Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C22H30O3 |
Molecular Weight | 342.4718 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 6 / 6 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
[H][C@@]12CC[C@](O)(C(C)=O)[C@@]1(C)CC[C@@]3([H])[C@@]2([H])C=C(C)C4=CC(=O)CC[C@]34C
InChI
InChIKey=VXIMPSPISRVBPZ-NWUMPJBXSA-N
InChI=1S/C22H30O3/c1-13-11-16-17(20(3)8-5-15(24)12-19(13)20)6-9-21(4)18(16)7-10-22(21,25)14(2)23/h11-12,16-18,25H,5-10H2,1-4H3/t16-,17+,18+,20-,21+,22+/m1/s1
DescriptionCurator's Comment: description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/pubmed/?term=23395103
Curator's Comment: description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/pubmed/?term=23395103
Megestrol acetate is a progestational hormone used most commonly as the acetate ester. As the acetate, it is more potent than progesterone both as a progestagen and as an ovulation inhibitor. It has also been used in the palliative treatment of breast cancer. MEGACE Oral Suspension is indicated for the treatment of anorexia, cachexia, or an unexplained, significant weight loss in patients with a diagnosis of acquired immunodeficiency syndrome (AIDS). The precise mechanism by which megestrol acetate produces effects in anorexia and cachexia is unknown at the present time. But its progestin antitumour activity may involve suppression of luteinizing hormone by inhibition of pituitary function. Studies also suggest that the megestrol's weight gain effect is related to its appetite-stimulant or metabolic effects rather than its glucocorticoid-like effects or the production of edema. It has also been suggested that megestrol may alter metabolic pathyways via interferences with the production or action of mediators such as cachectin, a hormone that inhibits adipocyte lipogenic enzymes. The major route of drug elimination in humans is urine. When radiolabeled megestrol acetate was administered to humans in doses of 4 to 90 mg, the urinary excretion within 10 days ranged from 56.5% to 78.4% (mean 66.4%) and fecal excretion ranged from 7.7% to 30.3% (mean 19.8%). The total recovered radioactivity varied between 83.1% and 94.7% (mean 86.2%). Megestrol acetate metabolites which were identified in urine constituted 5% to 8% of the dose administered. Respiratory excretion as labeled carbon dioxide and fat storage may have accounted for at least part of the radioactivity not found in urine and feces. Plasma steady-state pharmacokinetics of megestrol acetate were evaluated in 10 adult, cachectic male patients with acquired immunodeficiency syndrome (AIDS) and an involuntary weight loss greater than 10% of baseline. Patients received single oral doses of 800 mg/day of MEGACE Oral Suspension for 21 days. Plasma concentration data obtained on day 21 were evaluated for up to 48 hours past the last dose.
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL208 Sources: https://www.ncbi.nlm.nih.gov/pubmed/15086241 |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
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Palliative | MEGACE Approved UseMegestrol acetate oral suspension is indicated for the treatment of anorexia, cachexia, or an unexplained, significant weight loss in patients with a diagnosis of acquired immunodeficiency syndrome (AIDS). Launch Date1993 |
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Palliative | MEGACE Approved UseMegestrol acetate oral suspension is indicated for the treatment of anorexia, cachexia, or an unexplained, significant weight loss in patients with a diagnosis of acquired immunodeficiency syndrome (AIDS). Launch Date1993 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
753 ng/mL |
800 mg 1 times / day steady-state, oral dose: 800 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
490 ng/mL |
750 mg 1 times / day steady-state, oral dose: 750 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
1133 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
625 mg single, oral dose: 625 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
1618 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
625 mg single, oral dose: 625 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
1364 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
800 mg single, oral dose: 800 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
187 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
800 mg single, oral dose: 800 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
10476 ng × h/mL |
800 mg 1 times / day steady-state, oral dose: 800 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
6779 ng × h/mL |
750 mg 1 times / day steady-state, oral dose: 750 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
12095 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
