LEFAMULIN ACETATE

Details

Stereochemistry	ABSOLUTE
Molecular Formula	C28H45NO5S.C2H4O2
Molecular Weight	567.778
Optical Activity	UNSPECIFIED
Defined Stereocenters	10 / 11
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure Search

SMILES

CC(O)=O.[H][C@@]12C(=O)CC[C@]13CC[C@@H](C)[C@@]2(C)[C@@H](C[C@@](C)(C=C)[C@@H](O)[C@@H]3C)OC(=O)CS[C@@H]4CC[C@@H](N)C[C@H]4O

InChI

InChIKey=WSMXIQXWHPSVDE-QALMONEZSA-N

InChI=1S/C28H45NO5S.C2H4O2/c1-6-26(4)14-22(34-23(32)15-35-21-8-7-18(29)13-20(21)31)27(5)16(2)9-11-28(17(3)25(26)33)12-10-19(30)24(27)28;1-2(3)4/h6,16-18,20-22,24-25,31,33H,1,7-15,29H2,2-5H3;1H3,(H,3,4)/t16?,17-,18+,20+,21+,22+,24-,25-,26+,27-,28-;/m0./s1

HIDE SMILES / InChI

Description
Sources: https://www.ncbi.nlm.nih.gov/mesh/2002015 | https://www.nabriva.com/pipeline-research | https://www.ncbi.nlm.nih.gov/pubmed/30513017

LEFAMULIN is a pleuromutilin antibiotic under development for the treatment of community-acquired bacterial pneumonia, as well as acute bacterial skin and skin structure infections. It inhibits bacterial protein synthesis by binding to the peptidyl transferase center of the 50S ribosome, resulting in the cessation of bacterial growth.

Originator

Approval Year

C_max

Value	Dose	Analyte	Population
3.5 μg/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	150 mg single, intravenous dose: 150 mg route of administration: Intravenous experiment type: SINGLE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
3.6 μg/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	150 mg 2 times / day steady-state, intravenous dose: 150 mg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
2.24 μg/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	600 mg single, oral dose: 600 mg route of administration: Oral experiment type: SINGLE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FASTED
2.24 μg/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	600 mg 2 times / day steady-state, oral dose: 600 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FASTED

AUC

Value	Dose	Analyte	Population
27 μg × h/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	150 mg single, intravenous dose: 150 mg route of administration: Intravenous experiment type: SINGLE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
28.6 μg × h/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	150 mg 2 times / day steady-state, intravenous dose: 150 mg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
30.7 μg × h/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	600 mg single, oral dose: 600 mg route of administration: Oral experiment type: SINGLE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FASTED
32.7 μg × h/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	600 mg 2 times / day steady-state, oral dose: 600 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FASTED

T_1/2

Value	Dose	Analyte	Population
8 h DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	150 mg single, intravenous dose: 150 mg route of administration: Intravenous experiment type: SINGLE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
8 h DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	150 mg 2 times / day steady-state, intravenous dose: 150 mg route of administration: Intravenous experiment type: STEADY-STATE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
8 h DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	600 mg single, oral dose: 600 mg route of administration: Oral experiment type: SINGLE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FASTED
8 h DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	600 mg 2 times / day steady-state, oral dose: 600 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	LEFAMULIN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FASTED

