Details
| Stereochemistry | ABSOLUTE |
| Molecular Formula | C34H53NO11 |
| Molecular Weight | 651.7847 |
| Optical Activity | UNSPECIFIED |
| Defined Stereocenters | 5 / 5 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
COCCOCCOCCOCCOCCOCCOCCO[C@H]1CC[C@@]2(O)[C@H]3CC4=C5C(O[C@@H]1[C@@]25CCN3CC=C)=C(O)C=C4
InChI
InChIKey=XNKCCCKFOQNXKV-ZRSCBOBOSA-N
InChI=1S/C34H53NO11/c1-3-9-35-10-8-33-30-26-4-5-27(36)31(30)46-32(33)28(6-7-34(33,37)29(35)25-26)45-24-23-44-22-21-43-20-19-42-18-17-41-16-15-40-14-13-39-12-11-38-2/h3-5,28-29,32,36-37H,1,6-25H2,2H3/t28-,29+,32-,33-,34+/m0/s1
| Molecular Formula | C34H53NO11 |
| Molecular Weight | 651.7847 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 5 / 5 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
DescriptionCurator's Comment: description was created based on several sources, including
http://www.ncbi.nlm.nih.gov/pubmed/24896818; http://www.nektar.com/product_pipeline/cns_pain_oral_naloxegol_nktr118.html
Curator's Comment: description was created based on several sources, including
http://www.ncbi.nlm.nih.gov/pubmed/24896818; http://www.nektar.com/product_pipeline/cns_pain_oral_naloxegol_nktr118.html
MOVANTIK (naloxegol) is a peripherally-acting mu-opioid receptor antagonist indicated for the treatment of opioid-induced constipation (OIC) in adult patients with chronic noncancer pain. It is being investigated for the treatment of constipation as a side effect of prescription opioid pain medicines.
Originator
Curator's Comment: Naloxegol was developed using Nektar's oral small molecule polymer conjugate technology.In September 2009, AstraZeneca and Nektar Therapeutics entered into a worldwide agreement for naloxegol. Under Nektar's agreement with AstraZeneca, AstraZeneca is responsible for development and commercialization. MOVANTIK is a trademark and MOVENTIG is a registered trademark of the AstraZeneca group of companies.
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: P35372|||G8XRH8|||Q5TDA1|||Q9UN57 Gene ID: 4988.0 Gene Symbol: OPRM1 Target Organism: Homo sapiens (Human) Sources: https://www.ncbi.nlm.nih.gov/pubmed/26312011 |
7.4 nM [Ki] |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Secondary | MOVANTIK Approved UseIndicated for the treatment of opioid-induced constipation (OIC) in adult patients with chronic non-cancer pain. Launch Date2014 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
8 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
5 mg 1 times / day multiple, oral dose: 5 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
81.1 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
25 mg 1 times / day multiple, oral dose: 25 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
100 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
50 mg 1 times / day multiple, oral dose: 50 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
39 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
5 mg 1 times / day multiple, oral dose: 5 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
334.8 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
25 mg 1 times / day multiple, oral dose: 25 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
403.6 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
50 mg 1 times / day multiple, oral dose: 50 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
17.4 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
5 mg 1 times / day multiple, oral dose: 5 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
14.1 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
25 mg 1 times / day multiple, oral dose: 25 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
20.3 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23726675 |
50 mg 1 times / day multiple, oral dose: 50 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
6 h |
unknown, unknown |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
95.8% |
unknown, unknown |
NALOXEGOL OXALATE plasma | Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Doses
| Dose | Population | Adverse events |
|---|---|---|
1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years Health Status: healthy Age Group: 18 - 45 years Sex: M Sources: |
Other AEs: Gastrointestinal disorder (NOS), Nausea... Other AEs: Gastrointestinal disorder (NOS) (16.7%) Sources: Nausea (16.7%) CNS disorder (NOS) (33.3%) Somnolence (16.7%) Dizziness (16.7%) |
250 mg 2 times / day steady, oral Highest studied dose Dose: 250 mg, 2 times / day Route: oral Route: steady Dose: 250 mg, 2 times / day Sources: |
healthy, 59 years (range: 18 - 65 years) Health Status: healthy Age Group: 59 years (range: 18 - 65 years) Sex: M+F Sources: |
Other AEs: Myalgia, Restless leg syndrome... Other AEs: Myalgia (33.3%) Sources: Restless leg syndrome (16.7%) Dizziness (50%) |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
