Details
| Stereochemistry | RACEMIC |
| Molecular Formula | C10H13N3O5S |
| Molecular Weight | 287.292 |
| Optical Activity | ( + / - ) |
| Defined Stereocenters | 0 / 1 |
| E/Z Centers | 1 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
CC1CS(=O)(=O)CCN1\N=C\C2=CC=C(O2)[N+]([O-])=O
InChI
InChIKey=ARFHIAQFJWUCFH-IZZDOVSWSA-N
InChI=1S/C10H13N3O5S/c1-8-7-19(16,17)5-4-12(8)11-6-9-2-3-10(18-9)13(14)15/h2-3,6,8H,4-5,7H2,1H3/b11-6+
| Molecular Formula | C10H13N3O5S |
| Molecular Weight | 287.292 |
| Charge | 0 |
| Count |
|
| Stereochemistry | RACEMIC |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 1 |
| E/Z Centers | 1 |
| Optical Activity | ( + / - ) |
DescriptionSources: https://www.drugs.com/mmx/nifurtimox.htmlCurator's Comment: description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/pubmed/27282514 | https://www.drugs.com/international/nifurtimox.html | https://www.ncbi.nlm.nih.gov/pubmed/23518280
Sources: https://www.drugs.com/mmx/nifurtimox.html
Curator's Comment: description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/pubmed/27282514 | https://www.drugs.com/international/nifurtimox.html | https://www.ncbi.nlm.nih.gov/pubmed/23518280
Nifurtimox is a nitrofuran derivative used as a primary agent in the treatment of American trypanosomiasis (Chagas' disease) caused by Trypanosoma cruzi, especially in the acute, early stage of the disease. The efficacy of nifurtimox in the treatment of chronic Chagas' disease varies from one country to another, possibly due to variation in the sensitivity of different strains of the organism. Nifurtimox has also been used to treat African trypanosomiasis (sleeping sickness) and is active in the second stage of the disease (central nervous system involvement). When nifurtimox is given on its own, about half of all patients will relapse, but the combination of melarsoprol with nifurtimox appears to be efficacious. Nifurtimox forms a nitro-anion radical metabolite that reacts with nucleic acids of the parasite causing significant break down of DNA. Nifurtimox undergoes reduction and creates oxygen radicals such as superoxide. These radicals are toxic to T. cruzi. Mammalian cells are protected by the presence of catalase, glutathione, peroxidases, and superoxide dismutase. Accumulation of hydrogen peroxide to cytotoxic levels results in parasite death. Side effects occur following chronic administration, particularly in elderly people. Major toxicities include immediate hypersensitivities such as anaphylaxis and delayed hypersensitivity reaction involving icterus and dermatitis. Central nervous system disturbances and peripheral neuropathy may also occur.
CNS Activity
Originator
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL4188 Sources: https://www.ncbi.nlm.nih.gov/pubmed/20131843 |
|||
Target ID: CHEMBL368 Sources: https://www.ncbi.nlm.nih.gov/pubmed/23518280 |
1.8 µM [IC50] |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Curative | Lampit Approved UseUnknown |
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| Primary | Lampit Approved UseUnknown |
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| Primary | Lampit Approved UseUnknown |
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| Curative | Lampit Approved UseUnknown |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
568 μg/L |
120 mg single, oral dose: 120 mg route of administration: Oral experiment type: SINGLE co-administered: |
NIFURTIMOX plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
568 μg/L |
120 mg 1 times / day unknown, oral dose: 120 mg route of administration: Oral experiment type: UNKNOWN co-administered: |
NIFURTIMOX plasma | Homo sapiens population: UNHEALTHY age: UNKNOWN sex: FEMALE / MALE food status: HIGH-FAT |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
2670 μg × h/L |
120 mg single, oral dose: 120 mg route of administration: Oral experiment type: SINGLE co-administered: |
NIFURTIMOX plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
2670 μg × h/L |
120 mg 1 times / day unknown, oral dose: 120 mg route of administration: Oral experiment type: UNKNOWN co-administered: |
NIFURTIMOX plasma | Homo sapiens population: UNHEALTHY age: UNKNOWN sex: FEMALE / MALE food status: HIGH-FAT |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
3.3 h |
120 mg single, oral dose: 120 mg route of administration: Oral experiment type: SINGLE co-administered: |
NIFURTIMOX plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
3.3 h |
120 mg 1 times / day unknown, oral dose: 120 mg route of administration: Oral experiment type: UNKNOWN co-administered: |
NIFURTIMOX plasma | Homo sapiens population: UNHEALTHY age: UNKNOWN sex: FEMALE / MALE food status: HIGH-FAT |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
