DIPHENOXYLATE

Details

Stereochemistry	ACHIRAL
Molecular Formula	C30H32N2O2
Molecular Weight	452.5873
Optical Activity	NONE
Defined Stereocenters	0 / 0
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure Search

SMILES

CCOC(=O)C1(CCN(CCC(C#N)(C2=CC=CC=C2)C3=CC=CC=C3)CC1)C4=CC=CC=C4

InChI

InChIKey=HYPPXZBJBPSRLK-UHFFFAOYSA-N

InChI=1S/C30H32N2O2/c1-2-34-28(33)29(25-12-6-3-7-13-25)18-21-32(22-19-29)23-20-30(24-31,26-14-8-4-9-15-26)27-16-10-5-11-17-27/h3-17H,2,18-23H2,1H3

HIDE SMILES / InChI

Molecular Formula	C30H32N2O2
Molecular Weight	452.5873
Charge	0
Count

Stereochemistry	ACHIRAL
Additional Stereochemistry	No
Defined Stereocenters	0 / 0
E/Z Centers	0
Optical Activity	NONE

Description
Sources: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f170584a-1072-4fd7-b1dc-6756703483b9
Curator's Comment: description was created based on several sources, including ISBN-13: 978-0323055932

Diphenoxylate is an opioid drug used for the treatment of acute diarrhea. The drug is used in combination with atropine and marketed under names Lomotil and Diphenoxylate hydrochloride and atropine sulfate. Diphenoxylate is biotransformed in man by ester hydrolysis to diphenoxylic acid (difenoxine), which is biologically active and the major metabolite in the blood. The drug exerts its action by activating mu opioid receptors of intestinal mucosa.

CNS Activity

Originator

Approval Year

Targets

Primary Target	Pharmacology	Condition	Potency
Mu-type opioid receptor 61 Target ID: P35372\|\|\|G8XRH8\|\|\|Q5TDA1\|\|\|Q9UN57 Gene ID: 4988.0 Gene Symbol: OPRM1 Target Organism: Homo sapiens (Human) Sources: ISBN-13: 978-0323055932	Agonist 2637

Conditions

Condition	Modality	Targets	Highest Phase	Product
Acute diarrhea 4 Sources: https://www.hpra.ie/img/uploaded/swedocuments/PA%20899-7-1%20PIL%20-2162562-11062015155951-635696351923400000.pdf	Curative		Approved 8307	LOMOTIL Approved Use Lomotil is effective as adjunctive therapy in the management of diarrhea. Launch Date -2.93414404E11

C_max

Value	Dose	Co-administered	Analyte	Population
622.68 ng/mL EXPERIMENT https://www.researchgate.net/publication/254338105_Determination_of_diphenoxylate_in_rat_plasma_by_gradient_elution_LC-ESI-MS	10 mg/kg single, oral dose: 10 mg/kg route of administration: Oral experiment type: SINGLE co-administered:		DIPHENOXYLATE plasma	Rattus norvegicus population: HEALTHY age: ADULT sex: MALE food status: FASTED
9.5 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/5026379	5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered:		DIPHENOXYLATE plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED

AUC

Value	Dose	Co-administered	Analyte	Population
7157.61 ng × h/mL EXPERIMENT https://www.researchgate.net/publication/254338105_Determination_of_diphenoxylate_in_rat_plasma_by_gradient_elution_LC-ESI-MS	10 mg/kg single, oral dose: 10 mg/kg route of administration: Oral experiment type: SINGLE co-administered:		DIPHENOXYLATE plasma	Rattus norvegicus population: HEALTHY age: ADULT sex: MALE food status: FASTED

T_1/2

Value	Dose	Co-administered	Analyte	Population
10.68 h EXPERIMENT https://www.researchgate.net/publication/254338105_Determination_of_diphenoxylate_in_rat_plasma_by_gradient_elution_LC-ESI-MS	10 mg/kg single, oral dose: 10 mg/kg route of administration: Oral experiment type: SINGLE co-administered:		DIPHENOXYLATE plasma	Rattus norvegicus population: HEALTHY age: ADULT sex: MALE food status: FASTED
2.5 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/5026379	5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered:		DIPHENOXYLATE plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED

F_unbound

Value	Dose	Co-administered	Analyte	Population
15.5% OTHER https://go.drugbank.com/drugs/DB01081			DIPHENOXYLATE unknown	Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN

Doses

Dose	Population	Adverse events
20 mg 1 times / day steady, oral Studied dose Dose: 20 mg, 1 times / day Route: oral Route: steady Dose: 20 mg, 1 times / day Co-administed with:: atropine sulfate(0.025 mg) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012462s048lbl.pdf	unhealthy Health Status: unhealthy Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012462s048lbl.pdf	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012462s048lbl.pdf
300 mg 1 times / day steady, oral (max) Dose: 300 mg, 1 times / day Route: oral Route: steady Dose: 300 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012462s048lbl.pdf	unhealthy Health Status: unhealthy Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012462s048lbl.pdf	Other AEs: Drug dependence... Other AEs: Drug dependence Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012462s048lbl.pdf

AEs

AE	Significance	Dose	Population
Drug dependence		300 mg 1 times / day steady, oral (max) Dose: 300 mg, 1 times / day Route: oral Route: steady Dose: 300 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012462s048lbl.pdf	unhealthy Health Status: unhealthy Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012462s048lbl.pdf

Overview

CYP3A4	CYP2C9	CYP2D6	hERG
inducer 753 inhibitor 1532	inducer 372	inducer 97 inhibitor 1789	inhibitor 1570

