METHYLNALTREXONE BROMIDE

Details

Stereochemistry	ABSOLUTE
Molecular Formula	C21H26NO4.Br
Molecular Weight	436.339
Optical Activity	UNSPECIFIED
Defined Stereocenters	5 / 5
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure Search

SMILES

[Br-].[H][C@]12OC3=C4C(C[C@]5([H])[C@](O)(CCC1=O)[C@]24CC[N@+]5(C)CC6CC6)=CC=C3O

InChI

InChIKey=IFGIYSGOEZJNBE-NQMNLMSRSA-N

InChI=1S/C21H25NO4.BrH/c1-22(11-12-2-3-12)9-8-20-17-13-4-5-14(23)18(17)26-19(20)15(24)6-7-21(20,25)16(22)10-13;/h4-5,12,16,19,25H,2-3,6-11H2,1H3;1H/t16-,19+,20+,21-,22-;/m1./s1

HIDE SMILES / InChI

Description
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf | https://www.ncbi.nlm.nih.gov/pubmed/20234787

Methylnaltrexone, is a peripherally acting μ-opioid receptor antagonist that acts on the gastrointestinal tract to inhibit the opioid-induced decrease in gastric motility and transit time. It is used to treat opiate-induced constipation in adults with chronic non-cancer pain and in adults with advanced illness who are receiving palliative care.

CNS Activity

Originator

Approval Year

Targets

Primary Target	Pharmacology	Condition	Potency
Mu opioid receptor 221 Target ID: CHEMBL233 Sources: https://www.ncbi.nlm.nih.gov/pubmed/16634692	Antagonist 2778

Conditions

Condition	Modality	Targets	Highest Phase	Product
Opioid-induced constipation 8 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf	Secondary		Approved 8429	RELISTOR Approved Use RELISTOR is an opioid antagonist indicated for: Treatment of opioid-induced constipation (OIC) in adult patients with chronic non‑cancer pain (1.1) Treatment of opioid-induced constipation in patients with advanced illness who are receiving palliative care, when response to laxative therapy has not been sufficient. Limitation of Use: Use beyond four months has not been studied (1.2) 1.1 Opioid-Induced Constipation in Adult Patients with Chronic Non-Cancer Pain RELISTOR is indicated for the treatment of opioid-induced constipation in adult patients with chronic non‑cancer pain. 1.2 Opioid-Induced Constipation in Adult Patients with Advanced Illness RELISTOR is indicated for the treatment of opioid-induced constipation in adult patients with advanced illness who are receiving palliative care, when response to laxative therapy has not been sufficient. Limitation of Use Use of RELISTOR beyond four months has not been studied in the advanced illness population. Launch Date 2008

C_max

Value	Dose	Co-administered	Analyte	Population
538 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15831777/	0.3 mg/kg single, intravenous dose: 0.3 mg/kg route of administration: Intravenous experiment type: SINGLE co-administered:		METHYLNALTREXONE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FED

AUC

Value	Dose	Co-administered	Analyte	Population
224 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15831777/	0.3 mg/kg single, intravenous dose: 0.3 mg/kg route of administration: Intravenous experiment type: SINGLE co-administered:		METHYLNALTREXONE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FED

T_1/2

Value	Dose	Co-administered	Analyte	Population
2.5 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15831777/	0.3 mg/kg single, intravenous dose: 0.3 mg/kg route of administration: Intravenous experiment type: SINGLE co-administered:		METHYLNALTREXONE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FED

F_unbound

Value	Dose	Co-administered	Analyte	Population
85% EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15831777/	0.3 mg/kg single, intravenous dose: 0.3 mg/kg route of administration: Intravenous experiment type: SINGLE co-administered:		METHYLNALTREXONE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FED