58% |
120 mg single, oral dose: 120 mg route of administration: Oral experiment type: SINGLE co-administered: |
NIFURTIMOX plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
57.6% |
120 mg 1 times / day unknown, oral dose: 120 mg route of administration: Oral experiment type: UNKNOWN co-administered: |
NIFURTIMOX plasma | Homo sapiens population: UNHEALTHY age: UNKNOWN sex: FEMALE / MALE food status: HIGH-FAT |
Doses
| Dose | Population | Adverse events |
|---|---|---|
40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
Other AEs: Anorexia, AST increased... Other AEs: Anorexia (grade 2-3, 40%) Sources: AST increased (grade 1, 80%) ALT increased (grade 1, 20%) Limb pain (grade 3, 20%) Seizure (grade 3, 20%) |
40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
DLT: Neuropathy, Pulmonary hemorrhage... Other AEs: Anorexia, Seizure... Dose limiting toxicities: Neuropathy (grade 3, 50%) Other AEs:Pulmonary hemorrhage (grade 3, 25%) Anorexia Sources: Seizure (100%) Nausea |
30 mg/kg 3 times / day multiple, oral MTD Dose: 30 mg/kg, 3 times / day Route: oral Route: multiple Dose: 30 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
Other AEs: Stomach pain, Anorexia... Other AEs: Stomach pain (33.3%) Sources: Anorexia Neuropathy (50%) Seizure (16.7%) Nausea |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| ALT increased | grade 1, 20% | 40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
| AST increased | grade 1, 80% | 40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
| Anorexia | grade 2-3, 40% | 40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
| Limb pain | grade 3, 20% | 40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
| Seizure | grade 3, 20% | 40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
| Anorexia | 40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
|
| Nausea | 40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
|
| Seizure | 100% | 40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
| Pulmonary hemorrhage | grade 3, 25% DLT |
40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
| Neuropathy | grade 3, 50% DLT |
40 mg/kg 3 times / day multiple, oral Highest studied dose Dose: 40 mg/kg, 3 times / day Route: oral Route: multiple Dose: 40 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
| Anorexia | 30 mg/kg 3 times / day multiple, oral MTD Dose: 30 mg/kg, 3 times / day Route: oral Route: multiple Dose: 30 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
|
| Nausea | 30 mg/kg 3 times / day multiple, oral MTD Dose: 30 mg/kg, 3 times / day Route: oral Route: multiple Dose: 30 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
|
| Seizure | 16.7% | 30 mg/kg 3 times / day multiple, oral MTD Dose: 30 mg/kg, 3 times / day Route: oral Route: multiple Dose: 30 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
| Stomach pain | 33.3% | 30 mg/kg 3 times / day multiple, oral MTD Dose: 30 mg/kg, 3 times / day Route: oral Route: multiple Dose: 30 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
| Neuropathy | 50% | 30 mg/kg 3 times / day multiple, oral MTD Dose: 30 mg/kg, 3 times / day Route: oral Route: multiple Dose: 30 mg/kg, 3 times / day Sources: |
unhealthy, CHILD Health Status: unhealthy Age Group: CHILD Sex: M+F Food Status: UNKNOWN Sources: |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
Drug as perpetrator
Drug as victim
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/213464Orig1s000MultidisciplineR.pdf Page: 103 | 207 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/213464Orig1s000MultidisciplineR.pdf Page: 103.0 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/213464Orig1s000MultidisciplineR.pdf Page: 103 | 205 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/213464Orig1s000MultidisciplineR.pdf Page: 103.0 |
no |
Tox targets
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/213464Orig1s000MultidisciplineR.pdf Page: 48.0 |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Nitroreductive metabolic activation of some carcinogenic nitro heterocyclic food contaminants in rat mammary tissue cellular fractions. | 2009-01 |
|
| Nifurtimox plus pyrimethamine for treatment of murine toxoplasmosis. | 1998-10 |
|
| Treatment of experimental pneumocystosis: review of 7 years of experience and development of a new system for classifying antimicrobial drugs. | 1992-09 |
Patents
Sample Use Guides
In Vivo Use Guide
Sources: https://www.drugs.com/mmx/nifurtimox.html
For acute and chronic infections: Oral, 8 to 10 mg per kg of body weight per day in three or four divided doses after meals, for ninety to one hundred twenty days.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/27282514
