Details
Stereochemistry | RACEMIC |
Molecular Formula | C21H27NO |
Molecular Weight | 309.4452 |
Optical Activity | ( + / - ) |
Defined Stereocenters | 0 / 1 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
CCC(=O)C(CC(C)N(C)C)(C1=CC=CC=C1)C2=CC=CC=C2
InChI
InChIKey=USSIQXCVUWKGNF-UHFFFAOYSA-N
InChI=1S/C21H27NO/c1-5-20(23)21(16-17(2)22(3)4,18-12-8-6-9-13-18)19-14-10-7-11-15-19/h6-15,17H,5,16H2,1-4H3
Molecular Formula | C21H27NO |
Molecular Weight | 309.4452 |
Charge | 0 |
Count |
|
Stereochemistry | RACEMIC |
Additional Stereochemistry | No |
Defined Stereocenters | 0 / 1 |
E/Z Centers | 0 |
Optical Activity | ( + / - ) |
DescriptionCurator's Comment: description was created based on several sources, including:
http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/006134s040s041lbl.pdf | https://www.drugs.com/pro/diskets.html
Curator's Comment: description was created based on several sources, including:
http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/006134s040s041lbl.pdf | https://www.drugs.com/pro/diskets.html
Methadone, sold under the brand names Dolophine among others, is an synthetic opioid that is used as the hydrochloride to treat pain and as maintenance therapy or to help with detoxification in people with opioid dependence. Methadone hydrochloride is a mu-agonist; a synthetic opioid analgesic with multiple actions qualitatively similar to those of morphine. Some data also indicate that methadone acts as an antagonist at the NMDA-receptor. The contribution of NMDA receptor antagonism to methadone’s efficacy is unknown. Most common adverse reactions are: lightheadedness, dizziness, sedation, nausea, vomiting, and sweating. Avoid use mixed agonist/antagonist and partial agonist opioid analgesics with DOLOPHINE because they may reduce analgesic effect of DOLOPHINE or precipitate withdrawal symptoms.
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL233 |
3.51 nM [Ki] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Palliative | DOLOPHINE HYDROCHLORIDE Approved UseFor the treatment of moderate to severe pain not responsive to non-narcotic analgesics. For detoxification treatment of opioid addiction (heroin or other morphine-like drugs). For maintenance treatment of opioid addiction (heroin or other morphine-like drugs), in conjunction with appropriate social and medical services. Note – Outpatient maintenance and outpatient detoxification treatment may be provided only by Opioid Treatment Programs (OTPs) certified by the Federal Substance Abuse and Mental Health Services Administration (SAMHSA) and registered by the Drug Enforcement Administration (DEA). This does not preclude the maintenance treatment of a patient with concurrent opioid addiction who is hospitalized for conditions other than opioid addiction and who requires temporary maintenance during the critical period of his/her stay, or of a patient whose enrollment has been verified in a program which has been certified for maintenance treatment with methadone. Launch Date1947 |
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Palliative | DOLOPHINE HYDROCHLORIDE Approved UseFor the treatment of moderate to severe pain not responsive to non-narcotic analgesics. For detoxification treatment of opioid addiction (heroin or other morphine-like drugs). For maintenance treatment of opioid addiction (heroin or other morphine-like drugs), in conjunction with appropriate social and medical services. Note – Outpatient maintenance and outpatient detoxification treatment may be provided only by Opioid Treatment Programs (OTPs) certified by the Federal Substance Abuse and Mental Health Services Administration (SAMHSA) and registered by the Drug Enforcement Administration (DEA). This does not preclude the maintenance treatment of a patient with concurrent opioid addiction who is hospitalized for conditions other than opioid addiction and who requires temporary maintenance during the critical period of his/her stay, or of a patient whose enrollment has been verified in a program which has been certified for maintenance treatment with methadone. Launch Date1947 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
548 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8641323/ |
60 mg 1 times / day steady-state, oral dose: 60 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
METHADONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FED |
|
494 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15151520/ |
70 mg 1 times / day steady-state, oral dose: 70 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
METHADONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
40.2 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22621465/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
METHADONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
54 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8641323/ |
60 mg 1 times / day steady-state, oral dose: 60 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
2-ETHYLIDENE-1,5-DIMETHYL-3,3-DIPHENYLPYRROLIDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
8.54 mg × h/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8641323/ |
60 mg 1 times / day steady-state, oral dose: 60 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
METHADONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FED |
|
8.27 μg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15151520/ |
70 mg 1 times / day steady-state, oral dose: 70 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
METHADONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
1073 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22621465/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
METHADONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
0.61 mg × h/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8641323/ |
60 mg 1 times / day steady-state, oral dose: 60 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
2-ETHYLIDENE-1,5-DIMETHYL-3,3-DIPHENYLPYRROLIDINE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
31.2 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8641323/ |
60 mg 1 times / day steady-state, oral dose: 60 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
METHADONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FED |
|
