Details
| Stereochemistry | ABSOLUTE |
| Molecular Formula | C21H25NO3 |
| Molecular Weight | 339.4281 |
| Optical Activity | UNSPECIFIED |
| Defined Stereocenters | 4 / 4 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
OC1=C2O[C@H]3C(=C)CC[C@@]4(O)[C@H]5CC(C=C1)=C2[C@@]34CCN5CC6CC6
InChI
InChIKey=WJBLNOPPDWQMCH-MBPVOVBZSA-N
InChI=1S/C21H25NO3/c1-12-6-7-21(24)16-10-14-4-5-15(23)18-17(14)20(21,19(12)25-18)8-9-22(16)11-13-2-3-13/h4-5,13,16,19,23-24H,1-3,6-11H2/t16-,19+,20+,21-/m1/s1
| Molecular Formula | C21H25NO3 |
| Molecular Weight | 339.4281 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 4 / 4 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
Nalmefene is the first medication approved for alcoholism
with the primary goal of reducing alcohol intake in an as
needed approach. Nalmefene
received a marketing authorization valid throughout the
European Union on February 25, 2013 and is under development
in Asia. Nalmefene is an opioid system modulator with a
distinct μ, δ, and κ receptor profile. In vitro studies have demonstrated
that Nalmefene is a selective opioid receptor ligand
with antagonist activity at the μ and δ receptors and partial
agonist activity at the κ receptor. In vivo studies have demonstrated
that nalmefene reduces alcohol consumption, possibly
by modulating cortico-mesolimbic functions. In the US, immediate-release injectable nalmefene was approved in 1995 as an antidote for opioid overdose. It was sold under the trade name Revex. The product was discontinued by its manufacturer around 2008. Currently Nalmefene is sold under the trade name Selincro. Selincro is indicated for the reduction of alcohol consumption in adult patients with alcohol dependence who have a high drinking-risk level, without physical withdrawal symptoms and who do not require immediate detoxification.
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
| 0.44 nM [Ki] | |||
| 9.3 nM [Ki] | |||
| 0.12 nM [Ki] |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | Selincro Approved UseSelincro is indicated for the reduction of alcohol consumption in adult patients with alcohol dependence who have a high drinking-risk level, without physical withdrawal symptoms and who do not require immediate detoxification. Launch Date2013 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
24.3 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
50 mg single, oral dose: 50 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
57.9 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
100 mg single, oral dose: 100 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
155 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
200 mg single, oral dose: 200 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
177 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
274 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
50 mg single, oral dose: 50 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
647 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
100 mg single, oral dose: 100 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
1320 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
200 mg single, oral dose: 200 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
1876 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
314 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
20 mg 2 times / day steady-state, oral dose: 20 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
16.9 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3943269/ |
2 mg single, intravenous dose: 2 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
109 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3943269/ |
6 mg single, intravenous dose: 6 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
191 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3943269/ |
12 mg single, intravenous dose: 12 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
385 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3943269/ |
24 mg single, intravenous dose: 24 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
16.6 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8877019/ |
1 mg single, intravenous dose: 1 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
29.4 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8877019/ |
2 mg single, intravenous dose: 2 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
10.3 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
50 mg single, oral dose: 50 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
11.4 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
100 mg single, oral dose: 100 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
9.8 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
200 mg single, oral dose: 200 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
11.7 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
9.1 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3680580/ |
20 mg 2 times / day steady-state, oral dose: 20 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
8.2 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3943269/ |
6 mg single, intravenous dose: 6 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
8.6 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3943269/ |
12 mg single, intravenous dose: 12 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
