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 Date-7.0649283E11 |
|||
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 Date-7.0649283E11 |
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 |
---|---|---|
Rhabdomyolysis and acute renal failure following methadone abuse. | 1992 |
|
Desipramine in opioid-dependent cocaine abusers maintained on buprenorphine vs methadone. | 1999 Sep |
|
Methadone dose increase and abstinence reinforcement for treatment of continued heroin use during methadone maintenance. | 2000 Apr |
|
Methadone, ciprofloxacin, and adverse drug reactions. | 2000 Dec 16 |
|
Thrice-weekly versus daily buprenorphine maintenance. | 2000 Jun 15 |
|
[Methadone withdrawal syndrome induced by nevirapine]. | 2000 Mar 18 |
|
A comparison of levomethadyl acetate, buprenorphine, and methadone for opioid dependence. | 2000 Nov 2 |
|
Pain responses in methadone-maintained opioid abusers. | 2000 Oct |
|
Methadone maintenance treatment (MMT): a review of historical and clinical issues. | 2000 Oct-Nov |
|
[Postpartum risk factors in the development of children born to opiate-addicted mothers; comparison between mothers with and without methadone substitution]. | 2000 Sep |
|
The effect of stimulant and sedative use on treatment outcome of patients admitted to methadone maintenance treatment. | 2000 Spring |
|
Interindividual variability of the clinical pharmacokinetics of methadone: implications for the treatment of opioid dependence. | 2002 |
|
Continuous epidural infusion of racemic methadone results in effective postoperative analgesia and low plasma concentrations. | 2002 Jan |
|
Cognitive impairment in methadone maintenance patients. | 2002 Jun 1 |
|
Bradycardia associated with intravenous methadone administered for sedation in a patient with acute respiratory distress syndrome. | 2002 Sep |
|
Utility of crossover designs in clinical trials: efficacy of desipramine vs. placebo in opioid-dependent cocaine abusers. | 2002 Spring |
|
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 |
|
QT interval prolongation in patients on methadone with concomitant drugs. | 2004 Aug |
|
Methadone metabolism by human placenta. | 2004 Aug 1 |
|
Epidural clonidine, bupivacaine and methadone as the sole analgesic agent after thoracotomy for lung resection. | 2004 Sep |
|
Methadone maintenance and male sexual dysfunction. | 2005 |
|
Cocaine-related torsade de pointes in a methadone maintenance patient. | 2005 |
|
Adipocyte-derived hormones in heroin addicts: the influence of methadone maintenance treatment. | 2005 |
|
QTc interval prolongation in patients on long-term methadone maintenance therapy. | 2005 |
|
Effects of buprenorphine on cardiac repolarization in a patient with methadone-related torsade de pointes. | 2005 Apr |
|
Torsades de pointes with methadone. | 2005 Apr |
|
Measurement of QTc in patients receiving chronic methadone therapy. | 2005 Apr |
|
Methadone-related Torsades de Pointes in a sickle cell patient treated for chronic pain. | 2005 Apr |
|
[Methadone-induced heart arrhythmia]. | 2005 Aug 11 |
|
Factors associated with methadone maintenance therapy use among a cohort of polysubstance using injection drug users in Vancouver. | 2005 Dec 12 |
|
Methadone versus buprenorphine with contingency management or performance feedback for cocaine and opioid dependence. | 2005 Feb |
|
Methadone-induced bradycardia. | 2005 Jul |
|
Neuropsychological functioning in methadone maintenance patients versus abstinent heroin abusers. | 2005 Jun 1 |
|
Dextromethorphan-induced delirium and possible methadone interaction. | 2005 Mar |
|
[Methadone and sleep apnea syndrome]. | 2005 Mar |
|
Caution with nalbuphine in patients on long-term opioids. | 2005 Mar |
|
Methadone-induced Torsade de pointes tachycardias. | 2005 May 14 |
|
QT prolongation and torsades de pointes among methadone users: reports to the FDA spontaneous reporting system. | 2005 Nov |
|
[Torsades de pointes during methadone treatment]. | 2005 Oct |
|
Methadone doses of 100 mg or greater are more effective than lower doses at suppressing heroin self-administration in opioid-dependent volunteers. | 2005 Oct |
|
QT prolongation and syncope with methadone, doxepin, and a beta-blocker. | 2005 Oct |
|
Central sleep apnea in stable methadone maintenance treatment patients. | 2005 Sep |
|
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 |
|
Does naltrexone treatment lead to depression? Findings from a randomized controlled trial in subjects with opioid dependence. | 2006 Jan |
|
Bradycardia during methadone therapy in an infant. | 2006 Jan |
|
A randomized controlled trial of interim methadone maintenance. | 2006 Jan |
|
Frequency of high-risk use of QT-prolonging medications. | 2006 Jun |
|
Changes in HIV risk behaviors among patients receiving combined pharmacological and behavioral interventions for heroin and cocaine dependence. | 2006 May |
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 16 16:06:40 UTC 2022
by
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on
Fri Dec 16 16:06:40 UTC 2022
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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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Classification Tree | Code System | Code | ||
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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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28017
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M7286
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C62044
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3119
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SUB08833MIG
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DB00333
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4095
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CHEMBL651
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D008691
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788
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UC6VBE7V1Z
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UC6VBE7V1Z
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Methadone
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5458
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50140
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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 ?-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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