Doses

Dose	Population	Adverse events
200 mg 2 times / day multiple, intravenous Highest studied dose Dose: 200 mg, 2 times / day Route: intravenous Route: multiple Dose: 200 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf	healthy, adults Health Status: healthy Age Group: adults Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf
400 mg single, intravenous Highest studied dose Dose: 400 mg Route: intravenous Route: single Dose: 400 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf	healthy, adults Health Status: healthy Age Group: adults Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf
600 mg 2 times / day multiple, oral Highest studied dose Dose: 600 mg, 2 times / day Route: oral Route: multiple Dose: 600 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf	healthy, adults Health Status: healthy Age Group: adults Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf
750 mg single, oral Highest studied dose Dose: 750 mg Route: oral Route: single Dose: 750 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf	healthy, adults Health Status: healthy Age Group: adults Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf
600 mg 2 times / day multiple, oral Recommended Dose: 600 mg, 2 times / day Route: oral Route: multiple Dose: 600 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	unhealthy, adults n = 368 Health Status: unhealthy Condition: community-acquired bacterial pneumonia (CABP) Age Group: adults Sex: M+F Population Size: 368 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	Other AEs: Diarrhea, Nausea... Other AEs: Diarrhea (12%) Nausea (5%) Vomiting (3%) Alanine aminotransferase increased (2%) Aspartate aminotransferase increased (2%) Liver function test increased (2%) Anemia (<2%) Thrombocytopenia (<2%) Atrial fibrillation (<2%) Palpitations (<2%) Abdominal pain (<2%) Constipation (<2%) Dyspepsia (<2%) Epigastric discomfort (<2%) Gastritis erosive (<2%) Clostridium difficile colitis (<2%) Oropharyngeal candidiasis (<2%) Vulvovaginal candidiasis (<2%) Somnolence (<2%) Urinary retention (<2%) Anxiety (<2%) Diarrhea (12%) Nausea (5%) Vomiting (3%) Alanine aminotransferase increased (2%) Aspartate aminotransferase increased (2%) Liver function test increased (2%) Anemia (<2%) Thrombocytopenia (<2%) Atrial fibrillation (<2%) Palpitations (<2%) Abdominal pain (<2%) Constipation (<2%) Dyspepsia (<2%) Epigastric discomfort (<2%) Gastritis erosive (<2%) Clostridium difficile colitis (<2%) Oropharyngeal candidiasis (<2%) Vulvovaginal candidiasis (<2%) Somnolence (<2%) Urinary retention (<2%) Anxiety (<2%) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf
150 \| 600 mg\|mg 2 \| 2 times / day\|day multiple\|multiple, intravenous\|oral (complex) Recommended Dose: 150 \| 600 mg\|mg, 2 \| 2 times / day\|day Route: intravenous\|oral Route: multiple\|multiple Dose: 150 \| 600 mg\|mg, 2 \| 2 times / day\|day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	unhealthy, adults n = 273 Health Status: unhealthy Condition: community-acquired bacterial pneumonia (CABP) Age Group: adults Sex: M+F Population Size: 273 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf	Other AEs: Infusion site pain, Infusion site phlebitis... Other AEs: Infusion site pain (7%) Infusion site phlebitis (7%) Injection site reaction (7%) Alanine aminotransferase increased (3%) Aspartate aminotransferase increased (3%) Liver function test increased (3%) Nausea (3%) Hypokalemia (3%) Insomnia (3%) Headache (2%) Anemia (<2%) Thrombocytopenia (<2%) Atrial fibrillation (<2%) Palpitations (<2%) Abdominal pain (<2%) Constipation (<2%) Dyspepsia (<2%) Epigastric discomfort (<2%) Gastritis erosive (<2%) Clostridium difficile colitis (<2%) Oropharyngeal candidiasis (<2%) Vulvovaginal candidiasis (<2%) Somnolence (<2%) Urinary retention (<2%) Anxiety (<2%) Infusion site pain (7%) Infusion site phlebitis (7%) Injection site reaction (7%) Alanine aminotransferase increased (3%) Aspartate aminotransferase increased (3%) Liver function test increased (3%) Nausea (3%) Hypokalemia (3%) Insomnia (3%) Headache (2%) Anemia (<2%) Thrombocytopenia (<2%) Atrial fibrillation (<2%) Palpitations (<2%) Abdominal pain (<2%) Constipation (<2%) Dyspepsia (<2%) Epigastric discomfort (<2%) Gastritis erosive (<2%) Clostridium difficile colitis (<2%) Oropharyngeal candidiasis (<2%) Vulvovaginal candidiasis (<2%) Somnolence (<2%) Urinary retention (<2%) Anxiety (<2%) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211672s000,211673s000lbl.pdf
150 \| 600 mg\|mg 2 \| 2 times / day\|day multiple\|multiple, intravenous\|oral (complex) Recommended Dose: 150 \| 600 mg\|mg, 2 \| 2 times / day\|day Route: intravenous\|oral Route: multiple\|multiple Dose: 150 \| 600 mg\|mg, 2 \| 2 times / day\|day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf	unhealthy, adults n = 273 Health Status: unhealthy Condition: community-acquired bacterial pneumonia (CABP) Age Group: adults Sex: M+F Population Size: 273 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf	Disc. AE: Infectious pleural effusion, Lung abscess... Other AEs: Infectious pleural effusion, Lung abscess... AEs leading to discontinuation/dose reduction: Infectious pleural effusion (1 patient) Lung abscess (1 patient) Pneumonia (1 patient) Pulmonary tuberculosis (1 patient) Acute respiratory distress syndrome (1 patient) Acute respiratory failure (1 patient) Chronic obstructive pulmonary disease (1 patient) Pulmonary edema (1 patient) Vomiting (2 patients) Abdominal pain upper (1 patient) Infusion site phlebitis (1 patient) Injection site reaction (1 patient) Hepatitis toxic (1 patient) Other AEs: Infectious pleural effusion (1 patient) Lung abscess (1 patient) Pneumonia (1 patient) Pulmonary tuberculosis (1 patient) Acute respiratory distress syndrome (1 patient) Acute respiratory failure (1 patient) Chronic obstructive pulmonary disease (1 patient) Pulmonary edema (1 patient) Vomiting (2 patients) Abdominal pain upper (1 patient) Infusion site phlebitis (1 patient) Injection site reaction (1 patient) Hepatitis toxic (1 patient) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf

