Details
| Stereochemistry | ABSOLUTE |
| Molecular Formula | C19H29NO3 |
| Molecular Weight | 319.4385 |
| Optical Activity | ( + ) |
| Defined Stereocenters | 3 / 3 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
COC1=C(OC)C=C2[C@H]3C[C@@H](O)[C@H](CC(C)C)CN3CCC2=C1
InChI
InChIKey=WEQLWGNDNRARGE-DJIMGWMZSA-N
InChI=1S/C19H29NO3/c1-12(2)7-14-11-20-6-5-13-8-18(22-3)19(23-4)9-15(13)16(20)10-17(14)21/h8-9,12,14,16-17,21H,5-7,10-11H2,1-4H3/t14-,16-,17-/m1/s1
| Molecular Formula | C19H29NO3 |
| Molecular Weight | 319.4385 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 3 / 3 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
(+)-alpha-Dihydrotetrabenazine (HTBZ) is an active component of tetrabenazine. Tetrabenazine is a mixture of closely-related compounds (isomers) and is readily metabolized in the human body to HTBZ and related isomers. Tetrabenazine is a drug for the symptomatic treatment of hyperkinetic movement disorder and is marketed under the trade names Nitoman in Canada and Xenazine in New Zealand and some parts of Europe, and is also available in the USA as an orphan drug. (+)-alpha-Dihydrotetrabenazine
and related benzo[a]quinolizines have been labeled with tritium and carbon-11 radioisotopes and used for in vitro and in vivo studies of the VMAT2 in animal and human brain. Adeptio Pharmaceuticals is developing alpha-dihydrotetrabenazine (HTBZ) for the treatment of neurological disorders. It acts by inhibiting vesicular monoamine transporter 2 (VMAT2), thereby blocking the transport of dopamine into axon terminals or into storage vesicles.
Originator
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL4828 |
0.97 nM [Ki] | ||
Target ID: Q05940 Gene ID: 6571.0 Gene Symbol: SLC18A2 Target Organism: Homo sapiens (Human) Sources: https://www.ncbi.nlm.nih.gov/pubmed/30160230 |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | Unknown Approved UseUnknown |
|||
| Primary | INGREZZA Approved UseINGREZZA is indicated for the treatment of adults with tardive dyskinesia Launch Date2017 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
0.19 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
1 mg single, oral dose: 1 mg route of administration: Oral experiment type: SINGLE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
31.7 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
75 mg single, oral dose: 75 mg route of administration: Oral experiment type: SINGLE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
56.2 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
150 mg single, oral dose: 150 mg route of administration: Oral experiment type: SINGLE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
35.1 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
50 mg 1 times / day steady-state, oral dose: 50 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
64 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
100 mg 1 times / day steady-state, oral dose: 100 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
39.4 ng/mL |
80 mg 1 times / day steady-state, oral dose: 80 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NBI-98782 unknown | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
9.22 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
1 mg single, oral dose: 1 mg route of administration: Oral experiment type: SINGLE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
1150 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
75 mg single, oral dose: 75 mg route of administration: Oral experiment type: SINGLE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
1840 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
150 mg single, oral dose: 150 mg route of administration: Oral experiment type: SINGLE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
630 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
50 mg 1 times / day steady-state, oral dose: 50 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
1110 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
100 mg 1 times / day steady-state, oral dose: 100 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
695 ng × h/mL |
80 mg 1 times / day steady-state, oral dose: 80 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NBI-98782 unknown | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
32 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
1 mg single, oral dose: 1 mg route of administration: Oral experiment type: SINGLE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
21 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
75 mg single, oral dose: 75 mg route of administration: Oral experiment type: SINGLE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
19 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
150 mg single, oral dose: 150 mg route of administration: Oral experiment type: SINGLE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
21 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
50 mg 1 times / day steady-state, oral dose: 50 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
19 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/28839339/ |
100 mg 1 times / day steady-state, oral dose: 100 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NBI-98782 plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
18.5 h |
80 mg 1 times / day steady-state, oral dose: 80 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NBI-98782 unknown | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
36% |
80 mg 1 times / day steady-state, oral dose: 80 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NBI-98782 unknown | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
Doses
| Dose | Population | Adverse events |
|---|---|---|
40 mg 1 times / day steady, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: steady Dose: 40 mg, 1 times / day Sources: |
unhealthy, 18 - 85 years Health Status: unhealthy Age Group: 18 - 85 years Sex: M+F Sources: |
Disc. AE: Syncope... AEs leading to discontinuation/dose reduction: Syncope (1 patient) Sources: |
80 mg 1 times / day steady, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18 - 85 years Health Status: unhealthy Age Group: 18 - 85 years Sex: M+F Sources: |
Disc. AE: Syncope, Cardiac failure... AEs leading to discontinuation/dose reduction: Syncope (1 patient) Sources: Cardiac failure (1 patient) |
40 mg 1 times / day steady, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: steady Dose: 40 mg, 1 times / day Sources: |
unhealthy, 26 - 84 years Health Status: unhealthy Age Group: 26 - 84 years Sex: unknown Sources: |
