Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C32H31BrN2O2 |
Molecular Weight | 555.505 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 2 / 2 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
COC1=NC2=CC=C(Br)C=C2C=C1[C@@H](C3=CC=CC=C3)[C@@](O)(CCN(C)C)C4=CC=CC5=CC=CC=C45
InChI
InChIKey=QUIJNHUBAXPXFS-XLJNKUFUSA-N
InChI=1S/C32H31BrN2O2/c1-35(2)19-18-32(36,28-15-9-13-22-10-7-8-14-26(22)28)30(23-11-5-4-6-12-23)27-21-24-20-25(33)16-17-29(24)34-31(27)37-3/h4-17,20-21,30,36H,18-19H2,1-3H3/t30-,32-/m1/s1
Bedaquiline (trade name Sirturo, code names TMC207 and R207910) is a diarylquinoline anti-tuberculosis drug, which was discovered by a team led by Koen Andries at Janssen Pharmaceutica. When it was approved by the FDA on the 28th December 2012, it was the first new medicine to fight TB in more than forty years, and is specifically approved to treat multi-drug-resistant tuberculosis. Bedaquiline is a diarylquinoline antimycobacterial drug that inhibits the proton pump of mycobacterial ATP (adenosine 5'-triphosphate) synthase, an enzyme that is essential for the generation of energy in Mycobacterium tuberculosis. Bacterial death occurs as a result of bedaquiline.
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: P9WPS0 Gene ID: NA Gene Symbol: atpE Target Organism: Mycobacterium tuberculosis (strain CDC 1551 / Oshkosh) Sources: http://www.ncbi.nlm.nih.gov/pubmed/17496888 |
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Target ID: P9WPS1 Gene ID: 886937.0 Gene Symbol: atpE Target Organism: Mycobacterium tuberculosis (strain ATCC 25618 / H37Rv) Sources: http://www.ncbi.nlm.nih.gov/pubmed/17496888 |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
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Curative | SIRTURO Approved UseIndicated as part of combination therapy in the treatment of adults (18 years and older) with pulmonary multi-drug resistant tuberculosis (MDR-TB). Reserve SIRTURO for use when an effective treatment regimen cannot otherwise be provided. Administer SIRTURO by directly observed therapy (DOT). This indication is approved under accelerated approval based on time to sputum culture conversion Launch Date2012 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
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2.547 mg/L |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
BEDAQUILINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
3.755 mg/L |
450 mg single, oral dose: 450 mg route of administration: Oral experiment type: SINGLE co-administered: |
BEDAQUILINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
38.737 mg × h/L |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
BEDAQUILINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
64.53 mg × h/mL |
450 mg single, oral dose: 450 mg route of administration: Oral experiment type: SINGLE co-administered: |
BEDAQUILINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
24 h |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
BEDAQUILINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
24 h |
450 mg single, oral dose: 450 mg route of administration: Oral experiment type: SINGLE co-administered: |
BEDAQUILINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
0.01% |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
BEDAQUILINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
0.01% |
450 mg single, oral dose: 450 mg route of administration: Oral experiment type: SINGLE co-administered: |
BEDAQUILINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
0.01% |
400 mg 1 times / day unknown, oral dose: 400 mg route of administration: Oral experiment type: UNKNOWN co-administered: |
BEDAQUILINE plasma | Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
400 mg 4 times / week multiple, oral Overdose Dose: 400 mg, 4 times / week Route: oral Route: multiple Dose: 400 mg, 4 times / week Sources: |
unhealthy, 21 years n = 1 Health Status: unhealthy Age Group: 21 years Sex: M Population Size: 1 Sources: |
|
400 | 200 mg|mg 1|3 times / day|week multiple, oral (complex) Recommended Dose: 400 | 200 mg|mg, 1|3 times / day|week Route: oral Route: multiple Dose: 400 | 200 mg|mg, 1|3 times / day|week Sources: |
unhealthy, 34 years n = 79 Health Status: unhealthy Condition: y multi-drug resistant tuberculosis Age Group: 34 years Sex: M+F Population Size: 79 Sources: |
Other AEs: Death... Other AEs: Death (11.4%) Sources: |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Death | 11.4% | 400 | 200 mg|mg 1|3 times / day|week multiple, oral (complex) Recommended Dose: 400 | 200 mg|mg, 1|3 times / day|week Route: oral Route: multiple Dose: 400 | 200 mg|mg, 1|3 times / day|week Sources: |
