Details
| Stereochemistry | RACEMIC |
| Molecular Formula | C18H19N3O.ClH.2H2O |
| Molecular Weight | 365.854 |
| Optical Activity | ( + / - ) |
| Defined Stereocenters | 0 / 1 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
O.O.Cl.CN1C2=C(C3=C1C=CC=C3)C(=O)C(CN4C=CN=C4C)CC2
InChI
InChIKey=VRSLTNZJOUZKLX-UHFFFAOYSA-N
InChI=1S/C18H19N3O.ClH.2H2O/c1-12-19-9-10-21(12)11-13-7-8-16-17(18(13)22)14-5-3-4-6-15(14)20(16)2;;;/h3-6,9-10,13H,7-8,11H2,1-2H3;1H;2*1H2
| Molecular Formula | C18H19N3O |
| Molecular Weight | 293.363 |
| Charge | 0 |
| Count |
|
| Stereochemistry | RACEMIC |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 1 |
| E/Z Centers | 0 |
| Optical Activity | ( + / - ) |
| 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 | H2O |
| Molecular Weight | 18.0153 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ACHIRAL |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 0 |
| Optical Activity | NONE |
DescriptionSources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2005/020103s008s025,020605s008lbl.pdfCurator's Comment: description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/mesh/68017294 |
https://www.ncbi.nlm.nih.gov/pubmed/11474424
Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2005/020103s008s025,020605s008lbl.pdf
Curator's Comment: description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/mesh/68017294 |
https://www.ncbi.nlm.nih.gov/pubmed/11474424
Ondansetron (ZOFRAN®) is a selective 5-HT3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by radiotherapy, anesthesia, surgery or cytotoxic chemotherapy drugs, including cisplatin, and has reported anxiolytic and neuroleptic properties. While its mechanism of action has not been fully characterized, ondansetron is not a dopamine-receptor antagonist. It is not certain whether ondansetron's antiemetic action is mediated centrally, peripherally, or in both sites. However, cytotoxic chemotherapy appears to be associated with release of serotonin from the enterochromaffin cells of the small intestine. The released serotonin may stimulate the vagal afferents through the 5-HT3 receptors and initiate the vomiting reflex.
CNS Activity
Originator
Sources: https://www.ncbi.nlm.nih.gov/pubmed/9884318
Curator's Comment: Glaxo Wellcome is a predecessor of GlaxoSmithKline plc.
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL1899 |
8.31 null [pKi] |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Preventing | ZOFRAN Approved UsePrevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy, including cisplatin ≥50 mg/m2. Prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy. Prevention of nausea and vomiting associated with radiotherapy in patients receiving either total body irradiation, single high-dose fraction to the abdomen, or daily fractions to the abdomen. Prevention of postoperative nausea and/or vomiting. As with other antiemetics, routine prophylaxis is not recommended for patients in whom there is little expectation that nausea and/or vomiting will occur postoperatively. In patients where nausea and/or vomiting must be avoided postoperatively, ZOFRAN® is recommended even where the incidence of postoperative nausea and/or vomiting is low. Launch Date1992 |
|||
| Preventing | ZOFRAN Approved UsePrevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy, including cisplatin ≥50 mg/m2. Prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy. Prevention of nausea and vomiting associated with radiotherapy in patients receiving either total body irradiation, single high-dose fraction to the abdomen, or daily fractions to the abdomen. Prevention of postoperative nausea and/or vomiting. As with other antiemetics, routine prophylaxis is not recommended for patients in whom there is little expectation that nausea and/or vomiting will occur postoperatively. In patients where nausea and/or vomiting must be avoided postoperatively, ZOFRAN® is recommended even where the incidence of postoperative nausea and/or vomiting is low. Launch Date1992 |
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| Preventing | ZOFRAN Approved UsePrevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy, including cisplatin ≥50 mg/m2. Prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy. Prevention of nausea and vomiting associated with radiotherapy in patients receiving either total body irradiation, single high-dose fraction to the abdomen, or daily fractions to the abdomen. Prevention of postoperative nausea and/or vomiting. As with other antiemetics, routine prophylaxis is not recommended for patients in whom there is little expectation that nausea and/or vomiting will occur postoperatively. In patients where nausea and/or vomiting must be avoided postoperatively, ZOFRAN® is recommended even where the incidence of postoperative nausea and/or vomiting is low. Launch Date1992 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
32.096 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT00934180 |
8 mg single, oral dose: 8 mg route of administration: oral experiment type: single co-administered: |
