient) |
unknown Health Status: unknown Sources: |
Other AEs: Epidural hematoma, Spinal hematoma... Other AEs: Epidural hematoma Sources: Spinal hematoma |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Electrocardiogram QTc interval prolonged | grade 1, 3.4% | 550 mg 1 times / day single, oral Highest studied dose Dose: 550 mg, 1 times / day Route: oral Route: single Dose: 550 mg, 1 times / day Sources: Page: dexxience-epar-refusal-public-assessment-report_.pdf - p.50 |
healthy, adult n = 59 Health Status: healthy Age Group: adult Sex: M Population Size: 59 Sources: Page: dexxience-epar-refusal-public-assessment-report_.pdf - p.50 |
Haemorrhage | 2.4% Disc. AE |
80 mg 1 times / day multiple, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: multiple Dose: 80 mg, 1 times / day Sources: |
unhealthy, median age 76.6 years n = 3716 Health Status: unhealthy Condition: Venous thromboembolism Age Group: median age 76.6 years Sex: M+F Population Size: 3716 Sources: |
Pulmonary embolism | Disc. AE | 80 mg 1 times / day multiple, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: multiple Dose: 80 mg, 1 times / day Sources: |
unhealthy, median age 76.6 years n = 3716 Health Status: unhealthy Condition: Venous thromboembolism Age Group: median age 76.6 years Sex: M+F Population Size: 3716 Sources: |
Thrombosis venous deep | Disc. AE | 80 mg 1 times / day multiple, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: multiple Dose: 80 mg, 1 times / day Sources: |
unhealthy, median age 76.6 years n = 3716 Health Status: unhealthy Condition: Venous thromboembolism Age Group: median age 76.6 years Sex: M+F Population Size: 3716 Sources: |
Bleeding | grade 5, 1 patient | 80 mg 1 times / day steady, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: Page: 208383Orig1s000MedR.pdf - p.76 |
unhealthy, median age 76.6 years n = 3716 Health Status: unhealthy Condition: Venous thromboembolism Age Group: median age 76.6 years Sex: M+F Population Size: 3716 Sources: Page: 208383Orig1s000MedR.pdf - p.76 |
Gastrointestinal bleeding | major, 19 patients | 80 mg 1 times / day steady, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: Page: 208383Orig1s000MedR.pdf - p.76 |
unhealthy, median age 76.6 years n = 3716 Health Status: unhealthy Condition: Venous thromboembolism Age Group: median age 76.6 years Sex: M+F Population Size: 3716 Sources: Page: 208383Orig1s000MedR.pdf - p.76 |
Intracranial hemorrhage | major, 2 patients | 80 mg 1 times / day steady, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: Page: 208383Orig1s000MedR.pdf - p.76 |
unhealthy, median age 76.6 years n = 3716 Health Status: unhealthy Condition: Venous thromboembolism Age Group: median age 76.6 years Sex: M+F Population Size: 3716 Sources: Page: 208383Orig1s000MedR.pdf - p.76 |
Epidural hematoma | unknown Health Status: unknown Sources: |
||
Spinal hematoma | unknown Health Status: unknown Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 14.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
yes [IC50 11.6 uM] | |||
Page: 15.0 |
yes [IC50 11.6 uM] | |||
Page: 43.0 |
yes [Inhibition 10 uM] |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 12.0 |
minor | |||
Page: 12.0 |
minor | |||
Page: 12.0 |
minor | |||
Page: 12.0 |
minor | |||
Page: 12.0 |
minor | |||
Page: 12.0 |
minor | |||
Page: 12.0 |
minor | unlikely Page: 12.0 |
||
Page: 8.0 |
yes | yes (co-administration study) Comment: ketoconazole increased cmax of betrixaban 2.3x, auc 2.3x; verapamil increased cmax of betrixaban 5x, auc 3x;digoxin had no effect on inhibition Page: 8.0 |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 9.0 |
PubMed
Title | Date | PubMed |
---|---|---|
New anticoagulants: focus on venous thromboembolism. | 2009 Jul |
|
Emerging antithrombotic agents for thromboprophylaxis, clinical potential and patient considerations. | 2010 |
|
New synthetic antithrombotic agents for venous thromboembolism: pentasaccharides, direct thrombin inhibitors, direct Xa inhibitors. | 2010 Dec |
|
Novel anticoagulants for stroke prevention in atrial fibrillation: current clinical evidence and future developments. | 2010 Dec 14 |
|
Post-operative thromboprophylaxis: new oral thrombin and factor X inhibitors and their place in clinical practice. | 2010 May 24 |
|
New anticoagulants for the prevention of venous thromboembolism. | 2010 May 25 |
Patents
Sample Use Guides
In Vivo Use Guide
Sources: https://clinicaltrials.gov/ct2/show/NCT01583218
80 mg PO QD for 35 day + 7 days.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/24344662
In a tissue factor-induced thrombin-generation assay, betrixaban, in concentrations ranging between 5 and 25 ng/ml, inhibited thrombin generation to trough and peak levels comparable to those achieved by 2.5 mg of fondaparinux.
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Classification Tree | Code System | Code | ||
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NCI_THESAURUS |
C263
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NDF-RT |
N0000175637
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DTXSID10954727
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CHEMBL512351
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1927851
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Betrixaban
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C75154
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Betrixaban
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m12019
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TT-02
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ACTIVE MOIETY
METABOLITE (PARENT)
METABOLITE (PARENT)
METABOLITE (PARENT)
METABOLITE ACTIVE (PARENT)
METABOLITE ACTIVE (PARENT)
METABOLITE INACTIVE (PARENT)
METABOLITE INACTIVE (PARENT)
SALT/SOLVATE (PARENT)