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
Ca2+ channels 41 CYP2B6 770	P-gp 1491	CYP2C19 283 CYP1A2 671 CYP2B6 521

Drug as perpetrator

Target	Modality	Activity	Clinical evidence
CYP2C19 1484	inducer 1515 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: abstract	minor	yes (co-administration study) Comment: diphenoxylate decreased omeprazole AUC and Cmax Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: abstract
CYP2B6 946	inhibitor 3185 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: 18805.0	no
CYP2D6 1826	inhibitor 3185 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: 18805.0	no
CYP3A4 1857	inhibitor 3185 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: 18805.0	no
CYP2B6 946	inducer 1515 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: 18805.0	no	no (co-administration study) Comment: diphenoxylate had no effect on buproprion AUC and Cmax Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: 18805.0
CYP2D6 1826	inducer 1515 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: 18805.0	no	no (co-administration study) Comment: diphenoxylate had no effect on metroprolol AUC and Cmax Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: 18805.0
CYP3A4 1857	inducer 1515 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: 18805.0	no	no (co-administration study) Comment: diphenoxylate had no effect on testosterone AUC and Cmax Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: 18805.0
Ca2+ channels 44	inhibitor 3185 Sources: https://www.sciencedirect.com/science/article/abs/pii/S0041008X03003727 Page: 136.0	unlikely
CYP1A2 1620	inducer 1515 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: abstract	yes	yes (co-administration study) Comment: diphenoxylate decreased phenacetin AUC and Cmax Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: abstract
CYP2C9 1747	inducer 1515 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: abstract	yes	yes (co-administration study) Comment: diphenoxylate decreased tolbutamide AUC and Cmax Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4694398/ Page: abstract

Drug as victim

Target	Modality	Activity	Metabolite	Clinical evidence
P-gp 1491	substrate 3264 Sources: https://www.sciencedirect.com/science/article/abs/pii/S0041008X03003727 Page: 135.0	no

Tox targets

Target	Modality	Activity	Metabolite	Clinical evidence
hERG 1603	inhibitor 1584 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249760/ Page: abstract

Sourcing

Vendor/Aggregator	ID	URL
ChEBI	CHEBI:4639	https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:4639
ChemicalBook	CB3301641	https://www.chemicalbook.com/ChemicalProductProperty_EN_CB3301641
ZINC	ZINC000003830716	http://zinc15.docking.org/substances/ZINC000003830716

PubMed

Title	Date	PubMed
[Irritable colon].	2001 Aug 20	11530562
Drug treatment for faecal incontinence in adults.	2003	12917921
Medical management of fecal incontinence.	2004 Jan	14978639
Protective effect of Arque-Ajeeb on acute experimental diarrhoea in rats.	2004 Jul 6	15238156
A randomized controlled trial of mycophenolate mofetil in patients with IgA nephropathy [ISRCTN62574616].	2004 Mar 25	15043759
The clinical and pathologic significance of microscopic colitis.	2004 May-Jun	15115927
Evaluation of antimotility effect of Lantana camara L. var. acuelata constituents on neostigmine induced gastrointestinal transit in mice.	2005 Sep 17	16168064
[Treating travelers' diarrhea. When should medication be given?].	2007 Dec	18097699
Drug-induced diarrhea.	2007 Oct	17991336
Methylnaltrexone in the treatment of opioid-induced constipation.	2008	21677823
Long-term outcome of in-patients with substance use disorders: A study from North India.	2008 Oct	19823613
Antimotility agents for chronic diarrhoea in people with HIV/AIDS.	2008 Oct 8	18843696
Inappropriate prescribing in the hospitalized elderly patient: defining the problem, evaluation tools, and possible solutions.	2010 Apr 7	20396637
Development of a list of potentially inappropriate drugs for the korean elderly using the delphi method.	2010 Dec	21818443
Lymphocytic colitis presenting as difficult diarrhoea in an African woman: a case report and review of the literature.	2010 Jan 29	20205879

Patents

Sample Use Guides

In Vivo Use Guide

Adults: The recommended initial dosage is two Lomotil tablets (each tablet contains 2,5 mg diphenoxylate hydrochloride) four times daily; Dosage schedule for children: The recommended initial total daily dosage of Lomotil liquid for children is 0.3 to 0.4 mg/kg, administered in four divided doses.

Route of Administration: Oral

In Vitro Use Guide

Unknown

Substance Class	Chemical Created by `admin` on `Sun Dec 18 17:35:52 UTC 2022` Edited by `admin` on `Sun Dec 18 17:35:52 UTC 2022`
Record UNII	73312P173G
Record Status	`Validated (UNII)`
Record Version

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Name

Type

Language

DIPHENOXYLATE

Official Name

English

diphenoxylate [INN]

Common Name

English

ISONIPECOTIC ACID, 1-(3-CYANO-3,3-DIPHENYLPROPYL)-4-PHENYL-, ETHYL ESTER

Common Name

English

DIPHENOXYLATE [MI]

Common Name

English

DIPHENOXYLATE [VANDF]

Common Name

English

DIPHENOXYLATE [HSDB]

Common Name

English

1-(3-CYANO-3,3-DIPHENYLPROPYL)-4-PHENYLPIPERIDINE-4-CARBOXYLIC ACID ETHYL ESTER

Systematic Name

English

Diphenoxylate [WHO-DD]

Common Name

English

IDS-ND-016

Code

English

4-PIPERIDINECARBOXYLIC ACID, 1-(3-CYANO-3,3-DIPHENYLPROPYL)-4-PHENYL-, ETHYL ESTER

Systematic Name

English

Classification Tree Code System Code

NDF-RT

N0000178374