Nilotinib dihydrochloride dihydrate

Details

Stereochemistry	ACHIRAL
Molecular Formula	C28H22F3N7O.2ClH.2H2O
Molecular Weight	638.468
Optical Activity	NONE
Defined Stereocenters	0 / 0
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure of Nilotinib dihydrochloride dihydrate

Structure Search

SMILES

O.O.Cl.Cl.CC1=CN(C=N1)C2=CC(=CC(NC(=O)C3=CC=C(C)C(NC4=NC(=CC=N4)C5=CN=CC=C5)=C3)=C2)C(F)(F)F

InChI

InChIKey=UWLYJIFMRDCBAV-UHFFFAOYSA-N

InChI=1S/C28H22F3N7O.2ClH.2H2O/c1-17-5-6-19(10-25(17)37-27-33-9-7-24(36-27)20-4-3-8-32-14-20)26(39)35-22-11-21(28(29,30)31)12-23(13-22)38-15-18(2)34-16-38;;;;/h3-16H,1-2H3,(H,35,39)(H,33,36,37);2*1H;2*1H2

HIDE SMILES / InChI

Molecular Formula	H2O
Molecular Weight	18.0153
Charge	0
Count

Stereochemistry	ACHIRAL
Additional Stereochemistry	No
Defined Stereocenters	0 / 0
E/Z Centers	0
Optical Activity	NONE

Molecular Formula	ClH
Molecular Weight	36.461
Charge	0
Count

Stereochemistry	ACHIRAL
Additional Stereochemistry	No
Defined Stereocenters	0 / 0
E/Z Centers	0
Optical Activity	NONE

Molecular Formula	C28H22F3N7O
Molecular Weight	529.5158
Charge	0
Count

Stereochemistry	ACHIRAL
Additional Stereochemistry	No
Defined Stereocenters	0 / 0
E/Z Centers	0
Optical Activity	NONE

Description
Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/022068lbl.pdf
Curator's Comment: description was created based on several sources, including https://www.ncbi.nlm.nih.gov/pubmed/16721371 | https://www.ncbi.nlm.nih.gov/pubmed/19920925

Nilotinib (AMN107, trade name Tasigna) is a kinase inhibitor indicated for the treatment of chronic phase and accelerated phase Philadelphia chromosome-positive chronic myelogenous leukemia (CML) in adult patients resistant to or intolerant to prior therapy that included imatinib. Nilotinib is an inhibitor of the Bcr-Abl kinase. Nilotinib binds to and stabilizes the inactive conformation of the kinase domain of Abl protein. In vitro, nilotinib inhibited Bcr-Abl mediated proliferation of murine leukemic cell lines and human cell lines derived from Ph+ CML patients. Under the conditions of the assays, nilotinib was able to overcome imatinib resistance resulting from Bcr-Abl kinase mutations, in 32 out of 33 mutations tested. In vivo, nilotinib reduced the tumor size in a murine Bcr-Abl xenograft model. Nilotinib inhibited the autophosphorylation of the following kinases at IC50 values as indicated: Bcr-Abl (20-60 nM), PDGFR (69 nM) and c-Kit (210 nM). Nilotinib is currently being trialed in people with Parkinson's disease, as it appears to be able to halt progression of the disease and even improve their symptoms. The drug also has a number of adverse effects typical of anti-cancer drugs: a headache, fatigue, gastrointestinal problems such as nausea, vomiting, diarrhea and constipation, muscle and joint pain, rash and other skin conditions, flu-like symptoms, and reduced blood cell count. Less typical side effects are those of the cardiovascular system, such as hypertension (high blood pressure), various types of arrhythmia, and prolonged QT interval. Interaction of nilotinib with OATP1B1 and OATP1B3 may alter its hepatic disposition and can lead to transporter mediated drug-drug interactions. Nilotinib is an inhibitor of OATP-1B1 transporter but not for OATP-1B3. Main metabolic pathways identified in healthy subjects are oxidation and hydroxylation. Nilotinib is the main circulating component in the serum. None of the metabolites contributes significantly to the pharmacological activity of nilotinib.

