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

Details

Stereochemistry ABSOLUTE
Molecular Formula C21H25NO3
Molecular Weight 339.4281
Optical Activity UNSPECIFIED
Defined Stereocenters 4 / 4
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of NALMEFENE

SMILES

[H][C@@]12OC3=C4C(C[C@H]5N(CC6CC6)CC[C@@]14[C@@]5(O)CCC2=C)=CC=C3O

InChI

InChIKey=WJBLNOPPDWQMCH-MBPVOVBZSA-N
InChI=1S/C21H25NO3/c1-12-6-7-21(24)16-10-14-4-5-15(23)18-17(14)20(21,19(12)25-18)8-9-22(16)11-13-2-3-13/h4-5,13,16,19,23-24H,1-3,6-11H2/t16-,19+,20+,21-/m1/s1

HIDE SMILES / InChI
Nalmefene is the first medication approved for alcoholism with the primary goal of reducing alcohol intake in an as needed approach. Nalmefene received a marketing authorization valid throughout the European Union on February 25, 2013 and is under development in Asia. Nalmefene is an opioid system modulator with a distinct μ, δ, and κ receptor profile. In vitro studies have demonstrated that Nalmefene is a selective opioid receptor ligand with antagonist activity at the μ and δ receptors and partial agonist activity at the κ receptor. In vivo studies have demonstrated that nalmefene reduces alcohol consumption, possibly by modulating cortico-mesolimbic functions. In the US, immediate-release injectable nalmefene was approved in 1995 as an antidote for opioid overdose. It was sold under the trade name Revex. The product was discontinued by its manufacturer around 2008. Currently Nalmefene is sold under the trade name Selincro. Selincro is indicated for the reduction of alcohol consumption in adult patients with alcohol dependence who have a high drinking-risk level, without physical withdrawal symptoms and who do not require immediate detoxification.

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
Selincro

Approved Use

Selincro is indicated for the reduction of alcohol consumption in adult patients with alcohol dependence who have a high drinking-risk level, without physical withdrawal symptoms and who do not require immediate detoxification.

Launch Date

1.36175039E12
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
155 ng/mL
200 mg single, oral
dose: 200 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
177 ng/mL
300 mg single, oral
dose: 300 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
24.3 ng/mL
50 mg single, oral
dose: 50 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
57.9 ng/mL
100 mg single, oral
dose: 100 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
109 ng × h/mL
6 mg single, intravenous
dose: 6 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
1320 ng × h/mL
200 mg single, oral
dose: 200 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
16.6 ng × h/mL
1 mg single, intravenous
dose: 1 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
16.9 ng × h/mL
2 mg single, intravenous
dose: 2 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
1876 ng × h/mL
300 mg single, oral
dose: 300 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
191 ng × h/mL
12 mg single, intravenous
dose: 12 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
274 ng × h/mL
50 mg single, oral
dose: 50 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
29.4 ng × h/mL
2 mg single, intravenous
dose: 2 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
314 ng × h/mL
20 mg 2 times / day steady-state, oral
dose: 20 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
385 ng × h/mL
24 mg single, intravenous
dose: 24 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
647 ng × h/mL
100 mg single, oral
dose: 100 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
8.2 h
6 mg single, intravenous
dose: 6 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
9.8 h
200 mg single, oral
dose: 200 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
10.8 h
1 mg single, intravenous
dose: 1 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
11.7 h
300 mg single, oral
dose: 300 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
8.6 h
12 mg single, intravenous
dose: 12 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
10.3 h
50 mg single, oral
dose: 50 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
9.4 h
2 mg single, intravenous
dose: 2 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
9.1 h
20 mg 2 times / day steady-state, oral
dose: 20 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
8.9 h
24 mg single, intravenous
dose: 24 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
11.4 h
100 mg single, oral
dose: 100 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NALMEFENE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
Doses