ONDANSETRON plasma | Homo sapiens |
|
30.196 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT00934921 |
8 mg single, oral dose: 8 mg route of administration: oral experiment type: single co-administered: |
ONDANSETRON plasma | Homo sapiens |
|
26.2 ng/mL |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
ONDANSETRON plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
42.7 ng/mL |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
ONDANSETRON plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE food status: UNKNOWN |
|
125.8 ng/mL |
24 mg single, oral dose: 24 mg route of administration: Oral experiment type: SINGLE co-administered: |
ONDANSETRON plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
194.4 ng/mL |
24 mg single, oral dose: 24 mg route of administration: Oral experiment type: SINGLE co-administered: |
ONDANSETRON plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE food status: UNKNOWN |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
237.935 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT00934180 |
8 mg single, oral dose: 8 mg route of administration: oral experiment type: single co-administered: |
ONDANSETRON plasma | Homo sapiens |
|
224.155 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT00934180 |
8 mg single, oral dose: 8 mg route of administration: oral experiment type: single co-administered: |
ONDANSETRON plasma | Homo sapiens |
|
293.492 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT00934921 |
8 mg single, oral dose: 8 mg route of administration: oral experiment type: single co-administered: |
ONDANSETRON plasma | Homo sapiens |
|
270.928 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT00934921 |
8 mg single, oral dose: 8 mg route of administration: oral experiment type: single co-administered: |
ONDANSETRON plasma | Homo sapiens |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
3.1 h |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
ONDANSETRON plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
3.5 h |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
ONDANSETRON plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE food status: UNKNOWN |
|
4.7 h |
24 mg single, oral dose: 24 mg route of administration: Oral experiment type: SINGLE co-administered: |
ONDANSETRON plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
5.8 h |
24 mg single, oral dose: 24 mg route of administration: Oral experiment type: SINGLE co-administered: |
ONDANSETRON plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE food status: UNKNOWN |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
27% |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
ONDANSETRON plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
Drug as perpetrator
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
| no [IC50 >100 uM] | ||||
| yes [IC50 0.15 uM] | yes (co-administration study) Comment: [PMID:23241029]: IC50 = 0.3 uM; Ondansetron treatment caused a statistically significantly higher Cmax of metformin compared with placebo and apparently decreased the renal clearance of metformin by 37% |
|||
| yes [IC50 0.89 uM] | ||||
| yes [IC50 17.4 uM] | ||||
| yes [IC50 6.9 uM] | yes (co-administration study) Comment: [PMID:23241029]: IC50 = 0.16 uM; Ondansetron treatment caused a statistically significantly higher Cmax of metformin compared with placebo and apparently decreased the renal clearance of metformin by 37% |
Drug as victim
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
| yes | ||||
| yes | ||||
| yes | likely (co-administration study) Comment: inducers or inhibitors of CYP1A2 may change the clearance and, hence, the half-life of ondansetron |
|||
| yes | likely (co-administration study) Comment: inducers or inhibitors of CYP2D6 may change the clearance and, hence, the half-life of ondansetron |
|||
| yes | yes (co-administration study) Comment: In patients treated with potent inducers of CYP3A4 (i.e., phenytoin, carbamazepine, and rifampin), the clearance of ondansetron was significantly increased and ondansetron blood concentrations were decreased. However, on the basis of available data, no dosage adjustment for ZOFRAN is recommended for patients on these drugs. |
Tox targets
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
PubMed
| Title | Date | PubMed |
|---|---|---|
| Intestinal obstruction in pregnancy by ondansetron. | 2014-12 |
|
| Ondansetron can enhance cisplatin-induced nephrotoxicity via inhibition of multiple toxin and extrusion proteins (MATEs). | 2013-11-15 |
|
| Prophylaxis of radiation-induced nausea and vomiting using 5-hydroxytryptamine-3 serotonin receptor antagonists: a systematic review of randomized trials. | 2012-01-01 |
|
| In vivo assessment of antiemetic drugs and mechanism of lycorine-induced nausea and emesis. | 2011-12 |
|
| Association of ABCB1, 5-HT3B receptor and CYP2D6 genetic polymorphisms with ondansetron and metoclopramide antiemetic response in Indonesian cancer patients treated with highly emetogenic chemotherapy. | 2011-10 |