Doses

Dose	Population	Adverse events
0.5 mg/kg single, subcutaneous Highest studied dose Dose: 0.5 mg/kg Route: subcutaneous Route: single Dose: 0.5 mg/kg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_ClinPharmR.pdf https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_MedR_P3.pdf	healthy, 18-45 n = 119 Health Status: healthy Age Group: 18-45 Population Size: 119 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_ClinPharmR.pdf https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_MedR_P3.pdf	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_ClinPharmR.pdf https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_MedR_P3.pdf
450 mg 1 times / day multiple, oral Recommended Dose: 450 mg, 1 times / day Route: oral Route: multiple Dose: 450 mg, 1 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/30613162 Page: p.144	unhealthy, 51.6 n = 200 Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Age Group: 51.6 Sex: M+F Population Size: 200 Sources: https://pubmed.ncbi.nlm.nih.gov/30613162 Page: p.144	Disc. AE: Vertigo... AEs leading to discontinuation/dose reduction: Vertigo (0.5%) Sources: https://pubmed.ncbi.nlm.nih.gov/30613162 Page: p.144
0.45 mg/kg 1 times / 6 hours multiple, intravenous Highest studied dose Dose: 0.45 mg/kg, 1 times / 6 hours Route: intravenous Route: multiple Dose: 0.45 mg/kg, 1 times / 6 hours Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_MedR_P3.pdf https://pdf.hres.ca/dpd_pm/00015521.PDF	healthy n = 8 Health Status: healthy Sex: M Population Size: 8 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_MedR_P3.pdf https://pdf.hres.ca/dpd_pm/00015521.PDF	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_MedR_P3.pdf https://pdf.hres.ca/dpd_pm/00015521.PDF
0.64 mg/kg single, intravenous Highest studied dose Dose: 0.64 mg/kg Route: intravenous Route: single Dose: 0.64 mg/kg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_MedR_P3.pdf Page: p.17	healthy Health Status: healthy Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_MedR_P3.pdf Page: p.17	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/021964s000_MedR_P3.pdf Page: p.17
12 mg 1 times / day multiple, subcutaneous Recommended Dose: 12 mg, 1 times / day Route: subcutaneous Route: multiple Dose: 12 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.9	unhealthy n = 150 Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Population Size: 150 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.9	Disc. AE: Abdominal pain... AEs leading to discontinuation/dose reduction: Abdominal pain (2%) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.9
12 mg 1 times / day multiple, subcutaneous Recommended Dose: 12 mg, 1 times / day Route: subcutaneous Route: multiple Dose: 12 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1	Disc. AE: Gastrointestinal perforation, Diarrhea... AEs leading to discontinuation/dose reduction: Gastrointestinal perforation Diarrhea (severe) Opiate withdrawal symptoms Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1
450 mg 1 times / day multiple, oral Recommended Dose: 450 mg, 1 times / day Route: oral Route: multiple Dose: 450 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1	Disc. AE: Gastrointestinal perforation, Diarrhea... AEs leading to discontinuation/dose reduction: Gastrointestinal perforation Diarrhea (severe) Opiate withdrawal symptoms Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1

AEs

AE	Significance	Dose	Population
Vertigo	0.5% Disc. AE	450 mg 1 times / day multiple, oral Recommended Dose: 450 mg, 1 times / day Route: oral Route: multiple Dose: 450 mg, 1 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/30613162 Page: p.144	unhealthy, 51.6 n = 200 Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Age Group: 51.6 Sex: M+F Population Size: 200 Sources: https://pubmed.ncbi.nlm.nih.gov/30613162 Page: p.144
Abdominal pain	2% Disc. AE	12 mg 1 times / day multiple, subcutaneous Recommended Dose: 12 mg, 1 times / day Route: subcutaneous Route: multiple Dose: 12 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.9	unhealthy n = 150 Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Population Size: 150 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.9
Gastrointestinal perforation	Disc. AE	12 mg 1 times / day multiple, subcutaneous Recommended Dose: 12 mg, 1 times / day Route: subcutaneous Route: multiple Dose: 12 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1
Opiate withdrawal symptoms	Disc. AE	12 mg 1 times / day multiple, subcutaneous Recommended Dose: 12 mg, 1 times / day Route: subcutaneous Route: multiple Dose: 12 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1
Diarrhea	severe Disc. AE	12 mg 1 times / day multiple, subcutaneous Recommended Dose: 12 mg, 1 times / day Route: subcutaneous Route: multiple Dose: 12 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1
Gastrointestinal perforation	Disc. AE	450 mg 1 times / day multiple, oral Recommended Dose: 450 mg, 1 times / day Route: oral Route: multiple Dose: 450 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1
Opiate withdrawal symptoms	Disc. AE	450 mg 1 times / day multiple, oral Recommended Dose: 450 mg, 1 times / day Route: oral Route: multiple Dose: 450 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1
Diarrhea	severe Disc. AE	450 mg 1 times / day multiple, oral Recommended Dose: 450 mg, 1 times / day Route: oral Route: multiple Dose: 450 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Opioid-induced constipation in adults with chronic non-cancer pain Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208271s000lbl.pdf Page: p.1