Other AEs: Somnolence, Anticholinergic syndrome... Other AEs: Somnolence (10.9%) Sources: Anticholinergic syndrome (5.4%) Balance disorder (4.1%) Headache (3.4%) Akathisia (2.7%) Vomiting (2.6%) Nausea (2.3%) Arthralgia (2.3%) |
80 mg 1 times / day steady, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 26 - 84 years Health Status: unhealthy Age Group: 26 - 84 years Sex: unknown Sources: |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Syncope | 1 patient Disc. AE |
40 mg 1 times / day steady, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: steady Dose: 40 mg, 1 times / day Sources: |
unhealthy, 18 - 85 years Health Status: unhealthy Age Group: 18 - 85 years Sex: M+F Sources: |
| Cardiac failure | 1 patient Disc. AE |
80 mg 1 times / day steady, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18 - 85 years Health Status: unhealthy Age Group: 18 - 85 years Sex: M+F Sources: |
| Syncope | 1 patient Disc. AE |
80 mg 1 times / day steady, oral Recommended Dose: 80 mg, 1 times / day Route: oral Route: steady Dose: 80 mg, 1 times / day Sources: |
unhealthy, 18 - 85 years Health Status: unhealthy Age Group: 18 - 85 years Sex: M+F Sources: |
| Somnolence | 10.9% | 40 mg 1 times / day steady, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: steady Dose: 40 mg, 1 times / day Sources: |
unhealthy, 26 - 84 years Health Status: unhealthy Age Group: 26 - 84 years Sex: unknown Sources: |
| Arthralgia | 2.3% | 40 mg 1 times / day steady, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: steady Dose: 40 mg, 1 times / day Sources: |
unhealthy, 26 - 84 years Health Status: unhealthy Age Group: 26 - 84 years Sex: unknown Sources: |
| Nausea | 2.3% | 40 mg 1 times / day steady, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: steady Dose: 40 mg, 1 times / day Sources: |
unhealthy, 26 - 84 years Health Status: unhealthy Age Group: 26 - 84 years Sex: unknown Sources: |
| Vomiting | 2.6% | 40 mg 1 times / day steady, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: steady Dose: 40 mg, 1 times / day Sources: |
unhealthy, 26 - 84 years Health Status: unhealthy Age Group: 26 - 84 years Sex: unknown Sources: |
| Akathisia | 2.7% | 40 mg 1 times / day steady, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: steady Dose: 40 mg, 1 times / day Sources: |
unhealthy, 26 - 84 years Health Status: unhealthy Age Group: 26 - 84 years Sex: unknown Sources: |
| Headache | 3.4% | 40 mg 1 times / day steady, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: steady Dose: 40 mg, 1 times / day Sources: |
unhealthy, 26 - 84 years Health Status: unhealthy Age Group: 26 - 84 years Sex: unknown Sources: |
| Balance disorder | 4.1% | 40 mg 1 times / day steady, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: steady Dose: 40 mg, 1 times / day Sources: |
unhealthy, 26 - 84 years Health Status: unhealthy Age Group: 26 - 84 years Sex: unknown Sources: |
| Anticholinergic syndrome | 5.4% | 40 mg 1 times / day steady, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: steady Dose: 40 mg, 1 times / day Sources: |
unhealthy, 26 - 84 years Health Status: unhealthy Age Group: 26 - 84 years Sex: unknown Sources: |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as perpetrator
Drug as victim
Tox targets
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2017/209241Orig1s000PharmR.pdf#page=24 Page: 24.0 |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Lessons from 11C-dihydrotetrabenazine imaging in a xenograft mouse model of rat insulinoma: is PET imaging of pancreatic beta cell mass feasible? | 2017-12 |
|
| Differences in Dihydrotetrabenazine Isomer Concentrations Following Administration of Tetrabenazine and Valbenazine. | 2017-09 |
|
| Early synaptic dysfunction induced by α-synuclein in a rat model of Parkinson's disease. | 2017-07-25 |
|
| Pharmacologic Characterization of Valbenazine (NBI-98854) and Its Metabolites. | 2017-06 |
|
| A ring-closing metathesis-based approach to the synthesis of (+)-tetrabenazine. | 2012-07-20 |
Sample Use Guides
In Vivo Use Guide
Sources: https://clinicaltrials.gov/ct2/show/NCT02844179
Single dose administration of (+)-alpha-Dihydrotetrabenazine (HTBZ), escalating dosage amounts 7.5 - 30 mg orally
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/7589162
(+)-alpha-Dihydrotetrabenazine is a vesicular monoamine transporter (VMAT2) inhibtior with an Ki value of 0.97 nM. IC50 value: 0.97± 0.48 nM. The (+)-isomer showed high affinity in vitro (Ki = 0.97 +/- 0.48 nM) for the vesicular monoamine transporter (VMAT2) in rat brain striatum, whereas the (-)-isomer was inactive (Ki = 2.2 +/- 0.3 uM).
| Substance Class |
Chemical
Created
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admin
on
Edited
Tue Apr 01 21:09:18 GMT 2025
by
admin
on
Tue Apr 01 21:09:18 GMT 2025
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| Record UNII |
IFRYDMLSGE
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Validated (UNII)
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FDA ORPHAN DRUG |
607417
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FDA ORPHAN DRUG |
498715
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14580381
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DTXSID30561896
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300000044642
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IFRYDMLSGE
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85081-18-1
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BINDER->LIGAND |
BINDING
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METABOLIC ENZYME -> SUBSTRATE |
MAJOR
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METABOLIC ENZYME -> SUBSTRATE |
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TARGET -> INHIBITOR |
VMAT2 inhibitors that cause reversible reduction of dopamine release at the presynaptic nerve terminal by selectively inhibiting presynaptic VMAT2.
Ki
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RACEMATE -> ENANTIOMER |
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PRODRUG -> METABOLITE ACTIVE |
| Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
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| Excretion (urine, unchanged) | PHARMACOKINETIC |
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| Excretion (feces, unchanged) | PHARMACOKINETIC |
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| Plasma protein binding | PHARMACOKINETIC |
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