Neural tumor cell lines (U-87, U373, CHLA-02-ATRT and PFSK-1), medulloblastoma cell lines (Daoy and D283) and TC-71, 143B, MG-63, MMH-ES, RD-ES, SK-ES-1 and SK-N-MC cell lines were used for activity evaluation. The viability of cells exposed to nifurtimox and BSO was determined using a modified methyl tetrazolium (MTT; Sigma) assay. 0.5–1.0 × 10^4 cells/well of exponentially growing cells were plated in 96-well plates. 24 hours later, nifurtimox or BSO was added to each well at concentrations up to 200mkM. After 72, 96, or 120 hours of continuous drug exposure, 15 μL of 5 mg/ml MTT was added to each well and the plates were incubated for 4 hours at 37 °C. Medium was replaced with 150 μL of DMSO and the optical density (OD) was measured at 550 nm using a microplate spectrophotometer (Anthos Analytical, Durham, NC). Cell numbers were estimated from OD measurements in individual wells. Relative cell viability was calculated by subtracting the background OD of media alone and then dividing by the OD of control wells.
| Substance Class |
Chemical
Created
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M84I3K7C2O
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WHO-ESSENTIAL MEDICINES LIST |
6.5.5.1
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WHO-VATC |
QP51AC01
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FDA ORPHAN DRUG |
310110
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WHO-ESSENTIAL MEDICINES LIST |
6.5.5.2
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NCI_THESAURUS |
C277
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FDA ORPHAN DRUG |
419213
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WHO-ATC |
P01CC01
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m7892
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DB11820
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Nifurtimox
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100000083878
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CHEMBL290960
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7421
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M84I3K7C2O
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D009547
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23256-30-6
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Nifurtimox
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SUB09280MIG
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CD-134
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2615
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1929
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M84I3K7C2O
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NIFURTIMOX
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PRIMARY | Description: A yellow to orange-yellow, crystalline powder; odourless. Solubility: Practically insoluble in water and ether R; freely soluble in dimethylformamide R; sparingly soluble in dioxan R. Category: Antitrypanosomal drug. Storage: Nifurtimox should be kept in a well-closed container. Definition: Nifurtimox contains not less than 98.0% and not more than 102.0% of C10H13N3O5S, calculated with reference to thedried substance. | ||
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6842999
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C71734
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BINDER->LIGAND |
BINDING
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EXCRETED UNCHANGED |
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TARGET ORGANISM->INHIBITOR |
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TARGET ORGANISM->INHIBITOR |
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TARGET ORGANISM->INHIBITOR |
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METABOLITE -> PARENT |
URINE
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METABOLITE -> PARENT |
PLASMA
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METABOLITE -> PARENT |
PLASMA
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METABOLITE INACTIVE -> PARENT |
MAJOR
PLASMA
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METABOLITE -> PARENT |
PLASMA
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METABOLITE -> PARENT |
URINE
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METABOLITE -> PARENT |
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METABOLITE INACTIVE -> PARENT |
IN FASTED STATE
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ACTIVE MOIETY |
| Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
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| Tmax | PHARMACOKINETIC |
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FED CONDITION |
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| Biological Half-life | PHARMACOKINETIC |
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