CNS Activity

Originator

Approval Year

Targets

Primary Target	Pharmacology	Condition	Potency
Bcr/Abl fusion protein 21 Target ID: CHEMBL2096618 Sources: https://www.ncbi.nlm.nih.gov/pubmed/19920925	Inhibitor 8504		0.33 nM [IC50]

Conditions

Condition	Modality	Targets	Highest Phase	Product
Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML) 13 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/022068s023lbl.pdf	Primary		Approved 8583	TASIGNA Approved Use Tasigna is a kinase inhibitor indicated for: The treatment of newly diagnosed adult patients with Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML) in chronic phase. The treatment of chronic phase (CP) and accelerated phase (AP) Ph+ CML in adult patients resistant to or intolerant to prior therapy that included imatinib. (1.2) 1.1 Newly Diagnosed Ph+ CML-CP Tasigna (nilotinib) is indicated for the treatment of adult patients with newly diagnosed Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML) in chronic phase. The effectiveness of Tasigna is based on major molecular response and cytogenetic response rates [see Clinical Studies (14.1) Launch Date 2007

C_max

Value	Dose	Analyte	Population
405.111 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01077544	230 mg/m^2 single, oral dose: 230 mg/m^2 route of administration: oral experiment type: single co-administered:	NILOTINIB plasma	Homo sapiens population: unhealthy age: Children sex: food status:
402.715 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01077544	230 mg/m^2 single, oral dose: 230 mg/m^2 route of administration: oral experiment type: single co-administered:	NILOTINIB plasma	Homo sapiens population: unhealthy age: Children sex: food status:
1550 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19924121	400 mg 2 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED
2300 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19924121	400 mg 2 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: HIGH-FAT
3320 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19924121	600 mg 2 times / day steady-state, oral dose: 600 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED
6010 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19924121	600 mg 2 times / day steady-state, oral dose: 600 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: HIGH-FAT
2490 ng/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	1200 mg 1 times / day steady-state, oral dose: 1200 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
2190 ng/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	800 mg 1 times / day steady-state, oral dose: 800 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
403 ng/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	50 mg 1 times / day steady-state, oral dose: 50 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
1360 ng/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/30179260	300 mg 2 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB plasma	Homo sapiens population: UNHEALTHY age: UNKNOWN sex: FEMALE / MALE food status: FASTED
1595 ng/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/30179260	400 mg 2 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB plasma	Homo sapiens population: UNHEALTHY age: UNKNOWN sex: FEMALE / MALE food status: FASTED

AUC

Value	Dose	Analyte	Population
4160.969 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01077544	230 mg/m^2 single, oral dose: 230 mg/m^2 route of administration: oral experiment type: single co-administered:	NILOTINIB plasma	Homo sapiens population: unhealthy age: Children sex: food status:
2795.782 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01077544	230 mg/m^2 single, oral dose: 230 mg/m^2 route of administration: oral experiment type: single co-administered:	NILOTINIB plasma	Homo sapiens population: unhealthy age: Children sex: food status:
5707.368 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01077544	230 mg/m^2 single, oral dose: 230 mg/m^2 route of administration: oral experiment type: single co-administered:	NILOTINIB plasma	Homo sapiens population: unhealthy age: Children sex: food status:
3393.296 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01077544	230 mg/m^2 single, oral dose: 230 mg/m^2 route of administration: oral experiment type: single co-administered:	NILOTINIB plasma	Homo sapiens population: unhealthy age: Children sex: food status:
15129.182 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01077544	230 mg/m^2 2 times / day steady, oral dose: 230 mg/m^2 route of administration: oral experiment type: steady co-administered:	NILOTINIB plasma	Homo sapiens population: unhealthy age: Children sex: food status:
14383.076 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01077544	230 mg/m^2 2 times / day steady, oral dose: 230 mg/m^2 route of administration: oral experiment type: steady co-administered:	NILOTINIB plasma	Homo sapiens population: unhealthy age: Children sex: food status:
12700 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19924121	400 mg 2 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED
18200 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19924121	400 mg 2 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: HIGH-FAT
24500 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19924121	600 mg 2 times / day steady-state, oral dose: 600 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED
43100 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/19924121	600 mg 2 times / day steady-state, oral dose: 600 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: HIGH-FAT
28000 ng × h/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	1200 mg 1 times / day steady-state, oral dose: 1200 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
26600 ng × h/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	800 mg 1 times / day steady-state, oral dose: 800 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
4480 ng × h/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	50 mg 1 times / day steady-state, oral dose: 50 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
11865 ng × h/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/30179260	300 mg 2 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB plasma	Homo sapiens population: UNHEALTHY age: UNKNOWN sex: FEMALE / MALE food status: FASTED
13656 ng × h/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/30179260	400 mg 2 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB plasma	Homo sapiens population: UNHEALTHY age: UNKNOWN sex: FEMALE / MALE food status: FASTED