|
| Differential time course of action of 5-HT3 and NK1 receptor antagonists when used with highly and moderately emetogenic chemotherapy (HEC and MEC). | 2011-09 |
|
| Profiling of a prescription drug library for potential renal drug-drug interactions mediated by the organic cation transporter 2. | 2011-07-14 |
|
| Pemirolast reduces cisplatin-induced kaolin intake in rats. | 2011-07-01 |
|
| Discovery of 1-[2-(2,4-dimethylphenylsulfanyl)phenyl]piperazine (Lu AA21004): a novel multimodal compound for the treatment of major depressive disorder. | 2011-05-12 |
|
| Single-dose fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with cisplatin therapy: randomized, double-blind study protocol--EASE. | 2011-04-10 |
|
| Multimodal prevention of pain, nausea and vomiting after breast cancer surgery. | 2010-10 |
|
| Ondansetron-induced migraine-type headache. | 2010-09 |
|
| Acute anti-emetic withdrawal associated with a hemorrhagic cerebellar arteriovenous malformation. | 2010-08 |
|
| Ondansetron-induced headache in a parturient mimicking postdural puncture headache. | 2010-02 |
|
| The lesser of two adverse reactions. | 2010-01 |
|
| Clinical trial: oral ondansetron for reducing vomiting secondary to acute gastroenteritis in children--a double-blind randomized study. | 2010-01 |
|
| Ondansetron and seizures. | 2009-12 |
|
| Coronary vasospasm and atrial fibrillation associated with ondansetron therapy. | 2009-03 |
|
| A within-group design of nontreatment seeking 5-HTTLPR genotyped alcohol-dependent subjects receiving ondansetron and sertraline. | 2009-02 |
|
| Comparative efficacy of maropitant and selected drugs in preventing emesis induced by centrally or peripherally acting emetogens in dogs. | 2008-12 |
|
| Droperidol and ondansetron-induced QT interval prolongation: a clinical drug interaction study. | 2008-08 |
|
| Neonatal extrapyramidal movements. Neonatal withdrawal due to maternal citalopram and ondansetron use. | 2008-03 |
|
| Coronary spasm after injection of ondansetron: case report and review of the literature. | 2008-01-24 |
|
| Ondansetron-associated hypokalemia in a 2-year-old with pre-B-cell ALL. | 2008-01 |
|
| Ondansetron and carpopedal spasm. | 2008-01 |
|
| Comparison of the effectiveness of metoclopramide, ondansetron, and granisetron on the prevention of nausea and vomiting after laparoscopic cholecystectomy. | 2007-12 |
|
| Ondansetron given intravenously attenuates arterial blood pressure drop due to spinal anesthesia: a double-blind, placebo-controlled study. | 2007-11-11 |
|
| The influence of dexamethasone in the decrease of chemotherapy-induced nausea and vomiting. | 2007-06-30 |
|
| Tropisetron, ondansetron, and granisetron for control of chemotherapy-induced emesis in Turkish cancer patients: a comparison of efficacy, side-effect profile, and cost. | 2007-05-29 |
|
| Spinal NK-1 receptor expressing neurons mediate opioid-induced hyperalgesia and antinociceptive tolerance via activation of descending pathways. | 2007-05 |
|
| Antiemetic neurokinin-1 antagonist aprepitant and ifosfamide-induced encephalopathy. | 2007-04 |
|
| Chronic fluoxetine treatment increases the expression of PSA-NCAM in the medial prefrontal cortex. | 2007-04 |
|
| Reversal of cocaine-induced behavioral sensitization and associated phosphorylation of the NR2B and GluR1 subunits of the NMDA and AMPA receptors. | 2007-02 |
|
| Interactions between metoclopramide and morphine: enhanced antinociception and motor dysfunction in rats. | 2007-01-05 |
|
| Can dantrolene contribute to methotrexate toxicity? | 2006-09 |
|
| Acute myocardial infarction in man treated with epirubicin for non-Hodgkin lymphoma. | 1995-10 |
|
| A phase II study of ondansetron as antiemetic prophylaxis in patients receiving high-dose polychemotherapy and stem cell transplantation. | 1995-09 |
|
| Molecular cloning of human 5-hydroxytryptamine3 receptor: heterogeneity in distribution and function among species. | 1995-09 |
|
| Adjusting the dose of intravenous ondansetron plus dexamethasone to the emetogenic potential of the chemotherapy regimen. | 1995-08 |
|
| Dysphoria after treatment with ondansetron. | 1995-07 |
|
| The efficacy of prophylactic ondansetron, droperidol, perphenazine, and metoclopramide in the prevention of nausea and vomiting after major gynecologic surgery. | 1995-07 |
|
| Inhibitory effect of ethanol on the 5-hydroxytryptamine-induced Bezold-Jarisch reflex--involvement of peripheral 5-HT3 receptors. | 1995-05-26 |
|
| Managing an extrapyramidal reaction caused by ondansetron. | 1995-05 |
|
| Nephrogenic diabetes insipidus following high dose epirubicin chemotherapy for metastatic soft tissue sarcoma. | 1995 |
|
| Ondansetron-induced headache. Our experience in gynecological cancer. | 1995 |
|
| Extrapyramidal reaction caused by ondansetron. | 1994-02 |
|
| Cardiorespiratory decompensation following methylprednisolone administration. | 1993-07-01 |
|
| Progress in the control of acute and delayed emesis induced by cisplatin. | 1991 |
|