Doses

DosePopulationAdverse events​
18 mg 1 times / day steady, oral
Recommended
Dose: 18 mg, 1 times / day
Route: oral
Route: steady
Dose: 18 mg, 1 times / day
Sources:
unhealthy, 39 years
n = 1
Health Status: unhealthy
Condition: alcohol dependence and Schizoaffective Disorder
Age Group: 39 years
Sex: M
Population Size: 1
Sources:
Disc. AE: Psychiatric decompensation...
AEs leading to
discontinuation/dose reduction:
Psychiatric decompensation (1 patient)
Sources:
300 mg 1 times / day multiple, oral
Highest studied dose
Dose: 300 mg, 1 times / day
Route: oral
Route: multiple
Dose: 300 mg, 1 times / day
Sources:
healthy, adult
n = 4
Health Status: healthy
Age Group: adult
Sex: M
Population Size: 4
Sources:
300 mg single, oral
Highest studied dose
Dose: 300 mg
Route: oral
Route: single
Dose: 300 mg
Sources:
healthy, adult
n = 4
Health Status: healthy
Age Group: adult
Sex: M
Population Size: 4
Sources:
0.75 ug/kg single, intravenous
Highest studied dose
Dose: 0.75 ug/kg
Route: intravenous
Route: single
Dose: 0.75 ug/kg
Sources:
unhealthy, adult
n = 3
Health Status: unhealthy
Condition: postoperative pain
Age Group: adult
Sex: M+F
Population Size: 3
Sources:
DLT: Anesthesia reversal...
Dose limiting toxicities:
Anesthesia reversal (2 patients)
Sources:
0.5 ug/kg single, intravenous
MTD
Dose: 0.5 ug/kg
Route: intravenous
Route: single
Dose: 0.5 ug/kg
Sources:
unhealthy, adult
n = 18
Health Status: unhealthy
Condition: postoperative pain
Age Group: adult
Sex: M+F
Population Size: 18
Sources:
DLT: Anesthesia reversal...
Dose limiting toxicities:
Anesthesia reversal (3 patients)
Sources:
20 mg 2 times / day steady, oral
Recommended
Dose: 20 mg, 2 times / day
Route: oral
Route: steady
Dose: 20 mg, 2 times / day
Sources:
unhealthy, adult
n = 7
Health Status: unhealthy
Condition: alcohol dependence
Age Group: adult
Sex: M+F
Population Size: 7
Sources:
Disc. AE: Dizziness...
AEs leading to
discontinuation/dose reduction:
Dizziness (1 patient)
Sources:
5 mg 2 times / day steady, oral
Studied dose
Dose: 5 mg, 2 times / day
Route: oral
Route: steady
Dose: 5 mg, 2 times / day
Sources:
unhealthy, adult
n = 7
Health Status: unhealthy
Condition: alcohol dependence
Age Group: adult
Sex: M+F
Population Size: 7
Sources:
Disc. AE: Dizziness, Rash...
AEs leading to
discontinuation/dose reduction:
Dizziness (1 patient)
Rash (1 patient)
Sources:
AEs

AEs

AESignificanceDosePopulation
Psychiatric decompensation 1 patient
Disc. AE
18 mg 1 times / day steady, oral
Recommended
Dose: 18 mg, 1 times / day
Route: oral
Route: steady
Dose: 18 mg, 1 times / day
Sources:
unhealthy, 39 years
n = 1
Health Status: unhealthy
Condition: alcohol dependence and Schizoaffective Disorder
Age Group: 39 years
Sex: M
Population Size: 1
Sources:
Anesthesia reversal 2 patients
DLT
0.75 ug/kg single, intravenous
Highest studied dose
Dose: 0.75 ug/kg
Route: intravenous
Route: single
Dose: 0.75 ug/kg
Sources:
unhealthy, adult
n = 3
Health Status: unhealthy
Condition: postoperative pain
Age Group: adult
Sex: M+F
Population Size: 3
Sources:
Anesthesia reversal 3 patients
DLT
0.5 ug/kg single, intravenous
MTD
Dose: 0.5 ug/kg
Route: intravenous
Route: single
Dose: 0.5 ug/kg
Sources:
unhealthy, adult
n = 18
Health Status: unhealthy
Condition: postoperative pain
Age Group: adult
Sex: M+F
Population Size: 18
Sources:
Dizziness 1 patient
Disc. AE
20 mg 2 times / day steady, oral
Recommended
Dose: 20 mg, 2 times / day
Route: oral
Route: steady
Dose: 20 mg, 2 times / day
Sources:
unhealthy, adult
n = 7
Health Status: unhealthy
Condition: alcohol dependence
Age Group: adult
Sex: M+F
Population Size: 7
Sources:
Dizziness 1 patient
Disc. AE
5 mg 2 times / day steady, oral
Studied dose
Dose: 5 mg, 2 times / day
Route: oral
Route: steady
Dose: 5 mg, 2 times / day
Sources:
unhealthy, adult
n = 7
Health Status: unhealthy
Condition: alcohol dependence
Age Group: adult
Sex: M+F
Population Size: 7
Sources:
Rash 1 patient
Disc. AE
5 mg 2 times / day steady, oral
Studied dose
Dose: 5 mg, 2 times / day
Route: oral
Route: steady
Dose: 5 mg, 2 times / day
Sources:
unhealthy, adult
n = 7
Health Status: unhealthy
Condition: alcohol dependence
Age Group: adult
Sex: M+F
Population Size: 7
Sources:
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG



Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
minor
minor
no
no
no
no
no
no
yes
yes
yes
Tox targets
PubMed

