Details
Stereochemistry | ACHIRAL |
Molecular Formula | C18H22N2S.BrH |
Molecular Weight | 379.358 |
Optical Activity | NONE |
Defined Stereocenters | 0 / 0 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
Br.CC1=CC(C)=C(SC2=CC=CC=C2N3CCNCC3)C=C1
InChI
InChIKey=VNGRUFUIHGGOOM-UHFFFAOYSA-N
InChI=1S/C18H22N2S.BrH/c1-14-7-8-17(15(2)13-14)21-18-6-4-3-5-16(18)20-11-9-19-10-12-20;/h3-8,13,19H,9-12H2,1-2H3;1H
DescriptionCurator's Comment: description was created based on several sources, including
http://www.ncbi.nlm.nih.gov/pubmed/?term=15341484; http://www.ncbi.nlm.nih.gov/pubmed/?term=21486038
Curator's Comment: description was created based on several sources, including
http://www.ncbi.nlm.nih.gov/pubmed/?term=15341484; http://www.ncbi.nlm.nih.gov/pubmed/?term=21486038
Vortioxetine is an antidepressant for the treatment of major depressive disorder. Vortioxetine’s mechanism of action is not fully understood. Vortioxetine binds with high affinity to the serotonin transporter and its antidepressant actions are believed to be secondary to enhancing serotonin in the central nervous system through inhibition of reuptake. Vortioxetine also displays binding affinities to other serotonin (5-HT) receptors, including 5-HT3, 5-HT1A, and 5-HT7. Due to multimodal neurotransmitter enhancer profile, it has been suggested that it might need lesser receptor occupancy rate for clinical trials than other selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors. Since vortioxetine is an agonist and antagonist of multiple serotonin receptors, potential interactions may occur with other medications that alter the serotonergic pathways. There is an increased risk of serotonin syndrome when vortioxetine is used in combination with other serotonergic agents.
Originator
Sources: https://www.lundbeck.com/upload/us/files/pdf/2016_Releases/TRINTELLIX%20Launch%20Press%20Release_6%201%2016_FINAL.pdf
Curator's Comment: Trintellix (vortioxetine) was discovered by Lundbeck researchers in Copenhagen, Denmark. The clinical trial program in the United States was conducted jointly by Lundbeck and Takeda, and Takeda holds the new drug application for the U.S. market. Trintellix is a trademark of H. Lundbeck A/S and used under license by Takeda Pharmaceuticals America, Inc.
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: P46098 Gene ID: 3359.0 Gene Symbol: HTR3A Target Organism: Homo sapiens (Human) |
3.7 nM [Ki] | ||
Target ID: P34969 Gene ID: 3363.0 Gene Symbol: HTR7 Target Organism: Homo sapiens (Human) |
19.0 nM [Ki] | ||
Target ID: P28221 Gene ID: 3352.0 Gene Symbol: HTR1D Target Organism: Homo sapiens (Human) |
54.0 nM [Ki] | ||
Target ID: P28222 Gene ID: 3351.0 Gene Symbol: HTR1B Target Organism: Homo sapiens (Human) |
33.0 nM [Ki] | ||
Target ID: P08908 Gene ID: 3350.0 Gene Symbol: HTR1A Target Organism: Homo sapiens (Human) |
15.0 nM [Ki] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | BRINTELLIX Approved UseIndicated for the treatment of major depressive disorder (MDD). Launch Date2013 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
17.92 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29189941/ |
10 mg 1 times / day multiple, oral dose: 10 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
VORTIOXETINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
4.6 ng/mL |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
VORTIOXETINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
33 ng/mL |
20 mg 1 times / day steady-state, oral dose: 20 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
VORTIOXETINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
1.374 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
LU-AA34443 plasma | Homo sapiens population: unhealthy age: sex: food status: |
|
2.654 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
LU-AA34443 plasma | Homo sapiens population: healthy age: sex: food status: |
|
0.008 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
LU-AA39835 plasma | Homo sapiens population: unhealthy age: sex: food status: |
|
0.0289999999999999 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
LU-AA39835 plasma | Homo sapiens population: healthy age: sex: food status: |
|
1.67 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
VORTIOXETINE plasma | Homo sapiens population: unhealthy age: sex: food status: |
|
2.078 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
VORTIOXETINE plasma | Homo sapiens population: healthy age: sex: food status: |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
344 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29189941/ |
10 mg 1 times / day multiple, oral dose: 10 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
VORTIOXETINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
