Details
Stereochemistry | ACHIRAL |
Molecular Formula | C3H11NO7P2 |
Molecular Weight | 235.0695 |
Optical Activity | NONE |
Defined Stereocenters | 0 / 0 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
NCCC(O)(P(O)(O)=O)P(O)(O)=O
InChI
InChIKey=WRUUGTRCQOWXEG-UHFFFAOYSA-N
InChI=1S/C3H11NO7P2/c4-2-1-3(5,12(6,7)8)13(9,10)11/h5H,1-2,4H2,(H2,6,7,8)(H2,9,10,11)
Pamidronic acid (Pamidronate Disodium) is a bone resorption inhibitor. The principal pharmacologic action of pamidronate disodium is inhibition of bone resorption. Although the mechanism of
antiresorptive action is not completely understood, several factors are thought to contribute to this action. Pamidronate disodium
adsorbs to calcium phosphate (hydroxyapatite) crystals in bone and may directly block dissolution of this mineral component of bone.
In vitro studies also suggest that inhibition of osteoclast activity contributes to inhibition of bone resorption. In animal studies, at doses
recommended for the treatment of hypercalcemia, pamidronate disodium inhibits bone resorption apparently without inhibiting bone
formation and mineralization. Of relevance to the treatment of hypercalcemia of malignancy is the finding that pamidronate disodium
inhibits the accelerated bone resorption that results from osteoclast hyperactivity induced by various tumors in animal studies. Pamidronate disodium, in conjunction with adequate hydration, is indicated for the treatment of moderate or severe hypercalcemia
associated with malignancy, with or without bone metastases. Pamidronate disodium is indicated for the treatment of patients with moderate to severe Paget’s disease of bone. Pamidronate disodium is indicated, in conjunction with standard antineoplastic therapy, for the treatment of osteolytic bone metastases
of breast cancer and osteolytic lesions of multiple myeloma.
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
55.9 nM [Ki] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | PAMIDRONATE DISODIUM Approved UseHypercalcemia of Malignancy
Pamidronate disodium, in conjunction with adequate hydration, is indicated for the treatment of moderate or severe hypercalcemia
associated with malignancy, with or without bone metastases. Patients who have either epidermoid or non-epidermoid tumors respond
to treatment with pamidronate disodium. Vigorous saline hydration, an integral part of hypercalcemia therapy, should be initiated
promptly and an attempt should be made to restore the urine output to about 2 L/day throughout treatment. Mild or asymptomatic
hypercalcemia may be treated with conservative measures (i.e., saline hydration, with or without loop diuretics). Patients should
be hydrated adequately throughout the treatment, but overhydration, especially in those patients who have cardiac failure, must
be avoided. Diuretic therapy should not be employed prior to correction of hypovolemia. The safety and efficacy of pamidronate
disodium in the treatment of hypercalcemia associated with hyperparathyroidism or with other non-tumor-related conditions has not
been established.
Paget’s Disease
Pamidronate disodium is indicated for the treatment of patients with moderate to severe Paget’s disease of bone. The effectiveness
of pamidronate disodium was demonstrated primarily in patients with serum alkaline phosphatase ≥3 times the upper limit of normal.
Pamidronate disodium therapy in patients with Paget’s disease has been effective in reducing serum alkaline phosphatase and urinary
hydroxyproline levels by ≥50% in at least 50% of patients, and by ≥30% in at least 80% of patients. Pamidronate disodium therapy
has also been effective in reducing these biochemical markers in patients with Paget’s disease who failed to respond, or no longer
responded to other treatments.
