Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C24H25NO4 |
Molecular Weight | 391.4596 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 3 / 3 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
[H][C@]12C[C@@H](OC(=O)C3=CC=CC=C3)C=C[C@]14CCN(C)CC5=CC=C(OC)C(O2)=C45
InChI
InChIKey=JKVNJTYHRABHIY-WXVUKLJWSA-N
InChI=1S/C24H25NO4/c1-25-13-12-24-11-10-18(28-23(26)16-6-4-3-5-7-16)14-20(24)29-22-19(27-2)9-8-17(15-25)21(22)24/h3-11,18,20H,12-15H2,1-2H3/t18-,20-,24-/m0/s1
Molecular Formula | C24H25NO4 |
Molecular Weight | 391.4596 |
Charge | 0 |
Count |
|
Stereochemistry | ABSOLUTE |
Additional Stereochemistry | No |
Defined Stereocenters | 3 / 3 |
E/Z Centers | 0 |
Optical Activity | UNSPECIFIED |
DescriptionSources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/021169s031-021224s029-021615s022lbl.pdfCurator's Comment: description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/mesh/68005702 |
https://www.ncbi.nlm.nih.gov/pubmed/12177686
Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/021169s031-021224s029-021615s022lbl.pdf
Curator's Comment: description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/mesh/68005702 |
https://www.ncbi.nlm.nih.gov/pubmed/12177686
Galantamine (RAZADYNE®, galantamine hydrobromide) is a benzazepine derived from norbelladine. It is found in Galanthus and other Amaryllidaceae. It is a reversible, competitive acetylcholinesterase inhibitor that is used for the treatment of mild to moderate dementia of the Alzheimer’s type. Although the etiology of cognitive impairment in Alzheimer’s disease is not fully understood, it has been reported that acetylcholine-producing neurons degenerate in the brains of patients with Alzheimer’s disease. The degree of this cholinergic loss has been correlated with degree of cognitive impairment and density of amyloid plaques (a neuropathological hallmark of Alzheimer’s disease). While the precise mechanism of galantamine’s (RAZADYNE®, galantamine hydrobromide) action is unknown, it is postulated to exert its therapeutic effect by enhancing cholinergic function. This is accomplished by increasing the concentration of acetylcholine through reversible inhibition of its hydrolysis by acetylcholinesterase. If this mechanism is correct, galantamine’s (RAZADYNE®, galantamine hydrobromide) effect may lessen as the disease process advances and fewer cholinergic neurons remain functionally intact. There is no evidence that galantamine (RAZADYNE®, galantamine hydrobromide) alters the course of the underlying dementing process.
CNS Activity
Originator
Sources: https://www.ncbi.nlm.nih.gov/pubmed/12177686
Curator's Comment: # Janssen Pharmaceuticals, a division of Ortho-McNeil-Jannsen Pharmaceuticals
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL220 |
0.35 µM [IC50] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Palliative | RAZADYNE Approved UseGalantamine hydrobromide is a cholinesterase inhibitor indicated for the treatment of mild to moderate dementia of the Alzheimer’s type. Launch Date2001 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
84.3 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/16238894 |
24 mg single, oral dose: 24 mg route of administration: Oral experiment type: SINGLE co-administered: |
GALANTAMINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
1050 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/16238894 |
24 mg single, oral dose: 24 mg route of administration: Oral experiment type: SINGLE co-administered: |
GALANTAMINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
8.53 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/16238894 |
24 mg single, oral dose: 24 mg route of administration: Oral experiment type: SINGLE co-administered: |
GALANTAMINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
82% |
GALANTAMINE plasma | Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
8 mg 2 times / day steady, oral Dose: 8 mg, 2 times / day Route: oral Route: steady Dose: 8 mg, 2 times / day Sources: |
unhealthy, 90 years n = 1 Health Status: unhealthy Condition: Alzheimer's disease Age Group: 90 years Sex: M Population Size: 1 Sources: |
Disc. AE: Nightmares... AEs leading to discontinuation/dose reduction: Nightmares (1 patient) Sources: |
32 mg 1 times / day steady, oral Highest studied dose Dose: 32 mg, 1 times / day Route: oral Route: steady Dose: 32 mg, 1 times / day Sources: |
unhealthy, adult n = 429 Health Status: unhealthy Condition: Alzheimer's disease Age Group: adult Sex: unknown Population Size: 429 Sources: |