unhealthy, 34 years n = 79 Health Status: unhealthy Condition: y multi-drug resistant tuberculosis Age Group: 34 years Sex: M+F Population Size: 79 Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
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OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
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Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
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Page: 8.0 |
no | |||
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no | |||
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no | |||
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no | |||
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no | |||
Page: 8.0 |
no | |||
Page: 8.0 |
no | |||
Page: 8.0 |
no | |||
Page: 8.0 |
no | |||
Page: 8.0 |
no | |||
Page: 8.0 |
no | |||
Page: 8.0 |
no | |||
Page: 8.0 |
no | |||
Page: 8.0 |
no | |||
Page: 23.0 |
no |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 5.0 |
major | yes (co-administration study) Comment: ketoconazole increased bedaquiline exposure 22%, rifampin decreased bedaquiline exposure 52% Page: 5.0 |
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Page: 2.0 |
yes |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 5.0 |
PubMed
Title | Date | PubMed |
---|---|---|
New drugs being developed for the treatment of tuberculosis. | 2005 Jul |
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New small-molecule synthetic antimycobacterials. | 2005 Jun |
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In vitro antimycobacterial spectrum of a diarylquinoline ATP synthase inhibitor. | 2007 Nov |
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In vitro interactions between new antitubercular drug candidates SQ109 and TMC207. | 2010 Jul |
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TMC207: the first compound of a new class of potent anti-tuberculosis drugs. | 2010 Jun |
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Bactericidal activity of the diarylquinoline TMC207 against Mycobacterium tuberculosis outside and within cells. | 2010 Sep |
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Short-course chemotherapy with TMC207 and rifapentine in a murine model of latent tuberculosis infection. | 2011 Sep 15 |
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Efflux inhibition with verapamil potentiates bedaquiline in Mycobacterium tuberculosis. | 2014 |
Patents
Sample Use Guides
400 mg once daily for 2 weeks followed by 200 mg 3 times per week for 22 weeks with food. Swallow SIRTURO (bedaquiline) tablets whole with water.
Route of Administration:
Oral
Modification of the atpE target gene, and/or upregulation of the MmpS5-MmpL5 efflux pump have been associated with increased bedaquiline MIC values in isolates of M.
tuberculosis. Target-based mutations generated in preclinical studies lead to 8- to 133-fold increases in bedaquiline MIC, resulting in MICs ranging from 0.25 to 4.0 ug/mL. Efflux-based mutations have been seen in preclinical and clinical isolates. These lead to
2- to 8-fold increases in bedaquiline MICs, resulting in bedaquiline MICs ranging from 0.25 to 0.50 ug/ mL.
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FDA ORPHAN DRUG |
589917
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NDF-RT |
N0000186775
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QJ04AK05
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NCI_THESAURUS |
C280
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WHO-ATC |
J04AK05
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FDA ORPHAN DRUG |
199304
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LIVERTOX |
NBK548859
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Bedaquiline
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SUB32824
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EU/3/05/314 POSITIVE
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PRIMARY | On 26 August 2005, orphan designation (EU/3/05/314) was granted by the European Commission to Tibotec Pharmaceuticals Ltd., Ireland, for (1R,2S) 6-bromo-alpha-[2-(dimethylamino)ethyl]-2-methoxy-alpha-(1-naphthyl)-beta-phenyl-3-quinolineethanol for the treatment of tuberculosis. | ||
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Bedaquiline
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N0000186774
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PRIMARY | Diarylquinolines [Chemical/Ingredient] | ||
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C493870
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ACTIVE MOIETY
METABOLITE LESS ACTIVE (PARENT)
SALT/SOLVATE (PARENT)