625 mg single, oral dose: 625 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
16268 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
625 mg single, oral dose: 625 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
18625 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
800 mg single, oral dose: 800 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
8942 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
800 mg single, oral dose: 800 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
33.68 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
625 mg single, oral dose: 625 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
39.75 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
625 mg single, oral dose: 625 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
32.84 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
800 mg single, oral dose: 800 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
31.38 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19774117/ |
800 mg single, oral dose: 800 mg route of administration: Oral experiment type: SINGLE co-administered: |
MEGESTROL ACETATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
Doses
Dose | Population | Adverse events |
---|---|---|
400 mg 2 times / day multiple, oral Dose: 400 mg, 2 times / day Route: oral Route: multiple Dose: 400 mg, 2 times / day Sources: |
unhealthy, 54-68 years n = 2 Health Status: unhealthy Age Group: 54-68 years Sex: F Population Size: 2 Sources: |
Disc. AE: Osteoporosis... AEs leading to discontinuation/dose reduction: Osteoporosis (2 patients) Sources: |
625 mg 1 times / day multiple, oral Recommended Dose: 625 mg, 1 times / day Route: oral Route: multiple Dose: 625 mg, 1 times / day Sources: |
unhealthy, 65 years n = 1 Health Status: unhealthy Age Group: 65 years Sex: M Population Size: 1 Sources: |
Disc. AE: Adrenal insufficiency... AEs leading to discontinuation/dose reduction: Adrenal insufficiency (1 patient) Sources: |
40 mg 2 times / day multiple, oral Dose: 40 mg, 2 times / day Route: oral Route: multiple Dose: 40 mg, 2 times / day Sources: |
unhealthy, 85 years n = 1 Health Status: unhealthy Condition: Alzheimer's disease Age Group: 85 years Sex: F Population Size: 1 Sources: |
Disc. AE: Deep vein thrombosis... AEs leading to discontinuation/dose reduction: Deep vein thrombosis (1 patient) Sources: |
400 mg 2 times / day multiple, oral Dose: 400 mg, 2 times / day Route: oral Route: multiple Dose: 400 mg, 2 times / day Sources: |
unhealthy, 86 years n = 1 Health Status: unhealthy Condition: Alzheimer's disease Age Group: 86 years Sex: F Population Size: 1 Sources: |
Disc. AE: Deep vein thrombosis... AEs leading to discontinuation/dose reduction: Deep vein thrombosis (1 patient) Sources: |
1600 mg 1 times / day multiple, oral Highest studied dose Dose: 1600 mg, 1 times / day Route: oral Route: multiple Dose: 1600 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Condition: advanced breast cancer Sex: F Sources: |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Osteoporosis | 2 patients Disc. AE |
400 mg 2 times / day multiple, oral Dose: 400 mg, 2 times / day Route: oral Route: multiple Dose: 400 mg, 2 times / day Sources: |
unhealthy, 54-68 years n = 2 Health Status: unhealthy Age Group: 54-68 years Sex: F Population Size: 2 Sources: |
Adrenal insufficiency | 1 patient Disc. AE |
625 mg 1 times / day multiple, oral Recommended Dose: 625 mg, 1 times / day Route: oral Route: multiple Dose: 625 mg, 1 times / day Sources: |
unhealthy, 65 years n = 1 Health Status: unhealthy Age Group: 65 years Sex: M Population Size: 1 Sources: |
Deep vein thrombosis | 1 patient Disc. AE |
40 mg 2 times / day multiple, oral Dose: 40 mg, 2 times / day Route: oral Route: multiple Dose: 40 mg, 2 times / day Sources: |
unhealthy, 85 years n = 1 Health Status: unhealthy Condition: Alzheimer's disease Age Group: 85 years Sex: F Population Size: 1 Sources: |
Deep vein thrombosis | 1 patient Disc. AE |
400 mg 2 times / day multiple, oral Dose: 400 mg, 2 times / day Route: oral Route: multiple Dose: 400 mg, 2 times / day Sources: |
unhealthy, 86 years n = 1 Health Status: unhealthy Condition: Alzheimer's disease Age Group: 86 years Sex: F Population Size: 1 Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
yes | ||||
yes |
PubMed
Title | Date | PubMed |
---|---|---|
Effect of nomegestrol acetate on human estrogen sulfotransferase activity in the hormone-dependent MCF-7 and T-47D breast cancer cell lines. | 2003 Nov-Dec |
|
Nomegestrol acetate: a progestin that deserves recognition. | 2004 Apr |
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The role of MRI in the conservative management of endometrial cancer. | 2004 Apr |
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A comparison of the central effects of different progestins used in hormone replacement therapy. | 2004 Aug 20 |