|
8.9 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/3943269/ |
24 mg single, intravenous dose: 24 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
10.8 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8877019/ |
1 mg single, intravenous dose: 1 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
9.4 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8877019/ |
2 mg single, intravenous dose: 2 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NALMEFENE plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
Doses
| Dose | Population | Adverse events |
|---|---|---|
18 mg 1 times / day steady, oral Recommended Dose: 18 mg, 1 times / day Route: oral Route: steady Dose: 18 mg, 1 times / day Sources: |
unhealthy, 39 years |
Disc. AE: Psychiatric decompensation... AEs leading to discontinuation/dose reduction: Psychiatric decompensation (1 patient) Sources: |
300 mg 1 times / day multiple, oral Highest studied dose Dose: 300 mg, 1 times / day Route: oral Route: multiple Dose: 300 mg, 1 times / day Sources: |
healthy, adult |
|
300 mg single, oral Highest studied dose |
healthy, adult |
|
0.75 ug/kg single, intravenous Highest studied dose Dose: 0.75 ug/kg Route: intravenous Route: single Dose: 0.75 ug/kg Sources: |
unhealthy, adult |
DLT: Anesthesia reversal... Dose limiting toxicities: Anesthesia reversal (2 patients) Sources: |
0.5 ug/kg single, intravenous MTD Dose: 0.5 ug/kg Route: intravenous Route: single Dose: 0.5 ug/kg Sources: |
unhealthy, adult |
DLT: Anesthesia reversal... Dose limiting toxicities: Anesthesia reversal (3 patients) Sources: |
20 mg 2 times / day steady, oral Recommended Dose: 20 mg, 2 times / day Route: oral Route: steady Dose: 20 mg, 2 times / day Sources: |
unhealthy, adult |
Disc. AE: Dizziness... AEs leading to discontinuation/dose reduction: Dizziness (1 patient) Sources: |
5 mg 2 times / day steady, oral Studied dose Dose: 5 mg, 2 times / day Route: oral Route: steady Dose: 5 mg, 2 times / day Sources: |
unhealthy, adult |
Disc. AE: Dizziness, Rash... AEs leading to discontinuation/dose reduction: Dizziness (1 patient) Sources: Rash (1 patient) |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Psychiatric decompensation | 1 patient Disc. AE |
18 mg 1 times / day steady, oral Recommended Dose: 18 mg, 1 times / day Route: oral Route: steady Dose: 18 mg, 1 times / day Sources: |
unhealthy, 39 years |
| Anesthesia reversal | 2 patients DLT |
0.75 ug/kg single, intravenous Highest studied dose Dose: 0.75 ug/kg Route: intravenous Route: single Dose: 0.75 ug/kg Sources: |
unhealthy, adult |
| Anesthesia reversal | 3 patients DLT |
0.5 ug/kg single, intravenous MTD Dose: 0.5 ug/kg Route: intravenous Route: single Dose: 0.5 ug/kg Sources: |
unhealthy, adult |
| Dizziness | 1 patient Disc. AE |
20 mg 2 times / day steady, oral Recommended Dose: 20 mg, 2 times / day Route: oral Route: steady Dose: 20 mg, 2 times / day Sources: |
unhealthy, adult |
| Dizziness | 1 patient Disc. AE |
5 mg 2 times / day steady, oral Studied dose Dose: 5 mg, 2 times / day Route: oral Route: steady Dose: 5 mg, 2 times / day Sources: |
unhealthy, adult |
| Rash | 1 patient Disc. AE |
5 mg 2 times / day steady, oral Studied dose Dose: 5 mg, 2 times / day Route: oral Route: steady Dose: 5 mg, 2 times / day Sources: |
unhealthy, adult |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as perpetrator
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no |
Drug as victim
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
| minor | ||||
| minor | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| no | ||||
| yes | ||||
| yes | ||||
| yes |
Tox targets
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
PubMed
| Title | Date | PubMed |
|---|---|---|
| Long-term efficacy, tolerability and safety of nalmefene as-needed in patients with alcohol dependence: A 1-year, randomised controlled study. | 2014-08 |
|
| Treatment of Gambling Disorders. | 2014-06-01 |
|
| Opioid antagonists for alcohol dependence. | 2010-12-08 |
|
| Pharmacogenetics: a tool for identifying genetic factors in drug dependence and response to treatment. | 2010-12 |
|
| Emerging drugs to treat alcoholism. | 2010-12 |
|
| [Serum NT-proBNP levels in neonates with severe asphyxia and the effects of nalmefene on the NT-proBNP levels]. | 2010-11 |
|
| Nalmefene for treatment of alcohol dependence. | 2010-11 |
|
| Nalmefene in the treatment of pathological gambling: multicentre, double-blind, placebo-controlled study. | 2010-10 |
|
| Brain imaging studies in pathological gambling. | 2010-10 |
|
| Antipruritic treatment with systemic μ-opioid receptor antagonists: a review. | 2010-10 |
|
| Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters. | 2010-09-07 |
|
| Human exposures to immobilising agents: results of an online survey. | 2010-08-28 |
|
| [Clinical observation of the effect of nalmefene in treatment of septic shock]. | 2010-06 |
|
| In vivo characterization of the opioid antagonist nalmefene in mice. | 2010-04-10 |
|
| Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal. | 2010-01-20 |
|
| The Effects of Naltrexone Among Alcohol Non-Abstainers: Results from the COMBINE Study. | 2010 |
|
| Pediatric sedation: a global challenge. | 2010 |
|
| Pathological gambling and compulsive buying: do they fall within an obsessive-compulsive spectrum? | 2010 |
