U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ACHIRAL
Molecular Formula C20H28O2
Molecular Weight 300.4351
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 4
Charge 0

SHOW SMILES / InChI
Structure of ISOTRETINOIN

SMILES

CC(\C=C\C1=C(C)CCCC1(C)C)=C/C=C/C(C)=C\C(O)=O

InChI

InChIKey=SHGAZHPCJJPHSC-XFYACQKRSA-N
InChI=1S/C20H28O2/c1-15(8-6-9-16(2)14-19(21)22)11-12-18-17(3)10-7-13-20(18,4)5/h6,8-9,11-12,14H,7,10,13H2,1-5H3,(H,21,22)/b9-6+,12-11+,15-8+,16-14-

HIDE SMILES / InChI

Description

Alitretinoin, or 9-cis-retinoic acid, is a form of vitamin A. It is also used in medicine as an antineoplastic (anti-cancer) agent developed by Ligand Pharmaceuticals. Alitretinoin (9-cis-retinoic acid) is a naturally-occurring endogenous retinoid indicated for topical treatment of cutaneous lesions in patients with AIDS-related Kaposi's sarcoma. Alitretinoin inhibits the growth of Kaposi's sarcoma (KS) cells in vitro. Alitretinoin binds to and activates all known intracellular retinoid receptor subtypes (RARa, RARb, RARg, RXRa, RXRb and RXRg). Once activated these receptors function as transcription factors that regulate the expression of genes that control the process of cellular differentiation and proliferation in both normal and neoplastic cells. In the United States, topical alitretinoin (in the form of a gel; trade name Panretin) is indicated for the treatment of skin lesions in AIDS-related Kaposi's sarcoma.

CNS Activity

Originator

Approval Year

Targets

Primary TargetPharmacologyConditionPotency
10.0 nM [EC50]
50.0 nM [EC50]
195.0 nM [EC50]
3.0 nM [EC50]
140.0 nM [EC50]

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
ACCUTANE
Primary
RETIN-A
Palliative
TRETINOIN

Cmax

ValueDoseCo-administeredAnalytePopulation
314 ng/mL
40 mg single, oral
ISOTRETINOIN plasma
Homo sapiens

AUC

ValueDoseCo-administeredAnalytePopulation
4055 ng × h/mL
40 mg single, oral
ISOTRETINOIN plasma
Homo sapiens

T1/2

ValueDoseCo-administeredAnalytePopulation
24 h
40 mg single, oral
ISOTRETINOIN plasma
Homo sapiens

Funbound

ValueDoseCo-administeredAnalytePopulation
0.1%
40 mg single, oral
ISOTRETINOIN plasma
Homo sapiens

Doses

AEs

Drug as perpetrator​

Drug as victim

PubMed

Sample Use Guides

In Vivo Use Guide
acute promyelocytic leukemia (APL): The recommended dose is 45 mg/m2/day administered as two evenly divided doses until complete remission is documented. Therapy should be discontinued 30 days after achievement of complete remission or after 90 days of treatment, whichever occurs first. acne vulgaris: RETIN-A Gel, Cream or Liquid should be applied once a day, before retiring, to the skin where acne lesions appear, using enough to cover the entire affected area lightly. Liquid: the liquid may be applied using a fingertip, gauze pad, or cotton swab. If gauze or cotton is employed, care should be taken not to oversaturate it, to the extent that the liquid would run into areas where treatment is not intended. Gel: Excessive application results in “pilling” of the gel, which minimizes the likelihood of over application by the patient.
Route of Administration: Other
In Vitro Use Guide
Human bronchial SMCs were used and pretreated with or without tretinoin, also known as all-trans-retinoic acid (ATRA), (2 μM) for 20 min before the addition of PDGF (1 μg/ml), or ATRA alone. The neutral comet assay, which determines the incidence of double-stranded DNA breaks, was used to demonstrate that ATRA treatment induced apoptosis of bovine and human pulmonary artery SMC. In contrast, apoptotic cell death was not produced in response to ATRA in human bronchial airway SMC, as monitored by comet assay. Similarly, TUNEL assay and the measurement of mitochondrial membrane potential failed to demonstrate significant apoptosis by ATRA in airway SMCs. Positive controls, daunorubicin (DNR) and hydrogen peroxide, effectively elicited apoptosis in airway SMC. Because ATRA inhibited both morphologic and actin cytoskeletal changes induced by PDGF, it was characterized the effects of ATRA on PDGF-induced airway SMC migration using a modified Boyden chamber assay, which allows for determination of motility in random directions. PDGF caused a 4-fold increase in migration of airway SMCs after 24 h, and ATRA blocked these events. ATRA by itself had no effect. While the therapeutic level of ATRA in human plasma could reach 1–2 μM, the effects on airway SMC migration were observed with ATRA concentrations as low as 0.2 μM. DMSO, which is used as vehicle for ATRA and other retinoids, has no effect on PDGF-induced airway SMC migration. This does not appear to be due to the effects of ATRA on cell proliferation, as MTT assay showed that ATRA is not effective in inhibiting PDGF-induced cell proliferation; additionally, migration assay with 4 h of PDGF treatment also exhibits the ability of ATRA to inhibit migratory responses, as monitored using a modified Boyden chamber assay. Thus, although ATRA is ineffective in inhibiting proliferation and inducing apoptosis of airway SMCs, ATRA is an efficient inhibitor of airway SMC migration. Furthermore, using actinomycin D, a general inhibitor of gene transcription, showed that ATRA inhibition of SMC migration does not mediate gene transcriptional events.