Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C20H32F2O5 |
Molecular Weight | 390.4619 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 4 / 4 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
[H][C@@]12CC(=O)[C@H](CCCCCCC(O)=O)[C@@]1([H])CC[C@@](O)(O2)C(F)(F)CCCC
InChI
InChIKey=WGFOBBZOWHGYQH-MXHNKVEKSA-N
InChI=1S/C20H32F2O5/c1-2-3-11-19(21,22)20(26)12-10-15-14(16(23)13-17(15)27-20)8-6-4-5-7-9-18(24)25/h14-15,17,26H,2-13H2,1H3,(H,24,25)/t14-,15-,17-,20-/m1/s1
DescriptionSources: http://www.drugbank.ca/drugs/DB01046Curator's Comment: Description was created based on several sources, including
http://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/021908Orig1s008.pdf
Sources: http://www.drugbank.ca/drugs/DB01046
Curator's Comment: Description was created based on several sources, including
http://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/021908Orig1s008.pdf
Lubiprostone is a medication used in the management of idiopathic chronic constipation. It is a bicyclic fatty acid (prostaglandin E1 derivative) which acts by specifically activating ClC-2 chloride channels on the apical aspect of gastrointestinal epithelial cells, producing a chloride-rich fluid secretion. These secretions soften the stool, increase motility, and promote spontaneous bowel movements (SBM). Lubiprostone acts by specifically activating ClC-2 chloride channels, which is a normal constituent of the apical membrane of the human intestine, in a protein kinase A action independent fashion. Activation of ClC-2 chloride channels causes an efflux of chloride ions into the lumen, which in turn leads to an efflux of sodium ions through a paracellular pathway to maintain isoelectric neutrality. As a result, water follows sodium into the lumen in order to maintain isotonic equilibrium, thereby increasing intestinal fluid secretion. By increasing intestinal fluid secretion, lubiprostone increases motility in the intestine, thereby increasing the passage of stool and alleviating symptoms associated with chronic idiopathic constipation. Activation of ClC-2 chloride channels may also stimulate the recovery of muscosal barrier function by restoring tight junction protein complexes in the intestine. Patch clamp cell studies in human cell lines have indicated that the majority of the beneficial biological activity of lubiprostone and its metabolites is observed only on the apical (luminal) portion of the gastrointestinal epithelium. Lubiprostone is marketed under the trade name Amitiza among others.
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL1628478 |
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Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | Amitiza Approved UseAmitiza is a chloride channel activator indicated for:
• Treatment of chronic idiopathic constipation in adults
• Treatment of irritable bowel syndrome with constipation in women ≥ 18 years old Launch Date2006 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
41.5 pg/mL |
24 μg single, oral dose: 24 μg route of administration: Oral experiment type: SINGLE co-administered: |
15-HYDROXY LUBIPROSTONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
37.5 pg/mL |
24 μg single, oral dose: 24 μg route of administration: Oral experiment type: SINGLE co-administered: |
15-HYDROXY LUBIPROSTONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
57.1 pg × h/mL |
24 μg single, oral dose: 24 μg route of administration: Oral experiment type: SINGLE co-administered: |
15-HYDROXY LUBIPROSTONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
39.6 pg × h/mL |
24 μg single, oral dose: 24 μg route of administration: Oral experiment type: SINGLE co-administered: |
15-HYDROXY LUBIPROSTONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
1.15 h |
24 μg single, oral dose: 24 μg route of administration: Oral experiment type: SINGLE co-administered: |
15-HYDROXY LUBIPROSTONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
6% |
24 μg single, oral dose: 24 μg route of administration: Oral experiment type: SINGLE co-administered: |
15-HYDROXY LUBIPROSTONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
24 ug 2 times / day multiple, oral Recommended Dose: 24 ug, 2 times / day Route: oral Route: multiple Dose: 24 ug, 2 times / day Sources: Page: p.1, 4 |
unhealthy n = 1113 Health Status: unhealthy Condition: Chronic idiopathic constipation Population Size: 1113 Sources: Page: p.1, 4 |
Disc. AE: Nausea, Dyspnea... AEs leading to discontinuation/dose reduction: Nausea (9%) Sources: Page: p.1, 4Dyspnea (2%) |