Osteolytic Bone Metastases of Breast Cancer and Osteolytic Lesions of Multiple Myeloma
Pamidronate disodium is indicated, in conjunction with standard antineoplastic therapy, for the treatment of osteolytic bone metastases
of breast cancer and osteolytic lesions of multiple myeloma. The pamidronate disodium treatment effect appeared to be smaller in
the study of breast cancer patients receiving hormonal therapy than in the study of those receiving chemotherapy, however, overall
evidence of clinical benefit has been demonstrated. Launch Date1991 |
|||
Primary | PAMIDRONATE DISODIUM Approved UseHypercalcemia of Malignancy
Pamidronate disodium, in conjunction with adequate hydration, is indicated for the treatment of moderate or severe hypercalcemia
associated with malignancy, with or without bone metastases. Patients who have either epidermoid or non-epidermoid tumors respond
to treatment with pamidronate disodium. Vigorous saline hydration, an integral part of hypercalcemia therapy, should be initiated
promptly and an attempt should be made to restore the urine output to about 2 L/day throughout treatment. Mild or asymptomatic
hypercalcemia may be treated with conservative measures (i.e., saline hydration, with or without loop diuretics). Patients should
be hydrated adequately throughout the treatment, but overhydration, especially in those patients who have cardiac failure, must
be avoided. Diuretic therapy should not be employed prior to correction of hypovolemia. The safety and efficacy of pamidronate
disodium in the treatment of hypercalcemia associated with hyperparathyroidism or with other non-tumor-related conditions has not
been established.
Paget’s Disease
Pamidronate disodium is indicated for the treatment of patients with moderate to severe Paget’s disease of bone. The effectiveness
of pamidronate disodium was demonstrated primarily in patients with serum alkaline phosphatase ≥3 times the upper limit of normal.
Pamidronate disodium therapy in patients with Paget’s disease has been effective in reducing serum alkaline phosphatase and urinary
hydroxyproline levels by ≥50% in at least 50% of patients, and by ≥30% in at least 80% of patients. Pamidronate disodium therapy
has also been effective in reducing these biochemical markers in patients with Paget’s disease who failed to respond, or no longer
responded to other treatments.
Osteolytic Bone Metastases of Breast Cancer and Osteolytic Lesions of Multiple Myeloma
Pamidronate disodium is indicated, in conjunction with standard antineoplastic therapy, for the treatment of osteolytic bone metastases
of breast cancer and osteolytic lesions of multiple myeloma. The pamidronate disodium treatment effect appeared to be smaller in
the study of breast cancer patients receiving hormonal therapy than in the study of those receiving chemotherapy, however, overall
evidence of clinical benefit has been demonstrated. Launch Date1991 |
|||
Primary | PAMIDRONATE DISODIUM Approved UseHypercalcemia of Malignancy
Pamidronate disodium, in conjunction with adequate hydration, is indicated for the treatment of moderate or severe hypercalcemia
associated with malignancy, with or without bone metastases. Patients who have either epidermoid or non-epidermoid tumors respond
to treatment with pamidronate disodium. Vigorous saline hydration, an integral part of hypercalcemia therapy, should be initiated
promptly and an attempt should be made to restore the urine output to about 2 L/day throughout treatment. Mild or asymptomatic
hypercalcemia may be treated with conservative measures (i.e., saline hydration, with or without loop diuretics). Patients should
be hydrated adequately throughout the treatment, but overhydration, especially in those patients who have cardiac failure, must
be avoided. Diuretic therapy should not be employed prior to correction of hypovolemia. The safety and efficacy of pamidronate
disodium in the treatment of hypercalcemia associated with hyperparathyroidism or with other non-tumor-related conditions has not
been established.
Paget’s Disease
Pamidronate disodium is indicated for the treatment of patients with moderate to severe Paget’s disease of bone. The effectiveness
of pamidronate disodium was demonstrated primarily in patients with serum alkaline phosphatase ≥3 times the upper limit of normal.
Pamidronate disodium therapy in patients with Paget’s disease has been effective in reducing serum alkaline phosphatase and urinary
hydroxyproline levels by ≥50% in at least 50% of patients, and by ≥30% in at least 80% of patients. Pamidronate disodium therapy
has also been effective in reducing these biochemical markers in patients with Paget’s disease who failed to respond, or no longer
responded to other treatments.