Overview

CYP3A4	CYP2C9	CYP2D6	hERG
inhibitor 1587 inducer 781	inhibitor 1767 inducer 389	inhibitor 1852	inhibitor 1612

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
CYP1A2 1524 CYP2A6 707 CYP2B6 810 CYP2C19 1478 P-gp 1461 BCRP 699 OCT2 647 OATP1B1 788 OATP1B3 706 OCT1 512 OAT1 599 OAT3 642 MATE1 306 MATE2 263	P-gp 1537 BCRP 561 OCT1 327 OCT2 355 OAT1 326 OAT3 339 OATP1B1 406 OATP1B3 350 MATE1 135 MATE2 96 MRP2 205	CYP1A2 701 CYP2A6 79 CYP2B6 547 CYP2C19 293 CYP2E1 128

Drug as perpetrator

Target	Modality	Activity	Clinical evidence
BCRP 773	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	no
CYP2E1 970	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	no
P-gp 1650	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	no
CYP1A2 1692	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
CYP1A2 1692	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
CYP2A6 739	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
CYP2A6 739	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
CYP2B6 1001	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
CYP2B6 1001	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
CYP2C19 1553	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
CYP2C19 1553	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
CYP2C9 1819	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
CYP2C9 1819	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
CYP3A4 1925	inducer 1573 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
CYP3A4 1925	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	not significant
OATP1B1 803	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	not significant
OATP1B3 715	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	not significant
MATE1 308	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	unlikely [IC50 >10 uM]
MATE2 263	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	unlikely [IC50 >10 uM]
OAT1 603	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	unlikely [IC50 >10 uM]
OAT3 644	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	unlikely [IC50 >10 uM]
OCT2 648	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	unlikely [IC50 >100 uM]
OCT1 543	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	unlikely [IC50 >25 uM]
CYP2D6 1891	inhibitor 3277 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0	weak	no (co-administration study) Comment: injection of drug did not affect metabolism of dextromethorphan: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/021964s019,208271s003lbl.pdf#page=9 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=7 Page: 7.0

Drug as victim

Target	Modality	Activity
BCRP 561	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	no
MRP2 205	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	no
OAT1 326	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	no
OAT3 339	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	no
OATP1B1 406	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	no
OATP1B3 350	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	no
P-gp 1537	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	no
MATE1 135	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	yes
MATE2 96	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	yes
OCT1 327	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	yes
OCT2 355	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000ClinpharmR.pdf#page=43 Page: 43.0	yes

Tox targets

Target	Modality	Activity	Metabolite	Clinical evidence
hERG 1647	inhibitor 1626 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/208271Orig1s000PharmR.pdf#page=5 Page: 5,11

Sourcing

Vendor/Aggregator	ID	URL
AK Scientific	3844AH
AbovChem LLC	HY-75766
Compound Cloud	5361917
Compound Cloud	5361918
Molnova	M15801
Sigma Aldrich	1430735
Sigma Aldrich	1430735\|USP
Sigma Aldrich	SML0277
Sigma Aldrich	SML0277\|SIGMA
Tetrahedron	TS82083
Toronto Research Chemicals	M320350
ZINC	ZINC000245204949	http://zinc15.docking.org/substances/ZINC000245204949
eMolecules	313117500
mcule	MCULE-4324317094
mcule	MCULE-4625269332