PubMed

TitleDatePubMed
The role of endogenous opioids in congestive heart failure: effects of nalmefene on systemic and regional hemodynamics in dogs.
1987 Feb
Standard binding and functional assays related to medications development division testing for potential cocaine and opiate narcotic treatment medications.
1998 Mar
Acute effects of nalmefene on LH, prolactin, and testosterone in male rhesus monkeys.
2000 Jun
New developments in the pharmacotherapy of alcohol dependence.
2001
Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.
2001 Jan-Feb
Pharmacological control of opioid-induced pruritus: a quantitative systematic review of randomized trials.
2001 Jun
A review of the potential role of methylnaltrexone in opioid bowel dysfunction.
2001 Nov
Nalmefene for elective reversal of procedural sedation in children.
2001 Nov
Preclinical models to evaluate potential pharmacotherapeutic agents in treating alcoholism and studying the neuropharmacological bases of ethanol-seeking behaviors in rats.
2002 Aug
Mesa Grande: a methodological analysis of clinical trials of treatments for alcohol use disorders.
2002 Mar
[Drug therapy of alcohol dependence--a critical review].
2003
Synergistic effects of cannabinoid inverse agonist AM251 and opioid antagonist nalmefene on food intake in mice.
2004 Mar 5
Stimulation of the hypothalamic-pituitary-adrenal axis with the opioid antagonist nalmefene.
2005
Determination of nalmefene by high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry.
2005 Apr
Prolonged central mu-opioid receptor occupancy after single and repeated nalmefene dosing.
2005 Dec
Phobic memory and somatic vulnerabilities in anorexia nervosa: a necessary unity?
2005 Sep 6
Multicenter investigation of the opioid antagonist nalmefene in the treatment of pathological gambling.
2006 Feb
Targeted nalmefene with simple medical management in the treatment of heavy drinkers: a randomized double-blind placebo-controlled multicenter study.
2007 Jul
Emerging pharmacologic options for treating postoperative ileus.
2007 Oct 15
Evidence of accelerated ageing in clinical drug addiction from immune, hepatic and metabolic biomarkers.
2007 Sep 24
Cholestatic hepatitis as a possible new side-effect of oxycodone: a case report.
2008 May 1
Predicting response to opiate antagonists and placebo in the treatment of pathological gambling.
2008 Nov
Pediatric sedation: a global challenge.
2010
Nalmefene in the treatment of pathological gambling: multicentre, double-blind, placebo-controlled study.
2010 Oct
Brain imaging studies in pathological gambling.
2010 Oct
Treatment of Gambling Disorders.
2014 Jun 1
Patents

Sample Use Guides

How much to take - The recommended dose is one tablet on days when you think there is a risk you will drink alcohol - The maximum dose is one tablet per day. How and when to take - You should take the tablet 1-2 hours before you start drinking alcohol. - Swallow the tablet whole, do not crush or divide the tablet. - You can take Selincro (Nalmefene) with or without food. Each film-coated tablet contains 18.06 mg nalmefene (as hydrochloride dihydrate).
Route of Administration: Oral
In Vitro Use Guide
Nalmefene antagonized the bindings of [3H]-dihydromorphine, [3H]-ethylketocyclazocine and [3H]-D-ala-D-leu enkephalin with IC50's in the low nanomolar range in rat brain membranes.. At the central mu receptor, nalmefene bound with an IC50 of 1.0 nM
Name Type Language
NALMEFENE
HSDB   INN   MART.   MI   USAN   VANDF   WHO-DD  
USAN   INN  
Official Name English
NALMEFENE [USAN]
Common Name English
17-(Cyclopropylmethyl)-4,5α-epoxy-6-methylenemorphinan-3,14-diol
Systematic Name English
SRD-174
Code English
ORF-11676
Code English
NALMEFENE [HSDB]
Common Name English
Nalmefene [WHO-DD]
Common Name English
ORF 11676
Code English
ORF 1167
Code English
JKB-121
Code English
JF-1
Code English
NALMEFENE [MI]
Common Name English
nalmefene [INN]
Common Name English
ORF-1167
Code English
MORPHINAN-3,14-DIOL, 17-(CYCLOPROPYLMETHYL)-4,5-EPOXY-6-METHYLENE-, (5.ALPHA.)-
Systematic Name English
NALMEFENE [VANDF]
Common Name English
SRD174
Code English
NALMEFENE [MART.]
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C681
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
NDF-RT N0000000154
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
WHO-VATC QN07BB05
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
WHO-ATC N07BB05
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
NDF-RT N0000175691
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
LIVERTOX NBK548295
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
Code System Code Type Description
MESH
C038981
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
INN
5189
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
EVMPD
SUB09139MIG
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
WIKIPEDIA
NALMEFENE
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
NCI_THESAURUS
C61855
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
USAN
T-2
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
IUPHAR
1628
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
FDA UNII
TOV02TDP9I
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
ChEMBL
CHEMBL982
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
DAILYMED
TOV02TDP9I
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
DRUG CENTRAL
1876
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
CAS
55096-26-9
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
DRUG BANK
DB06230
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
EPA CompTox
DTXSID8023347
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
PUBCHEM
5284594
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
HSDB
6761
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
SMS_ID
100000084441
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY
RXCUI
31479
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY RxNorm
MERCK INDEX
m7715
Created by admin on Sat Dec 16 17:44:25 UTC 2023 , Edited by admin on Sat Dec 16 17:44:25 UTC 2023
PRIMARY Merck Index