Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C24H30O6 |
Molecular Weight | 414.4914 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 8 / 8 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
[H][C@@]12C[C@@]3(C)[C@@]([H])(CC[C@@]34CCC(=O)O4)[C@]5([H])[C@@H](CC6=CC(=O)CC[C@]6(C)[C@@]15O2)C(=O)OC
InChI
InChIKey=JUKPWJGBANNWMW-VWBFHTRKSA-N
InChI=1S/C24H30O6/c1-21-7-4-14(25)10-13(21)11-15(20(27)28-3)19-16-5-8-23(9-6-18(26)30-23)22(16,2)12-17-24(19,21)29-17/h10,15-17,19H,4-9,11-12H2,1-3H3/t15-,16+,17-,19+,21+,22+,23-,24-/m1/s1
Molecular Formula | C24H30O6 |
Molecular Weight | 414.4914 |
Charge | 0 |
Count |
|
Stereochemistry | ABSOLUTE |
Additional Stereochemistry | No |
Defined Stereocenters | 7 / 8 |
E/Z Centers | 0 |
Optical Activity | UNSPECIFIED |
DescriptionSources: http://www.drugbank.ca/drugs/DB00700Curator's Comment: Description was created based on several sources, including
https://www.drugs.com/cdi/eplerenone.html
Sources: http://www.drugbank.ca/drugs/DB00700
Curator's Comment: Description was created based on several sources, including
https://www.drugs.com/cdi/eplerenone.html
Eplerenone, an aldosterone receptor antagonist similar to spironolactone, has been shown to produce sustained increases in plasma renin and serum aldosterone, consistent with inhibition of the negative regulatory feedback of aldosterone on renin secretion. The resulting increased plasma renin activity and aldosterone circulating levels do not overcome the effects of eplerenone. Eplerenone selectively binds to recombinant human mineralocorticoid receptors relative to its binding to recombinant human glucocorticoid, progesterone and androgen receptors. Eplerenone binds to the mineralocorticoid receptor and thereby blocks the binding of aldosterone (component of the renin-angiotensin-aldosterone-system, or RAAS). Aldosterone synthesis, which occurs primarily in the adrenal gland, is modulated by multiple factors, including angiotensin II and non-RAAS mediators such as adrenocorticotropic hormone (ACTH) and potassium. Aldosterone binds to mineralocorticoid receptors in both epithelial (e.g., kidney) and nonepithelial (e.g., heart, blood vessels, and brain) tissues and increases blood pressure through induction of sodium reabsorption and possibly other mechanisms. Used for improvement of survival of stable patients with left ventricular systolic dysfunction (ejection fraction <40%) and clinical evidence of congestive heart failure after an acute myocardial infarction.
Originator
Sources: http://adisinsight.springer.com/drugs/800007155
Curator's Comment: # Novartis
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL1994 Sources: https://www.ncbi.nlm.nih.gov/pubmed/20672820 |
122.0 nM [IC50] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | INSPRA Approved UseINSPRA is an aldosterone antagonist indicated for:
Improving survival of stable patients with LV systolic dysfunction (LVEF ≤40%) and CHF after an acute myocardial infarction.
Hypertension, alone or combined with other agents. Launch Date2002 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
2.49 μg/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/14570778 |
100 mg single, oral dose: 100 mg route of administration: Oral experiment type: SINGLE co-administered: |
EPLERENONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
18.4 μg × h/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/14570778 |
100 mg single, oral dose: 100 mg route of administration: Oral experiment type: SINGLE co-administered: |
EPLERENONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
3.01 h EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/14570778 |
100 mg single, oral dose: 100 mg route of administration: Oral experiment type: SINGLE co-administered: |
EPLERENONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
38.2% EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/14570778 |
100 mg single, oral dose: 100 mg route of administration: Oral experiment type: SINGLE co-administered: |
EPLERENONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
Doses
Dose | Population | Adverse events |
---|---|---|
200 mg 2 times / day multiple, oral Highest studied dose Dose: 200 mg, 2 times / day Route: oral Route: multiple Dose: 200 mg, 2 times / day Sources: |
unhealthy, 21-80 years n = 48 Health Status: unhealthy Condition: hypertension Age Group: 21-80 years Sex: M+F Population Size: 48 Sources: |
Other AEs: Arthralgia, Dizziness... Other AEs: Arthralgia (6%) Sources: Dizziness (6%) Leg cramps (6%) Infection respiratory (13%) Sinusitis (2%) Nausea (4%) |
400 mg 1 times / day multiple, oral Highest studied dose Dose: 400 mg, 1 times / day Route: oral Route: multiple Dose: 400 mg, 1 times / day Sources: |