F_unbound

Value	Dose	Analyte	Population
2% DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	1200 mg 1 times / day steady-state, oral dose: 1200 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
2% DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	800 mg 1 times / day steady-state, oral dose: 800 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
2% DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	50 mg 1 times / day steady-state, oral dose: 50 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	NILOTINIB serum	Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
1.6% OTHER GOV https://www.ema.europa.eu/en/documents/scientific-discussion/tasigna-epar-scientific-discussion_en.pdf		NILOTINIB plasma	Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN

Doses

Dose	Population	Adverse events
400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 56 years (range: 26-85 years) Health Status: unhealthy Age Group: 56 years (range: 26-85 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	Disc. AE: Thrombocytopenia, Neutropenia... AEs leading to discontinuation/dose reduction: Thrombocytopenia (5 patients) Neutropenia (1 patient) Bilirubin increased (2 patients) Hepatotoxicity (2 patients) Skin rash (1 patient) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
600 mg 2 times / day steady, oral MTD Dose: 600 mg, 2 times / day Route: oral Route: steady Dose: 600 mg, 2 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/19924121/	unhealthy, 56.2 ± 15.3 years Health Status: unhealthy Age Group: 56.2 ± 15.3 years Sex: M+F Sources: https://pubmed.ncbi.nlm.nih.gov/19924121/	Sources: https://pubmed.ncbi.nlm.nih.gov/19924121/
400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 59 years (range: 22-79 years) Health Status: unhealthy Age Group: 59 years (range: 22-79 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	Disc. AE: Rash, Pancreatitis... AEs leading to discontinuation/dose reduction: Rash (1 patient) Pancreatitis (1 patient) Myocardial infarction (1 patient) Thrombocytopenia (grade 3, 1 patient) Neutropenia (grade 3, 1 patient) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
1200 mg 1 times / day steady, oral Dose: 1200 mg, 1 times / day Route: oral Route: steady Dose: 1200 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	unhealthy, 60 years (range: 15-83 years) Health Status: unhealthy Age Group: 60 years (range: 15-83 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	Other AEs: Rash, Fatigue... Other AEs: Rash (grade 3-4, 3%) Fatigue (grade 3-4, 3%) Bilirubin total increased (grade 3-4, 3%) Conjugated bilirubin level increased (grade 3-4, 3%) Bilirubin unconjugated increased (grade 3-4, 6%) Lipase increased (grade 3-4, 3%) ALT increased (grade 3-4, 9%) Aspartate aminotransferase increased (grade 3-4, 9%) Thrombocytopenia (grade 3-4, 17%) Neutropenia (grade 3-4, 14%) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235

AEs

Overview

CYP3A4	CYP2C9	CYP2D6	hERG
inducer 1087 substrate 1946	inducer 440 inhibitor 2438 substrate 1193	inhibitor 2507	inhibitor 2217