273.42 ng × h/mL |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
VORTIOXETINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
71.942 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
LU-AA34443 plasma | Homo sapiens population: unhealthy age: sex: food status: |
|
88.614 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
LU-AA34443 plasma | Homo sapiens population: healthy age: sex: food status: |
|
122.899 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
LU-AA34443 plasma | Homo sapiens population: healthy age: sex: food status: |
|
124.708 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
LU-AA34443 plasma | Homo sapiens population: unhealthy age: sex: food status: |
|
0.078 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
LU-AA39835 plasma | Homo sapiens population: unhealthy age: sex: food status: |
|
1.143 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
LU-AA39835 plasma | Homo sapiens population: healthy age: sex: food status: |
|
166.955 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
VORTIOXETINE plasma | Homo sapiens population: healthy age: sex: food status: |
|
188.662999999999 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
VORTIOXETINE plasma | Homo sapiens population: unhealthy age: sex: food status: |
|
187.202 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
VORTIOXETINE plasma | Homo sapiens population: healthy age: sex: food status: |
|
288.053 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02170220 |
5 mg single, oral dose: 5 mg route of administration: oral experiment type: single co-administered: |
VORTIOXETINE plasma | Homo sapiens population: unhealthy age: sex: food status: |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
58.84 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29189941/ |
10 mg 1 times / day multiple, oral dose: 10 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
VORTIOXETINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
60.62 h |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
VORTIOXETINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
66 h |
20 mg 1 times / day steady-state, oral dose: 20 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
VORTIOXETINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
1% EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29189941/ |
10 mg 1 times / day multiple, oral dose: 10 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
VORTIOXETINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
1% |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
VORTIOXETINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
2% |
20 mg 1 times / day steady-state, oral dose: 20 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
VORTIOXETINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
60 mg 1 times / day steady, oral Highest studied dose Dose: 60 mg, 1 times / day Route: oral Route: steady Dose: 60 mg, 1 times / day Sources: |
healthy, 24 years(range: 18–53) years. n = 5 Health Status: healthy Age Group: 24 years(range: 18–53) years. Sex: M Population Size: 5 Sources: |
|
75 mg single, oral Highest studied dose |
healthy, 24 years(range: 18–53) years. n = 6 Health Status: healthy Age Group: 24 years(range: 18–53) years. Sex: M+F Population Size: 6 Sources: |
|
9 mg single, intravenous Dose: 9 mg Route: intravenous Route: single Dose: 9 mg Sources: |
healthy, 24 years(range: 18–53) years. n = 22 Health Status: healthy Age Group: 24 years(range: 18–53) years. Sex: M+F Population Size: 22 Sources: |
|
250 mg single, oral Overdose Dose: 250 mg Route: oral Route: single Dose: 250 mg Co-administed with:: clonazepam(10 mg) Sources: |
unhealthy, 50 years n = 1 Health Status: unhealthy Condition: major depressive disorder Age Group: 50 years Sex: M Population Size: 1 Sources: |
Other AEs: Suicide attempt... |
20 mg 1 times / day steady, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: steady Dose: 20 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: major depressive disorder Age Group: adult Sources: |
Disc. AE: Nausea... Other AEs: Suicidal ideation, Suicidal behavior... AEs leading to discontinuation/dose reduction: Nausea Other AEs:Suicidal ideation Sources: Suicidal behavior |
20 mg 1 times / day steady, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: steady Dose: 20 mg, 1 times / day Sources: Page: p. 97 |
unhealthy, adult Health Status: unhealthy Condition: major depressive disorder Age Group: adult Sources: Page: p. 97 |
Disc. AE: Reaction skin, Vomiting... AEs leading to discontinuation/dose reduction: Reaction skin Sources: Page: p. 97Vomiting |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Suicide attempt | 250 mg single, oral Overdose Dose: 250 mg Route: oral Route: single Dose: 250 mg Co-administed with:: clonazepam(10 mg) Sources: |
