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Details

Stereochemistry ABSOLUTE
Molecular Formula C39H66O5
Molecular Weight 614.9383
Optical Activity UNSPECIFIED
Defined Stereocenters 5 / 5
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of TREPROSTINIL PALMITIL

SMILES

[H][C@]12C[C@@H](O)[C@H](CC[C@@H](O)CCCCC)[C@@]1([H])CC3=C(C2)C(OCC(=O)OCCCCCCCCCCCCCCCC)=CC=C3

InChI

InChIKey=XOKCXRVJBBLBSX-HDMCCQRMSA-N
InChI=1S/C39H66O5/c1-3-5-7-8-9-10-11-12-13-14-15-16-17-19-26-43-39(42)30-44-38-23-20-21-31-27-35-32(28-36(31)38)29-37(41)34(35)25-24-33(40)22-18-6-4-2/h20-21,23,32-35,37,40-41H,3-19,22,24-30H2,1-2H3/t32-,33-,34+,35-,37+/m0/s1

HIDE SMILES / InChI

Molecular Formula C39H66O5
Molecular Weight 614.9383
Charge 0
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 5 / 5
E/Z Centers 0
Optical Activity UNSPECIFIED

Description
Curator's Comment: Description was created based on several sources, including: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412595/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515411/

Treprostinil (marketed under the trade names Remodulin for infusion) is a vasodilator that is used for the treatment of pulmonary arterial hypertension. Pulmonary arterial hypertension (PAH) is a disease in which blood pressure is abnormally high in the arteries between the heart and lungs. PAH is characterized by symptoms of shortness of breath during physical exertion. The condition can ultimately lead to heart failure. Treprostinil is a potent oral antiplatelet agent. The major pharmacologic actions of treprostinil are direct vasodilation of pulmonary and systemic arterial vascular beds and inhibition of platelet aggregation. In animals, the vasodilatory effects reduce right and left ventricular afterload and increase cardiac output and stroke volume. Other studies have shown that treprostinil causes a dose-related negative inotropic and lusitropic effect. No major effects on cardiac conduction have been observed. Treprostinil had high affinity for the Prostaglandin D2 receptor (DP1), Prostaglandin E2 receptor EP2 subtype (EP2) and Prostaglandin D2 receptor (IP) receptors (Ki 4.4, 3.6 and 32 nM, respectively), low affinity for EP1 and EP4 receptors and even lower affinity for EP3, Prostaglandin F (FP) and thromboxane (TP) receptors. Treprostinil has demonstrated a unique effect on PPAR gamma, a transcription factor important in vascular pathogenesis as a mediator of proliferation, inflammation and apoptosis. Through a complementary, yet cyclic AMP-independent pathway, treprostinil activates PPARs, another mechanism that contributes to the anti-growth benefits of the prostacyclin class.

Originator

Curator's Comment: By 1976, Vane and fellow researcher Salvador Moncada published the first paper on prostacyclin, in the scientific journal Nature. The collaboration produced a synthetic molecule which was given the name epoprostenol. But like native prostacyclin, the structure of the epoprostenol molecule proved to be unstable in solution, prone to rapid degradation. This presented a challenge for both in vitro experiments and clinical applications. To overcome this challenge, the research team that discovered prostacyclin was determined to continue the research in an attempt to build upon the success they had seen with the prototype molecule. The research team synthesized nearly 1,000 analogs.

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
REMODULIN

Approved Use

Remodulin is a prostacyclin vasodilator indicated for: Treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to diminish symptoms associated with exercise. Studies establishing effectiveness included patients with NYHA Functional Class II-IV symptoms and etiologies of idiopathic or heritable PAH (58%), PAH associated with congenital systemic-to-pulmonary shunts (23%), or PAH associated with connective tissue diseases (19%) (1.1) Patients who require transition from Flolan®, to reduce the rate of clinical deterioration. The risks and benefits of each drug should be carefully considered prior to transition. (1.2) 1.1 Pulmonary Arterial Hypertension Remodulin is indicated for the treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to diminish symptoms associated with exercise. Studies establishing effectiveness included patients with NYHA Functional Class II-IV symptoms and etiologies of idiopathic or heritable PAH (58%), PAH associated with congenital systemic-to-pulmonary shunts (23%), or PAH associated with connective tissue diseases (19%) [see Clinical Studies (14.1)