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
CYP3A4/5 296 CYP2C8 1057 CYP2C19 2057 P-gp 1741 UGT1A1 246	P-gp 2052 MRP1 113 CYP2J2 71 CYP1A2 1197 CYP2C8 810 OCT1 393	CYP2B6 669 CYP2C8 198 CYP1A1 151 CYP1A2 832 UGT1A1 78 CYP2C19 329 P-gp 301 MRP2 146

Drug as perpetrator

Target	Modality	Activity	Clinical evidence
CYP2C19 2141	inducer 1966 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	no
MRP2 625	inducer 1966 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	no
P-gp 1932	inducer 1966 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	no
UGT1A1 303	inducer 1966 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	weak
P-gp 1932	inhibitor 4027 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes [IC50 1.7 uM]
CYP2C9 2497	inhibitor 4027 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes [Ki 0.132 uM]
UGT1A1 303	inhibitor 4027 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes [Ki 0.19 uM]	yes (pharmacogenomic study) Comment: The (TA)7/(TA)7 genotype was associated with a statistically significant increase in risk of nilotinib-induced hyperbilirubinemia relative to the (TA)6/(TA)6 and (TA)6/(TA)7 genotypes. Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf
CYP2C8 1117	inhibitor 4027 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes [Ki 0.236 uM]
CYP3A4/5 357	inhibitor 4027 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes [Ki 0.448 uM]	yes (co-administration study) Comment: nilotinib increased auc of midazolam by 30% Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf
CYP2D6 2546	inhibitor 4027 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes [Ki 1.46 uM]
CYP2C19 2141	inhibitor 4027 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes [Ki 3.82 uM]
CYP1A1 272	inducer 1966 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes
CYP1A2 2333	inducer 1966 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes
CYP2B6 1160	inducer 1966 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes
CYP2C8 1117	inducer 1966 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes
CYP2C9 2497	inducer 1966 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes
CYP3A4 2633	inducer 1966 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes

Drug as victim

Target	Modality	Activity	Clinical evidence
CYP3A4 1946	substrate 4014 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	major	yes (co-administration study) Comment: ketoconazole increased auc of nilotinib by 3x, cmax by 84% Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf
CYP1A2 1197	substrate 4014 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	minor
CYP2C8 810	substrate 4014 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	minor
CYP2C9 1193	substrate 4014 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	minor
CYP2J2 71	substrate 4014 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	minor
MRP1 113	substrate 4014 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	no
OCT1 393	substrate 4014 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	no
P-gp 2052	substrate 4014 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf	yes

Tox targets

Target	Modality	Activity	Metabolite	Clinical evidence
hERG 2263	inhibitor 2237 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_PharmR_P1.pdf

Sourcing

Vendor/Aggregator	ID	URL
ChEBI	CHEBI:52172	https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:52172
ChemicalBook	CB5966228	https://www.chemicalbook.com/ChemicalProductProperty_EN_CB5966228
eMolecules	10645209	https://www.emolecules.com/cgi-bin/more?vid=10645209
MolPort	MolPort-003-987-089	https://www.molport.com/shop/molecule-link/MolPort-003-987-089
Selleck Chemicals	Nilotinib	http://www.selleckchem.com/products/Nilotinib.html
ZINC	ZINC000006716957	http://zinc15.docking.org/substances/ZINC000006716957