Osteolytic Bone Metastases of Breast Cancer and Osteolytic Lesions of Multiple Myeloma
Pamidronate disodium is indicated, in conjunction with standard antineoplastic therapy, for the treatment of osteolytic bone metastases
of breast cancer and osteolytic lesions of multiple myeloma. The pamidronate disodium treatment effect appeared to be smaller in
the study of breast cancer patients receiving hormonal therapy than in the study of those receiving chemotherapy, however, overall
evidence of clinical benefit has been demonstrated. Launch Date1991 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
1.92 μg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9115053/ |
90 mg single, intravenous dose: 90 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
PAMIDRONATE DISODIUM plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
1.44 μg/mL |
60 mg single, intravenous dose: 60 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
PAMIDRONATE DISODIUM unknown | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
2.61 μg/mL |
90 mg single, intravenous dose: 90 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
PAMIDRONATE DISODIUM unknown | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
0.73 μg/mL |
30 mg single, intravenous dose: 30 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
PAMIDRONATE DISODIUM unknown | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
10.2 μg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/9115053/ |
90 mg single, intravenous dose: 90 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
PAMIDRONATE DISODIUM plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
28 h |
60 mg single, intravenous dose: 60 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
PAMIDRONATE DISODIUM unknown | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
28 h |
90 mg single, intravenous dose: 90 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
PAMIDRONATE DISODIUM unknown | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
28 h |
30 mg single, intravenous dose: 30 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
PAMIDRONATE DISODIUM unknown | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
5.6 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 5.6 mg/kg, 3 times / day Route: oral Route: multiple Dose: 5.6 mg/kg, 3 times / day Sources: |
unhealthy, adult n = 9 Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sex: M+F Population Size: 9 Sources: |
Disc. AE: Diarrhea... AEs leading to discontinuation/dose reduction: Diarrhea Sources: |
120 mg/kg 1 times / day multiple, intravenous Overdose Dose: 120 mg/kg, 1 times / day Route: intravenous Route: multiple Dose: 120 mg/kg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sources: |
Disc. AE: Hypocalcemia... AEs leading to discontinuation/dose reduction: Hypocalcemia Sources: |
285 mg/kg 1 times / day multiple, intravenous Overdose Dose: 285 mg/kg, 1 times / day Route: intravenous Route: multiple Dose: 285 mg/kg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sex: F Sources: |
Disc. AE: Fever, Hypotension... AEs leading to discontinuation/dose reduction: Fever Sources: Hypotension Taste perversion |
90 mg/kg 1 times / day single, intravenous Recommended Dose: 90 mg/kg, 1 times / day Route: intravenous Route: single Dose: 90 mg/kg, 1 times / day Sources: |
unhealthy, adult n = 182 Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sex: M+F Population Size: 182 Sources: |
Disc. AE: Interstitial pneumonitis, Hypocalcemia... AEs leading to discontinuation/dose reduction: Interstitial pneumonitis Sources: Hypocalcemia Bone pain |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Diarrhea | Disc. AE | 5.6 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 5.6 mg/kg, 3 times / day Route: oral Route: multiple Dose: 5.6 mg/kg, 3 times / day Sources: |
unhealthy, adult n = 9 Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sex: M+F Population Size: 9 Sources: |
Hypocalcemia | Disc. AE | 120 mg/kg 1 times / day multiple, intravenous Overdose Dose: 120 mg/kg, 1 times / day Route: intravenous Route: multiple Dose: 120 mg/kg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sources: |
Fever | Disc. AE | 285 mg/kg 1 times / day multiple, intravenous Overdose Dose: 285 mg/kg, 1 times / day Route: intravenous Route: multiple Dose: 285 mg/kg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sex: F Sources: |