Other AEs: Nausea, Vomiting... Other AEs: Nausea (42%) Sources: Vomiting (21%) Diarrhea (16%) Anorexia (15%) Weight loss (8%) Dizziness (15%) |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Nightmares | 1 patient Disc. AE |
8 mg 2 times / day steady, oral Dose: 8 mg, 2 times / day Route: oral Route: steady Dose: 8 mg, 2 times / day Sources: |
unhealthy, 90 years n = 1 Health Status: unhealthy Condition: Alzheimer's disease Age Group: 90 years Sex: M Population Size: 1 Sources: |
Anorexia | 15% | 32 mg 1 times / day steady, oral Highest studied dose Dose: 32 mg, 1 times / day Route: oral Route: steady Dose: 32 mg, 1 times / day Sources: |
unhealthy, adult n = 429 Health Status: unhealthy Condition: Alzheimer's disease Age Group: adult Sex: unknown Population Size: 429 Sources: |
Dizziness | 15% | 32 mg 1 times / day steady, oral Highest studied dose Dose: 32 mg, 1 times / day Route: oral Route: steady Dose: 32 mg, 1 times / day Sources: |
unhealthy, adult n = 429 Health Status: unhealthy Condition: Alzheimer's disease Age Group: adult Sex: unknown Population Size: 429 Sources: |
Diarrhea | 16% | 32 mg 1 times / day steady, oral Highest studied dose Dose: 32 mg, 1 times / day Route: oral Route: steady Dose: 32 mg, 1 times / day Sources: |
unhealthy, adult n = 429 Health Status: unhealthy Condition: Alzheimer's disease Age Group: adult Sex: unknown Population Size: 429 Sources: |
Vomiting | 21% | 32 mg 1 times / day steady, oral Highest studied dose Dose: 32 mg, 1 times / day Route: oral Route: steady Dose: 32 mg, 1 times / day Sources: |
unhealthy, adult n = 429 Health Status: unhealthy Condition: Alzheimer's disease Age Group: adult Sex: unknown Population Size: 429 Sources: |
Nausea | 42% | 32 mg 1 times / day steady, oral Highest studied dose Dose: 32 mg, 1 times / day Route: oral Route: steady Dose: 32 mg, 1 times / day Sources: |
unhealthy, adult n = 429 Health Status: unhealthy Condition: Alzheimer's disease Age Group: adult Sex: unknown Population Size: 429 Sources: |
Weight loss | 8% | 32 mg 1 times / day steady, oral Highest studied dose Dose: 32 mg, 1 times / day Route: oral Route: steady Dose: 32 mg, 1 times / day Sources: |
unhealthy, adult n = 429 Health Status: unhealthy Condition: Alzheimer's disease Age Group: adult Sex: unknown Population Size: 429 Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
inconclusive [Activation 15.8489 uM] | ||||
no [IC50 >10 uM] | ||||
no [IC50 >10 uM] | ||||
no [IC50 >10 uM] | ||||
no [IC50 >10 uM] | ||||
no [IC50 >10 uM] | ||||
no [IC50 >10 uM] | ||||
no [IC50 >133 uM] | ||||
no [IC50 >133 uM] | ||||
no [IC50 >133 uM] | ||||
no [IC50 >133 uM] | ||||
no | ||||
no | ||||
no | ||||
Page: 4, 20, (ClinPharm) 34, 38-39 |
no | no (co-administration study) Comment: Coadministration of Galantamine (multiple doses) had no effect on the pharmacokinetics of R-/S-Warfarin (CYP2C9 substrate) Page: 4, 20, (ClinPharm) 34, 38-39 |
||
yes [IC50 0.6 uM] | no (co-administration study) Comment: Coadministration of Galantamine (multiple doses) had no effect on the pharmacokinetics of Digoxin (P-gp substrate) Page: 4, 20, (ClinPharm) 38, 40 |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 2, 4, 19-20, (ClinPharm) 15, 38, 42-23, 45 |
major [Km 187 uM] | yes (co-administration study) Comment: Vmax = 5.2 nmol/mg protein/h (Pharmacogenetics, 9, 661 (1999)); Coadministration (multiple doses) of ketoconazole (strong CYP3A4 inhibitor, CYP2D6 inhibitor) and paroxetin (strong CYP2D6 inhibitor) increased Galantamine AUC by 30% and 40%. Page: 2, 4, 19-20, (ClinPharm) 15, 38, 42-23, 45 |
||
Page: 2, 4, 19-20, (ClinPharm) 15, 38, 42-44 |
major | yes (co-administration study) Comment: Coadministration (multiple doses) of ketoconazole (strong CYP3A4 inhibitor, CYP2D6 inhibitor) increased Galantamine AUC by 30%. Coadministration of erythromycin (moderate CYP3A4 inhibitor) increased Galantamine AUC by only 10%. Page: 2, 4, 19-20, (ClinPharm) 15, 38, 42-44 |
||
yes |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
PubMed
Title | Date | PubMed |
---|---|---|
Structure of acetylcholinesterase complexed with (-)-galanthamine at 2.3 A resolution. | 1999 Dec 17 |
|
Therapeutic continuity in Alzheimer's disease: switching patients to galantamine. Introduction. | 2001 |
|
Galantamine for Alzheimer's disease. | 2001 |
|
Maintaining cognitive function in Alzheimer disease: how effective are current treatments? | 2001 Aug |
|
Unsafe prescription medication switching recommendations. | 2001 Dec |
|
[Alzheimer dementia. Comparison of the effectiveness of cholinesterase inhibitors and gingko]. | 2001 Dec 13 |
|
Galantamine: effect on nicotinic receptor binding, acetylcholinesterase inhibition, and learning. | 2001 Feb 13 |
|
