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Details

Stereochemistry ABSOLUTE
Molecular Formula C23H16O6.2C19H21NO4
Molecular Weight 1043.1182
Optical Activity UNSPECIFIED
Defined Stereocenters 8 / 8
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of DINALOXONE PAMOATE

SMILES

OC1=CC=C2C[C@H]3N(CC=C)CC[C@@]45[C@@H](OC1=C24)C(=O)CC[C@@]35O.OC6=CC=C7C[C@H]8N(CC=C)CC[C@@]9%10[C@@H](OC6=C79)C(=O)CC[C@@]8%10O.OC(=O)C%11=CC%12=CC=CC=C%12C(CC%13=C(O)C(=CC%14=CC=CC=C%13%14)C(O)=O)=C%11O

InChI

InChIKey=BFXHRYXMFBRRFN-SXYFAJAHSA-N
InChI=1S/C23H16O6.2C19H21NO4/c24-20-16(14-7-3-1-5-12(14)9-18(20)22(26)27)11-17-15-8-4-2-6-13(15)10-19(21(17)25)23(28)29;2*1-2-8-20-9-7-18-15-11-3-4-12(21)16(15)24-17(18)13(22)5-6-19(18,23)14(20)10-11/h1-10,24-25H,11H2,(H,26,27)(H,28,29);2*2-4,14,17,21,23H,1,5-10H2/t;2*14-,17+,18+,19-/m.11/s1

HIDE SMILES / InChI

Molecular Formula C23H16O6
Molecular Weight 388.3695
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Molecular Formula C19H21NO4
Molecular Weight 327.3743
Charge 0
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 4 / 4
E/Z Centers 0
Optical Activity UNSPECIFIED

Naloxone, sold under the brand name Narcan among others, is a medication used to block the effects of opioids, especially in overdose. Naloxone has an extremely high affinity for μ-opioid receptors in the central nervous system (CNS). Naloxone is a μ-opioid receptor (MOR) inverse agonist, and its rapid blockade of those receptors often produces rapid onset of withdrawal symptoms. Naloxone also has an antagonist action, though with a lower affinity, at κ- (KOR) and δ-opioid receptors (DOR). If administered in the absence of concomitant opioid use, no functional pharmacological activity occurs (except the inability for the body to combat pain naturally). In contrast to direct opiate agonists, which elicit opiate withdrawal symptoms when discontinued in opiate-tolerant people, no evidence indicates the development of tolerance or dependence on naloxone. The mechanism of action is not completely understood, but studies suggest it functions to produce withdrawal symptoms by competing for opiate receptor sites within the CNS (a competitive antagonist, not a direct agonist), thereby preventing the action of both endogenous and xenobiotic opiates on these receptors without directly producing any effects itself. When administered parenterally (e.g. intravenously or by injection), as is most common, naloxone has a rapid distribution throughout the body. The mean serum half-life has been shown to range from 30 to 81 minutes, shorter than the average half-life of some opiates, necessitating repeat dosing if opioid receptors must be stopped from triggering for an extended period. Naloxone is primarily metabolized by the liver. Its major metabolite is naloxone-3-glucuronide, which is excreted in the urine. Naloxone is useful both in acute opioid overdose and in reducing respiratory or mental depression due to opioids. Whether it is useful in those in cardiac arrest due to an opioid overdose is unclear. Naloxone is poorly absorbed when taken by mouth, so it is commonly combined with a number of oral opioid preparations, including buprenorphine and pentazocine, so that when taken orally, just the opioid has an effect, but if misused by injecting, the naloxone blocks the effect of the opioid. In a meta-analysis of people with shock, including septic, cardiogenic, hemorrhagic, or spinal shock, those who received naloxone had improved blood flow. Naloxone is also experimentally used in the treatment for congenital insensitivity to pain with anhidrosis, an extremely rare disorder (one in 125 million) that renders one unable to feel pain or differentiate temperatures. Naloxone can also be used as an antidote in overdose of clonidine, a medication that lowers blood pressure.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
7.3 nM [IC50]
49.8 nM [IC50]
138.0 nM [IC50]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
NARCAN

Approved Use

Pentazocine Hydrochloride and Naloxone Hydrochloride Tablets, USP is indicated for the relief of moderate to severe pain. Pentazocine Hydrochloride and Naloxone Hydrochloride Tablets, USP is indicated for oral use only.