Hypotension | Disc. AE | 285 mg/kg 1 times / day multiple, intravenous Overdose Dose: 285 mg/kg, 1 times / day Route: intravenous Route: multiple Dose: 285 mg/kg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sex: F Sources: |
Taste perversion | Disc. AE | 285 mg/kg 1 times / day multiple, intravenous Overdose Dose: 285 mg/kg, 1 times / day Route: intravenous Route: multiple Dose: 285 mg/kg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sex: F Sources: |
Bone pain | Disc. AE | 90 mg/kg 1 times / day single, intravenous Recommended Dose: 90 mg/kg, 1 times / day Route: intravenous Route: single Dose: 90 mg/kg, 1 times / day Sources: |
unhealthy, adult n = 182 Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sex: M+F Population Size: 182 Sources: |
Hypocalcemia | Disc. AE | 90 mg/kg 1 times / day single, intravenous Recommended Dose: 90 mg/kg, 1 times / day Route: intravenous Route: single Dose: 90 mg/kg, 1 times / day Sources: |
unhealthy, adult n = 182 Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sex: M+F Population Size: 182 Sources: |
Interstitial pneumonitis | Disc. AE | 90 mg/kg 1 times / day single, intravenous Recommended Dose: 90 mg/kg, 1 times / day Route: intravenous Route: single Dose: 90 mg/kg, 1 times / day Sources: |
unhealthy, adult n = 182 Health Status: unhealthy Condition: hypercalcemia Age Group: adult Sex: M+F Population Size: 182 Sources: |
PubMed
Title | Date | PubMed |
---|---|---|
Bisphosphonates in multiple myeloma. | 2001 |
|
Bisphosphonates for osteoporosis in people with cystic fibrosis. | 2001 |
|
Incremental cost analysis of ambulatory clinic and home-based intravenous therapy for patients with multiple myeloma. | 2001 |
|
The clinical and cost considerations of bisphosphonates in preventing bone complications in patients with metastatic breast cancer or multiple myeloma. | 2001 |
|
Tumor 'flare' hypercalcemia--an additional indication for bisphosphonates? | 2001 |
|
Chemical and biological prerequisites for novel bisphosphonate molecules: results of comparative preclinical studies. | 2001 Apr |
|
Intravenous bisphosphonate for hypercalcemia accompanying subcutaneous fat necrosis: a novel treatment approach. | 2001 Apr |
|
New advances in the biology and treatment of myeloma bone disease. | 2001 Apr |
|
Adjuvant bisphosphonate therapy: the future. | 2001 Aug |
|
Idiopathic orbital inflammation following intravenous pamidronate. | 2001 Aug |
|
Pamidronate in incident pain due to bone metastases. | 2001 Aug |
|
Scintigraphic evaluation of pamidronate and corticosteroid therapy in a patient with progressive diaphyseal dysplasia (Camurati-Engelmann disease). | 2001 Aug |
|
Pamidronate-related nephrotoxicity (tubulointerstitial nephritis) in a patient with osteolytic bone metastases. | 2001 Dec |
|
Structure-activity relationships for inhibition of farnesyl diphosphate synthase in vitro and inhibition of bone resorption in vivo by nitrogen-containing bisphosphonates. | 2001 Feb |
|
Primary prevention of glucocorticoid-induced osteoporosis with intravenous pamidronate and calcium: a prospective controlled 1-year study comparing a single infusion, an infusion given once every 3 months, and calcium alone. | 2001 Jan |
|
A newly developed bisphosphonate, YM529, is a potent apoptosis inducer of human myeloma cells. | 2001 Jan |
|
Pamidronate for bone pain from osteolytic lesions in Langerhans'-cell histiocytosis. | 2001 Jul 19 |
|
Ocular adverse effects of alendronic acid. | 2001 Jun |
|
Collapsing focal segmental glomerulosclerosis following treatment with high-dose pamidronate. | 2001 Jun |
|
Osteogenesis imperfecta: lifelong management is imperative and feasible. | 2001 Mar |
|
Pamidronate increases markers of bone formation in patients with multiple myeloma in plateau phase under interferon-alpha treatment. | 2001 May |
|
Visualization of bisphosphonate-induced caspase-3 activity in apoptotic osteoclasts in vitro. | 2001 May |
|
Essential requirement of antigen presentation by monocyte lineage cells for the activation of primary human gamma delta T cells by aminobisphosphonate antigen. | 2001 May 1 |
|
[Two cases of effective weekly paclitaxel administration for metastatic breast cancer]. | 2001 Nov |
|
Bisphosphonates in the treatment of Charcot neuroarthropathy: a double-blind randomised controlled trial. | 2001 Nov |
|
Extracellular signal-regulated kinases and calcium channels are involved in the proliferative effect of bisphosphonates on osteoblastic cells in vitro. | 2001 Nov |
|