unhealthy, 21-80 years n = 56 Health Status: unhealthy Condition: hypertension Age Group: 21-80 years Sex: M+F Population Size: 56 Sources: |
Other AEs: Dizziness, Nausea... |
50 mg 1 times / day multiple, oral Dose: 50 mg, 1 times / day Route: oral Route: multiple Dose: 50 mg, 1 times / day Sources: |
healthy n = 15 |
Other AEs: Palpitations, Diarrhoea... Other AEs: Palpitations (below serious, 1 patient) Sources: Diarrhoea (below serious, 1 patient) Fatigue (below serious, 2 patients) Vessel puncture site reaction (below serious, 1 patient) Fungal skin infection (below serious, 1 patient) Nasopharyngitis (below serious, 3 patients) Dizziness (below serious, 2 patients) Headache (below serious, 5 patients) Pollakiuria (below serious, 1 patient) |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Infection respiratory | 13% | 200 mg 2 times / day multiple, oral Highest studied dose Dose: 200 mg, 2 times / day Route: oral Route: multiple Dose: 200 mg, 2 times / day Sources: |
unhealthy, 21-80 years n = 48 Health Status: unhealthy Condition: hypertension Age Group: 21-80 years Sex: M+F Population Size: 48 Sources: |
Sinusitis | 2% | 200 mg 2 times / day multiple, oral Highest studied dose Dose: 200 mg, 2 times / day Route: oral Route: multiple Dose: 200 mg, 2 times / day Sources: |
unhealthy, 21-80 years n = 48 Health Status: unhealthy Condition: hypertension Age Group: 21-80 years Sex: M+F Population Size: 48 Sources: |
Nausea | 4% | 200 mg 2 times / day multiple, oral Highest studied dose Dose: 200 mg, 2 times / day Route: oral Route: multiple Dose: 200 mg, 2 times / day Sources: |
unhealthy, 21-80 years n = 48 Health Status: unhealthy Condition: hypertension Age Group: 21-80 years Sex: M+F Population Size: 48 Sources: |
Arthralgia | 6% | 200 mg 2 times / day multiple, oral Highest studied dose Dose: 200 mg, 2 times / day Route: oral Route: multiple Dose: 200 mg, 2 times / day Sources: |
unhealthy, 21-80 years n = 48 Health Status: unhealthy Condition: hypertension Age Group: 21-80 years Sex: M+F Population Size: 48 Sources: |
Dizziness | 6% | 200 mg 2 times / day multiple, oral Highest studied dose Dose: 200 mg, 2 times / day Route: oral Route: multiple Dose: 200 mg, 2 times / day Sources: |
unhealthy, 21-80 years n = 48 Health Status: unhealthy Condition: hypertension Age Group: 21-80 years Sex: M+F Population Size: 48 Sources: |
Leg cramps | 6% | 200 mg 2 times / day multiple, oral Highest studied dose Dose: 200 mg, 2 times / day Route: oral Route: multiple Dose: 200 mg, 2 times / day Sources: |
unhealthy, 21-80 years n = 48 Health Status: unhealthy Condition: hypertension Age Group: 21-80 years Sex: M+F Population Size: 48 Sources: |
Dizziness | 2% | 400 mg 1 times / day multiple, oral Highest studied dose Dose: 400 mg, 1 times / day Route: oral Route: multiple Dose: 400 mg, 1 times / day Sources: |
unhealthy, 21-80 years n = 56 Health Status: unhealthy Condition: hypertension Age Group: 21-80 years Sex: M+F Population Size: 56 Sources: |
Nausea | 5% | 400 mg 1 times / day multiple, oral Highest studied dose Dose: 400 mg, 1 times / day Route: oral Route: multiple Dose: 400 mg, 1 times / day Sources: |
unhealthy, 21-80 years n = 56 Health Status: unhealthy Condition: hypertension Age Group: 21-80 years Sex: M+F Population Size: 56 Sources: |
Diarrhoea | below serious, 1 patient | 50 mg 1 times / day multiple, oral Dose: 50 mg, 1 times / day Route: oral Route: multiple Dose: 50 mg, 1 times / day Sources: |
healthy n = 15 |
Fungal skin infection | below serious, 1 patient | 50 mg 1 times / day multiple, oral Dose: 50 mg, 1 times / day Route: oral Route: multiple Dose: 50 mg, 1 times / day Sources: |
healthy n = 15 |
Palpitations | below serious, 1 patient | 50 mg 1 times / day multiple, oral Dose: 50 mg, 1 times / day Route: oral Route: multiple Dose: 50 mg, 1 times / day Sources: |
healthy n = 15 |
Pollakiuria | below serious, 1 patient | 50 mg 1 times / day multiple, oral Dose: 50 mg, 1 times / day Route: oral Route: multiple Dose: 50 mg, 1 times / day Sources: |
healthy n = 15 |
Vessel puncture site reaction | below serious, 1 patient | 50 mg 1 times / day multiple, oral Dose: 50 mg, 1 times / day Route: oral Route: multiple Dose: 50 mg, 1 times / day Sources: |
healthy n = 15 |
Dizziness | below serious, 2 patients | 50 mg 1 times / day multiple, oral Dose: 50 mg, 1 times / day Route: oral Route: multiple Dose: 50 mg, 1 times / day Sources: |
healthy n = 15 |
Fatigue | below serious, 2 patients | 50 mg 1 times / day multiple, oral Dose: 50 mg, 1 times / day Route: oral Route: multiple Dose: 50 mg, 1 times / day Sources: |