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Osteoporosis associated with megestrol acetate. | 2004 Dec |
|
[Nome gesrol (lutenyl) induced severe acute hepatitis]. | 2004 Jan |
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Serum leptin levels and body composition in postmenopausal women: effects of hormone therapy. | 2004 Jul-Aug |
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Therapy for unresectable hepatocellular carcinoma: review of the randomized clinical trials-II: systemic and local non-embolization-based therapies in unresectable and advanced hepatocellular carcinoma. | 2004 Jun |
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Aromatase inhibition in the treatment of advanced breast cancer: is there a relationship between potency and clinical efficacy? | 2004 May 4 |
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Cost utility and budget impact of third-generation aromatase inhibitors for advanced breast cancer: a literature-based model analysis of costs in the Italian National Health Service. | 2004 Sep |
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Clinical utility of serum HER2/neu in monitoring and prediction of progression-free survival in metastatic breast cancer patients treated with trastuzumab-based therapies. | 2005 |
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The science of megestrol acetate delivery: potential to improve outcomes in cachexia. | 2005 |
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Retrospective review of megestrol use for weight loss in an elderly veteran population. | 2005 Apr |
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Effects of the combined treatment with thalidomide, megestrol and interleukine-2 in cirrhotic patients with advanced hepatocellular carcinoma. A pilot study. | 2005 Apr |
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Treatment with inhibitors of angiogenesis in advanced hepatocellular carcinoma: a new tool in our hands or simply a hope? | 2005 Apr |
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The effects of aromatase inhibitors on lipids and thrombosis. | 2005 Aug |
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Bone loss and the aromatase inhibitors. | 2005 Aug |
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Role of aromatase inhibitors in breast cancer. | 2005 Aug |
|
[Actions of a 19-norprogesterone derivative on mammary gland: nomegestrol acetate]. | 2005 Feb |
|
Effect of nomegestrol acetate on estrogen biosynthesis and transformation in MCF-7 and T47-D breast cancer cells. | 2005 Jan |
|
Control of sulfatase activity by nomegestrol acetate in normal and cancerous human breast tissues. | 2005 Jul-Aug |
|
Nomegestrol acetate may enhance the skeletal effects of estradiol on biochemical markers of bone turnover in menopausal women after a 12-week treatment period. | 2005 Jun |
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Pregnancy following intracytoplasmic sperm injection and preimplantation genetic diagnosis after the conservative management of endometrial cancer. | 2005 Jun |
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Antigenotoxic effects of ascorbic acid against megestrol acetate-induced genotoxicity in mice. | 2005 Mar |
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Hormonal treatment of a recurrent granulosa cell tumor of the ovary: case report and review of the literature. | 2005 Mar |
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Phase II study of sequential hormonal therapy with anastrozole/exemestane in advanced and metastatic breast cancer. | 2005 May 9 |
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Benign metastasizing leiomyoma responsive to megestrol: case report and review of the literature. | 2005 Nov-Dec |
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The role of aromatase inhibitors in ameliorating deleterious effects of ovarian stimulation on outcome of infertility treatment. | 2005 Oct 4 |
|
[Isolation and identification of two new epimer from the mother liquid of megestrol acetate]. | 2005 Sep |
|
Review of cost-effectiveness analyses in hormonal therapies in advanced breast cancer. | 2005 Sep |
|
Bleeding patterns during continuous estradiol with different sequential progestogens therapy. | 2005 Sep-Oct |
|
Progestogens: effects on clinical and biochemical parameters in postmenopausal women. | 2005 Sep-Oct |
|
Letrozole: a pharmacoeconomic review of its use in postmenopausal women with breast cancer. | 2006 |
|
Megestrol attenuates the hormonal response to CCK-4-induced panic attacks. | 2006 |
|
Hepatocellular carcinoma--Pathological complete response to oral capecitabine, megestrol and thalidomide. | 2006 |
|