Disc. AE: Diarrhea, Abdominal pain... AEs leading to discontinuation/dose reduction: Diarrhea (3.1%) Sources: Abdominal pain (2.9%) Nausea (1.1%) Vomiting (0.9%) Depression (0.2%) Hypotension (0.2%) Influenza like illness (0.2%) Chills (0.2%) Abdominal pain upper (1.1%) Hyperhidrosis (0.9%) Back pain (0.4%) Myalgia (0.4%) Liver function test abnormal (0.4%) Headache (0.4%) |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
Disc. AE: Diarrhea, Abdominal pain... AEs leading to discontinuation/dose reduction: Diarrhea (0.9%) Sources: Abdominal pain (0.9%) Nausea (1.1%) Vomiting (0.5%) Depression (0.2%) Hypotension (0.2%) Dizziness (0.5%) Abdominal discomfort (0.2%) |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Dizziness | 16.7% | 1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years Health Status: healthy Age Group: 18 - 45 years Sex: M Sources: |
| Gastrointestinal disorder (NOS) | 16.7% | 1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years Health Status: healthy Age Group: 18 - 45 years Sex: M Sources: |
| Nausea | 16.7% | 1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years Health Status: healthy Age Group: 18 - 45 years Sex: M Sources: |
| Somnolence | 16.7% | 1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years Health Status: healthy Age Group: 18 - 45 years Sex: M Sources: |
| CNS disorder (NOS) | 33.3% | 1000 mg single, oral Highest studied dose |
healthy, 18 - 45 years Health Status: healthy Age Group: 18 - 45 years Sex: M Sources: |
| Restless leg syndrome | 16.7% | 250 mg 2 times / day steady, oral Highest studied dose Dose: 250 mg, 2 times / day Route: oral Route: steady Dose: 250 mg, 2 times / day Sources: |
healthy, 59 years (range: 18 - 65 years) Health Status: healthy Age Group: 59 years (range: 18 - 65 years) Sex: M+F Sources: |
| Myalgia | 33.3% | 250 mg 2 times / day steady, oral Highest studied dose Dose: 250 mg, 2 times / day Route: oral Route: steady Dose: 250 mg, 2 times / day Sources: |
healthy, 59 years (range: 18 - 65 years) Health Status: healthy Age Group: 59 years (range: 18 - 65 years) Sex: M+F Sources: |
| Dizziness | 50% | 250 mg 2 times / day steady, oral Highest studied dose Dose: 250 mg, 2 times / day Route: oral Route: steady Dose: 250 mg, 2 times / day Sources: |
healthy, 59 years (range: 18 - 65 years) Health Status: healthy Age Group: 59 years (range: 18 - 65 years) Sex: M+F Sources: |
| Chills | 0.2% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Depression | 0.2% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Hypotension | 0.2% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Influenza like illness | 0.2% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Back pain | 0.4% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Headache | 0.4% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Liver function test abnormal | 0.4% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Myalgia | 0.4% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Hyperhidrosis | 0.9% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Vomiting | 0.9% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Abdominal pain upper | 1.1% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Nausea | 1.1% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Abdominal pain | 2.9% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Diarrhea | 3.1% Disc. AE |
25 mg 1 times / day steady, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: steady Dose: 25 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Abdominal discomfort | 0.2% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Depression | 0.2% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Hypotension | 0.2% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Dizziness | 0.5% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Vomiting | 0.5% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Abdominal pain | 0.9% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Diarrhea | 0.9% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
| Nausea | 1.1% Disc. AE |
12.5 mg 1 times / day steady, oral Dose: 12.5 mg, 1 times / day Route: oral Route: steady Dose: 12.5 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: M+F Sources: |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as perpetrator
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [IC50 >100 uM] | |||
Page: 12.0 |
no [Inhibition 100 uM] | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no | |||
Page: 12.0 |
no |
Drug as victim
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/204760Orig1s000ClinPharm.pdf#page=63 Page: 63.0 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/204760Orig1s000ClinPharm.pdf#page=63 Page: 63.0 |
no | |||
Page: 10.0 |
yes | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/204760Orig1s000ClinPharm.pdf#page=24 Page: 24.0 |
yes | yes (co-administration study) Comment: Co-administration with ketoconazole, a strong CYP3A4/P-gp inhibitor, resulted in 11-fold and ~ 12.85-fold increases in Cmax and AUC of naloxegol. Therefore dosing with such drugs is contraindicated. Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/204760Orig1s000ClinPharm.pdf#page=24 Page: 24.0 |