Launch Date

1.02193922E12
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
0.71 ng/mL
0.5 mg 3 times / day multiple, oral
dose: 0.5 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
TREPROSTINIL plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
0.54 ng/mL
0.5 mg single, oral
dose: 0.5 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
TREPROSTINIL plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
6.53 ng × h/mL
0.5 mg 3 times / day multiple, oral
dose: 0.5 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
TREPROSTINIL plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
2.46 ng × h/mL
0.5 mg single, oral
dose: 0.5 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
TREPROSTINIL plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
1.34 h
0.5 mg 3 times / day multiple, oral
dose: 0.5 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
TREPROSTINIL plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
1.06 h
0.5 mg single, oral
dose: 0.5 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
TREPROSTINIL plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
9%
TREPROSTINIL plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
20 mg 3 times / day steady, subcutaneous
Overdose
Dose: 20 mg, 3 times / day
Route: subcutaneous
Route: steady
Dose: 20 mg, 3 times / day
Co-administed with::
chlorothiazide(500 mg)
lasix(40 mg)
coumadin(4 mg)
Sources:
unhealthy, 10 years
n = 1
Health Status: unhealthy
Condition: pulmonary hypertension
Age Group: 10 years
Sex: F
Population Size: 1
Sources:
Disc. AE: Nausea, Blurred vision...
AEs leading to
discontinuation/dose reduction:
Nausea (1 patient)
Blurred vision (1 patient)
Sources:
7.5 mg single, subcutaneous
Overdose
Dose: 7.5 mg
Route: subcutaneous
Route: single
Dose: 7.5 mg
Sources:
unhealthy, 29 years
n = 1
Health Status: unhealthy
Condition: group 1 pulmonary arterial hypertension
Age Group: 29 years
Sex: F
Population Size: 1
Sources:
Disc. AE: Circulatory collapse...
AEs leading to
discontinuation/dose reduction:
Circulatory collapse (1 patient)
Sources:
150 ug single, respiratory
Highest studied dose
Dose: 150 ug
Route: respiratory
Route: single
Dose: 150 ug
Sources:
healthy, 30.3 years
n = 43
Health Status: healthy
Age Group: 30.3 years
Sex: M+F
Population Size: 43
Sources:
Other AEs: Cough, Throat irritation...
Other AEs:
Cough (26 patients)
Throat irritation (26 patients)
Sources:
100 mg single, subcutaneous (min)
Overdose
Dose: 100 mg
Route: subcutaneous
Route: single
Dose: 100 mg
Sources:
unhealthy, 58 years
n = 1
Health Status: unhealthy
Condition: CREST syndrome, Raynaud's syndrome, esophageal motility impairment, and severe pulmonary hypertension
Age Group: 58 years
Sex: F
Population Size: 1
Sources:
Disc. AE: Hypotension, Tachycardia...
AEs leading to
discontinuation/dose reduction:
Hypotension (1 patient)
Tachycardia (1 patient)
Arrhythmia ventricular (1 patient)
Dyspnea (1 patient)
Sources:
36 ug 4 times / day steady, respiratory (max)
Recommended
Dose: 36 ug, 4 times / day
Route: respiratory
Route: steady
Dose: 36 ug, 4 times / day
Sources:
unhealthy, 7.1 - 19.2 years
n = 29
Health Status: unhealthy
Condition: pulmonary hypertension
Age Group: 7.1 - 19.2 years
Sex: M+F
Population Size: 29
Sources:
Disc. AE: Bronchospasm...
AEs leading to
discontinuation/dose reduction:
Bronchospasm (3 patients)
Sources:
AEs