| Ondansetron: a new entity in emesis control. | 1990-11 |
|
| Effects of the 5-HT3 receptor antagonist, GR38032F, on raised dopaminergic activity in the mesolimbic system of the rat and marmoset brain. | 1987-12 |
Sample Use Guides
To prevent nausea and vomiting associated with cancer chemotherapy the recommended adult oral dosage of ondansetron (ZOFRAN®) is a single 24-mg tablet administered 30 minutes before the start of single-day highly emetogenic chemotherapy; for moderately emetogenic cancer chemotherapy the recommended adult oral dosage is one 8-mg ondansetron (ZOFRAN®) tablet given twice a day (every 12 hours) for 1 to 2 days after completion of chemotherapy: the first dose should be administered 30 minutes before the start of emetogenic chemotherapy, with a subsequent dose 8 hours after the first dose.
To prevent nausea and vomiting associated with radiotherapy the recommended adult oral dosage is one 8-mg ondansetron (ZOFRAN®) tablet given 3 times a day; for total body irradiation, one 8-mg ondansetron (ZOFRAN®) tablet should be administered 1 to 2 hours before each fraction of radiotherapy administered each day; for single high-dose fraction radiotherapy to the abdomen, one 8-mg ondansetron (ZOFRAN®) tablet should be administered 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for 1 to 2 days after completion of radiotherapy; for daily fractionated radiotherapy to the abdomen, one 8-mg ondansetron (ZOFRAN®) tablet should be administered 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for each day radiotherapy is given.
To prevent postoperative nausea and vomiting the recommended adult oral dosage is 16 mg given as two 8-mg ondansetron (ZOFRAN®) tablets 1 hour before induction of anesthesia.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/2969267
On the isolated vagus nerve and superior cervical ganglion of the rat, R,S-GR38032F (ondansetron) behaved as a reversible competitive antagonist of 5-HT-induced depolarization with pKB values of 8.61+/-0.08 (n=19) and 8.13+/-0.07 (n=16), respectively. The resolved R- and S-isomers of GR38032F were approximately equipotent as 5-HT antagonists on the rat vagus nerve: the pKB values were 8.95+/-0.05 (n=16) and 8.63+/-0.08 (n=17), respectively. R,S-GR38032F was also an effective antagonist of 5-HT on the rabbit isolated vagus nerve: in this case the pKB value was 9.40+/-0.14 (n=4).
| Substance Class |
Chemical
Created
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| Record UNII |
NMH84OZK2B
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Validated (UNII)
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NCI_THESAURUS |
C267
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NCI_THESAURUS |
C94726
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CFR |
21 CFR 216.24
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203148
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SUB46120
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BASIS OF STRENGTH->SUBSTANCE |
ASSAY (HPLC)
USP
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BASIS OF STRENGTH->SUBSTANCE |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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ANHYDROUS->SOLVATE | |||
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PARENT -> SALT/SOLVATE |
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| Related Record | Type | Details | ||
|---|---|---|---|---|
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
USP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
USP
|
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|
IMPURITY -> PARENT |
sum of impurities A and G: not more than the area of the principal peak in the chromatogram obtained with reference solution (a) (0.2 per cent)
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
|
||
|
IMPURITY -> PARENT |
sum of impurities A and G: not more than the area of the principal peak in the chromatogram obtained with reference solution (a) (0.2 per cent)
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
|
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|
IMPURITY -> PARENT |
sum of impurities E and F: not more than the sum of the areas of the corresponding peaks in the chromatogram obtained with reference solution (g) (0.2 per cent)
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
USP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
USP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
USP
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IMPURITY -> PARENT |
UNSPECIFIED
EP
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IMPURITY -> PARENT |
sum of impurities E and F: not more than the sum of the areas of the corresponding peaks in the chromatogram obtained with reference solution (g) (0.2 per cent)
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
For the calculation of contents, multiply the peak areas by 0.6
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (TLC)
EP
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ACTIVE MOIETY |
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