Launch Date

1971
Primary
NARCAN

Approved Use

Pentazocine Hydrochloride and Naloxone Hydrochloride Tablets, USP is indicated for the relief of moderate to severe pain. Pentazocine Hydrochloride and Naloxone Hydrochloride Tablets, USP is indicated for oral use only.

Launch Date

1971
Primary
NARCAN

Approved Use

Pentazocine Hydrochloride and Naloxone Hydrochloride Tablets, USP is indicated for the relief of moderate to severe pain. Pentazocine Hydrochloride and Naloxone Hydrochloride Tablets, USP is indicated for oral use only.

Launch Date

1971
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
1.09 ng/mL
10 mg/kg single, nasal
dose: 10 mg/kg
route of administration: Nasal
experiment type: SINGLE
co-administered:
NALOXONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
0.87 ng/mL
0.4 mg single, intramuscular
dose: 0.4 mg
route of administration: Intramuscular
experiment type: SINGLE
co-administered:
NALOXONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
9.62 ng/mL
8 mg single, nasal
dose: 8 mg
route of administration: Nasal
experiment type: SINGLE
co-administered:
NALOXONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
4.83 ng/mL
4 mg single, nasal
dose: 4 mg
route of administration: Nasal
experiment type: SINGLE
co-administered:
NALOXONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
37.1 ng × min/mL
10 mg/kg single, nasal
dose: 10 mg/kg
route of administration: Nasal
experiment type: SINGLE
co-administered:
NALOXONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
1.68 ng × h/mL
0.4 mg single, intramuscular
dose: 0.4 mg
route of administration: Intramuscular
experiment type: SINGLE
co-administered:
NALOXONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
15 ng × h/mL
8 mg single, nasal
dose: 8 mg
route of administration: Nasal
experiment type: SINGLE
co-administered:
NALOXONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
7.9 ng × h/mL
4 mg single, nasal
dose: 4 mg
route of administration: Nasal
experiment type: SINGLE
co-administered:
NALOXONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
28.2 min
10 mg/kg single, nasal
dose: 10 mg/kg
route of administration: Nasal
experiment type: SINGLE
co-administered:
NALOXONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
1.2 h
0.4 mg single, intramuscular
dose: 0.4 mg
route of administration: Intramuscular
experiment type: SINGLE
co-administered:
NALOXONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
2.1 h
8 mg single, nasal
dose: 8 mg
route of administration: Nasal
experiment type: SINGLE
co-administered:
NALOXONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
0.8 mg single, intramuscular
Dose: 0.8 mg
Route: intramuscular
Route: single
Dose: 0.8 mg
Sources:
healthy, 23.8 years (range: 22.6–25 years)
n = 12
Health Status: healthy
Age Group: 23.8 years (range: 22.6–25 years)
Sex: M+F
Population Size: 12
Sources:
160 mg/m2 single, intravenous (starting)
Highest studied dose
Dose: 160 mg/m2
Route: intravenous
Route: single
Dose: 160 mg/m2
Sources:
unhealthy, 35-85 years
n = 38
Health Status: unhealthy
Condition: acute ischemic stroke
Age Group: 35-85 years
Population Size: 38
Sources:
Disc. AE: Hypotension, Bradycardia...
Other AEs: Nausea, Emesis...
AEs leading to
discontinuation/dose reduction:
Hypotension (3 patients)
Bradycardia (2 patients)
Myoclonus (1 patient)
Hypertension (1 patient)
Other AEs:
Nausea (32%)
Emesis (5%)
Seizures (5%)
Headache (5%)
Confusion (5%)
Agitation (3%)
Sources:
8 mg single, intranasal
Dose: 8 mg
Route: intranasal
Route: single
Dose: 8 mg
Sources:
healthy, adult
n = 28
Health Status: healthy
Age Group: adult
Population Size: 28
Sources:
AEs