|
| Primary biliary cirrhosis. | 2009-09 |
|
| The Gambling Symptom Assessment Scale (G-SAS): a reliability and validity study. | 2009-03-31 |
|
| Unconditioned behavioral effects of the powerful kappa-opioid hallucinogen salvinorin A in nonhuman primates: fast onset and entry into cerebrospinal fluid. | 2009-02 |
|
| Opioid antagonists for pharmacological treatment of alcohol dependence - a critical review. | 2008-11 |
|
| Predicting response to opiate antagonists and placebo in the treatment of pathological gambling. | 2008-11 |
|
| Agenda for specialty section in addiction medicine. | 2008-10 |
|
| [Pharmacokinetics of nalmefene after a single or multiple intravenous doses in Chinese healthy volunteers]. | 2008-10 |
|
| The effects of herkinorin, the first mu-selective ligand from a salvinorin A-derived scaffold, in a neuroendocrine biomarker assay in nonhuman primates. | 2008-10 |
|
| Effects of opioid receptor gene variation on targeted nalmefene treatment in heavy drinkers. | 2008-07 |
|
| Cholestatic hepatitis as a possible new side-effect of oxycodone: a case report. | 2008-05-01 |
|
| Imaging of opioid receptors in the central nervous system. | 2008-05 |
|
| Pharmacological evidence for a motivational role of kappa-opioid systems in ethanol dependence. | 2008-02 |
|
| Opioid-dependent anticipatory negative contrast and binge-like eating in rats with limited access to highly preferred food. | 2008-02 |
|
| Methylnaltrexone in the treatment of opioid-induced constipation. | 2008 |
|
| Emerging pharmacologic options for treating postoperative ileus. | 2007-10-15 |
|
| Evidence of accelerated ageing in clinical drug addiction from immune, hepatic and metabolic biomarkers. | 2007-09-24 |
|
| Plasma met-enkephalin, beta-endorphin and leu-enkephalin levels in human hepatic encephalopathy. | 2007-08-10 |
|
| Targeted nalmefene with simple medical management in the treatment of heavy drinkers: a randomized double-blind placebo-controlled multicenter study. | 2007-07 |
|
| Application of a sensitive liquid chromatographic/tandem mass spectrometric method to pharmacokinetic study of nalmefene in humans. | 2007-06-01 |
|
| Pharmacoprophylaxis of alcohol dependence: Review and update Part I: Pharmacology. | 2007-01 |
|
| Effects of salvinorin A, a kappa-opioid hallucinogen, on a neuroendocrine biomarker assay in nonhuman primates with high kappa-receptor homology to humans. | 2007-01 |
|
| Pharmacologic treatments for opioid dependence: detoxification and maintenance options. | 2007 |
|
| Opioids, dopamine, stress, and the addictions. | 2007 |
|
| Acamprosate: a new tool in the battle against alcohol dependence. | 2006-12 |
|
| The permeation of nalmefene hydrochloride across different regions of ovine nasal mucosa. | 2006-12 |
|
| Preclinical models to evaluate potential pharmacotherapeutic agents in treating alcoholism and studying the neuropharmacological bases of ethanol-seeking behaviors in rats. | 2002-08 |
|
| Dynorphin A1-13 causes elevation of serum levels of prolactin through an opioid receptor mechanism in humans: gender differences and implications for modulation of dopaminergic tone in the treatment of addictions. | 1999-01 |
|
| Standard binding and functional assays related to medications development division testing for potential cocaine and opiate narcotic treatment medications. | 1998-03 |
|
| A double-blind, placebo-controlled pilot study to evaluate the efficacy and safety of oral nalmefene HCl for alcohol dependence. | 1994-10 |
|
| A panic attack precipitated by opiate blockade--a case study. | 1987-10 |
|
| The role of endogenous opioids in congestive heart failure: effects of nalmefene on systemic and regional hemodynamics in dogs. | 1987-02 |
|
| Nalmefene: intravenous safety and kinetics of a new opioid antagonist. | 1986-01 |
Patents
Sample Use Guides
How much to take
- The recommended dose is one tablet on days when you think there is a risk you will drink alcohol
- The maximum dose is one tablet per day.
How and when to take
- You should take the tablet 1-2 hours before you start drinking alcohol.
- Swallow the tablet whole, do not crush or divide the tablet.
- You can take Selincro (Nalmefene) with or without food.
Each film-coated tablet contains 18.06 mg nalmefene (as hydrochloride dihydrate).
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/2991678
Nalmefene antagonized the bindings of [3H]-dihydromorphine, [3H]-ethylketocyclazocine and [3H]-D-ala-D-leu enkephalin with IC50's in the low nanomolar range in rat brain membranes.. At the central mu receptor, nalmefene bound with an IC50 of 1.0 nM
| Substance Class |
Chemical
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SALT/SOLVATE -> PARENT |
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BINDING
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METABOLIC ENZYME -> SUBSTRATE |
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TARGET -> INHIBITOR |
| Related Record | Type | Details | ||
|---|---|---|---|---|
|
METABOLITE INACTIVE -> PARENT |
MAJOR
URINE
|
||
|
METABOLITE ACTIVE -> PARENT |
MINOR
|
| Related Record | Type | Details | ||
|---|---|---|---|---|
|
|
ACTIVE MOIETY |
|
| Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
|---|---|---|---|---|---|---|
| Biological Half-life | PHARMACOKINETIC |
|
|
|||