AEs

Overview

CYP3A4	CYP2C9	CYP2D6	hERG
substrate 1737	inhibitor 1767 substrate 1037 inducer 389	inhibitor 1852 substrate 1217 inducer 97	inhibitor 1612

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
OCT1 512 CYP1A2 1524 CYP2B6 810 CYP2C8 911 CYP2C19 1478 CYP3A4/5 278 BCRP 699 P-gp 1461 BSEP 402 OAT1 599 OAT3 642 OCT2 647 MATE1 306 MATE2 263 OATP1B1 788 OATP1B3 706	OCT1 327 P-gp 1537 CYP3A5 395 CYP2B6 664 CYP2C8 693 CYP2C19 991	CYP2B6 547 CYP2C8 168 CYP2C19 293

Drug as perpetrator

Target	Modality	Activity
BSEP 403	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=228 Page: 228.0	no [IC50 24.5 uM]
CYP2C8 965	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no [IC50 41 uM]
OAT1 603	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=228 Page: 228.0	no [IC50 >122 uM]
OAT3 644	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=228 Page: 228.0	no [IC50 >122 uM]
OCT2 648	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=228 Page: 228.0	no [IC50 >122 uM]
CYP1A2 1692	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no [IC50 >200 uM]
CYP2B6 1001	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no [IC50 >200 uM]
CYP2C19 1553	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no [IC50 >200 uM]
CYP2C9 1819	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no [IC50 >200 uM]
CYP2D6 1891	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no [IC50 >200 uM]
CYP2B6 1001	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no
CYP2C19 1553	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no
CYP2C8 965	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no
CYP2C9 1819	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no
CYP2D6 1891	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no
OATP1B1 803	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=270 Page: 126;270	weak [IC50 122 uM]
OATP1B3 715	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=270 Page: 126;270	weak [IC50 122 uM]
P-gp 1650	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=270 Page: 50;126;270	weak [IC50 13.76 uM]
MATE1 308	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=270 Page: 126;270	yes [IC50 0.297 uM]
BCRP 773	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=228 Page: 127;228	yes [IC50 42.2 uM]
MATE2 263	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=270 Page: 126;270	yes [IC50 76.4 uM]
CYP3A4/5 335	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=270 Page: 126;270	yes [Ki 0.86 uM]
OCT1 543	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=270 Page: 126;228;270	yes

Drug as victim

Target	Modality	Activity	Clinical evidence
CYP2B6 664	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no
CYP2C19 991	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no
CYP2C8 693	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no
CYP2C9 1037	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no
CYP2D6 1217	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=227 Page: 227.0	no
CYP3A5 395	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=270 Page: 270.0	no
OCT1 327	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=228 Page: 125;228	yes
P-gp 1537	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=126 Page: 125;269;270	yes
CYP3A4 1737	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=126 Page: 126;269;270	yes	yes (co-administration study) Comment: increased the arithmetic mean Cmax and AUC0-inf of LEF by 58% and 165%, respectively, when administered with ketoconazole (strong inhibitor); reduced the arithmetic mean Cmax and AUC0-inf of LEF by 57% and 72%, respectively, when administered with rifampin (strong inducer) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=126 Page: 126;269;270