AEs

AESignificanceDosePopulation
Hypertension 1 patient
Disc. AE
160 mg/m2 single, intravenous (starting)
Highest studied dose
Dose: 160 mg/m2
Route: intravenous
Route: single
Dose: 160 mg/m2
Sources:
unhealthy, 35-85 years
n = 38
Health Status: unhealthy
Condition: acute ischemic stroke
Age Group: 35-85 years
Population Size: 38
Sources:
Myoclonus 1 patient
Disc. AE
160 mg/m2 single, intravenous (starting)
Highest studied dose
Dose: 160 mg/m2
Route: intravenous
Route: single
Dose: 160 mg/m2
Sources:
unhealthy, 35-85 years
n = 38
Health Status: unhealthy
Condition: acute ischemic stroke
Age Group: 35-85 years
Population Size: 38
Sources:
Bradycardia 2 patients
Disc. AE
160 mg/m2 single, intravenous (starting)
Highest studied dose
Dose: 160 mg/m2
Route: intravenous
Route: single
Dose: 160 mg/m2
Sources:
unhealthy, 35-85 years
n = 38
Health Status: unhealthy
Condition: acute ischemic stroke
Age Group: 35-85 years
Population Size: 38
Sources:
Hypotension 3 patients
Disc. AE
160 mg/m2 single, intravenous (starting)
Highest studied dose
Dose: 160 mg/m2
Route: intravenous
Route: single
Dose: 160 mg/m2
Sources:
unhealthy, 35-85 years
n = 38
Health Status: unhealthy
Condition: acute ischemic stroke
Age Group: 35-85 years
Population Size: 38
Sources:
Agitation 3%
160 mg/m2 single, intravenous (starting)
Highest studied dose
Dose: 160 mg/m2
Route: intravenous
Route: single
Dose: 160 mg/m2
Sources:
unhealthy, 35-85 years
n = 38
Health Status: unhealthy
Condition: acute ischemic stroke
Age Group: 35-85 years
Population Size: 38
Sources:
Nausea 32%
160 mg/m2 single, intravenous (starting)
Highest studied dose
Dose: 160 mg/m2
Route: intravenous
Route: single
Dose: 160 mg/m2
Sources:
unhealthy, 35-85 years
n = 38
Health Status: unhealthy
Condition: acute ischemic stroke
Age Group: 35-85 years
Population Size: 38
Sources:
Confusion 5%
160 mg/m2 single, intravenous (starting)
Highest studied dose
Dose: 160 mg/m2
Route: intravenous
Route: single
Dose: 160 mg/m2
Sources:
unhealthy, 35-85 years
n = 38
Health Status: unhealthy
Condition: acute ischemic stroke
Age Group: 35-85 years
Population Size: 38
Sources:
Emesis 5%
160 mg/m2 single, intravenous (starting)
Highest studied dose
Dose: 160 mg/m2
Route: intravenous
Route: single
Dose: 160 mg/m2
Sources:
unhealthy, 35-85 years
n = 38
Health Status: unhealthy
Condition: acute ischemic stroke
Age Group: 35-85 years
Population Size: 38
Sources:
Headache 5%
160 mg/m2 single, intravenous (starting)
Highest studied dose
Dose: 160 mg/m2
Route: intravenous
Route: single
Dose: 160 mg/m2
Sources:
unhealthy, 35-85 years
n = 38
Health Status: unhealthy
Condition: acute ischemic stroke
Age Group: 35-85 years
Population Size: 38
Sources:
Seizures 5%
160 mg/m2 single, intravenous (starting)
Highest studied dose
Dose: 160 mg/m2
Route: intravenous
Route: single
Dose: 160 mg/m2
Sources:
unhealthy, 35-85 years
n = 38
Health Status: unhealthy
Condition: acute ischemic stroke
Age Group: 35-85 years
Population Size: 38
Sources:
PubMed