144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Other AEs: Nausea, Diarrhea... Other AEs: Nausea (45%) Sources: Page: p.8Diarrhea (35%) Vomiting (27%) Dizziness (14%) Headache (12%) Abdominal pain (8%) Flash hot (8%) Retching (8%) Dyspnea (4%) Pallor (4%) Stomach discomfort (4%) Anorexia (2%) Asthenia (2%) Chest discomfort (2%) Dry mouth (2%) Hyperhidrosis (2%) Syncope (2%) |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Dyspnea | 2% Disc. AE |
24 ug 2 times / day multiple, oral Recommended Dose: 24 ug, 2 times / day Route: oral Route: multiple Dose: 24 ug, 2 times / day Sources: Page: p.1, 4 |
unhealthy n = 1113 Health Status: unhealthy Condition: Chronic idiopathic constipation Population Size: 1113 Sources: Page: p.1, 4 |
Nausea | 9% Disc. AE |
24 ug 2 times / day multiple, oral Recommended Dose: 24 ug, 2 times / day Route: oral Route: multiple Dose: 24 ug, 2 times / day Sources: Page: p.1, 4 |
unhealthy n = 1113 Health Status: unhealthy Condition: Chronic idiopathic constipation Population Size: 1113 Sources: Page: p.1, 4 |
Headache | 12% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Dizziness | 14% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Anorexia | 2% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Asthenia | 2% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Chest discomfort | 2% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Dry mouth | 2% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Hyperhidrosis | 2% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Syncope | 2% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Vomiting | 27% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Diarrhea | 35% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Dyspnea | 4% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Pallor | 4% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Stomach discomfort | 4% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Nausea | 45% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Abdominal pain | 8% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Flash hot | 8% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
Retching | 8% | 144 ug single, oral Studied dose Dose: 144 ug Route: oral Route: single Dose: 144 ug Sources: Page: p.8 |
healthy n = 51 Health Status: healthy Population Size: 51 Sources: Page: p.8 |
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/2006/021908s000_Amitiza_BIOPHARMR.pdf Page: 6, 14, 19 |
no |
PubMed
Title | Date | PubMed |
---|---|---|
FDA approves one drug for irritable bowel syndrome but suspends another. | 2008 Aug |
|
Lubiprostone for chronic idiopathic constipation and irritable bowel syndrome with constipation. | 2008 Aug |
|
Lubiprostone for constipation and irritable bowel syndrome with constipation. | 2008 Dec |
|
Opioid-induced bowel dysfunction. | 2008 Feb |
|
Conquering IBS in women: the clinician's pursuit of optimum management strategies. | 2008 Jul |
|
Pharmaceutical approval update. | 2008 Jun |
|
Lubiprostone activates non-CFTR-dependent respiratory epithelial chloride secretion in cystic fibrosis mice. | 2008 Nov |
|
[Functional and motor gastrointestinal disorders]. | 2008 Oct |
|
Comparison of the chloride channel activator lubiprostone and the oral laxative Polyethylene Glycol 3350 on mucosal barrier repair in ischemic-injured porcine intestine. | 2008 Oct 21 |
|
Cellular mechanisms underlying the laxative effect of flavonol naringenin on rat constipation model. | 2008 Oct 3 |
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Lubiprostone--a novel treatment for irritable bowel syndrome with constipation. | 2008 Sep |
|
Gateways to clinical trials. | 2008 Sep |
|
Constipation in the elderly: management strategies. | 2009 |
|
Function and dysfunction of the colon and anorectum in adults: working team report of the Swedish Motility Group (SMoG). | 2009 |
|
Stimulation of mucosal secretion by lubiprostone (SPI-0211) in guinea pig small intestine and colon. | 2009 Apr |
|
Treatment of dysautonomia associated with Parkinson's disease. | 2009 Dec |
|
The FDA and IBS drug development. | 2009 Dec |
|
Effect of a chloride channel activator, lubiprostone, on colonic sensory and motor functions in healthy subjects. | 2009 Feb |
|
Clinical trial: lubiprostone in patients with constipation-associated irritable bowel syndrome--results of two randomized, placebo-controlled studies. | 2009 Feb 1 |
|
Lubiprostone: chronic constipation and irritable bowel syndrome with constipation. | 2009 Jan |
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Constipation: evaluation and treatment of colonic and anorectal motility disorders. | 2009 Jan |
|
Pathogenesis and management of irritable bowel syndrome. | 2009 Jan-Mar |