healthy n = 15 |
Nasopharyngitis | below serious, 3 patients | 50 mg 1 times / day multiple, oral Dose: 50 mg, 1 times / day Route: oral Route: multiple Dose: 50 mg, 1 times / day Sources: |
healthy n = 15 |
Headache | below serious, 5 patients | 50 mg 1 times / day multiple, oral Dose: 50 mg, 1 times / day Route: oral Route: multiple Dose: 50 mg, 1 times / day Sources: |
healthy n = 15 |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 18.0 |
no [IC50 >300 uM] | |||
Page: 18.0 |
no [IC50 >300 uM] | |||
Page: 18.0 |
no [IC50 >300 uM] | |||
Page: 18.0 |
no [IC50 >300 uM] | |||
Page: 45.0 |
no | |||
Page: 18.0 |
no | |||
Page: 18.0 |
no | |||
Page: 41.0 |
weak |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 9, 10, 15 |
major | yes (co-administration study) Comment: coadministered with ketoconazole increased elperenone AUC by 5.5-fold and Cmax by 1.7-fold and with erythromycin increased AUC by 1.8-fold and Cmax 61% Page: 9, 10, 15 |
||
Page: 18, 34 |
no | |||
Page: 10.0 |
yes | yes (co-administration study) Comment: coadminstration with fluconazole increased eplerenone AUC by 2.2-fold and Cmax by 1.4-fold Page: 10.0 |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sources: https://pubmed.ncbi.nlm.nih.gov/21764470/ |
PubMed
Title | Date | PubMed |
---|---|---|
Mineralocorticoid and angiotensin receptor antagonism during hyperaldosteronemia. | 2002 Aug |
|
Efficacy of eplerenone added to renin-angiotensin blockade in hypertensive patients. | 2002 Aug |
|
Selective aldosterone blockade prevents angiotensin II/salt-induced vascular inflammation in the rat heart. | 2002 Dec |
|
Involvement of CYP3A in the metabolism of eplerenone in humans and dogs: differential metabolism by CYP3A4 and CYP3A5. | 2002 Dec |
|
Effects of long-term monotherapy with eplerenone, a novel aldosterone blocker, on progression of left ventricular dysfunction and remodeling in dogs with heart failure. | 2002 Dec 3 |
|
Results from late-breaking clinical trial sessions at the American College of Cardiology 51st Annual Scientific Session. | 2002 Jul 3 |
|
Interconversion pharmacokinetics of eplerenone, a selective aldosterone blocker, and its lactone-ring open form. | 2002 Jun |
|
Increased carotid wall elastic modulus and fibronectin in aldosterone-salt-treated rats: effects of eplerenone. | 2002 Nov 26 |
|
The role of aldosterone receptor blockade in the management of cardiovascular disease. | 2002 Oct |
|
Aldosterone receptor antagonists for hypertension: what do they offer? | 2003 |
|
Primary aldosteronism - treatment options. | 2003 Aug |
|
Selective aldosterone blockade with eplerenone in patients with congestive heart failure. | 2003 Aug |
|
Aldosterone blockade and vascular calcification in hemodialysis patients. | 2003 Aug 15 |
|
Eplerenone: a selective aldosterone blocker. | 2003 Fall |
|
[Aldosterone and its antagonists in heart failure]. | 2003 Jan 18 |
|
[Anti-angiogenic effects of aldosterone antagonists in the fibrin chamber in rats]. | 2003 Jul-Aug |
|
Hyperkalemia, congestive heart failure, and aldosterone receptor antagonism. | 2003 Jul-Aug |
|
Gateways to clinical trials. | 2003 Jun |
|
Aldosterone resurgens--letter from EPHESUS. | 2003 Jun |
|
Eplerenone. | 2003 Mar |
|
Aldo is back: recent advances and unresolved controversies in hyperaldosteronism. | 2003 Mar |
|
Aldosterone antagonism and hypertension. | 2003 May |
|
New developments in the pharmacological treatment of chronic heart failure. | 2003 May |
|
Eplerenone: cardiovascular protection. | 2003 May 20 |
|
RAAS escape: a real clinical entity that may be important in the progression of cardiovascular and renal disease. | 2003 Oct |
|
Long-term safety and efficacy of the selective aldosterone blocker eplerenone in patients with essential hypertension. | 2003 Sep |
|
New developments in the management of hypertension. | 2003 Sep 1 |
|
Adjunctive treatment with eplerenone reduced morbidity and mortality in acute myocardial infarction. | 2003 Sep-Oct |
|
Aldosterone receptor antagonists: focus on eplerenone. | 2003 Winter |
Sample Use Guides
In Vivo Use Guide
Sources: https://www.drugs.com/cdi/eplerenone.html
Congestive heart failure post-myocardial infarction:
Initial dosage: 25 mg orally once daily. Dosage should titrated to the target dose of 50 mg once daily preferably within 4 weeks.
Usual Adult Dose for Hypertension
50 mg orally once daily. Patients with an inadequate blood pressure response should be increased to 50 mg twice a day.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/27153999
Eplerenone (10uM) significantly decreased corticosterone- (0.81 fold compared to treatment with corticosterone alone) and 11-DHC-driven (0.64 fold compared to treatment with 11-DHC alone) mouse VSMC calcification