unhealthy, 50 years n = 1 Health Status: unhealthy Condition: major depressive disorder Age Group: 50 years Sex: M Population Size: 1 Sources: |
|
Suicidal behavior | 20 mg 1 times / day steady, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: steady Dose: 20 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: major depressive disorder Age Group: adult Sources: |
|
Suicidal ideation | 20 mg 1 times / day steady, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: steady Dose: 20 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: major depressive disorder Age Group: adult Sources: |
|
Nausea | Disc. AE | 20 mg 1 times / day steady, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: steady Dose: 20 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Condition: major depressive disorder Age Group: adult Sources: |
Reaction skin | Disc. AE | 20 mg 1 times / day steady, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: steady Dose: 20 mg, 1 times / day Sources: Page: p. 97 |
unhealthy, adult Health Status: unhealthy Condition: major depressive disorder Age Group: adult Sources: Page: p. 97 |
Vomiting | Disc. AE | 20 mg 1 times / day steady, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: steady Dose: 20 mg, 1 times / day Sources: Page: p. 97 |
unhealthy, adult Health Status: unhealthy Condition: major depressive disorder Age Group: adult Sources: Page: p. 97 |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 27.0 |
moderate [IC50 4.4 uM] | no (co-administration study) Comment: no dose adjustment needed for vortioxetine coadministration with digoxin Page: 27.0 |
||
Page: 27.0 |
no [IC50 >34 uM] | |||
Page: 27.0 |
no [IC50 >34 uM] | |||
Page: 27.0 |
no [IC50 >34 uM] | |||
Page: 27.0 |
no [IC50 >34 uM] | |||
Page: 76.0 |
no [IC50 >34 uM] | |||
Page: 13.0 |
no | |||
Page: 13.0 |
no | |||
Page: 27.0 |
no | |||
Page: 27.0 |
no | |||
Page: 27.0 |
no | |||
Page: 27.0 |
no | |||
Page: 27.0 |
no | |||
Page: 27.0 |
no | |||
Page: 27.0 |
no | |||
Page: 76.0 |
no | |||
Page: 13.0 |
no | |||
Page: 13.0 |
no | |||
Page: 13.0 |
no | |||
Page: 13.0 |
no | |||
Page: 13.0 |
no | |||
Page: 13.0 |
no | |||
Page: 13.0 |
no | |||
Page: 13.0 |
no | |||
Page: 27.0 |
yes [Ki 15 uM] | |||
Page: 27.0 |
yes [Ki 9.34 uM] |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 45, 47, 48, 56 |
major | likely (co-administration study) Comment: dose decrease may be needed with CYP2D6 inhibitor such as bupropion, dose should be increased by 3 fold when administered with strong CYP inducer such as rifampacin Page: 45, 47, 48, 56 |
||
Page: 27.0 |
no | |||
Page: 48, 56 |
yes | |||
Page: 48, 56 |
yes | |||
Page: 48, 56, 80 |
yes | unlikely (co-administration study) Comment: no dose adjustment need with CYP2B6 substrate e.g. bupropion Page: 48, 56, 80 |
||
Page: 48, 56, 80 |
yes | unlikely (co-administration study) Comment: no dose adjustment need with CYP2C19 substrate e.g. diazepam Page: 48, 56, 80 |
||
Page: 48, 56, 80 |
yes | unlikely (co-administration study) Comment: no dose adjustment need with CYP2C9 substrate e.g. S-warfarin Page: 48, 56, 80 |
||
Page: 48, 56, 80 |
yes | unlikely (co-administration study) Comment: no dose adjustment need with CYP3A substrate e.g. midazolam Page: 48, 56, 80 |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 20, 145 |
Sample Use Guides
The recommended starting dose is 10 mg administered orally once daily without regard to meals. The dose should then be increased to 20 mg/day, as tolerated. Consider 5 mg/day for patients who do not tolerate higher doses. TRINTELLIX can be discontinued abruptly. However, it is
recommended that doses of 15 mg/day or 20 mg/day be reduced to 10 mg/day for one week prior to full discontinuation if possible. The maximum recommended dose is 10 mg/day in known CYP2D6 poor metabolizers.
Route of Administration:
Oral
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EMA ASSESSMENT REPORTS |
BRINTELLIX (AUTHORIZED: DEPRESSIVE DISORDER, MAJOR)
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NCI_THESAURUS |
C265
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CHEMBL2104993
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DTXSID501027850
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WW-44
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C125653
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56843850
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100000151836
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1439834
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DBSALT001117
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ACTIVE MOIETY
SUBSTANCE RECORD