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A 73-year-old man with long-term immobility presenting with abdominal pain. | 2009 Jul 14 |
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To the editor. CLC chloride channels and transporters: from genes to protein structure, pathology and physiology. | 2009 Jun |
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To the editor. CLC chloride channels and transporters: from genes to protein structure, pathology and physiology. | 2009 Jun |
|
Green light from the FDA for new drug development in irritable bowel syndrome and functional dyspepsia. | 2009 Jun |
|
Lubiprostone: in constipation-predominant irritable bowel syndrome. | 2009 Jun 18 |
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Lubiprostone to prevent fecal impaction. | 2009 Mar |
|
Lubiprostone: clinical applications beyond constipation. | 2009 Mar 7 |
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Treatment approaches to irritable bowel syndrome. | 2009 May |
|
The use of novel promotility and prosecretory agents for the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation. | 2009 May |
|
Lubiprostone: trials and tribulations. | 2009 May |
|
Lubiprostone stimulates secretion from tracheal submucosal glands of sheep, pigs, and humans. | 2009 May |
|
Lubiprostone neither decreases gastric and small-bowel transit time nor improves visualization of small bowel for capsule endoscopy: a double-blind, placebo-controlled study. | 2009 Nov |
|
Lubiprostone stimulates duodenal bicarbonate secretion in rats. | 2009 Oct |
|
Management of irritable bowel syndrome. | 2009 Sep |
|
Activation of intestinal Cl- secretion by lubiprostone requires the cystic fibrosis transmembrane conductance regulator. | 2009 Sep |
|
Efficacy and safety of lubiprostone in patients with chronic constipation. | 2010 Apr |
|
Update on the management of constipation in the elderly: new treatment options. | 2010 Aug 9 |
|
Dynamic [Cl(-)](i) measurement with chloride sensing quantum dots nanosensor in epithelial cells. | 2010 Feb 5 |
|
Review article: new receptor targets for medical therapy in irritable bowel syndrome. | 2010 Jan |
|
Prostaglandin E2-induced colonic secretion in patients with and without colorectal neoplasia. | 2010 Jan 26 |
|
[New drugs for the treatment of constipation]. | 2010 Jul |
|
Lubiprostone reverses the inhibitory action of morphine on intestinal secretion in guinea pig and mouse. | 2010 Jul |
|
Emerging new therapeutic options for the management of opioid induced constipation. | 2010 Mar |
|
Use of the chloride channel activator lubiprostone for constipation in adults with cystic fibrosis: a case series. | 2010 Mar |
|
Enteric nervous system: sensory physiology, diarrhea and constipation. | 2010 Mar |
|
Emerging pharmacologic therapies for irritable bowel syndrome. | 2010 Oct |
|
Pharmacologic management of chronic constipation. | 2010 Sep |
|
Lubiprostone ameliorates the cystic fibrosis mouse intestinal phenotype. | 2010 Sep 15 |
Sample Use Guides
Chronic idiopathic constipation
• 24 mcg taken twice daily orally with food and water
Irritable bowel syndrome with constipation
• 8 mcg taken twice daily orally with food and water
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/19179625
Lubiprostone, applied to the small intestinal mucosa in eight concentrations ranging from 1-3000 nM, evokes increases in Isc in a concentration-dependent manner with an EC50 of 42.5 nM. Lubiprostone applied to the mucosa of the colon in eight concentrations ranging from 1-3000 nM evokes increases in Isc in a concentration-dependent manner with an EC50 of 31.7 nM
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Classification Tree | Code System | Code | ||
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NDF-RT |
N0000175456
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QA06AX03
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A06AX03
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LIVERTOX |
NBK548000
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NCI_THESAURUS |
C78568
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NDF-RT |
N0000175573
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CHEMBL1201134
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m6919
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Lubiprostone
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DB01046
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Lubiprostone
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136790-76-6
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ACTIVE MOIETY
METABOLITE ACTIVE (PARENT)