Use of cholinesterase inhibitors for treatment of Alzheimer disease. | 2001 Jul |
|
Galantamine (reminyl) for Alzheimer's disease. | 2001 Jun 25 |
|
APOE genotype: no influence on galantamine treatment efficacy nor on rate of decline in Alzheimer's disease. | 2001 Mar-Apr |
|
Meeting the challenges of vascular dementia. Introduction. | 2001 May |
|
Alzheimer's disease and related disorders. | 2001 May |
|
Assessment of health economics in Alzheimer's disease (AHEAD): galantamine treatment in Canada. | 2001 Sep 25 |
|
Nicotinic receptor modulation: advantages for successful Alzheimer's disease therapy. | 2002 |
|
[New theory! Galantamine and nicotinic-cholinergic transmission]. | 2002 |
|
Economic analysis of galantamine, a cholinesterase inhibitor, in the treatment of patients with mild to moderate Alzheimer's disease in the Netherlands. | 2002 |
|
Galantamine for Alzheimer's disease. | 2002 |
|
Understanding and managing behavioural symptoms in Alzheimer's disease and related dementias: focus on rivastigmine. | 2002 |
|
An efficient enantioselective synthesis of (-)-galanthamine. | 2002 Aug 2 |
|
New drugs 2002, part 1. | 2002 Jan |
|
Switching cholinesterase inhibitors in patients with Alzheimer's disease. | 2002 Jun |
|
Evidence that the clinical effects of cholinesterase inhibitors are related to potency and targeting of action. | 2002 Jun |
|
[Dementing disorders. What benefits do the new anti-dementia drugs have?]. | 2002 May 6 |
|
[Treatment of Alzheimer's disease]. | 2002 Nov 1-15 |
|
The rationale behind cholinergic drug treatment for dementia related to cerebrovascular disease. | 2002 Nov 15 |
|
Treatment options: the latest evidence with galantamine (Reminyl). | 2002 Nov 15 |
|
Use of galantamine to treat vascular dementia. | 2002 Nov 9 |
|
The impact of journal advertisements on prescribers of cholinesterase inhibitors. | 2002 Oct |
|
The cholinergic approach for the treatment of vascular dementia: evidence from pre-clinical and clinical studies. | 2002 Oct-Nov |
|
Quaternary salts of E2020 analogues as acetylcholinesterase inhibitors for the reversal of neuromuscular block. | 2002 Sep 16 |
Sample Use Guides
The recommended starting dosage of RAZADYNE® tablets is 4 mg twice a day (8 mg/day). The dosage should be increased to the initial maintenance dosage of 8 mg twice a day (16 mg/day) after a minimum of 4 weeks. A further increase to 12 mg twice a day (24 mg/day) should be attempted after a minimum of 4 weeks at 8 mg twice a day (16 mg/day). Dosage increases should be based upon assessment of clinical benefit and tolerability of the previous dose.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/1954303
Galanthamine was evaluated as inhibitor of human acetylcholinesterase activity from samples of postmortem human brain, fresh brain cortex biopsies and human erythrocytes. The respective galanthamine concentration exerting a half maximal effect (IC50) on acetylcholinesterase in postmortem human brain frontal cortex was 3.2 uM versus 2.8 uM in the hippocampus region. In addition, galanthamine was 10-fold less potent in inhibiting the enzyme activity from human brain that from human erythrocytes.
Substance Class |
Chemical
Created
by
admin
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Edited
Sat Dec 16 11:32:57 GMT 2023
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Record UNII |
XOI2Q0ZF7G
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Record Status |
Validated (UNII)
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Record Version |
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300000042092
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224169-27-1
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12069
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SALT/SOLVATE -> PARENT |
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METABOLITE ACTIVE -> PRODRUG |
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ACTIVE MOIETY |
Originator: Galantos Pharma; Developer: Galantos Pharma, Neurodyn; Class Alkaloids: Benzazepine, Nootropic, Small molecule; Mechanism of Action: Acetylcholinesterase inhibitor, Nicotinic receptor modulator; Highest Development Phase: Phase I for Alzheimer's disease; Most Recent Events: 05 Mar 2016 Phase-I clinical trials in Alzheimer's disease (In volunteers) in Netherlands (Intranasal) (NTR5678), 09 Sep 2014 Phase-I clinical trials in Alzheimer's disease (In volunteers) in Canada prior to September 2014 (Intranasal), 09 Sep 2014 Efficacy, adverse events and pharmacokinetics data from a phase Ia trial in Alzheimer's disease (in volunteers) released by Neurodyn.
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