PubMed

Title	Date	PubMed
[Opioid-induced bowel dysfunction: a literature analysis on pathophysiology and treatment].	2008	19052708
Opioid-induced constipation in intensive care patients: relief in sight?	2008	18598388
New approaches to the treatment of opioid-induced constipation.	2008 Aug	18924451
Methylnaltrexone (Relistor) for opioid induced constipation.	2008 Aug 11	18688204
Methylnaltrexone reduced opioid-induced constipation in patients with terminal illness.	2008 Dec	19043042
Reversal of opioid-induced gastric dysfunction in a critically ill burn patient after methylnaltrexone.	2008 Dec	19020145
Managing opioid-induced constipation.	2008 Jul	18580669
The Food and Drug Administration approves methylnaltrexone bromide for opioid-induced constipation.	2008 Jul	18549816
Synergistic effects of methylnaltrexone with 5-fluorouracil and bevacizumab on inhibition of vascular endothelial growth factor-induced angiogenesis.	2008 Jun	18566238
Relistor approved for opioid-related constipation.	2008 Jun 1	18499867
Subcutaneous methylnaltrexone for the treatment of opioid-induced constipation in patients with advanced illness: a double-blind, randomized, parallel group, dose-ranging study.	2008 May	18440447
Opioid side effects--mechanism-based therapy.	2008 May 29	18509126
Methylnaltrexone for opioid-induced constipation in advanced illness.	2008 May 29	18509120
Methylnaltrexone: a new treatment for an old problem.	2008 Nov	18848552
Management of postoperative ileus: focus on alvimopan.	2008 Oct	19209278
Development of peripheral opioid antagonists' new insights into opioid effects.	2008 Oct	18828971
Efficacy and safety of mu-opioid antagonists in the treatment of opioid-induced bowel dysfunction: systematic review and meta-analysis of randomized controlled trials.	2008 Sep	18828197
[News from the cochrane library: mu opioid antagonists for opioid-induced bowel dysfunction].	2008 Sep	18810678
Methylnaltrexone, a new peripherally acting mu-opioid receptor antagonist being evaluated for the treatment of postoperative ileus.	2008 Sep	18694369
Methylnaltrexone for opioid-induced constipation in advanced illness.	2008 Sep 4	18777614
Methylnaltrexone for opioid-induced constipation in advanced illness.	2008 Sep 4	18768955
Management of constipation in the elderly: emerging therapeutic strategies.	2008 Sep 7	18777602
New drugs: methylnaltrexone bromide, alvimopan, and rilonacept.	2008 Sep-Oct	18826910
New drug update: 2008.	2009 Apr	19555139
Pharmacological management of postoperative ileus.	2009 Apr	19399212
Methylnaltrexone: the answer to opioid-induced constipation?	2009 Apr	19364251
Syntheses of novel high affinity ligands for opioid receptors.	2009 Apr 15	19282177
Novel opioid antagonists for opioid-induced bowel dysfunction and postoperative ileus.	2009 Apr 4	19217656
Methylnaltrexone: new drug. Opiate-induced constipation: barely more effective than placebo.	2009 Aug	19743572
Methylnaltrexone, a peripherally acting opioid receptor antagonist, enhances tumoricidal effects of 5-Fu on human carcinoma cells.	2009 Aug	19661297
Protease inhibitor-induced nausea and vomiting is attenuated by a peripherally acting, opioid-receptor antagonist in a rat model.	2009 Aug 21	19698111
Drug approvals: '08 in review. Methylnaltrexone (Relistor).	2009 Feb	19155882
Treating opioid-induced constipation with methylnaltrexone bromide.	2009 Feb 3-9	19263773
How safe and effective is methylnaltrexone for the treatment of opioid-induced constipation in advanced illness?	2009 Jan	19015651
Methylnaltrexone for treatment of opioid-induced constipation in advanced illness patients.	2009 Jan-Feb	19278178
Methylnaltrexone.	2009 Jul	19605844
Methylnaltrexone reduced body weight gain in ob/ob mice.	2009 Jul-Aug	19736901
Preventing paralytic ileus: can the anesthesiologist help.	2009 Jun	19583062
Prokinetic drugs for feed intolerance in critical illness: current and potential therapies.	2009 Jun	19485878
Peripherally acting mu-opioid receptor antagonists and postoperative ileus: mechanisms of action and clinical applicability.	2009 Jun	19448206
Pharmacologic pearls for end-of-life care.	2009 Jun 15	19530636
Opioid receptors in the gastrointestinal tract.	2009 Jun 5	19345246
An overview of constipation and newer therapies.	2009 Jun-Jul	19531698
Methylnaltrexone methobromide: the first peripherally active, centrally inactive opioid receptor-antagonist.	2009 Mar	19555136
Detailing of gastrointestinal symptoms in cancer patients with advanced disease: new methodologies, new insights, and a proposed approach.	2009 Mar	19365160
Methylnaltrexone for opioid-induced constipation.	2009 Mar	19240629
Methylnaltrexone treatment of opioid-induced constipation in patients with advanced illness.	2009 Nov	19713070
[Methylnaltrexone. A new approach for therapy of opioid-induced obstipation].	2009 Oct	19690895
[Successful treatment of treatment-resistant opioid-induced constipation in a patient with incomplete paraplegia with methylnaltrexone].	2009 Oct	19585156
Use of FDA approved methamphetamine to allow adjunctive use of methylnaltrexone to mediate core anti-growth factor signaling effects in glioblastoma.	2009 Sep	19322519

