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Home > Encyclopedia > (R) Fesoterodine

(R) Fesoterodine

(R) Fesoterodine structure

(R) Fesoterodine 

structure
  • CAS No:

    286930-02-7

  • Formula:

    C26H37NO3

  • Chemical Name:

    (R) Fesoterodine

  • Synonyms:

    (R) Fesoterodine;Propanoic Acid 2-Methyl- 2-[(1R)-3-[bis(1-methylethyl)amino]-1-phenylpropyl]-4-(hydroxymethyl)phenyl Ester;2-Methylpropanoic acid 2-[(1R)-3-[bis(1-methylethyl)amino]-1-phenylpropyl]-4-(hydroxymethyl)phenyl ester;Fesoterodine;Unii-621G617227;(R)-2-(3-(diisopropylamino)-1-phenylpropyl)-4-(hydroxymethyl)phenyl isobutyrate;PF-00695838;2-Methylpropionic acid 2-[3-(N,N-diisopropylamino)-1(R)-phen...

Description

Solid


Fesoterodine is a diarylmethane.|Fesoterodine is an antimuscarinic prodrug for the treatment of overactive bladder syndrome.|Fesoterodine is an anticholinergic and antispasmotic agent used to treat urinary incontinence and overactive bladder syndrome. Fesoterodine has not been implicated in causing liver enzyme elevations or clinically apparent acute liver injury.|Fesoterodine is a competitive muscarinic receptor antagonist with muscle relaxant and urinary antispasmodic properties. Fesoterodine is rapidly hydrolyzed in vivo into its active metabolite 5-hydroxy methyl tolterodine, which binds and inhibits muscarinic receptors on the bladder detrusor muscle, thereby preventing bladder contractions or spasms caused by acetylcholine. This results in the relaxation of bladder smooth muscle and greater bladder capacity, in addition to a reduction in involuntary muscle contractions and involuntary loss of urine. The active metabolite does not interact with alpha-adrenergic, serotonergic, histaminergic and excitatory amino acid receptors and is eliminated via renal excretion.


Fesoterodine, launched for the treatment of OAB, is an orally active pro-drug that is converted in vivo to its active metabolite 5-HMT through hydrolysis by non-specific esterases. 5-HMT is also an active metabolite of tolterodine (Detrol), which has been marketed for the treatment of OAB since 1998. 5-HMT is a potent muscarinic antagonist, with essentially equivalent affinity for M1, M2, M3, M4, and M5 receptors (Ki=0.32, 0.63, 1.26, 2, and 0.63 nM, respectively). The binding of 5-HMT is stereoselective; the corresponding S-enantiomer has at least 100 times lower binding affinity for all five receptors. Fesoterodine is supplied as its fumarate salt in an extended release tablet form. The recommended starting dose is 4 mg once daily. On the basis of individual response and tolerability, the dose may be increased to 8 mg once daily. Following oral administration, fesoterodine is not detected in the peripheral blood, thereby indicating a rapid and complete bioconversion to 5-HMT. Bioavailability of 5-HMT is about 52%. After single- or multiple-dose oral administration of fesoterodine in doses from 4 to 28 mg, plasma concentrations of 5-HMT are proportional to the dose. Maximum plasma levels are reached after approximately 5 h. No accumulation occurs after multiple-dose administration. 5-HMT is further metabolized in the liver through oxidation of the hydroxymethyl group and oxidative cleavage of N-alkyl groups mediated by CYP2D6 and CYP3A4. 5-HMT and its metabolites are primarily eliminated through renal excretion.The most common adverse events associated with fesoterodine include dry mouth, constipation, and dyspepsia. Fesoterodine is contraindicated in patients with urinary retention, gastric retention, or uncontrolled narrow-angle glaucoma.


ChEBI: Fesoterodine is a diarylmethane.

(R) Fesoterodine Basic Attributes

411.58

411.58

621G617227

DTXSID80182853

C74138

Colorless to light yellow

G04BD11|G - Genito urinary system and sex hormones

Characteristics

49.77000

5.48800

1.043

518.9ºC

267.6ºC

Highly soluble

Store at -20°C,unstable in solution, ready to use.

Safety Information

|Warning|H302 (100%): Harmful if swallowed [Warning Acute toxicity, oral]|P261, P264, P270, P271, P280, P301+P312, P302+P352, P304+P340, P305+P351+P338, P312, P321, P330, P332+P313, P337+P313, P362, P403+P233, P405, and P501|The GHS information provided by 1 company from 1 notification to the ECHA C&L Inventory.

