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Details

Stereochemistry RACEMIC
Molecular Formula C19H29NO3
Molecular Weight 319.4385
Optical Activity ( + / - )
Defined Stereocenters 3 / 3
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of ?-Dihydrotetrabenazine

SMILES

[H][C@]12C[C@@H](O)[C@H](CC(C)C)CN1CCC3=CC(OC)=C(OC)C=C23

InChI

InChIKey=WEQLWGNDNRARGE-DJIMGWMZSA-N
InChI=1S/C19H29NO3/c1-12(2)7-14-11-20-6-5-13-8-18(22-3)19(23-4)9-15(13)16(20)10-17(14)21/h8-9,12,14,16-17,21H,5-7,10-11H2,1-4H3/t14-,16-,17-/m1/s1

HIDE SMILES / InChI

Molecular Formula C19H29NO3
Molecular Weight 319.4385
Charge 0
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 3 / 3
E/Z Centers 0
Optical Activity UNSPECIFIED

(+)-alpha-Dihydrotetrabenazine (HTBZ) is an active component of tetrabenazine. Tetrabenazine is a mixture of closely-related compounds (isomers) and is readily metabolized in the human body to HTBZ and related isomers. Tetrabenazine is a drug for the symptomatic treatment of hyperkinetic movement disorder and is marketed under the trade names Nitoman in Canada and Xenazine in New Zealand and some parts of Europe, and is also available in the USA as an orphan drug. (+)-alpha-Dihydrotetrabenazine and related benzo[a]quinolizines have been labeled with tritium and carbon-11 radioisotopes and used for in vitro and in vivo studies of the VMAT2 in animal and human brain. Adeptio Pharmaceuticals is developing alpha-dihydrotetrabenazine (HTBZ) for the treatment of neurological disorders. It acts by inhibiting vesicular monoamine transporter 2 (VMAT2), thereby blocking the transport of dopamine into axon terminals or into storage vesicles.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
0.97 nM [Ki]
Target ID: Q05940
Gene ID: 6571.0
Gene Symbol: SLC18A2
Target Organism: Homo sapiens (Human)
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
Unknown

Approved Use

Unknown
Primary
INGREZZA

Approved Use

INGREZZA is indicated for the treatment of adults with tardive dyskinesia

Launch Date

1.49178234E12
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
0.19 ng/mL
1 mg single, oral
dose: 1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
39.4 ng/mL
80 mg 1 times / day steady-state, oral
dose: 80 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NBI-98782 unknown
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
64 ng/mL
100 mg 1 times / day steady-state, oral
dose: 100 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
35.1 ng/mL
50 mg 1 times / day steady-state, oral
dose: 50 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
31.7 ng/mL
75 mg single, oral
dose: 75 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
56.2 ng/mL
150 mg single, oral
dose: 150 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
9.22 ng × h/mL
1 mg single, oral
dose: 1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
695 ng × h/mL
80 mg 1 times / day steady-state, oral
dose: 80 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NBI-98782 unknown
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
1110 ng × h/mL
100 mg 1 times / day steady-state, oral
dose: 100 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
630 ng × h/mL
50 mg 1 times / day steady-state, oral
dose: 50 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
1150 ng × h/mL
75 mg single, oral
dose: 75 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
1840 ng × h/mL
150 mg single, oral
dose: 150 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
32 h
1 mg single, oral
dose: 1 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
18.5 h
80 mg 1 times / day steady-state, oral
dose: 80 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NBI-98782 unknown
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
19 h
100 mg 1 times / day steady-state, oral
dose: 100 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
21 h
50 mg 1 times / day steady-state, oral
dose: 50 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
21 h
75 mg single, oral
dose: 75 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
19 h
150 mg single, oral
dose: 150 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NBI-98782 plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
36%
80 mg 1 times / day steady-state, oral
dose: 80 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
NBI-98782 unknown
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
40 mg 1 times / day steady, oral
Recommended
Dose: 40 mg, 1 times / day
Route: oral
Route: steady
Dose: 40 mg, 1 times / day
Sources:
unhealthy, 18 - 85 years
n = 110
Health Status: unhealthy
Condition: schizophrenia or schizoaffective disorder, or mood disorder
Age Group: 18 - 85 years
Sex: M+F
Population Size: 110
Sources:
Disc. AE: Syncope...
AEs leading to
discontinuation/dose reduction:
Syncope (1 patient)
Sources:
80 mg 1 times / day steady, oral
Recommended
Dose: 80 mg, 1 times / day
Route: oral
Route: steady
Dose: 80 mg, 1 times / day
Sources:
unhealthy, 18 - 85 years
n = 112
Health Status: unhealthy
Condition: schizophrenia or schizoaffective disorder, or mood disorder
Age Group: 18 - 85 years
Sex: M+F
Population Size: 112
Sources:
Disc. AE: Syncope, Cardiac failure...
AEs leading to
discontinuation/dose reduction:
Syncope (1 patient)
Cardiac failure (1 patient)
Sources:
40 mg 1 times / day steady, oral
Recommended
Dose: 40 mg, 1 times / day
Route: oral
Route: steady
Dose: 40 mg, 1 times / day
Sources: Page: Table 1
unhealthy, 26 - 84 years
n = 262
Health Status: unhealthy
Condition: tardive dyskinesia
Age Group: 26 - 84 years
Sex: unknown
Population Size: 262
Sources: Page: Table 1
Other AEs: Somnolence, Anticholinergic syndrome...
Other AEs:
Somnolence (10.9%)
Anticholinergic syndrome (5.4%)
Balance disorder (4.1%)
Headache (3.4%)
Akathisia (2.7%)
Vomiting (2.6%)
Nausea (2.3%)
Arthralgia (2.3%)
Sources: Page: Table 1
80 mg 1 times / day steady, oral
Recommended
Dose: 80 mg, 1 times / day
Route: oral
Route: steady
Dose: 80 mg, 1 times / day
Sources: Page: 8.1
unhealthy, 26 - 84 years
Health Status: unhealthy
Condition: tardive dyskinesia
Age Group: 26 - 84 years
Sex: unknown
Sources: Page: 8.1
AEs