AEs

AESignificanceDosePopulation
Blurred vision 1 patient
Disc. AE
20 mg 3 times / day steady, subcutaneous
Overdose
Dose: 20 mg, 3 times / day
Route: subcutaneous
Route: steady
Dose: 20 mg, 3 times / day
Co-administed with::
chlorothiazide(500 mg)
lasix(40 mg)
coumadin(4 mg)
Sources:
unhealthy, 10 years
n = 1
Health Status: unhealthy
Condition: pulmonary hypertension
Age Group: 10 years
Sex: F
Population Size: 1
Sources:
Nausea 1 patient
Disc. AE
20 mg 3 times / day steady, subcutaneous
Overdose
Dose: 20 mg, 3 times / day
Route: subcutaneous
Route: steady
Dose: 20 mg, 3 times / day
Co-administed with::
chlorothiazide(500 mg)
lasix(40 mg)
coumadin(4 mg)
Sources:
unhealthy, 10 years
n = 1
Health Status: unhealthy
Condition: pulmonary hypertension
Age Group: 10 years
Sex: F
Population Size: 1
Sources:
Circulatory collapse 1 patient
Disc. AE
7.5 mg single, subcutaneous
Overdose
Dose: 7.5 mg
Route: subcutaneous
Route: single
Dose: 7.5 mg
Sources:
unhealthy, 29 years
n = 1
Health Status: unhealthy
Condition: group 1 pulmonary arterial hypertension
Age Group: 29 years
Sex: F
Population Size: 1
Sources:
Cough 26 patients
150 ug single, respiratory
Highest studied dose
Dose: 150 ug
Route: respiratory
Route: single
Dose: 150 ug
Sources:
healthy, 30.3 years
n = 43
Health Status: healthy
Age Group: 30.3 years
Sex: M+F
Population Size: 43
Sources:
Throat irritation 26 patients
150 ug single, respiratory
Highest studied dose
Dose: 150 ug
Route: respiratory
Route: single
Dose: 150 ug
Sources:
healthy, 30.3 years
n = 43
Health Status: healthy
Age Group: 30.3 years
Sex: M+F
Population Size: 43
Sources:
Arrhythmia ventricular 1 patient
Disc. AE
100 mg single, subcutaneous (min)
Overdose
Dose: 100 mg
Route: subcutaneous
Route: single
Dose: 100 mg
Sources:
unhealthy, 58 years
n = 1
Health Status: unhealthy
Condition: CREST syndrome, Raynaud's syndrome, esophageal motility impairment, and severe pulmonary hypertension
Age Group: 58 years
Sex: F
Population Size: 1
Sources:
Dyspnea 1 patient
Disc. AE
100 mg single, subcutaneous (min)
Overdose
Dose: 100 mg
Route: subcutaneous
Route: single
Dose: 100 mg
Sources:
unhealthy, 58 years
n = 1
Health Status: unhealthy
Condition: CREST syndrome, Raynaud's syndrome, esophageal motility impairment, and severe pulmonary hypertension
Age Group: 58 years
Sex: F
Population Size: 1
Sources:
Hypotension 1 patient
Disc. AE
100 mg single, subcutaneous (min)
Overdose
Dose: 100 mg
Route: subcutaneous
Route: single
Dose: 100 mg
Sources:
unhealthy, 58 years
n = 1
Health Status: unhealthy
Condition: CREST syndrome, Raynaud's syndrome, esophageal motility impairment, and severe pulmonary hypertension
Age Group: 58 years
Sex: F
Population Size: 1
Sources:
Tachycardia 1 patient
Disc. AE
100 mg single, subcutaneous (min)
Overdose
Dose: 100 mg
Route: subcutaneous
Route: single
Dose: 100 mg
Sources:
unhealthy, 58 years
n = 1
Health Status: unhealthy
Condition: CREST syndrome, Raynaud's syndrome, esophageal motility impairment, and severe pulmonary hypertension
Age Group: 58 years
Sex: F
Population Size: 1
Sources:
Bronchospasm 3 patients
Disc. AE
36 ug 4 times / day steady, respiratory (max)
Recommended
Dose: 36 ug, 4 times / day
Route: respiratory
Route: steady
Dose: 36 ug, 4 times / day
Sources:
unhealthy, 7.1 - 19.2 years
n = 29
Health Status: unhealthy
Condition: pulmonary hypertension
Age Group: 7.1 - 19.2 years
Sex: M+F
Population Size: 29
Sources:
Overview

OverviewOther

Drug as perpetrator​Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
major
yes (co-administration study)
Comment: Treprostinil plasma AUC and Cmax increased approximately 2-fold when administered with gemfibrozil; Treprostinil AUC decreased by 30% when adminsitered with rifampin;
Page: 12,14
minor
weak (co-administration study)
Comment: Treprostinil AUC decreased approximately 14%, no effect on Cmax when adminstered with fluconazole;
Page: 12,14
no
no
no
no
no
no
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
Treprostinil sodium Pharmacia.
2002 Apr
Absolute bioavailability and pharmacokinetics of treprostinil sodium administered by acute subcutaneous infusion.
2004 Jan
Treprostinil for pulmonary hypertension.
2004 Mar
[The best of clinical cardiovascular pharmacology in 2005].
2006 Jan
Gateways to clinical trials.
2006 Jan-Feb
Gateways to clinical trials.
2006 Jul-Aug
Efficacy of long-term subcutaneous treprostinil sodium therapy in pulmonary hypertension.
2006 Jun
Gateways to clinical trials.
2006 Mar
Treprostinil sodium (Remodulin), a prostacyclin analog, in the treatment of critical limb ischemia: open-label study.
2006 May-Jun
Gateways to clinical trials.
2006 Sep
The role of peroxisome proliferator-activated receptors in pulmonary vascular disease.
2007
IP receptor-dependent activation of PPARgamma by stable prostacyclin analogues.
2007 Sep 7
Treprostinil for pulmonary hypertension.
2008
A novel catheter system for totally implantable intravenous drug therapy: assessment of catheter function and patency with trepostinil therapy.
2008 Jan-Mar
Gateways to clinical trials.
2009 Sep
Smad-dependent and smad-independent induction of id1 by prostacyclin analogues inhibits proliferation of pulmonary artery smooth muscle cells in vitro and in vivo.
2010 Jul 23
Stability and antimicrobial effectiveness of treprostinil sodium in Sterile Diluent for Flolan.
2010 Jun
Binding and activity of the prostacyclin receptor (IP) agonists, treprostinil and iloprost, at human prostanoid receptors: treprostinil is a potent DP1 and EP2 agonist.
2012 Jul 1
Patents