Effects of a single Silastic contraceptive implant containing nomegestrol acetate (Uniplant) on endometrial morphology and ovarian function for 1 year. | 2006 Dec |
|
Durable response of metastatic endometrial carcinoma to treatment with fulvestrant (Faslodex) after prior progestin and anastrozole therapy. | 2006 Feb |
|
Effects of estrogen, raloxifene, and hormone replacement therapy on serum C-reactive protein and homocysteine levels. | 2006 Feb 20 |
|
Nanoparticles of poorly water-soluble drugs prepared by supercritical fluid extraction of emulsions. | 2006 Jan |
|
Short-term progestin treatments prevent estrous induction by a GnRH agonist implant in anestrous bitches. | 2006 Jan 20 |
|
Orchiectomy or androgen receptor blockade attenuates baroreflex-mediated bradycardia in conscious rats. | 2006 Jan 23 |
|
A successful live birth through in vitro fertilization program after conservative treatment of FIGO grade I endometrial cancer. | 2006 Jun |
|
Characterization of related impurities in megestrol acetate. | 2006 Jun 16 |
|
Second- and third-generation aromatase inhibitors as first-line endocrine therapy in postmenopausal metastatic breast cancer patients: a pooled analysis of the randomised trials. | 2006 Jun 19 |
|
Cyclic progestin administration increases energy expenditure and decreases body fat mass in perimenopausal women. | 2006 Mar-Apr |
|
New progestagens for contraceptive use. | 2006 Mar-Apr |
|
[Pharmacological therapy of cancer anorexia-cachexia]. | 2006 May |
|
Activation of nitric oxide synthesis in human endothelial cells using nomegestrol acetate. | 2006 Oct |
|
Testosterone supplementation of megestrol therapy does not enhance lean tissue accrual in men with human immunodeficiency virus-associated weight loss: a randomized, double-blind, placebo-controlled, multicenter trial. | 2007 Feb |
|
Longitudinal evaluation of serum leptin and bone mineral density in early postmenopausal women. | 2007 May-Jun |
Patents
Sample Use Guides
Oral Suspension is 800 mg/day (20 mL/day).
In clinical trials evaluating different dose schedules, daily doses of 400 and 800 mg/day.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/15297426
Megestrol acetate was shown to inhibit the growth of HepG2 cells in vitro in dose- and time-dependent manners with an IC (50) of 260 uM (24-h incubation)
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Classification Tree | Code System | Code | ||
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WHO-VATC |
QG03AC05
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WHO-ATC |
G03AC05
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LIVERTOX |
593
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WHO-ATC |
G03FB04
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CFR |
21 CFR 520.1341
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NCI_THESAURUS |
C776
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WHO-VATC |
QG03DB02
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WHO-ATC |
G03FA08
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WHO-ATC |
L02AB01
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WHO-VATC |
QG03FA08
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WHO-ATC |
G03AB01
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WHO-VATC |
QG03AB01
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NDF-RT |
N0000175602
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WHO-ATC |
G03DB02
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WHO-VATC |
QL02AB01
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NDF-RT |
N0000011301
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WHO-VATC |
QG03FB04
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WHO-ATC |
G03AA04
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WHO-VATC |
QG03AA04
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EA6LD1M70M
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1529
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C630
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6722
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6703
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3233
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EA6LD1M70M
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CHEMBL1201139
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MEGESTROL
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3562-63-8
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SUB08712MIG
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19090
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DTXSID00100933
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222-628-6
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100000081461
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D008535
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ACTIVE MOIETY