AEs

AESignificanceDosePopulation
Syncope 1 patient
Disc. AE
40 mg 1 times / day steady, oral
Recommended
Dose: 40 mg, 1 times / day
Route: oral
Route: steady
Dose: 40 mg, 1 times / day
Sources:
unhealthy, 18 - 85 years
n = 110
Health Status: unhealthy
Condition: schizophrenia or schizoaffective disorder, or mood disorder
Age Group: 18 - 85 years
Sex: M+F
Population Size: 110
Sources:
Cardiac failure 1 patient
Disc. AE
80 mg 1 times / day steady, oral
Recommended
Dose: 80 mg, 1 times / day
Route: oral
Route: steady
Dose: 80 mg, 1 times / day
Sources:
unhealthy, 18 - 85 years
n = 112
Health Status: unhealthy
Condition: schizophrenia or schizoaffective disorder, or mood disorder
Age Group: 18 - 85 years
Sex: M+F
Population Size: 112
Sources:
Syncope 1 patient
Disc. AE
80 mg 1 times / day steady, oral
Recommended
Dose: 80 mg, 1 times / day
Route: oral
Route: steady
Dose: 80 mg, 1 times / day
Sources:
unhealthy, 18 - 85 years
n = 112
Health Status: unhealthy
Condition: schizophrenia or schizoaffective disorder, or mood disorder
Age Group: 18 - 85 years
Sex: M+F
Population Size: 112
Sources:
Somnolence 10.9%
40 mg 1 times / day steady, oral
Recommended
Dose: 40 mg, 1 times / day
Route: oral
Route: steady
Dose: 40 mg, 1 times / day
Sources: Page: Table 1
unhealthy, 26 - 84 years
n = 262
Health Status: unhealthy
Condition: tardive dyskinesia
Age Group: 26 - 84 years
Sex: unknown
Population Size: 262
Sources: Page: Table 1
Arthralgia 2.3%
40 mg 1 times / day steady, oral
Recommended
Dose: 40 mg, 1 times / day
Route: oral
Route: steady
Dose: 40 mg, 1 times / day
Sources: Page: Table 1
unhealthy, 26 - 84 years
n = 262
Health Status: unhealthy
Condition: tardive dyskinesia
Age Group: 26 - 84 years
Sex: unknown
Population Size: 262
Sources: Page: Table 1
Nausea 2.3%
40 mg 1 times / day steady, oral
Recommended
Dose: 40 mg, 1 times / day
Route: oral
Route: steady
Dose: 40 mg, 1 times / day
Sources: Page: Table 1
unhealthy, 26 - 84 years
n = 262
Health Status: unhealthy
Condition: tardive dyskinesia
Age Group: 26 - 84 years
Sex: unknown
Population Size: 262
Sources: Page: Table 1
Vomiting 2.6%
40 mg 1 times / day steady, oral
Recommended
Dose: 40 mg, 1 times / day
Route: oral
Route: steady
Dose: 40 mg, 1 times / day
Sources: Page: Table 1
unhealthy, 26 - 84 years
n = 262
Health Status: unhealthy
Condition: tardive dyskinesia
Age Group: 26 - 84 years
Sex: unknown
Population Size: 262
Sources: Page: Table 1
Akathisia 2.7%
40 mg 1 times / day steady, oral
Recommended
Dose: 40 mg, 1 times / day
Route: oral
Route: steady
Dose: 40 mg, 1 times / day
Sources: Page: Table 1
unhealthy, 26 - 84 years
n = 262
Health Status: unhealthy
Condition: tardive dyskinesia
Age Group: 26 - 84 years
Sex: unknown
Population Size: 262
Sources: Page: Table 1
Headache 3.4%
40 mg 1 times / day steady, oral
Recommended
Dose: 40 mg, 1 times / day
Route: oral
Route: steady
Dose: 40 mg, 1 times / day
Sources: Page: Table 1
unhealthy, 26 - 84 years
n = 262
Health Status: unhealthy
Condition: tardive dyskinesia
Age Group: 26 - 84 years
Sex: unknown
Population Size: 262
Sources: Page: Table 1
Balance disorder 4.1%
40 mg 1 times / day steady, oral
Recommended
Dose: 40 mg, 1 times / day
Route: oral
Route: steady
Dose: 40 mg, 1 times / day
Sources: Page: Table 1
unhealthy, 26 - 84 years
n = 262
Health Status: unhealthy
Condition: tardive dyskinesia
Age Group: 26 - 84 years
Sex: unknown
Population Size: 262
Sources: Page: Table 1
Anticholinergic syndrome 5.4%
40 mg 1 times / day steady, oral
Recommended
Dose: 40 mg, 1 times / day
Route: oral
Route: steady
Dose: 40 mg, 1 times / day
Sources: Page: Table 1
unhealthy, 26 - 84 years
n = 262
Health Status: unhealthy
Condition: tardive dyskinesia
Age Group: 26 - 84 years
Sex: unknown
Population Size: 262
Sources: Page: Table 1
OverviewDrug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
unlikely
unlikely
unlikely
unlikely
unlikely
unlikely
unlikely
unlikely
unlikely
unlikely
unlikely
unlikely
unlikely
unlikely
unlikely
unlikely
yes [IC50 14.2 uM]
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
no
yes
yes
yes
yes
yes (co-administration study)
Comment: administered with ketoconazole: (similar PK parameters with parent drug) approximately 1.5-fold and 2-fold increase in the Cmax and AUC0-inf, respectively; administered with rifampin: about 50% decrease in Cmax and 80% decrease in AUC0-inf
Page: 22;30
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
Lessons from 11C-dihydrotetrabenazine imaging in a xenograft mouse model of rat insulinoma: is PET imaging of pancreatic beta cell mass feasible?
2017 Dec
Differences in Dihydrotetrabenazine Isomer Concentrations Following Administration of Tetrabenazine and Valbenazine.
2017 Sep
Patents