Patents

Sample Use Guides

In Vivo Use Guide

Dosing For opioid-induced constipation (OIC) in adult patients with chronic non-cancer pain: tablets: The recommended dosage is 450 mg once daily in the morning. injection: The recommended dosage is 12 mg subcutaneously once daily. For OIC in adult patients with advanced illness: The pre-filled syringe is only for patients who require an injection dose of 8 mg or 12 mg. Administer one dose every other day, as needed, but no more frequently than one dose in a 24-hour period

Route of Administration: Other

In Vitro Use Guide

There was tested the effect of methylnaltrexone on the action of 5-fluorouracil (5-FU) in three human cancer cell lines. Compared to 5-FU 10 muM alone on SW-480 cells (63.5+/-1.1%), on MCF-7 cells (58.3+/-3.1%), or on non-small cell lung cancer cells (81.3+/-1.6%), 5-FU 10 muM plus methylnaltrexone 1.0 muM reduced cancer cell growth in all three cell lines to 50.2+/-2.9% for SW-480 cells (p<0.05), 50.0+/-1.7% for MCF-7 cells (p<0.05) and 68.7+/-2.2% for lung cancer cells (p<0.01). Methylnaltrexone alone also showed anti-proliferative activity in the three cell lines. Methylnaltrexone at 1.0 muM, reduced SW-480 cell growth to 81.9+/-3.7% (p<0.01), MCF-7 cell growth to 85.9+/-2.4% (p<0.01) and lung cancer cell growth to 85.5+/-2.2% (p<0.01). Apoptosis was not induced by treatment of SW-480 cells with 1.0 or 10 muM methylnaltrexone for 48 h. However, methylnaltrexone increased the number of cells in the G(1)-phase and decreased the expression of cyclin A.

Name

Type

Language

METHYLNALTREXONE BROMIDE

Official Name

English

METHYLNALTREXONE BROMIDE [USAN]

Common Name

English

Methylnaltrexone Bromide [WHO-DD]

Common Name

English

methylnaltrexone bromide [INN]

Common Name

English

MORPHINAN-17-IUM-6-ONE, 17-(CYCLOPROPYLMETHYL)-4,5-EPOXY-3,14-DIHYDROXY-17-METHYL-, BROMIDE, (5.ALPHA.,17R)-

Systematic Name

English

METHYLNALTREXONE BROMIDE [ORANGE BOOK]

Common Name

English

NALTREXONE METHOBROMIDE

Common Name

English

METHYLNALTREXONE BROMIDE [EMA EPAR]

Common Name

English

METHYLNALTREXONE BROMIDE [VANDF]

Common Name

English

METHYLNALTREXONE BROMIDE [JAN]

Common Name

English

MRZ-2663BR

Code

English

MRZ2663BR

Code

English

N-METHYLNALTREXONE BROMIDE

Common Name

English

METHYLNALTREXONE BROMIDE [USP-RS]

Common Name

English

MOA728

Code

English

METHYLNALTREXONE BROMIDE [USP MONOGRAPH]

Common Name

English

METHYLNALTREXONE BROMIDE [MI]

Common Name

English

RELISTOR

Brand Name

English

NALTREXONE METHYLBROMIDE

Common Name

English

MOA-728

Code

English

METHYLNALTREXONE BROMIDE [MART.]

Common Name

English

Classification Tree Code System Code

WHO-VATC

QA06AH01