Substance Class |
Chemical
Created
by
admin
on
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Fri Dec 15 15:54:25 GMT 2023
by
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on
Fri Dec 15 15:54:25 GMT 2023
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Record UNII |
6995V82D0B
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Record Status |
Validated (UNII)
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Record Version |
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QC03DA04
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NBK547930
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C270
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C03DA04
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N0000175557
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N0000011310
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C843
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7596
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EPLERENONE
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II-52
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CHEMBL1095097
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m4951
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C414690
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DB00700
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6995V82D0B
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107724-20-9
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C47513
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100000092297
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Related Record | Type | Details | ||
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TARGET -> INHIBITOR |
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EXCRETED UNCHANGED |
FECAL; URINE
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BINDER->LIGAND |
BINDING
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METABOLIC ENZYME -> SUBSTRATE |
MAJOR
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Related Record | Type | Details | ||
---|---|---|---|---|
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METABOLITE -> PARENT |
MINOR
FECAL; URINE
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METABOLITE -> PARENT |
MINOR
PLASMA
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METABOLITE -> PARENT |
MINOR
FECAL
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METABOLITE -> PARENT |
Primarily mediated via CYP3A4. No active metabolites of eplerenone have been identified in human plasma
MINOR
FECAL; PLASMA; URINE
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METABOLITE -> PARENT |
Primarily mediated via CYP3A4. No active metabolites of eplerenone have been identified in human plasma
MAJOR
PLASMA; URINE
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METABOLITE -> PARENT |
MINOR
FECAL
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METABOLITE -> PARENT |
Primarily mediated via CYP3A4. No active metabolites of eplerenone have been identified in human plasma
MINOR
FECAL; URINE
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METABOLITE -> PARENT |
Major in fecal and urine; Primarily mediated via CYP3A4. No active metabolites of eplerenone have been identified in human plasma
MAJOR
FECAL; PLASMA; URINE
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METABOLITE -> PARENT |
Primarily mediated via CYP3A4. No active metabolites of eplerenone have been identified in human plasma
MINOR
FECAL
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|
METABOLITE -> PARENT |
Primarily mediated via CYP3A4. No active metabolites of eplerenone have been identified in human plasma
MINOR
FECAL; PLASMA; URINE
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Related Record | Type | Details | ||
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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Related Record | Type | Details | ||
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ACTIVE MOIETY |
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Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
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Tmax | PHARMACOKINETIC |
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ORAL ADMINISTRATION |
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Volume of Distribution | PHARMACOKINETIC |
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AT STEADY-STATE |
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Biological Half-life | PHARMACOKINETIC |
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