Sample Use Guides

Single dose administration of (+)-alpha-Dihydrotetrabenazine (HTBZ), escalating dosage amounts 7.5 - 30 mg orally
Route of Administration: Oral
In Vitro Use Guide
(+)-alpha-Dihydrotetrabenazine is a vesicular monoamine transporter (VMAT2) inhibtior with an Ki value of 0.97 nM. IC50 value: 0.97± 0.48 nM. The (+)-isomer showed high affinity in vitro (Ki = 0.97 +/- 0.48 nM) for the vesicular monoamine transporter (VMAT2) in rat brain striatum, whereas the (-)-isomer was inactive (Ki = 2.2 +/- 0.3 uM).
Substance Class Chemical
Created
by admin
on Sun Dec 18 21:08:19 UTC 2022
Edited
by admin
on Sun Dec 18 21:08:19 UTC 2022
Record UNII
OHZ3DQX6Q3
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
?-Dihydrotetrabenazine
Common Name English
REL-(2R,3R,11BR)-1,3,4,6,7,11B-HEXAHYDRO-9,10-DIMETHOXY-3-(2-METHYLPROPYL)-2H-BENZO(A)QUINOLIZIN-2-OL
Systematic Name English
.ALPHA.-HTBN
Common Name English
TRANS (2,3)-DIHYDROTETRABENAZINE
Common Name English
TETRABENAZINE METABOLITE M6
Common Name English
2H-BENZO(A)QUINOLIZIN-2-OL, 1,3,4,6,7,11B-HEXAHYDRO-9,10-DIMETHOXY-3-(2-METHYLPROPYL)-, (2R,3R,11BR)-REL-
Systematic Name English
(±)-.ALPHA.-HTBN
Common Name English
SD-946
Code English
Code System Code Type Description
CAS
171598-74-6
Created by admin on Sun Dec 18 21:08:20 UTC 2022 , Edited by admin on Sun Dec 18 21:08:20 UTC 2022
PRIMARY
FDA UNII
OHZ3DQX6Q3
Created by admin on Sun Dec 18 21:08:20 UTC 2022 , Edited by admin on Sun Dec 18 21:08:20 UTC 2022
PRIMARY
Related Record Type Details
ENANTIOMER -> RACEMATE
ENANTIOMER -> RACEMATE
Related Record Type Details
PARENT -> METABOLITE ACTIVE