39 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15151520/ |
70 mg 1 times / day steady-state, oral dose: 70 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
METHADONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
39.3 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22621465/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
METHADONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
Doses
Dose | Population | Adverse events |
---|---|---|
10 mg 3 times / day multiple, intravenous (starting) Recommended Dose: 10 mg, 3 times / day Route: intravenous Route: multiple Dose: 10 mg, 3 times / day Sources: |
pregnant, adult Health Status: pregnant Age Group: adult Sex: F Sources: |
Other AEs: Withdrawal syndrome neonatal... Other AEs: Withdrawal syndrome neonatal Sources: |
10 mg 3 times / day multiple, intravenous (starting) Recommended Dose: 10 mg, 3 times / day Route: intravenous Route: multiple Dose: 10 mg, 3 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
Other AEs: Respiratory depression, Addiction... Other AEs: Respiratory depression (grade 5) Sources: Addiction QT interval prolonged (grade 5) |
20 mg single, oral (starting) Recommended Dose: 20 mg Route: oral Route: single Dose: 20 mg Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
Other AEs: Respiratory depression, QT interval prolonged... Other AEs: Respiratory depression (grade 5) Sources: QT interval prolonged Arrhythmia (serious) |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Withdrawal syndrome neonatal | 10 mg 3 times / day multiple, intravenous (starting) Recommended Dose: 10 mg, 3 times / day Route: intravenous Route: multiple Dose: 10 mg, 3 times / day Sources: |
pregnant, adult Health Status: pregnant Age Group: adult Sex: F Sources: |
|
Addiction | 10 mg 3 times / day multiple, intravenous (starting) Recommended Dose: 10 mg, 3 times / day Route: intravenous Route: multiple Dose: 10 mg, 3 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
|
QT interval prolonged | grade 5 | 10 mg 3 times / day multiple, intravenous (starting) Recommended Dose: 10 mg, 3 times / day Route: intravenous Route: multiple Dose: 10 mg, 3 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
Respiratory depression | grade 5 | 10 mg 3 times / day multiple, intravenous (starting) Recommended Dose: 10 mg, 3 times / day Route: intravenous Route: multiple Dose: 10 mg, 3 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
QT interval prolonged | 20 mg single, oral (starting) Recommended Dose: 20 mg Route: oral Route: single Dose: 20 mg Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
|
Respiratory depression | grade 5 | 20 mg single, oral (starting) Recommended Dose: 20 mg Route: oral Route: single Dose: 20 mg Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
Arrhythmia | serious | 20 mg single, oral (starting) Recommended Dose: 20 mg Route: oral Route: single Dose: 20 mg Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sources: https://pubmed.ncbi.nlm.nih.gov/20484152/ Page: 8.0 |
major [Inhibition 0.6 uM] | |||
no | ||||
no | ||||
no | ||||
no | ||||
Sources: https://pubmed.ncbi.nlm.nih.gov/20484152/ Page: 8.0 |
unlikely | |||
yes [Ki 100 uM] | ||||
yes [Ki 2.5 uM] |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
yes | ||||
yes | yes (co-administration study) Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively Page: 29.0 |
|||
yes | yes (co-administration study) Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively Page: 29.0 |
|||
yes | yes (co-administration study) Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively Page: 29.0 |
|||
yes | yes (co-administration study) Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively Page: 29.0 |
|||
yes | yes (co-administration study) Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively Page: 29.0 |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
PubMed
Title | Date | PubMed |
---|---|---|
Transient hypertension. Associated with methadone intoxication. | 1976 Nov |
|
Rhabdomyolysis and acute renal failure following methadone abuse. | 1992 |
|
Cocaine-associated panic attacks in methadone-maintained patients. | 1992 |
|
Modulating effect of alcohol use on cocaine use. | 2000 Jan-Feb |
|
Thrice-weekly versus daily buprenorphine maintenance. | 2000 Jun 15 |
|
[Methadone withdrawal syndrome induced by nevirapine]. | 2000 Mar 18 |
|
Pain responses in methadone-maintained opioid abusers. | 2000 Oct |
|
Effect of perinatal buprenorphine exposure on development in the rat. | 2001 Aug |
|
Enteral methadone to expedite fentanyl discontinuation and prevent opioid abstinence syndrome in the PICU. | 2001 Dec |
|
Methadone is safe for treating hospitalized patients with severe pain. | 2001 Dec |
|
Reversible spastic paraparesis induced by high-dose intravenous methadone. | 2001 Feb |
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Pain intolerance in opioid-maintained former opiate addicts: effect of long-acting maintenance agent. | 2001 Jul 1 |
|
[Olanzapine efficacy in the treatment of cocaine abuse in methadone maintenance patients. Interaction with plasma levels]. | 2001 Jul-Aug |
|
Sleep-disordered breathing in stable methadone programme patients: a pilot study. | 2001 Mar |
|
Effects of urine testing frequency on outcome in a methadone take-home contingency program. | 2001 Mar 1 |
|
Continuous epidural infusion of racemic methadone results in effective postoperative analgesia and low plasma concentrations. | 2002 Jan |
|
Neuropsychological correlates of opioid dependence and withdrawal. | 2003 Apr |
|
Tiagabine increases cocaine-free urines in cocaine-dependent methadone-treated patients: results of a randomized pilot study. | 2003 Nov |
|
QT prolongation and Torsades de Pointes in patients infected with human immunodeficiency virus and treated with methadone. | 2003 Oct 15 |
|
[Torsade de pointes: a severe and unknown adverse effect in a patient taking methadone]. | 2003 Oct 8 |
|
Cost effectiveness of disulfiram: treating cocaine use in methadone-maintained patients. | 2004 Apr |
|
QT interval prolongation in patients on methadone with concomitant drugs. | 2004 Aug |
|
Directly observed therapy for the management of HIV-infected patients in a methadone program. | 2004 Jun 1 |
|