PubMed

Title	Date	PubMed
Low-level expression of proapoptotic Bcl-2-interacting mediator in leukemic cells in patients with chronic myeloid leukemia: role of BCR/ABL, characterization of underlying signaling pathways, and reexpression by novel pharmacologic compounds.	2005 Oct 15	16230407
The systemic mastocytosis-specific activating cKit mutation D816V can be inhibited by the tyrosine kinase inhibitor AMN107.	2005 Sep	16015383
[Novel inhibitors of Bcr-Abl].	2006	17245319
American Society of Clinical Oncology--42nd annual meeting. Poster presentations on leukemia and cytotoxic chemotherapy. 2-6 June 2006, Atlanta, GA, USA.	2006 Aug	16871453
Gateways to clinical trials.	2006 Dec	17235418
New insights into the pathophysiology of chronic myeloid leukemia and imatinib resistance.	2006 Dec 19	17179059
Activity of AMN107 in gleevec-resistant leukemia.	2006 Jan	16924763
Looking beyond imatinib: next line of targeted drugs for CML shows promise.	2006 Jan 25	16434621
Circumventing resistance to kinase-inhibitor therapy.	2006 Jun 15	16775240
Effects of AMN107, a novel aminopyrimidine tyrosine kinase inhibitor, on human mast cells bearing wild-type or mutated codon 816 c-kit.	2006 Nov	16797704
The CML-related oncoprotein BCR/ABL induces expression of histidine decarboxylase (HDC) and the synthesis of histamine in leukemic cells.	2006 Nov 15	16849647
Comparison of imatinib mesylate, dasatinib (BMS-354825), and nilotinib (AMN107) in an N-ethyl-N-nitrosourea (ENU)-based mutagenesis screen: high efficacy of drug combinations.	2006 Oct 1	16772610
Outcome of patients with Philadelphia chromosome-positive chronic myelogenous leukemia post-imatinib mesylate failure.	2007 Apr 15	17342766
Dynamics of BCR-ABL kinase domain mutations in chronic myeloid leukemia after sequential treatment with multiple tyrosine kinase inhibitors.	2007 Dec 1	17785585
Chemical proteomic profiles of the BCR-ABL inhibitors imatinib, nilotinib, and dasatinib reveal novel kinase and nonkinase targets.	2007 Dec 1	17720881
[Innovation of clinical trials for anti-cancer drugs in Japan--proposals from academia with special reference to the development of novel Bcr-Abl/Lyn tyrosine kinase inhibitor INNO-406 (NS-187) for imatinib-resistant chronic myelogenous leukemia].	2007 Feb	17301549
Simultaneous determination of AMN107 and Imatinib (Gleevec, Glivec, STI571) in cultured tumour cells using an isocratic high-performance liquid chromatography procedure with UV detection.	2007 Feb 1	16962394
MK-0457, a novel kinase inhibitor, is active in patients with chronic myeloid leukemia or acute lymphocytic leukemia with the T315I BCR-ABL mutation.	2007 Jan 15	16990603
Gateways to clinical trials.	2007 Jan-Feb	17344945
Novel tyrosine kinase inhibitor therapy before allogeneic stem cell transplantation in patients with chronic myeloid leukemia: no evidence for increased transplant-related toxicity.	2007 Jul 15	17559140
Gateways to clinical trials.	2007 Jun	17805439
Identification of BCR-ABL point mutations conferring resistance to the Abl kinase inhibitor AMN107 (nilotinib) by a random mutagenesis study.	2007 Jun 1	17303698
Emerging strategies for the treatment of mutant Bcr-Abl T315I myeloid leukemia.	2007 Mar	17382017
Emerging therapeutic options for Philadelphia-positive acute lymphocytic leukemia.	2007 Mar	17355221
Nilotinib (formerly AMN107), a highly selective BCR-ABL tyrosine kinase inhibitor, is effective in patients with Philadelphia chromosome-positive chronic myelogenous leukemia in chronic phase following imatinib resistance and intolerance.	2007 Nov 15	17715389
Crystal structure of the T315I mutant of AbI kinase.	2007 Sep	17718712
Sequential ABL kinase inhibitor therapy selects for compound drug-resistant BCR-ABL mutations with altered oncogenic potency.	2007 Sep	17710227
Tyrosine kinase inhibitors for the treatment of Philadelphia chromosome-positive adult acute lymphoblastic leukemia.	2007 Sep 15	17701954

Patents

Sample Use Guides

In Vivo Use Guide

400 mg orally twice daily, approximately 12 hours apart and should not be taken with food.