Toxicity

Rat, Oral, LD50: ~ 681 mg/kg Mouse, Oral, LD50: ~ 316 mg/kg Rat, Intravenous, NOAEL: 10 mg/kg Mouse, Intravenous, NOAEL: 10 mg/kg

Like most anticholinergic agents, fesoterodine has not been linked to episodes of liver enzyme elevations or clinically apparent liver injury. Fesoterodine is metabolized in the liver via the cytochrome P450 system (CYP 2D6 and 3A4). Its relative safety may relate to its relatively low daily dose.

5-HMT: 50% to albumin and alpha1-acid glycoprotein

Drug Information

For the treatment of overactive bladder (with symptoms of urinary frequency, urgency, or urge incontinence).|FDA Label|Treatment of the symptoms (increased urinary frequency and / or urgency and / or urgency incontinence) that may occur in patients with overactive-bladder syndrome.

Fesoterodine is an anticholinergic and antispasmotic agent used to treat urinary incontinence and overactive bladder syndrome. Fesoterodine has not been implicated in causing liver enzyme elevations or clinically apparent acute liver injury.

Anticholinergic Agents

In-vivo the fesoteridine prodrug is broken down into its active metabolite, 5-hydroxymethyl tolterodine (5-HMT), by plasma esterases. The 5-hydroxymethyl metabolite, which exhibits an antimuscarinic activity. Both urinary bladder contraction and salivation are mediated via cholinergic muscarinic receptors. Therefore, acting as a competitive muscarinic receptor antagonist, fesoterodine ultimately acts to decrease the detrusor pressure by its muscarinic antagonism, thereby decreasing bladder contraction and consequently, the urge to urinate.

Drugs that bind to but do not activate MUSCARINIC RECEPTORS, thereby blocking the actions of endogenous ACETYLCHOLINE or exogenous agonists. Muscarinic antagonists have widespread effects including actions on the iris and ciliary muscle of the eye, the heart and blood vessels, secretions of the respiratory tract, GI system, and salivary glands, GI motility, urinary bladder tone, and the central nervous system. (See all compounds classified as Muscarinic Antagonists.)|Drugs used in the treatment of urogenital conditions and diseases such as URINARY INCONTINENCE; PROSTATIC HYPERPLASIA; and ERECTILE DYSFUNCTION. (See all compounds classified as Urological Agents.)

Tmax (5-HMT): 5 hours post-adminitration of fesoterodine. AUC (0,∞)= 49.5 ng·h/ ml Bioavailability, 5-HMT = 52%|Renal: 70% of fesoterodine was recovered in urine as 5-HMT; 35% carboxy metabolite; 18% carboxy-N-desisopropylmetabolite, and 1% N-desisopropyl metabolite Fecal: 7% Hepatic: fesoterodine elimination via CYP2D6 and CYP3A4|IV, 5-HMT: 169 L|5-HMT, healthy subjects: 14.4 L/h 5-HMT is also secreted into the nephron.

Metabolized by ubiquitous, nonspecific esterases to transform fesoterodine into 5-HMT Extensive metabolism via CYP2D6 and CYP3A4 into inactive metabolites

7-8 hours for the active metabolite 5-hydroxymethyl tolterodine

Fesoterodine, once converted to its active metabolite, 5-hydroxymethyltolterodine, acts as a competitive antagonists at muscarinic receptors. This results in the inhibition of bladder contraction, decrease in detrusor pressure, and an incomplete emptying of the bladder.

fesoterodine

(R) Fesoterodine Use and Manufacturing

Uses

(R) Fesoterodine was scheduled to receive FDA approval in the United States on October 31, 2008, for the treatment of overactive bladder (OAB).

Human drugs -> Toviaz -> EMA Drug Category|Urologicals -> Human pharmacotherapeutic group

Computed Properties

Molecular Weight:411.6
XLogP3:5.5
Hydrogen Bond Donor Count:1
Hydrogen Bond Acceptor Count:4
Rotatable Bond Count:11
Exact Mass:411.27734404
Monoisotopic Mass:411.27734404
Topological Polar Surface Area:49.8
Heavy Atom Count:30
Complexity:491
Defined Atom Stereocenter Count:1
Covalently-Bonded Unit Count:1
Compound Is Canonicalized:Yes

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