||
Page: 9.0 |
yes | yes (co-administration study) Comment: Co-administration with ketoconazole, a strong CYP3A4/P-gp inhibitor, resulted in 11-fold and ~ 12.85-fold increases in Cmax and AUC of naloxegol. Therefore dosing with such drugs is contraindicated. Page: 9.0 |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Naloxegol: A Novel Therapy in the Management of Opioid-Induced Constipation. | 2016-11 |
|
| Naloxegol: treatment for opioid-induced constipation in chronic non-cancer pain. | 2015-03 |
|
| Naloxegol: First oral peripherally acting mu opioid receptor antagonists for opioid-induced constipation. | 2014-09-25 |
|
| A phase 2, double-blind, randomized, placebo-controlled, dose-escalation study to evaluate the efficacy, safety, and tolerability of naloxegol in patients with opioid-induced constipation. | 2013-09 |
|
| New approaches to the treatment of opioid-induced constipation. | 2008-08 |
|
| Opioid-induced bowel dysfunction: prevalence, pathophysiology and burden. | 2007-07 |
|
| Incidence, prevalence, and management of opioid bowel dysfunction. | 2001-11 |
Patents
| Substance Class |
Chemical
Created
by
admin
on
Edited
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by
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on
Mon Mar 31 21:02:50 GMT 2025
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| Record UNII |
44T7335BKE
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Validated (UNII)
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| Classification Tree | Code System | Code | ||
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NDF-RT |
N0000175691
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WHO-VATC |
QA06AH03
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WHO-ATC |
A06AH03
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NCI_THESAURUS |
C681
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4832
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DTXSID80234684
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1551777
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82975
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CHEMBL2219418
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ZZ-128
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C97506
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Naloxegol
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DB09049
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SUB126723
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NALOXEGOL
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56959087
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7539
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| Related Record | Type | Details | ||
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TARGET -> INHIBITOR | |||
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TRANSPORTER -> SUBSTRATE | |||
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METABOLIC ENZYME -> SUBSTRATE |
MINOR
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METABOLIC ENZYME -> SUBSTRATE |
MAJOR
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BINDER->LIGAND |
BINDING
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METABOLIC ENZYME -> SUBSTRATE |
MAJOR
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EXCRETED UNCHANGED |
In feces, ~ 68 % of radioactivity dose was found; 58 % of fecal radioactivity was characterized, with 16 % noted to be unchanged drug and remaining as metabolites.
FECAL
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EXCRETED UNCHANGED |
16 % of radioactivity dose was found in urine, with 10 % as unchanged drug and 6 % as metabolites.
URINE
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| Related Record | Type | Details | ||
|---|---|---|---|---|
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METABOLITE -> PARENT | |||
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METABOLITE -> PARENT |
PLASMA; URINE
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METABOLITE -> PARENT |
FECAL; PLASMA; URINE
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METABOLITE -> PARENT |
FECAL; URINE
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| Related Record | Type | Details | ||
|---|---|---|---|---|
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ACTIVE MOIETY |
| Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
|---|---|---|---|---|---|---|
| Tmax | PHARMACOKINETIC |
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ORAL ADMINISTRATION |
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| Biological Half-life | PHARMACOKINETIC |
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| Volume of Distribution | PHARMACOKINETIC |
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