PubMed

TitleDatePubMed
Changes in benzodiazepine-receptor activity modify morphine withdrawal syndrome in mice.
1992 Aug
Morphine preconditioning attenuates neutrophil activation in rat models of myocardial infarction.
1998 Dec
Neurotransmitter-mediated open-field behavioral action of CGRP.
1999
Repressive/defensive coping, endogenous opioids and health: how a life so perfect can make you sick.
1999 Jan 18
[The discriminative stimulus properties of naloxone during dissociative learning in a Y maze in morphine-dependent rats].
1999 Jan-Feb
Modification of naloxone-induced withdrawal signs by dextromethorphan in morphine-dependent mice.
1999 Jul 14
G-protein-coupled receptor heterodimerization modulates receptor function.
1999 Jun 17
Seizure and electroencephalographic changes in the newborn period induced by opiates and corrected by naloxone infusion.
1999 Mar
Effects of SCH 23390, raclopride, and haloperidol on morphine withdrawal-induced aggression in male mice.
1999 Sep
Acute detoxification of opioid-addicted patients with naloxone during propofol or methohexital anesthesia: a comparison of withdrawal symptoms, neuroendocrine, metabolic, and cardiovascular patterns.
2000 Apr
The effect of spinal ibuprofen on opioid withdrawal in the rat.
2000 Aug
Orphanin FQ/nociceptin inhibits morphine withdrawal.
2000 Jan 14
Fentanyl-induced chest wall rigidity and laryngospasm in preterm and term infants.
2000 Mar
Systemic naloxone enhances cerebral blood flow in anesthetized morphine-dependent rats.
2000 Nov 24
Enhanced spinal nociceptin receptor expression develops morphine tolerance and dependence.
2000 Oct 15
Opioid peptides alleviated while naloxone potentiated methamphetamine-induced striatal dopamine depletion in mice.
2001
Relief by naloxone of morphine-induced spasm of the sphincter of Oddi in a post-cholecystectomy patient.
2001 Aug
Role of nitric oxide in catalepsy and hyperthermia in morphine-dependent rats.
2001 Dec
Inverse agonists and neutral antagonists at mu opioid receptor (MOR): possible role of basal receptor signaling in narcotic dependence.
2001 Jun
Effects of Ferula gummosa Boiss. fractions on morphine dependence in mice.
2001 Sep
Deletion of the M5 muscarinic acetylcholine receptor attenuates morphine reinforcement and withdrawal but not morphine analgesia.
2002 Aug 20
Effect of naloxone-precipitated morphine withdrawal on CRH and vasopressin mRNA expression in the rat hypothalamic paraventricular nucleus.
2002 Dec 6
Dorsal and median raphe serotonergic system lesion does not alter the opiate withdrawal syndrome.
2002 Jul
Increase in serum level of interleukin-1 alpha mediates morphine anti-inflammatory effect in carrageenan-induced paw oedema in mice.
2002 Jul 21
Naloxone methiodide reverses opioid-induced respiratory depression and analgesia without withdrawal.
2002 Jun 7
Interleukin-2-induced antinociception in morphine-insensitive rats.
2002 Nov
Naloxone increases pain induced by topical capsaicin in healthy human volunteers.
2002 Sep
Identification of opioid-regulated genes in human lymphocytic cells by differential display: upregulation of Krüppel-like factor 7 by morphine.
2003 Dec 10
Decrease of morphine-induced reward effects and withdrawal symptoms in mice overexpressing gamma-aminobutyric acid transporter I.
2003 Nov 15
Morphine suppresses lymphocyte apoptosis by blocking p53-mediated death signaling.
2003 Sep 5
A neuroactive steroid, dehydroepiandrosterone sulfate, prevents the development of morphine dependence and tolerance via c-fos expression linked to the extracellular signal-regulated protein kinase.
2004 Jul 9
Evaluation of fresh and cryopreserved hepatocytes as in vitro drug metabolism tools for the prediction of metabolic clearance.
2004 Nov
Potentiated startle and hyperalgesia during withdrawal from acute morphine: effects of multiple opiate exposures.
2004 Nov
Effects of L-745,870, a dopamine D4 receptor antagonist, on naloxone-induced morphine dependence in mice.
2004 Oct
[Combination of morphine with low-dose naloxone for intravenous patient-controlled analgesia].
2005 Apr
Morphine-induced chemotaxis and brain-derived neurotrophic factor expression in microglia.
2005 Jan 12
The opioid fentanyl affects light input, electrical activity and Per gene expression in the hamster suprachiasmatic nuclei.
2005 Jun
Prediction of genotoxicity of chemical compounds by statistical learning methods.
2005 Jun
Effective opiate-receptor antagonist therapy of cholestatic pruritus induced by an oral contraceptive.
2005 May
Ultrafine particles cross cellular membranes by nonphagocytic mechanisms in lungs and in cultured cells.
2005 Nov
Patents