Route of Administration: Oral

In Vitro Use Guide

AMN107 (nilotinib) inhibited proliferation of Ba/F3 cells expressing G250E, E255K(V), F317L, M351T, F486S, M244V, L248R, Q252H, Y253H, E255K, E279K, E282D, V289S, and L348M Bcr-Abl mutants at <1 uM concentrations.

Substance Class	Chemical Created by `admin` on `Tue Apr 01 23:03:43 GMT 2025` Edited by `admin` on `Tue Apr 01 23:03:43 GMT 2025`
Record UNII	WM15I3PF3G
Record Status	`Validated (UNII)`
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Name

Type

Language

Benzamide, 4-methyl-N-[3-(4-methyl-1H-imidazol-1-yl)-5-(trifluoromethyl)phenyl]-3-[[4-(3-pyridinyl)-2-pyrimidinyl]amino]-, hydrochloride, hydrate (1:2:2)

Preferred Name

English

Nilotinib dihydrochloride dihydrate

Common Name

English

Code System Code Type Description

SMS_ID

100000176608

Created by admin on Tue Apr 01 23:03:43 GMT 2025 , Edited by admin on Tue Apr 01 23:03:43 GMT 2025

PRIMARY

CAS

1277165-20-4

Created by admin on Tue Apr 01 23:03:43 GMT 2025 , Edited by admin on Tue Apr 01 23:03:43 GMT 2025

PRIMARY

PUBCHEM

50990967

Created by admin on Tue Apr 01 23:03:43 GMT 2025 , Edited by admin on Tue Apr 01 23:03:43 GMT 2025

PRIMARY

FDA UNII

WM15I3PF3G

Created by admin on Tue Apr 01 23:03:43 GMT 2025 , Edited by admin on Tue Apr 01 23:03:43 GMT 2025

PRIMARY

Related Record Type Details


					F41401512X

Nilotinib

PARENT -> SALT/SOLVATE

Amount:

Related Record Type Details


					F41401512X

Nilotinib

ACTIVE MOIETY

Amount:

AE	Significance	Dose	Population
Neutropenia	1 patient Disc. AE	400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 56 years (range: 26-85 years) Health Status: unhealthy Age Group: 56 years (range: 26-85 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
Skin rash	1 patient Disc. AE	400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 56 years (range: 26-85 years) Health Status: unhealthy Age Group: 56 years (range: 26-85 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
Bilirubin increased	2 patients Disc. AE	400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 56 years (range: 26-85 years) Health Status: unhealthy Age Group: 56 years (range: 26-85 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
Hepatotoxicity	2 patients Disc. AE	400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 56 years (range: 26-85 years) Health Status: unhealthy Age Group: 56 years (range: 26-85 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
Thrombocytopenia	5 patients Disc. AE	400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 56 years (range: 26-85 years) Health Status: unhealthy Age Group: 56 years (range: 26-85 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
Myocardial infarction	1 patient Disc. AE	400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 59 years (range: 22-79 years) Health Status: unhealthy Age Group: 59 years (range: 22-79 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
Pancreatitis	1 patient Disc. AE	400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 59 years (range: 22-79 years) Health Status: unhealthy Age Group: 59 years (range: 22-79 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
Rash	1 patient Disc. AE	400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 59 years (range: 22-79 years) Health Status: unhealthy Age Group: 59 years (range: 22-79 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
Neutropenia	grade 3, 1 patient Disc. AE	400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 59 years (range: 22-79 years) Health Status: unhealthy Age Group: 59 years (range: 22-79 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
Thrombocytopenia	grade 3, 1 patient Disc. AE	400 mg 2 times / day steady, oral Recommended Dose: 400 mg, 2 times / day Route: oral Route: steady Dose: 400 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf	unhealthy, 59 years (range: 22-79 years) Health Status: unhealthy Age Group: 59 years (range: 22-79 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_MedR_P2.pdf
Neutropenia	grade 3-4, 14%	1200 mg 1 times / day steady, oral Dose: 1200 mg, 1 times / day Route: oral Route: steady Dose: 1200 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	unhealthy, 60 years (range: 15-83 years) Health Status: unhealthy Age Group: 60 years (range: 15-83 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235
Thrombocytopenia	grade 3-4, 17%	1200 mg 1 times / day steady, oral Dose: 1200 mg, 1 times / day Route: oral Route: steady Dose: 1200 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	unhealthy, 60 years (range: 15-83 years) Health Status: unhealthy Age Group: 60 years (range: 15-83 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235
Bilirubin total increased	grade 3-4, 3%	1200 mg 1 times / day steady, oral Dose: 1200 mg, 1 times / day Route: oral Route: steady Dose: 1200 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	unhealthy, 60 years (range: 15-83 years) Health Status: unhealthy Age Group: 60 years (range: 15-83 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235
Conjugated bilirubin level increased	grade 3-4, 3%	1200 mg 1 times / day steady, oral Dose: 1200 mg, 1 times / day Route: oral Route: steady Dose: 1200 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	unhealthy, 60 years (range: 15-83 years) Health Status: unhealthy Age Group: 60 years (range: 15-83 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235
Fatigue	grade 3-4, 3%	1200 mg 1 times / day steady, oral Dose: 1200 mg, 1 times / day Route: oral Route: steady Dose: 1200 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	unhealthy, 60 years (range: 15-83 years) Health Status: unhealthy Age Group: 60 years (range: 15-83 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235
Lipase increased	grade 3-4, 3%	1200 mg 1 times / day steady, oral Dose: 1200 mg, 1 times / day Route: oral Route: steady Dose: 1200 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	unhealthy, 60 years (range: 15-83 years) Health Status: unhealthy Age Group: 60 years (range: 15-83 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235
Rash	grade 3-4, 3%	1200 mg 1 times / day steady, oral Dose: 1200 mg, 1 times / day Route: oral Route: steady Dose: 1200 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	unhealthy, 60 years (range: 15-83 years) Health Status: unhealthy Age Group: 60 years (range: 15-83 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235
Bilirubin unconjugated increased	grade 3-4, 6%	1200 mg 1 times / day steady, oral Dose: 1200 mg, 1 times / day Route: oral Route: steady Dose: 1200 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	unhealthy, 60 years (range: 15-83 years) Health Status: unhealthy Age Group: 60 years (range: 15-83 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235
ALT increased	grade 3-4, 9%	1200 mg 1 times / day steady, oral Dose: 1200 mg, 1 times / day Route: oral Route: steady Dose: 1200 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	unhealthy, 60 years (range: 15-83 years) Health Status: unhealthy Age Group: 60 years (range: 15-83 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235
Aspartate aminotransferase increased	grade 3-4, 9%	1200 mg 1 times / day steady, oral Dose: 1200 mg, 1 times / day Route: oral Route: steady Dose: 1200 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235	unhealthy, 60 years (range: 15-83 years) Health Status: unhealthy Age Group: 60 years (range: 15-83 years) Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022068s000_ClinPharmR.pdf https://pubmed.ncbi.nlm.nih.gov/16775235

Details

SMILES

InChI

DescriptionSources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/022068lbl.pdfCurator's Comment: description was created based on several sources, including https://www.ncbi.nlm.nih.gov/pubmed/16721371 | https://www.ncbi.nlm.nih.gov/pubmed/19920925

CNS Activity

Originator

Approval Year

Targets

Conditions

Approved Use

Launch Date

Cmax

AUC

Funbound

Doses

AEs

Overview

OverviewOther

Drug as perpetrator​

Drug as victim

Tox targets

Sourcing

PubMed

Patents

Sample Use Guides

Description
Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/022068lbl.pdf
Curator's Comment: description was created based on several sources, including https://www.ncbi.nlm.nih.gov/pubmed/16721371 | https://www.ncbi.nlm.nih.gov/pubmed/19920925

C_max

F_unbound

Drug as perpetrator