Agonist-like or antagonist-like treatment for cocaine dependence with methadone for heroin dependence: two double-blind randomized clinical trials. | 2004 May |
|
[Routine ECG in methadone-assisted rehabilitation is wrong prioritization]. | 2004 Nov 18 |
|
Intravenous ketamine infusion as an adjuvant to morphine in a 2-year-old with severe cancer pain from metastatic neuroblastoma. | 2004 Oct |
|
Methadone-related Torsades de Pointes in a sickle cell patient treated for chronic pain. | 2005 Apr |
|
[Methadone-induced heart arrhythmia]. | 2005 Aug 11 |
|
Methadone treatment of chronic non-malignant pain and opioid dependence--a long-term follow-up. | 2006 Apr |
|
Variables associated with perceived sleep disorders in methadone maintenance treatment (MMT) patients. | 2006 Apr 28 |
Sample Use Guides
Chronic pain: oral initial dose - 2.5 mg every 8 to 12 hours; Intravenous initial dose: 2.5 mg to 10 mg every 8 to 12 hours
Opiate withdrawal: Initial dose - 20 to 30 mg orally; an additional 5 to 10 mg may be given orally after 2 to 4 hours if withdrawal symptoms have not been suppressed or if symptoms reappear.
-Maximum initial dose: 30 mg
-Maximum day 1 dose: 40 mg
Route of Administration:
Other
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/11561100
In the presence of 1 uM methadone, the maximum 86Rb+ efflux stimulated by nicotine (Emax) was markedly reduced, but the EC50 for nicotine was altered only slightly, if at all.
Substance Class |
Chemical
Created
by
admin
on
Edited
Fri Dec 15 15:04:46 GMT 2023
by
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on
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Record UNII |
UC6VBE7V1Z
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Record Status |
Validated (UNII)
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Record Version |
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WHO-ATC |
N07BC02
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NCI_THESAURUS |
C1506
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NDF-RT |
N0000175684
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WHO-ATC |
N02AC52
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NCI_THESAURUS |
C67413
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DEA NO. |
9250
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LIVERTOX |
NBK548084
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WHO-VATC |
QN07BC02
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CFR |
21 CFR 862.3620
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WHO-ESSENTIAL MEDICINES LIST |
24.5
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WHO-VATC |
QN02AC52
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NDF-RT |
N0000175690
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200-996-9
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6813
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DTXSID7023273
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m7286
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C62044
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3119
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CHEMBL651
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D008691
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UC6VBE7V1Z
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Methadone
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METHADONE
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297-88-1
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SUPERSEDED |
Related Record | Type | Details | ||
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SALT/SOLVATE -> PARENT | |||
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METABOLIC ENZYME -> SUBSTRATE | |||
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METABOLIC ENZYME -> SUBSTRATE | |||
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METABOLIC ENZYME -> SUBSTRATE |
CYP2C19 preferentially metabolized (R)-methadone,
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METABOLIC ENZYME -> SUBSTRATE |
CYP2B6 preferentially metabolized (S)-methadone,
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PARENT -> SALT/SOLVATE | |||
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TARGET->ANTAGONIST | |||
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BINDER->LIGAND |
BINDING
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METABOLIC ENZYME -> SUBSTRATE |
CYP3A4 showed no preference between the two enantiomers
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ACTIVE ENANTIOMER->RACEMATE |
approximately 50x the potency of the S-(+)-enantiomer as well as greater μ-opioid receptor selectivity
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SALT/SOLVATE -> PARENT |
APPROXIMATE PURE ANHYDROUS DRUG CONTENT (IN PERCENT)
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TRANSPORTER -> SUBSTRATE | |||
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SALT/SOLVATE -> PARENT |
APPROXIMATE PURE ANHYDROUS DRUG CONTENT (IN PERCENT)
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TARGET -> INHIBITOR |
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Related Record | Type | Details | ||
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METABOLITE INACTIVE -> PARENT |
The hierarchy of EDDPgeneration was CYP2B6 > CYP2C19zCYP3A4
MAJOR
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PARENT -> METABOLITE |
MINOR
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METABOLITE -> PARENT |
MINOR
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METABOLITE -> PARENT |
5-10% of the dose but there is a large individual variation due to pH, urine volume, dose and metabolic rate
MINOR
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METABOLITE ACTIVE -> PARENT | |||
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METABOLITE ACTIVE -> PARENT | |||
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METABOLITE ACTIVE -> PARENT |
Related Record | Type | Details | ||
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ACTIVE MOIETY |
Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
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Biological Half-life | PHARMACOKINETIC |
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Elimination PHARMACOKINETIC |
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