Sample Use Guides

In Vivo Use Guide
Curator's Comment: Treprostinil is available in three different formulations and four different routes of administration: Remodulin® (treprostinil sodium, intravenous and subcutaneous administration), Tyvaso® (treprostinil sodium, inhaled administration), and Orenitram® (treprostinil diolamine, oral administration) for the treatment of pulmonary arterial hypertension (PAH). https://www.ncbi.nlm.nih.gov/pubmed/?term=27286723
1.25 ng/kg/min (initial dose for continuous infusion, dosage should be chronically adjusted depending on clinical response)
Route of Administration: Other
In Vitro Use Guide
Curator's Comment: Treprostinil (0.15 - 15 ng/ml) slightly increased contractile dynamics of cardiomyocytes at clinically relevant concentrations.
Treprostinil (0.15 - 15 ng/ml) rat cardiomyocytes
Substance Class Chemical
Created
by admin
on Sat Dec 16 08:30:07 UTC 2023
Edited
by admin
on Sat Dec 16 08:30:07 UTC 2023
Record UNII
8GJK87S89F
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
TREPROSTINIL HEXADECYL ESTER
Preferred Name English
TREPROSTINIL PALMITIL
INN  
Official Name English
HEXADECYL 2-(((1R,2R,3AS,9AS)-2-HYDROXY-1-((S)-3-HYDROXYOCTYL)-2,3,3A,4,9,9A-HEXAHYDRO-1H-CYCLOPENTA(B)NAPHTHALEN-5-YL)OXY)ACETATE
Systematic Name English
TREPROSTINIL PALMITIL [USAN]
Common Name English
INS1009
Code English
treprostinil palmitil [INN]
Common Name English
INS-1009
Code English
HEXADECYL TREPROSTINIL
Common Name English
ACETIC ACID, 2-(((1R,2R,3AS,9AS)-2,3,3A,4,9,9A-HEXAHYDRO-2-HYDROXY-1-((3S)- 3-HYDROXYOCTYL)-1H-BENZ(F)INDEN-5-YL)OXY)-, HEXADECYL ESTER
Systematic Name English
Code System Code Type Description
INN
11087
Created by admin on Sat Dec 16 08:30:07 UTC 2023 , Edited by admin on Sat Dec 16 08:30:07 UTC 2023
PRIMARY
CAS
1706528-83-7
Created by admin on Sat Dec 16 08:30:07 UTC 2023 , Edited by admin on Sat Dec 16 08:30:07 UTC 2023
PRIMARY
PUBCHEM
91617675
Created by admin on Sat Dec 16 08:30:07 UTC 2023 , Edited by admin on Sat Dec 16 08:30:07 UTC 2023
PRIMARY
FDA UNII
8GJK87S89F
Created by admin on Sat Dec 16 08:30:07 UTC 2023 , Edited by admin on Sat Dec 16 08:30:07 UTC 2023
PRIMARY
USAN
JK-47
Created by admin on Sat Dec 16 08:30:07 UTC 2023 , Edited by admin on Sat Dec 16 08:30:07 UTC 2023
PRIMARY
SMS_ID
300000018836
Created by admin on Sat Dec 16 08:30:07 UTC 2023 , Edited by admin on Sat Dec 16 08:30:07 UTC 2023
PRIMARY
NCI_THESAURUS
C171934
Created by admin on Sat Dec 16 08:30:07 UTC 2023 , Edited by admin on Sat Dec 16 08:30:07 UTC 2023
PRIMARY
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