Details
Stereochemistry | ACHIRAL |
Molecular Formula | C22H28N6O3S |
Molecular Weight | 456.561 |
Optical Activity | NONE |
Defined Stereocenters | 0 / 0 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
CC(C)NC1=CC=CN=C1N2CCN(CC2)C(=O)C3=CC4=C(N3)C=CC(NS(C)(=O)=O)=C4
InChI
InChIKey=WHBIGIKBNXZKFE-UHFFFAOYSA-N
InChI=1S/C22H28N6O3S/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/h4-8,13-15,24-26H,9-12H2,1-3H3
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 |
---|---|---|---|---|
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 |
|
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 |
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 |
---|---|---|---|---|
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 |
|
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 |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
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 |
|
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 |
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 Health Status: unhealthy Age Group: >18 years Sex: M+F 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 Health Status: unhealthy 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 Health Status: unhealthy Age Group: >18 years Sex: M+F 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 Health Status: unhealthy Age Group: >18 years Sex: M+F 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 Health Status: unhealthy Age Group: >18 years Sex: M+F 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 Health Status: unhealthy Age Group: >18 years Sex: M+F 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 Health Status: unhealthy Age Group: >18 years Sex: M+F 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 Health Status: unhealthy Age Group: >18 years Sex: M+F 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 Health Status: unhealthy Age Group: >18 years Sex: M+F 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 Health Status: unhealthy Age Group: >18 years Sex: M+F 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 Health Status: unhealthy 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 |
---|---|---|
Expanded-spectrum nonnucleoside reverse transcriptase inhibitors inhibit clinically relevant mutant variants of human immunodeficiency virus type 1. | 1999 Dec |
|
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 |
|
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 |
|
Selection and characterization of human immunodeficiency virus type 1 variants resistant to the (+) and (-) enantiomers of 2'-deoxy-3'-oxa-4'-thio-5-fluorocytidine. | 2000 May |
|
Inhibition of clinically relevant mutant variants of HIV-1 by quinazolinone non-nucleoside reverse transcriptase inhibitors. | 2000 May 18 |
|
Delavirdine: clinical pharmacokinetics and drug interactions. | 2001 |
|
The emerging roles of non-nucleoside reverse transcriptase inhibitors in antiretroviral therapy. | 2001 |
|
Use of HIV protease inhibitors as pharmacoenhancers. | 2001 Feb |
|
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 |
|
Interaction of delavirdine with human liver microsomal cytochrome P450: inhibition of CYP2C9, CYP2C19, and CYP2D6. | 2001 Jan |
|
Combination therapy with indinavir, ritonavir, and delavirdine and nucleoside reverse transcriptase inhibitors in patients with HIV/AIDS who have failed multiple antiretroviral combinations. | 2001 May-Jun |
|
Anti-human immunodeficiency virus drugs are ineffective against Pneumocystis carinii in vitro and in vivo. | 2001 Nov 15 |
|
Drugs for HIV infection. | 2001 Nov 26 |
|
The stereoselective targeting of a specific enzyme-substrate complex is the molecular mechanism for the synergic inhibition of HIV-1 reverse transcriptase by (R)-(-)-PPO464: a novel generation of nonnucleoside inhibitors. | 2001 Nov 30 |
|
Can delavirdine substitute for ritonavir? | 2001 Nov-Dec |
|
Baseline antiretroviral drug susceptibility influences treatment response in patients receiving saquinavir-enhancing therapy. | 2001 Nov-Dec |
|
Non-nucleoside HIV-1 reverse transcriptase (RT) inhibitors: past, present, and future perspectives. | 2002 |
|
Lack of hepatotoxicity associated with nonnucleoside reverse transcriptase inhibitors. | 2002 Apr 1 |
|
Synthesis, biological evaluation, and binding mode of novel 1-[2-(diarylmethoxy)ethyl]-2-methyl-5-nitroimidazoles targeted at the HIV-1 reverse transcriptase. | 2002 Apr 11 |
|
Rhabdomyolysis with acute renal failure probably related to the interaction of atorvastatin and delavirdine. | 2002 Apr 15 |
|
Genotypic and phenotypic resistance patterns in early-stage HIV-1-infected patients failing initial therapy with stavudine, didanosine and nevirapine. | 2002 Dec |
|
Structural requirements for potent anti-human immunodeficiency virus (HIV) and sperm-immobilizing activities of cyclohexenyl thiourea and urea non-nucleoside inhibitors of HIV-1 reverse transcriptase. | 2002 Dec |
|
Synthesis of novel N-1 (allyloxymethyl) analogues of 6-benzyl-1-(ethoxymethyl)-5-isopropyluracil (MKC-442, emivirine) with improved activity against HIV-1 and its mutants. | 2002 Dec 19 |
|
Nelfinavir urinary stones. | 2002 Mar |
|
Delavirdine increases drug exposure of ritonavir-boosted protease inhibitors. | 2002 Mar 29 |
|
Pharmacia pilots patent share for HIV drug. | 2003 Apr |
|
Delavirdine malabsorption in HIV-infected subjects with spontaneous gastric hypoacidity. | 2003 Feb |
|
Simultaneous determination of nine antiretroviral compounds in human plasma using liquid chromatography. | 2003 Feb 5 |
|
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 |
|
Protease inhibitor-sparing regimens: new evidence strengthens position. | 2003 Jun 1 |
|
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 |
|
Clinical efficacy of antiretroviral combination therapy based on protease inhibitors or non-nucleoside analogue reverse transcriptase inhibitors: indirect comparison of controlled trials. | 2004 Jan 31 |
|
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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Classification Tree | Code System | Code | ||
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NDF-RT |
N0000009948
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WHO-VATC |
QJ05AG02
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LIVERTOX |
NBK547899
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NDF-RT |
N0000175460
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NCI_THESAURUS |
C97453
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NDF-RT |
N0000175463
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WHO-ATC |
J05AG02
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100000083479
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119573
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DB00705
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C65366
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Delavirdine
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7234
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83816
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799
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DOL5F9JD3E
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m4152
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D020008
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SUB06949MIG
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DELAVIRDINE
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5625
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136817-59-9
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DTXSID6022892
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ACTIVE MOIETY
METABOLITE (PARENT)
SALT/SOLVATE (PARENT)