Antibacterial effect of human V gamma 2V delta 2 T cells in vivo. | 2001 Nov |
|
Targeting of tumor cells for human gammadelta T cells by nonpeptide antigens. | 2001 Nov 1 |
|
Paget's disease of the spine and its management. | 2001 Oct |
|
A microcosting analysis of zoledronic acid and pamidronate therapy in patients with metastatic bone disease. | 2001 Oct |
|
Nitrogen-containing bisphosphonates induce apoptosis of Caco-2 cells in vitro by inhibiting the mevalonate pathway: a model of bisphosphonate-induced gastrointestinal toxicity. | 2001 Oct |
|
Pamidronate-induced remission of pain associated with hypertrophic pulmonary osteoarthropathy in chemoendocrine therapy-refractory inoperable metastatic breast carcinoma. | 2001 Oct |
|
Prevention of bone loss and fracture after lung transplantation: a pilot study. | 2001 Oct 15 |
|
Hypercalcemia in patients with oral squamous cell carcinoma. | 2001 Sep |
|
Intravenous pamidronate reduces osteoporosis and improves formation of the regenerate during distraction osteogenesis. A study in immature rabbits. | 2001 Sep |
|
Zoledronic acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma: a phase III, double-blind, comparative trial. | 2001 Sep-Oct |
|
Bone mineral density response to long-term bisphosphonate therapy in fibrous dysplasia. | 2001 Summer |
Patents
Sample Use Guides
Moderate Hypercalcemia
The recommended dose of pamidronate disodium in moderate hypercalcemia (corrected serum calcium* of approximately
12 to 13.5 mg/dL) is 60 to 90 mg given as a SINGLE-DOSE, intravenous infusion over 2 to 24 hours. Longer infusions (i.e., >2
hours) may reduce the risk for renal toxicity, particularly in patients with preexisting renal insufficiency.
Severe Hypercalcemia
The recommended dose of pamidronate disodium in severe hypercalcemia (corrected serum calcium* >13.5 mg/dL) is 90 mg
given as a SINGLE-DOSE, intravenous infusion over 2 to 24 hours. Longer infusions (i.e., >2 hours) may reduce the risk for
renal toxicity, particularly in patients with preexisting renal insufficiency.
Route of Administration:
Intravenous
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/21856057
Curator's Comment: Bone marrow stromal cells were isolated from the marrow aspirates obtained from the
long/iliac bones, and cultured in medium supplemented with 1 ng/ml bFGF.
BMSCs proliferation was significantly inhibited with 10(−4) M Pamidronic acid (pamidronate)
after 72h and 168h, and with 6 × 10(−5) M pamidronate after 168h. Alveolar osteoblasts cultured in osteogenic medium exhibited significantly lower alkaline phosphatase (AP) activities with 6 × 10(−5) M and 10(−4) M pamidronate (39% and 16%
of the unsupplemented group) as compared to all lower concentration groups after 168h.
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Classification Tree | Code System | Code | ||
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NDF-RT |
N0000007707
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NCI_THESAURUS |
C67439
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NCI_THESAURUS |
C443
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WHO-VATC |
QM05BA03
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LIVERTOX |
735
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NDF-RT |
N0000175579
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WHO-ATC |
M05BA03
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C019248
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CHEMBL834
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6305
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Pamidronic acid
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254-905-2
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C61875
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SUB09598MIG
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40391-99-9
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Pamidronate
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OYY3447OMC
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OYY3447OMC
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7259
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m8374
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100000092288
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2048
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DB00282
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ACTIVE MOIETY
SALT/SOLVATE (PARENT)
SALT/SOLVATE (PARENT)
SALT/SOLVATE (PARENT)