Tox targets

Target	Modality	Activity	Metabolite	Clinical evidence
hERG 1647	inhibitor 1626 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211672Orig1s000,%20211673Orig1s000MultidisciplineR.pdf#page=45 Page: 45.0

Sourcing

Vendor/Aggregator	ID	URL
001 Chemical	DY34218	https://www.001chemical.com/chem/1061337-51-6
BioChemPartner	BCP24164	http://www.biochempartner.com/1061337-51-6-BCP24164
DC Chemicals	DC8172	http://www.dcchemicals.com/product_show-Lefamulin_BC_3781_.html
Excenen	EX-A3600	https://www.excenen.com/searchresultlist.php?id=EX-A3600
Lab Network	LN01343920	https://labnetwork.com/frontend-app/p/#!/moleculedetails/LN01343920
Molcore	MC34218	https://www.molcore.com/product/1061337-51-6
MuseChem	I007398	https://www.musechem.com/product/I007398.html
Smolecule	S532713	http://www.smolecule.com/products/s532713
THE BioTek	bt-272945	https://www.thebiotek.com/product/inhibitors/bt-272945
THE BioTek	bt-468058	https://www.thebiotek.com/product/others/bt-468058
eNovation Chemicals	D666959	https://www.enovationchem.com/ProductDetails.asp?ProductID=D666959

PubMed

Title	Date	PubMed
Simultaneous assessment of the pharmacokinetics of a pleuromutilin, lefamulin, in plasma, soft tissues and pulmonary epithelial lining fluid.	2016 Apr	26747098
In Vitro Activity of Lefamulin Tested against Streptococcus pneumoniae with Defined Serotypes, Including Multidrug-Resistant Isolates Causing Lower Respiratory Tract Infections in the United States.	2016 Jul	27161634
Lefamulin: Review of a Promising Novel Pleuromutilin Antibiotic.	2018 Sep	30019769
Lefamulin: a promising new pleuromutilin antibiotic in the pipeline.	2019 Jan	30513017

Sample Use Guides

In Vitro Use Guide

Lefamulin was evaluated against various Streptococcus pneumoniae serotypes that were collected from adults with lower respiratory tract infections. Lefamulin exhibited MIC50 and MIC90 values of 0.12 and 0.25 μg/ml, respectively, against the entire collection (n = 822). Similar results were obtained for lefamulin against each of the most common serotypes as well as against multidrug-resistant isolates and strains that are nonsusceptible to ceftriaxone or erythromycin.

Name

Type

Language

LEFAMULIN ACETATE

Official Name

English

LEFAMULIN ACETATE [USAN]

Common Name

English

Lefamulin acetate [WHO-DD]

Common Name

English

BC-3781.AC

Code

English

ACETATE SALT OF (3AS,4R,5S,6S,8R,9R,9AR, 10R)-6-ETHENYL-5-HYDROXY-4,6,9,10- TETRAMETHYL-1-OXODECAHYDRO-3A,9-PROPANO-3AH-CYCLOPENTA(8)ANNULEN-8-YL (((1R,2R,4R)-4-AMINO-2-HYDROXYCYCLOHEXYL)SULFANYL)ACETATE ESTER

Systematic Name

English

ACETIC ACID, 2-(((1R,2R,4R)-4-AMINO-2-HYDROXYCYCLOHEXYL)THIO)-, (3AS,4R,5S,6S,8R,9R,9AR,10R)-6-ETHENYLDECAHYDRO-5-HYDROXY-4,6,9,10-TETRAMETHYL-1-OXO-3A,9-PROPANO-3AH-CYCLOPENTACYCLOOCTEN-8-YL ESTER, ACETATE (1:1)

Systematic Name

English

XENLETA

Brand Name

English

LEFAMULIN ACETATE [ORANGE BOOK]

Common Name

English

Code System Code Type Description

NCI_THESAURUS

C170100