Sample Use Guides

Opioid Overdose–Known or Suspected: An initial dose of 0.4 mg to 2 mg of NARCAN may be administered intravenously. If the desired degree of counteraction and improvement in respiratory functions are not obtained, it may be repeated at two- to three-minute intervals. If no response is observed after 10 mg of NARCAN have been administered, the diagnosis of opioid-induced or partial opioid-induced toxicity should be questioned. Intramuscular or subcutaneous administration may be necessary if the intravenous route is not available. Postoperative Opioid Depression: For the partial reversal of opioid depression following the use of opioids during surgery, smaller doses of NARCAN are usually sufficient. The dose of NARCAN should be titrated according to the patient’s response. For the initial reversal of respiratory depression, NARCAN should be injected in increments of 0.1 to 0.2 mg intravenously at two- to three-minute intervals to the desired degree of reversal, i.e., adequate ventilation and alertness without significant pain or discomfort. Larger than necessary dosage of NARCAN may result in significant reversal of analgesia and increase in blood pressure. Similarly, too rapid reversal may induce nausea, vomiting, sweating or circulatory stress. Repeat doses of NARCAN may be required within one- to two-hour intervals depending upon the amount, type (i.e., short or long acting) and time interval since last administration of an opioid. Supplemental intramuscular doses have been shown to produce a longer lasting effect.
Route of Administration: Other
MDCKII-MDR1 assay. Stock solutions of Naloxone (20 mM) were prepared in 100% DMSO and then diluted to the final concentration of 10 mkM, in Dulbecco’s PBS. Naloxone were tested in both directions, apicalto-basolateral (A→B) and basolateral-to-apical (B→A), in duplicate. The ratio BA/AB >2 indicates an efflux phenomena. Permeability studies were conducted at 37 ◦C in incubator for 60 min. The monolayer integrity was evaluated by measuring the TransEpithelial Electrical Resistance (TEER) by using the Millicell-ERS system (Millipore Corporation) and it was considered integer if the resistancewas between 200 and 300 cm2. After the transport study the monolayer integrity was measured in each well by adding a 0.02 mg/mL solution of lucifer yellow (LY); the test was conducted at 37 ◦C for 60 min, and the fluorescence (RFU) was measured at 485/535 nm.
Substance Class Chemical
Created
by admin
on Sat Dec 16 14:27:52 GMT 2023
Edited
by admin
on Sat Dec 16 14:27:52 GMT 2023
Record UNII
P7WJA2YB2Y
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
DINALOXONE PAMOATE
Common Name English
2-NAPHTHALENECARBOXYLIC ACID, 4,4'-METHYLENEBIS(3-HYDROXY-, COMPD. WITH (5.ALPHA.)-4,5-EPOXY-3,14-DIHYDROXY-17-(2-PROPENYL)MORPHINAN-6-ONE (1:2)
Systematic Name English
MORPHINAN-6-ONE, 4,5-EPOXY-3,14-DIHYDROXY-17-(2-PROPENYL)-, (5.ALPHA.)-, 4,4'-METHYLENEBIS(3-HYDROXY-2-NAPHTHALENECARBOXYLATE) (2:1) (SALT)
Systematic Name English
Code System Code Type Description
CAS
36415-94-8
Created by admin on Sat Dec 16 14:27:53 GMT 2023 , Edited by admin on Sat Dec 16 14:27:53 GMT 2023
PRIMARY
PUBCHEM
133082440
Created by admin on Sat Dec 16 14:27:53 GMT 2023 , Edited by admin on Sat Dec 16 14:27:53 GMT 2023
PRIMARY
CAS
83213-70-1
Created by admin on Sat Dec 16 14:27:53 GMT 2023 , Edited by admin on Sat Dec 16 14:27:53 GMT 2023
NON-SPECIFIC STOICHIOMETRY
FDA UNII
P7WJA2YB2Y
Created by admin on Sat Dec 16 14:27:53 GMT 2023 , Edited by admin on Sat Dec 16 14:27:53 GMT 2023
PRIMARY
Related Record Type Details
PARENT -> SALT/SOLVATE
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ACTIVE MOIETY